A new study by NATAL-The Israel Trauma and Resiliency Center holds up a mirror to Israel’s complicated reality since October 7, 2023.
Routines have slowly returned: workplaces are open, schools are running, and leisure has resumed, but a closer look shows the country has not fully found its footing. Persistent hypervigilance, trouble concentrating, disrupted sleep, rising substance use, and shorter tempers are present in many lives.
The study underscores that collective, national trauma is not a private matter; it spills into every sphere: our relationships, classrooms, clinics, and even the roads, and all of this carries a significant economic cost.
NATAL’s report tries to put what’s hard to measure into numbers, turning a national gut feeling into a clear, data-grounded picture: the cumulative cost of psychological harm could reach about NIS 500 billion. Most of this cost isn’t the obvious line items, like therapy bills or infrastructure repairs, but the quiet, everyday toll: sick days, eroded productivity, and diminished capacity among those affected and the people around them.
Effects of prolonged trauma
The estimates suggest that hundreds of thousands will face mental-health effects that undermine attention, memory, and the ability to get through a full workday; roughly 625,000 are expected to experience significant psychological impacts, and 60-80,000 may struggle to reenter, or remain in, the workforce.
At the same time, government agencies report a surge in applications for mental-health recognition.
This is a social and economic warning sign in its own right. Beyond the headline numbers, the report shows where this strain meets daily life: at home, on the road, and in our health.
At home: In the months after the war, reports to the Welfare and Social Affairs Ministry about domestic violence rose by roughly 65%, a sign of ongoing distress and intense pressure on support services. It bears repeating: most people living with post-trauma are not violent. But when distress goes untreated, it can surface as aggression behind closed doors.
On the road: 2024 ended with 439 road fatalities, an unusual jump in a year with less traffic. A similar pattern was documented after the Second Lebanon War, suggesting how prolonged stress and strain can blunt concentration and judgment. Road accidents can certainly cause post-trauma; the link can also run the other way, when post-traumatic symptoms show up as risky driving and, ultimately, more accidents.
Health and addictions: The report describes a close link between post-trauma and substance use, particularly among soldiers, evacuees, and residents of frontline communities. The rate of sedative use has nearly doubled (approximately 9.5% compared to 3.8% before), and prescriptions for opioids have jumped by more than 70%.
A separate study found that direct exposure to the events of October 7 was associated with an approximately 25% rise in the consumption of addictive substances.
In parallel, prolonged trauma imposes a physiological burden: in the months after the war there was an estimated 35% increase in severe heart attacks, and in communities adjacent to Gaza the rate of cardiac events was roughly eight times the national average. There was also an increase of about 20% in strokes and a troubling trend in metabolic indicators, most notably diabetes.
These aren’t just numbers. They’re fine cracks in everyday life, eroded patience, frayed relationships, and dulled judgment that, taken together, sap productivity and weaken the social fabric. The report’s conclusion is straightforward: timely help works, and it pays off.
For every dollar invested in treatment for depression and anxiety, the literature shows roughly four dollars saved through better functioning and fewer lost workdays. This is not just a question of turning a profit. It’s an engine of growth: accessible, prompt care; supported, gradual return to routine; and attentiveness to the quiet warning signs at home, on the roads, and in medication use.
Israel knows how to manage emergencies; the challenge now is to manage recovery. If we devote even a small share of our public effort to building a steady mental-health foundation, easy-to-reach services, phased returns to work, and community support, the “invisible costs” will begin to shrink.
That is how stability returns to homes and workplaces, and with it the recovery of the Israeli economy, and, just as importantly, the healing of our collective psyche.
The writer, who holds a PhD, is head of the Research Department at NATAL and a social economy expert.