Israel is currently facing an unprecedented national mental health crisis that affects every layer of society, on an individual, communal, and national level. This crisis extends far beyond the boundaries of the healthcare system: it affects the economy, society, culture, and even national security.
Addressing this reality requires a comprehensive, system-wide strategy that integrates both individual and collective responses, with trauma treatment becoming a top national priority and with urgent emphasis on the development of safe and effective treatment protocols.
As a researcher and psychotherapist with years of experience treating trauma survivors: combat veterans, victims of sexual violence, bereaved families – I have witnessed firsthand what it takes to process painful experiences, and what happens when the tools available are insufficient.
Since October 7, the nature of trauma itself has changed: not only in scale, but in kind. We are facing a collective trauma that has touched every layer of society, and that has not yet ended. There is not yet an “after” to recover into. This is fundamentally a different clinical reality, and it demands policy responses proportionate to the complexity at hand.
A wounded society
Even before October 7, research estimates suggested that between 4% and 9% of the Israeli population were living with symptoms of Post-Traumatic Stress Disorder, reflecting decades of conflict and cumulative exposure to trauma.
Since then, in the context of a multi-front war, mass displacement, hostage situations, reserve mobilization, profound societal polarization, and a rising sense of global isolation, hundreds of thousands of additional individuals have been affected by trauma at varying levels of severity.
PTSD manifests through intrusive memories, flashbacks, chronic hypervigilance, sleep disturbances, difficulty concentrating, and, in some cases, emotional numbing or dissociation. Beyond individual suffering, trauma reshapes relationships, parenting, occupational functioning, and social cohesion.
When it occurs at this scale, it evolves into collective trauma, a phenomenon that erodes social trust, weakens the sense of shared safety, and undermines a society’s ability to function stably over time.
The economic consequences are equally serious. Analysis by MAPS Israel and Social Finance Israel estimates the cumulative cost of widespread, untreated trauma at approximately 157 billion NIS to the state over the coming years.
This includes increased healthcare utilization, rising medication consumption, strain on welfare and education systems, and long-term impacts on workforce productivity. The stakes extend far beyond public health and affect the very fabric of society and its resilience.
Gaps in treatment
A range of effective treatments for PTSD currently exists: Cognitive Processing Therapy (CPT), Eye movement Desensitization and Reprocessing (EMDR), Somatic Experiencing (SE), Interpersonal Psychotherapy (IPT), pharmacological interventions, and other psychotherapeutic approaches.
These work for some patients, some of the time, and the Israeli public health system cannot provide sufficient access at the scale this moment demands. Waiting lists are long. The trained workforce is insufficient. Dropout rates are high.
And critically: not all patients respond to existing treatments. This gap is not new, but October 7 has made it acute and urgent.
A Scientific breakthrough
Among the most promising developments in trauma treatment in recent years is MDMA-assisted psychotherapy.
Large-scale clinical trials conducted by MAPS in the United States have shown that nearly 70% of participants no longer met the diagnostic criteria for PTSD by the end of the study, with substantial reductions in symptom severity after a limited number of sessions and a strong safety profile under controlled clinical conditions.
The approach combines a pharmacological agent with structured psychotherapy, enabling patients to process traumatic experiences within a regulated therapeutic environment. It is not a standalone drug treatment. It is a carefully designed clinical protocol.
The FDA has not yet approved the treatment. The main critiques focus on methodological challenges such as blinding and standardization, an unfamiliar combination of medication with psychotherapy, and questions regarding long-term safety. All of these are legitimate scientific concerns.
At the same time, many researchers and clinicians argue that the regulatory bar applied here has been unusually high relative to the demonstrated efficacy, and that a new balance is needed between regulatory caution and urgent clinical need.
This debate has reached the US Congress, veterans’ organizations, and, most recently, a presidential executive order calling for accelerated processes, a signal that the political and scientific conversation is moving.
The MDMA debate
In 2023, Australia became one of the first countries to authorize controlled use of MDMA-assisted psychotherapy within a regulated clinical framework, allowing treatment under strict medical supervision while maintaining rigorous safety and efficacy standards. Early real-world reports suggest outcomes broadly consistent with clinical trial data, both in effectiveness and safety profile.
Israel is in a unique position: it is simultaneously one of the world’s most trauma-affected societies and a global leader in trauma research and innovation. That combination is not a burden; it is an opportunity.
Pioneering work is already underway. MAPS Israel, an Israeli nonprofit organization dedicated to advancing research and innovative protocols for the treatment of PTSD and related conditions through psychedelic-assisted therapies, has partnered with several leading hospitals across Israel, initiated clinical trials, and is developing ethical standards and appropriate training for therapists.
As part of its Healing October 7 Project, MAPS Israel is running a first-of-its-kind global study comparing group-based MDMA-assisted psychotherapy with individual treatment, a model that may prove essential in expanding access to care across large affected populations.
Israel should not rush to approve any particular treatment but must now review this evidence seriously and ask the harder policy questions: how do we professionally and responsibly translate the most promising clinical evidence, from Israel and globally, into accessible, legal frameworks that prioritize public health?
Israel has the potential and the responsibility to become a global laboratory for innovative models of collective trauma treatment. By integrating scientific rigor, medical responsibility, and systemic thinking, it may not only address its current crisis but also offer scalable solutions for other societies facing collective trauma.
This requires continued investment in rigorous clinical research and supervised pilot programs. It requires the development of safe protocols as well as training and supervision programs for clinicians. And most importantly, it requires a regulatory conversation that is willing to engage with innovation without abandoning safety standards that protect patients.
Out of personal and collective trauma, there is a possibility not only for recovery, but for transformation and growth. Perhaps our deepest human commitment is to hold that possibility open, so even in the depth of pain, hope may still take root.
The people sitting across from me in the clinic deserve nothing less.■
Dr. Keren Tzarfaty (PhD) is a clinical researcher and psychotherapist, Director of MAPS Israel, an Israeli nonprofit organization dedicated to advancing research and innovative protocols for the treatment of PTSD and related conditions through psychedelic-assisted therapies, and a faculty member at the Integrative Psychotherapy Program in the School of Therapy, Counseling and Human Development;, University of Haifa.