Background
The ongoing war and the extensive scope of both personal and national trauma have greatly increased the need for mental health treatment in Israel. To provide services tailored to the population’s needs, it is essential to assess its mental health status and examine temporal trends.
Objectives
- Assess the proportion of individuals experiencing symptoms of depression, anxiety, and post-traumatic stress across our survey rounds in, and the extent of impairment in their functioning.
- Identify factors associated with symptoms and functional impairment.
- Examine patterns of seeking and receiving treatment among different population groups.
Method
An online self-administered survey was conducted among a representative sample of the adult population in Israel. The survey was conducted in four rounds: December 2023–January 2024, April–May 2024, September–October 2024, and July 2025. The fourth round included 2,713 respondents, of whom 1,282 were repeat respondents from previous rounds.
The survey included validated instruments for assessing symptoms of post-traumatic stress (PCL-5), depression (PHQ-9), anxiety (GAD-7), and impairment in daily functioning (WSAS). It also included questions about exposure to war-related events, perceived ability to cope with the situation, mental health history, patterns of seeking and receiving treatment, and the impact of the Twelve-Day War with Iran in June 2025 on mental health and daily functioning. To ensure representativeness, the survey data were weighed according to relevant population characteristics.
Findings
The proportion of respondents who met at least one clinical threshold for depression, anxiety, or post-traumatic stress declined over time, but remained high in the fourth round: 41% in January 2024, 32% in May 2024, 35% in October 2024, and 31% in July 2025. Thus, despite a moderate decline, about one-third still met at least one clinical threshold 21 months after the outbreak of the war.
Among respondents who had met a clinical threshold at the beginning of the study, in January 2024, distress persisted over time: about half of them remained above the threshold by July 2025. Among respondents who were above a threshold in the fourth round, 11% were new cases who had not met a threshold in previous rounds. This finding indicates a combination of persistent distress among part of the population and the emergence of new distress during the war.
Across the four survey rounds, rates of meeting a clinical threshold were higher among individuals with high-intensity personal exposure to war-related events, those who reported a low ability to cope, and Arab respondents than among other respondents. In multivariate analyses of the fourth round, low ability to cope was the factor most strongly associated with meeting at least one clinical threshold (OR = 6.0). Additional factors associated with a higher likelihood of meeting a threshold were exposure to trauma before October 7, 2023, any level of personal exposure to war-related events, indirect exposure through the media, being a woman, being Arab, having very low income, and being unmarried.
About one-fifth of respondents reported severe impairment in daily functioning due to their mental health status: 19% in October 2024 and 21% in July 2025. Functional impairment in July 2025 was especially common among respondents who met a clinical threshold: 53% of those who met a moderate threshold and 65% of those who met a high threshold reported severe functional impairment, compared with only 4% of those who did not meet any threshold.
In the fourth survey round, 35% of respondents reported a perceived need for mental health treatment since the outbreak of the war: 13% reported receiving some form of mental health treatment, 20% felt a need but did not seek treatment, and 2% sought treatment but did not receive or were still waiting for it. Among those who felt a need for treatment, 54% attributed this need to the war and the security situation – to a “large extent” or “very large extent”, and 67% reported that their distress had lasted six months or longer.
Among those who received treatment, the three main types of treatment were psychotherapy, psychiatric treatment, and mental health assistance from a family physician. Sixty-six percent reported receiving psychotherapy, most of them in the private sector, either paid for in full by the patient or subsidized; 37% reported receiving psychiatric treatment, of whom 62% were treated in the public sector and 38% in the private sector; and 18% reported receiving mental health assistance from a family physician.
Among those who felt a need for treatment but did not seek it, the main reasons for not seeking treatment were accessibility barriers and lack of fit or unwillingness to use available services. Forty-two percent cited accessibility issues, including the cost of treatment, waiting times, and distance from the provider; 42% reported that they were not interested in the help available, had not found suitable treatment, or had received help from another source; and 16% cited another reason.
According to respondents’ reports, the Twelve-Day War had a negative impact on both mental health (44%) and daily functioning (50%).
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Suggested citation (APA):
Samuel, H., Allon-Sidlik, S., Tzur Bitan, D., Konstantinov, V., Levinsky, Y., Gorelik, Y., Ohana, R., & Balicer, R. (2026). Mental Health During the Israel-Hamas War: An Ongoing National Survey of the Adult Population in Israel: Findings from Four Survey Rounds. S-245-26. Myers-JDC-Brookdale Institute.