Three years after the October 7 attack, one in five Israelis continues to report severe impairment in daily functioning due to their mental health, according to the latest round of the National Mental Health Barometer, an ongoing study conducted by Clalit Health Services' Research Institute and the Myers JDC Brookdale Institute.
The findings, based on a nationally representative sample of Israel’s general population and updated through May 2026, present a complex picture of the country’s mental health three years after October 7.
While most of the population is recovering, a significant group continues to experience psychological distress and persistent impairment in functioning. Among those who reported significant symptoms of anxiety, depression or post-traumatic stress, approximately half continue to report significant distress three years later.
The study found that approximately 20% of the population report severe impairment in daily functioning related to their mental health. Between October 2024 and May 2026, there was no decline in the rate of functional impairment, even as symptoms decreased.
The findings point to an extraordinary level of exposure to significant trauma by international standards. Approximately 15% of all respondents described themselves as being at the highest level of personal exposure, meaning they were personally present at the events of October 7 or later terror attacks, or knew someone closely who was injured, killed or abducted on October 7 or during the subsequent fighting.
The researchers describe this as a dramatic and unprecedented level of exposure compared with other national trauma events worldwide.
For comparison, following the September 11 attacks in the United States, approximately 4% of the population experienced direct exposure.
Against this backdrop, approximately one third of the population report feeling a need for mental health treatment, while 23% of those who have ever been diagnosed with a mental health disorder say they received their first diagnosis after October 7.
The study also found that the risk of psychological distress and impaired functioning was not limited to people who experienced the events directly. A strong and significant association was found between exposure to disturbing content in the media and videos and reports of post-traumatic stress, anxiety and depression symptoms. While the study cannot establish that this relationship is causal, the findings reinforce recommendations to avoid unnecessary exposure to disturbing images and videos in the media whenever possible.
The study also found that people who feel they lack sufficient support from their family or community are at greater risk of experiencing psychological distress and impairment in functioning related to their mental health.
Women reported higher levels of psychological distress and mental health related functional impairment than men. The highest rate was recorded among women aged 18 to 35, with 32% reporting impaired functioning, compared with approximately 20% in the overall sample.
The rate was 26% among women over 35 and 19% among men, both younger and older.
Among women under 35, approximately one third also exceeded the clinical threshold for symptoms of anxiety, depression or post-traumatic stress, compared with lower rates among older women and men.
The study examined five dimensions of functioning, including functioning at home, work and school, leisure activities alone or in social settings, and maintaining close relationships.
While going to work and managing the household remained relatively stable, the areas showing greater impairment were predominantly social. People reported difficulty maintaining relationships, forming new connections and sustaining close relationships.
Fifty percent reported that their leisure activities had been affected, while 35% said they had difficulty forming and maintaining close relationships.
The findings are particularly significant because family life, social connections and routine are among the main sources of resilience identified by the public itself. Fifty percent cited support from family and friends as helping them cope, while approximately 40% cited hobbies, sports and routine.
Following October 7, there was a significant increase in symptoms of anxiety, depression and post-traumatic stress. Although symptoms subsequently declined, approximately one-third of the population crossed the clinical threshold in at least one of these three areas during the period monitored.
Among those who crossed the clinical threshold and experienced significant symptoms and distress, recovery rates differed across conditions. Approximately half returned to the normal range for anxiety symptoms, compared with only 38% among those who crossed the clinical threshold for post-traumatic stress.
In other words, more than 60% of those who experienced significant post-traumatic stress symptoms continued to report substantial symptoms, indicating a group experiencing chronic suffering long after exposure to the events.
Approximately one-third of the population report feeling a need for mental health treatment. Among those who reported a need for treatment, approximately half did not seek care. Of those who did not seek treatment, 23% said they wanted to cope on their own, while 17% said they were not interested in the mental health treatment offered by the healthcare system.
The findings point to the need to continue expanding mental health services while also diversifying the ways support is provided and offering additional approaches tailored to different needs and preferences.
The study also highlights the importance of support networks outside the healthcare system. Sixty-six percent of respondents perceive their level of family support as high, while 39% perceive the support they receive from their community as high. Conversely, 31% reported that they do not receive a high level of support from either family or community.
The researchers found that a stronger sense of support was associated with greater resilience and fewer reports of significant psychological distress.
Prof. Ran Balicer, Deputy Director General and Head of the Innovation Division at Clalit Health Services, said: "The findings we have systematically collected over the past three years show that alongside a steady increase in the proportion of people receiving mental health treatment, psychological distress is becoming chronic for a significant part of the population and is accompanied by deep functional impairment."
"The data once again demonstrate just how unprecedented October 7 was globally in terms of the scale of the population’s exposure to trauma, both directly and indirectly through exposure to disturbing videos and media content. This helps explain the findings regarding the intensity of the national trauma and its lasting effects. We have much work ahead to continue expanding mental health services, remove barriers to access and make proactive and diverse treatment more accessible, tailored specifically to groups at risk."
Hadar Samuel, an expert researcher on the Health Policy team at the Myers JDC Brookdale Institute, added, "As we expected, most of the population is recovering. Alongside this, there is a substantial core of people who continue to struggle and fight, and it is therefore important to continue supporting them through existing approaches while also diversifying and offering new ways of coping."
"One of the issues of particular concern is the impact on the social dimension of people’s lives. People are reducing their leisure activities, struggling to maintain close relationships and in some cases becoming more isolated, precisely when family, friends, routine and activity are among the key sources of support they themselves identify as helping them cope.
"The study also shows that as the follow up progressed, family and community support networks were significantly associated with people’s ability to cope. This finding underscores that the response to the mental health consequences of the war cannot rely solely on the mental health system. Family, community and social connections are an integral part of the resilience infrastructure. Alongside expanding treatment services, strengthening these networks may be an important component of helping the public cope with the consequences of the war."