In collaboration with Clalit
Alongside the complex coping with the days that the State of Israel is going through, Clalit, the country's leading health organization, provides medical services to more than 52% of Israelis and is already building an expanded system adapted to the needs and growing demand for mental health treatments.
"Looking at the long term, we need to prepare for the growing demand for emotional and mental response, and to adapt treatment frameworks to the various evacuees," explains Dr. Yarden Lewinsky, a consultant psychiatrist in Clalit's Community Division. "We want people to leave their hotels and return to a certain routine, so our approach is that treatment should be done in mental health clinics or with our independent therapists spread across the country."
How do you prepare for this?
"In fact, we create appropriate solutions for everyone, according to the intensity of the distress and resources of each and every person. Both to identify what his condition is and to give him the right response.
"We're recruiting, expanding self-help tools and soon we'll be launching mental status monitoring tools so we can spot people as early as possible and not wait for someone to stew with their distress for a long time and only come for help when it's almost too late." Almost every person in the country has either been hurt themselves or knows someone close to them who has been hurt. For example, at parties in the Reim area, there were about 4,000 people from all over the country, all of whom experienced trauma. All these people have families and friends, so the blast circles create huge numbers. This does not mean that everyone in the State of Israel will need mental health treatment, but almost everyone needs or will need some kind of attention."
When would you advise someone to seek advice or guidance?
"First of all, it's important to emphasize: during times like these, it's okay not to feel okay. It is most natural to feel that we are not as we were before and to give ourselves a discount for that. This does not mean that we are sick or that we have a disorder, PTSD or any other problem.
"Of course, you can also contact the mental health support center or one of our services in Clalit, where they will know how to direct further response. The bottom line - the indicator is functioning. It's okay and normal for it to be a little difficult, but if you can't function normally, you need to consult."
Dr. Yarden Lewinsky, psychiatrist and consultant of the Clalit Community Division, photo: Galit Levinsky
Alongside the extensive preoccupation in the coming months and in the future thereafter, Clalit knew how to provide a response to the Israeli public from the first moment the war broke out. "We opened an emergency hotline on October 7, at ten o'clock in the morning," says Dr. Lewinsky.
"The call center was staffed by psychologists and social workers who received thousands of calls and provided initial response and guidance for further treatment if necessary. Subsequently, and in accordance with the service that already existed, we also offer a service of three therapeutic phone calls of 45 minutes.
"The hotline treated thousands of people. We allocated caregivers for an urgent response at these centers and our clinic teams went out and physically arrived, together with welfare and resilience personnel, at the evacuated hotels. The treatment of evacuees is a challenge in itself, which led us to establish a new mental health clinic at the Dead Sea and another clinic in Eilat, for the evacuees who arrived at hotels there."
"We mobilized immediately"
The person in charge of managing the mental health clinics in Eilat, which received tens of thousands of evacuees, is psychiatrist Dr. Ariel Gaon, director of Clalit's mental health system in Eilat.
Dr. Ariel Gaon, psychiatrist and director of the mental health system in Eilat,
"As a mental health clinic in Eilat, we treat members of all the health plans regularly, of course even before the war," says Dr. Gaon. "Now, since the beginning of the war, we have established another clinic, the Peace Clinic, in order to provide a long-term response to the evacuees, alongside the response we routinely provide to some 60,<> residents of Eilat.
"From the moment the evacuation began, we immediately mobilized with the entire staff of the Dekel Clinic, the existing mental health clinic in Eilat, together with the local welfare team, to provide a response. We opened a mental health room and all the teams supported the idea. The role of the operations room was to manage information and needs according to the population in the hotels, in order to provide a tailored response.
In addition, we recruited a dedicated team for the mission that made the necessary changes based on an understanding of what was happening on the ground. Thus, we managed a mental health system for 6,500 evacuees who received a response after a significant traumatic event.
"We received assistance from Yoseftal Hospital and Shalvata Hospital, which recruited teams that came here every day, in addition to people who volunteered for the mission. Most hotels had a hotline with a welfare team that directed evacuees to receive treatment as needed. Crews came to treat people in the hotels in every quiet corner that became a 'treatment room', even by the pool. The idea was to provide an initial response and identify those who would later need treatment or psychosocial intervention."
In the time that has passed since the beginning of the war, have you also built a more regulated systemfor those who need it?
"Absolutely. The other mental health clinic we opened, the Shalom Clinic, accepts only evacuees staying in Eilat from all the HMOs and helps greatly in this. In this way, we were able to treat those who need it in a more orderly manner, and now we are also prepared for regular and long-term treatment. Today, we treat hundreds of people during the week, at least 70 a day, in both clinics and with the assistance of teams that come to the city from Clalit mental health hospitals."
As is well known, many residents of the north were evacuated from their homes due to the war, and they too know how to provide a quick and accurate mental health response, according to each person's needs.
Dr. Leonid Brouda, Chief Psychiatrist and Director of the Northern District Mental Health System, Photo: Star 2000 Photographers
"Clalit's mental health system in the north is a large one, while Clalit is actually the only one that has mental health clinics in the area," explains Leonid Brouda, Clalit's chief psychiatrist in the northern district.
How did you prepare to deal with the issue of the many evacuees?
"We have about 20,90 evacuees from the province, scattered in very many hotels, more than <>, and in other places. We mapped them all to know where they were and how they could be treated in the new situation. Subsequently, we created a joint system with welfare, resilience centers and the Ministry of Health and built a clear work process that works well.
"The process determines that those who were in treatment before the outbreak of the war continue treatment with those therapists in remote therapy, or regular therapy, to the extent possible.
Regarding the new patients, wherever there are evacuees in need of mental health treatment, they turn first to the resilience centers of the social services. That's where the First Wave inquiries are centralized, along with the three free phone support calls we provide, and from there they are referred for further processing if necessary. That way, everyone gets the right response for him."
"The children respond to their parents"
One of the main mental health challenges is the treatment of children and adolescents, which Clalit also provides a solution for.
Sigal Sidlik-Alon, National Psychologist of Clalit, Photo: Osher Lupo
"There are children in the envelope who were exposed to death or threat to their lives," explains Sigal Sidlik-Alon, Clalit's national psychologist. "Children across the country saw their parents react emotionally to what was happening on that difficult Shabbat and were exposed to news reports intensively many times. In addition, to varying extents, the children did not return to school at the end of the extended holiday vacation, and this departure from routine also has an effect.
The prolonged and also this departure from the routine has an effect.
"Many people have been evacuated or evacuated from their homes and are staying in temporary housing, so routine has been disrupted and this also has implications for family relationships and the intensity of living in a temporary place without working or studying. Another challenge is the content to which many teenagers have been exposed on uncensored social networks, such as Instagram and TikTok.
"In addition, in many parts of the country there were many missile attacks and sirens, which contributed to an increase in stress and anxiety responses of parents and children. The fact that many children have a parent or other family members on reserve duty is also of significant concern."
"The effect on a daily basis can be expressed in sleep difficulties such as difficulty falling asleep or switching to sleeping with parents, a change in eating habits, as well as an increase in behavioral problems and even aggression.
"Due to the ongoing situation, it is important that parents aim to cope effectively and increase resilience. For example, a limit must be set alongside legitimizing children's feelings. It is important to remember that children, from the age of a few months to adolescence, respond to their parents' mental state. The extent to which they can trust that their parents or adults around them will see their needs and know what is the right thing to do to cope and protect them is critical."
In collaboration with Clalit