Healing a Nation: Addressing Israel’s Mental Health “Wicked Problem”

On the second day of the 2025 General Assembly, at the end of a panel called Healing a Nation: Addressing the Mental Health Crisis in Israel, one phrase captured the essence of what we are facing. 

It came from Rina Goldberg, Vice President of Israel & Overseas and Deputy Director for Israel at the Jewish Federations of North America. She reminded the audience that what Israel is living through is a wicked problem: “a problem so complex that every attempted solution reveals new challenges, where needs shift constantly, and where the goal is not to find a perfect answer, but to find better ones.”

Israel’s mental health crisis after October 7 is exactly this kind of wicked problem. And it demands what wicked problems always do: collaboration, evidence, humility, and long-term commitment.

This session brought together four different vantage points. Renee Wizig-Barrios, President and CEO of the Jewish Federation of Greater Houston and Co-Chair of JFNA's Rebuild Israel: Mental Health Working Group, moderated the discussion. Professor Jonathan Huppert of The Hebrew University offered the clinical and scientific perspective. Rina Goldberg represented the national philanthropic infrastructure. And my colleague, partner, and co-founder at ICAR Collective, Gila Tolub, spoke from the systems and population-health lens.

Together, these voices created a textured picture of what is unfolding in Israel—and what might actually move the needle.

A system already under strain

One of the themes Gila underscored is that Israel did not enter this moment with a strong mental health system. Even before the war, it was under-resourced, fragmented, and understaffed, with responsibility split for years between the government and the HMOs. Investment never kept pace with the country’s growth, leaving the system stretched and the NGO sector filling gaps without shared data or coordination. When Gila and our team began mapping the landscape after October 7, she recalled thinking there might be 200 organizations operating in this space. Instead, we found roughly 400.

These structural weaknesses were well known to practitioners. The war simply removed any ability to ignore them. “Israelis are resilient,” Gila said, “but resilience alone is not a national strategy.” It was a line that resonated across the room. Israelis continue to show extraordinary strength, yet the systems that should support that strength are still being built in real time.

What philanthropy has enabled—and why it matters

Rina described how, in the earliest days of the war, her team at the Jewish Federations of North America was making decisions with imperfect information, like the rest of the country. Now they can see the arc of their work. The emergency fund ultimately allocated $81 million to 168 mental health NGOs, supporting more than half a million Israelis  —from individual therapy sessions to community resilience programs.

As the months went on, the strategy matured. It expanded from direct care to community resilience, and then to the larger and more ambitious project of system-level reform. Rina described the national Mental Health and Well-Being Initiative launched with JDC and the Ministry of Health, and the establishment of eighteen outpatient trauma centers across the country—services that simply did not exist in a coherent way before. More than 5,000 Israelis have already received focused trauma treatment in their own communities, outside hospital settings.

This shift from emergency response to institution-building is essential. It is what transforms philanthropic dollars from temporary relief into long-term public capacity.

Training, evidence and the role of technology

Professor Jonathan Huppert offered the perspective of someone working every day inside the system. Even before October 7, he and his team had planned a series of trauma-focused training sessions for clinicians. After the attacks, they accelerated dramatically. “We decided to train everybody immediately,” he said. In November alone, 150 clinicians went through intensive training. Today, over 700 clinicians in more than eighty public clinics have been trained in one of eight evidence-based trauma treatments. Each training includes a workshop and at least twenty weeks of small-group supervision. Measurement is built into everything—patients reporting symptoms, clinicians reporting progress, supervisors reporting back to the center—creating constant feedback loops.

He also discussed the importance of stepped care. Not everyone needs the same level of intervention. Many people can benefit from community support, guided self-help, or digital tools as a first step. “It’s possible that everybody needs some kind of one-on-one,” he noted, “but not all of that one-on-one has to be from a mental health service provider.”

That is where technology comes in. Jonathan’s team has developed a treatment app based on one of the most validated PTSD protocols. It is a structured therapeutic pathway that can work alongside therapy, with lighter-touch support, or independently for those who will never set foot in a clinic. A major trial at Sheba Beyond is now under way.

The crisis as lived experience

During the audience Q&A, someone asked how the mental health crisis is showing up in daily life. The panel’s answers brought the abstract into sharp focus.

Gila told us about her twelve-year-old son, who explained that he copes with the overwhelming news by using what he calls a “frozen heart.” When he hears more than he can emotionally absorb, he consciously shuts down his heart and only “thaws” it when he feels ready. This was not a metaphor; this was a child articulating a dissociation strategy he invented on his own.

Then she described waking up one morning to find that her five-year-old daughter had developed a painful rash across her back after being awoken by a midnight missile siren and rushing to their bomb shelter. It turned out to be shingles—an illness typically seen in older adults—triggered by stress.

These were not isolated examples. Renee had opened the session by reminding us of the sheer scale: tens of thousands recognized as victims of terror, thousands of bereaved families, hundreds of thousands of displaced people. The clinical data show a doubling of PTSD diagnoses compared to pre-war levels, and yet much of the suffering is visible only through these everyday expressions—children who disconnect emotionally, adults who carry tension into their bodies, communities carrying invisible strain.

This is not just a clinical burden. It affects schooling, family dynamics, productivity, and national cohesion. It is the kind of diffuse, pervasive impact that makes mental health a true national challenge.

A population-level approach

Across the panel there was agreement that Israel now needs to think in population terms. A significant minority—perhaps 15 to 20 percent—will require structured treatment for PTSD, depression, anxiety, addictions or suicidality. But the vast majority of Israelis—80 to 85 percent—are functioning under chronic stress and need different kinds of support: credible information, normalization of trauma responses, accessible early interventions, supportive schools and workplaces, and easy referral pathways.

Treatment and prevention must run in parallel. One cannot substitute for the other.

So where do we go from here?

The session did not pretend that there is a single solution. Wicked problems don’t work that way. But the conversation made clear that progress is possible when sectors work together, when decisions are guided by evidence, and when we invest not only in what helps today, but in what will help five and ten years from now.

As Rina said, this crisis requires “ongoing adaptation and collaboration among stakeholders.” That is not just a description of the work ahead—it is an invitation.

Israel’s resilience is real. But resilience needs infrastructure. And building that infrastructure is something none of us can do alone.

Wicked problems require ecosystems, not isolated programs. It is work that will only succeed through partnership. Join us.