Warning to readers: This article addresses deaths by suicide, and some of its content may be psychologically disturbing.
As the third anniversary of the October 7 attacks approaches, Ronen Shalev feels his body telling him that something is approaching. "You start shaking," Shalev told DW. "It's not just one day and then things move on. We have many graves to visit, many families to meet. It's a difficult period and you feel it in your body."
Both of his children had attended the Nova concert in southern Israel, where nearly 400 people were killed in a terror attack carried out by Hamas and allied factions from Gaza. In total, about 1,200 people were killed in the attack, while about 250 were taken hostage. The attack led to the outbreak of war in Gaza, during which Israel killed tens of thousands of Palestinians and caused the displacement of a large portion of the Strip's population.
Shalev's son, Roi, was shot and taken to hospital, but survived. As for Ro'i's partner, Mabal Adam, she was killed in front of his eyes. Shalev's daughter, Lior, also managed to survive. Shortly after that day, Shalev's wife, Gabriella, disappeared before her body was found inside a burning car, along with a farewell note. “She couldn’t bear the sadness that came from that day,” Shalev says.
At the same time, his son Roui began showing symptoms of PTSD, mostly in the form of severe mood swings. “He went to therapy to please me, but he didn’t really believe in it,” Shalev recalls. “He thought he was fine and strong.” Two years after Gabriella's death, Roi, too, was no longer able to bear it. He wrote in a farewell message that he posted on his Instagram account: “I am alive, but I am dead inside. I am sorry.”
A country experiencing post-traumatic stress disorder
Since October 2023, Israel has been facing a mental health crisis of unprecedented scale. According to a report issued by the State Comptroller of Israel in February 2025, about 39 percent of Israelis reported suffering from symptoms of post-traumatic stress disorder, depression, anxiety, or a combination of these conditions, to a moderate or severe degree.
This represents about three million people, 600,000 of whom may suffer from severe cases. However, the report also found that the number of people receiving psychological treatment has increased by only 1 percent since October 7, 2023. Among the affected groups are survivors of the attack, as well as people who were evacuated from their homes in southern and northern Israel due to the war.
Noga Dagan-Bozaglo is a researcher at the Adva Center, a research center that focuses on issues of inequality in Israeli society. An extensive study was prepared on the mental health system in Israel and the challenges it faces after October 7.
She told DW that the country's mental health budget actually increased due to the war, but the increase was limited and late, at a time when the health system was facing an ongoing crisis that was not being adequately addressed. She added: "The biggest challenge is convincing people to work in the public mental health system in Israel, due to low wages compared to the private sector, as well as due to excessive work pressure."
Sedatives are often the first resort
The current situation affects not only patients, but also mental health workers. A study conducted by the University of Haifa showed that 84 percent of the therapists who provided treatment to those affected by the October 7 attacks themselves showed symptoms of psychological trauma, while about 45 percent of them said they felt psychologically exhausted.
The Israeli Ministry of Health has repeatedly stated that it has increased funding and the number of jobs available in the public mental health system, but a shortage of personnel still exists, especially in the areas located in the far north and south.
Because of these problems, the report stated that waiting times for treatment through Israel's public health care system exceed six months. In some cases, Dagan-Bozaglo says, patients had to wait more than a year before getting help.
NGOs and volunteers working in the field of mental health try to fill these gaps, but they, too, often suffer under work pressure. This also leads to increased use of prescription medications, while some people turn to alcohol or drugs.
The Israeli Ministry of Health announced earlier this year that it had recorded an increase of between 13 percent and 17 percent in the prescription of sedatives, hypnotics, and antidepressants.
Those most affected by this situation are people who cannot afford private psychological treatment. Dagan-Bozaglo describes the Israeli public health system's response to the crisis as "simply bad."
Soldiers are in danger
Combat soldiers have received special attention in the context of Israel's mental health crisis. Statistics published by the Israeli Knesset and the Israeli army indicate a sharp rise in suicide cases among reserve soldiers: from a maximum of one case per year during the six years preceding the war to 11 cases in 2024, in addition to nine cases being investigated as suspected suicides in 2025. These numbers do not include former soldiers who ended their lives due to psychological trauma after the end of their military service.
Dagan-Bozaglo says that specialists working with the army receive better wages and working conditions, but the shortage of personnel is still evident. She added: "Even within the army, the duration and quality of treatment are still far from the required level."
She believes that starting to solve the problem for both civilians and military personnel requires greater support for the regime, adding: “We have to acknowledge that the psychological trauma does not end after one year. This means investing money.”
Breaking the silence around suicide
Ronen Shalev gives regular lectures and meetings on the importance of mental health, and often addresses groups of soldiers. He believes this is the best way to continue his son's legacy of struggling to survive. Shalev, who himself was diagnosed with post-traumatic stress disorder, says he made a decision to live his life to the fullest extent possible.
His message is that the taboo associated with suicidal tendencies, which still exists in various circles of Israeli society, must be broken. “This is especially true for those who say they are strong,” he says. “Those are the most worrisome, because they are less likely to receive treatment.”
For Shalev, speaking publicly about his family's experience has become part of his personal recovery path, and a way to encourage others to seek help before reaching the crisis stage. He concludes by saying: “Life, despite all its pain, is still worth choosing.”
