In October 2029, will Israelis be able to say they are mentally better off than they were in October 2026?

In October 1980, Ronald Reagan, then the Republican presidential candidate, famously asked the American people during a televised debate against Jimmy Carter, “Are you better off than you were four years ago?”

When it comes to mental health in Israel, the answer in October 2026, three years after the Hamas massacre, is certainly no.

Although the shortage of mental health services and clinicians, the stigma surrounding mental health treatment, long wait times, and the lack of accessible, organized alternative therapies did not begin on October 7, 2023, the attack and the three years of the Iron Swords war have turned an already struggling system into one facing an acute crisis.

The State Comptroller has estimated that around 3 million Israelis suffer from symptoms of post-traumatic stress disorder (PTSD), anxiety, or depression, and that number, by all accounts, continues to grow. A recent report released by Clalit Health Services and the Myers-JDC-Brookdale Institute showed that as many as one in five adults in Israel report severe impairment in their daily functioning as a result of mental health issues.

As Israel approaches the October 27, 2026, election, political parties are finally beginning to examine what national plans they need to develop to address the crisis.

Earlier this month, I sat in on a roundtable discussion held by former Prime Minister Naftali Bennett's Beyachad party. Shahar Varon, a commander in the Maglan Unit who was seriously wounded in Gaza and is now running on Bennett's ticket, and Mati Gil, another member of the party's list, organized the discussion.

The room, however, was not filled with politicians. Instead, dozens of mental health professionals had gathered, including researchers, NGO heads, representatives of the health technology sector, CEOs, and others.

The message was clear: If Israel wants to heal, it needs a comprehensive national strategy.

Today, Israelis are, in so many ways, worse off mentally than they were three years ago. Three years from now, we should be better off.

After the meeting, I reviewed my notes. I began thinking more deeply about the discussion, particularly in relation to my upcoming book, Traumatech Nation, which will be published on October 29, two days after the election. The book explores the wave of innovation and new ideas that have emerged in Israel since the start of the war to address the country's growing mental health needs.

The challenge is not a lack of innovation. The challenge is understanding who needs care, breaking down the stigma that prevents people from seeking it, figuring out how to get that care to those who need it, and building a system that can measure whether we are actually delivering it effectively.

I decided to put some of these thoughts together because October marks both the anniversary of the Hamas massacre and the month of Israel's national election. It is a moment when the pain of the past and the possibility of a better future should be at the forefront of every Israeli's mind.

Any serious national strategy must begin by redefining who needs care.

Trauma affects not only the person who directly experiences a traumatic event, but also the people around them. Yet in Israel, when we talk about PTSD, we too often focus almost exclusively on those who lived in the Gaza envelope on October 7, 2023, or soldiers who fought on the battlefield.

But repeated studies have shown that women in Israel experience higher rates of PTSD and psychological distress than men. This suggests that the mental health consequences of the war extend far beyond those who were on the front lines.

Furthermore, those people who live with someone who has PTSD can begin to struggle with their own mental health. They may experience anxiety, depression, or other forms of emotional distress. Entire families can be affected, particularly children growing up with a parent who is struggling with PTSD or another mental health condition.

Earlier this year, a soldier suffering from PTSD told me that he could no longer bathe his children. The steam in the bathroom, the sound of running water, the heat, and the splashing in the confined space could all trigger his symptoms.

His children may never have set foot on a battlefield, but their father's trauma has nevertheless shaped their lives.

In many cases, the person directly affected by trauma, or an immediate family member, may be recognized by the Defense Ministry or the National Insurance Institute and qualify for benefits. But others in the wider circles of people affected by that trauma may not receive the same recognition, even when they are struggling with serious psychological consequences. Without that recognition, they may find it much harder to access the care they need.

During the roundtable discussion, one participant shared the story of a four-year-old girl whose father told her at the start of the war that he would protect the country.

She asked him, “Why are you going to protect the country? You need to protect me.”

Months later, he returned home struggling psychologically, unable to function and displaying violent behavior. His condition had deteriorated to the point that it was affecting his family, including the little girl who had wanted him home in the first place. 

A soldier, a soldier's spouse, or any other family member should be able to get help without navigating a complicated system or fighting to prove they deserve it.

But making care accessible also requires a better understanding of trauma, how it affects different people, and which treatments actually work. That is where research and technology can play an important role.

Earlier this year, Bar-Ilan University launched Israel's first multidisciplinary research center dedicated to studying the psychological consequences of October 7 and the war that followed.

The center brings together researchers from fields ranging from psychology and neuroscience to medicine, law, data science and communications. Its work will examine the long-term effects of the war on former hostages and their families, soldiers, evacuees, residents of the Gaza envelope, emergency responders, journalists and people who sustained physical injuries. It will also train the next generation of trauma researchers.

Such research is critical if Israel wants to understand not only who is suffering, but why some people recover. In contrast, others continue to struggle, and it will help identify which interventions make the greatest difference.

My book also examines how technology could help streamline and shorten the intake process, improve diagnosis, track patients' progress and determine whether treatments are working.

Artificial intelligence (AI), already commonplace in many fields, could play an important role. But the possibilities extend far beyond AI. They include neurofeedback techniques, the identification of biomarkers that could help improve diagnosis, and research into psychedelic-assisted therapies, including how these treatments might be used safely and effectively alongside or instead of existing medications, such as selective serotonin reuptake inhibitors (SSRIs). They also include approaches that treat the whole person rather than focusing only on individual symptoms.

Even something as straightforward as creating a digital platform that connects people with available services could make an enormous difference. Such platforms could be organized by city, age, population group or type of mental health condition, offering information about treatment options and helping people understand where and how to access care.

People shouldn't have to spend months figuring out whom to call, what treatment they need or whether they qualify for assistance. Technology could help make that process faster, simpler and more accessible.

Of course, even the most advanced technology will have limited impact if people are too ashamed or afraid to ask for help. That is why reducing the stigma surrounding mental health must be another national priority.

Resilience has become one of the most popular words in Israel since October 7. We constantly hear how resilient Israelis are, how they keep functioning despite everything they have endured, and how quickly they return to their routines. But functioning is not necessarily the same as being mentally healthy. People can go to work, care for their children and appear perfectly fine while suffering silently.

This is particularly true for people in the wider circles of trauma, whose struggles may receive little attention or recognition.

We also need to remember that trauma does not necessarily lead to PTSD, and that not every mental health condition Israelis are experiencing today is the result of the war. Trauma can result from a life-threatening experience or an event in which a person believes their life is in danger. It can also stem from sexual abuse, particularly childhood sexual abuse, domestic violence and other deeply distressing experiences.

Mental health conditions extend well beyond PTSD and include depression, anxiety, obsessive-compulsive disorder, schizophrenia and many others. A national mental health strategy must therefore address the broader mental health needs of the population, rather than focusing exclusively on war-related trauma.

And just as we need to broaden our understanding of who needs care, we also need to broaden the range of treatments available.

Among the most common treatments for depression, anxiety and trauma-related conditions are medications, including SSRIs, and various forms of psychotherapy, often referred to as talk therapy.

But these treatments do not work for everyone. Research suggests that many patients do not respond well to initial treatment. For example, SSRIs can take weeks to take effect, and patients may need to try several medications or adjust dosages before finding one that works.

In other words, offering more of the same treatments is unlikely to solve the problem. Israel needs to invest in a wider range of evidence-based options and make them accessible to those who could benefit.

Not everyone needs intensive psychotherapy or medication. Some people may benefit from other forms of support, including yoga, dance and movement therapy, improved nutrition, peer support groups or community-based programs. For others, these approaches may complement conventional treatment.

The goal should be to match people with the care they actually need, rather than expecting everyone to fit the same treatment model.

Ultimately, every person seeking mental health support should have access to an individualized care plan, with treatment and rehabilitation built around their specific needs, circumstances and progress.

If Israel is serious about becoming mentally healthier, it needs a system that can follow those individuals, assess whether their care is working, and change it when it isn't.

But who would oversee such a system? Who would decide where the money goes, which services to expand and whether the country is actually making progress?

Earlier this year, while reporting for The Media Line, I attended an ICAR Collective webinar that brought together candidates from several political parties to discuss how they would address Israel's children's mental health crisis. Many parties called for a national mental health administration, a single body to coordinate services and budgets, led by professionals with the expertise to make informed decisions.

One positive development, if we can call it that, to emerge from October 7 is that mental health is being discussed more openly and with less stigma. But talking about the problem will not be enough to solve it.

Israel needs a central body that knows which services are available, who is receiving care, where the gaps are, how much money is being spent, and whether that money is being well spent. It should coordinate the work of the government, health funds, NGOs, philanthropists and the private sector, rather than leaving each to operate largely on its own.

Mental health policy cannot depend on which party wins an election or who happens to be serving as health minister. Israel needs a long-term national plan, grounded in data, with clear goals, dedicated funding and measurable outcomes.

How many therapists are available, and how many more are needed? Where are the gaps in care? How much funding is available, how is it being used, and who is benefiting from it? How are diagnoses made, and which conventional and emerging treatment models are available for different conditions?

Where can technology be used to improve existing services, and where should research be directed to develop better ones?

These are questions that should be answered systematically, not separately by dozens of organizations. Today, many organizations are operating at best in isolation, at worst in competition, and with incomplete information.

Are all parties holding roundtable discussions on mental health, and, if so, will they continue these conversations after the election, when campaign promises end and the difficult work of governing begins?

And will people living with mental health conditions have a seat at the table alongside the researchers, clinicians, politicians and technology experts? Their voices may be among the most important. After all, who better to explain what the system is missing than the people trying to navigate it?

Israel is a country in trauma, although we certainly did not choose to become one. We can, however, choose how to respond. In this living laboratory, researchers, clinicians, and entrepreneurs have an opportunity to turn the painful reality Israel faces into better mental health care, both for Israelis and potentially for others around the world.

The next government will have to decide whether mental health remains a collection of well-intentioned initiatives or becomes a genuine national priority, with the leadership, resources and accountability to match.

Reagan's question was about whether Americans were better off after four years. Israel's next government should be prepared to answer a similar question in three.

In October 2029, will Israelis be able to say they are mentally better off than they were in October 2026?

That should be one of the measures by which the next government is judged.