The study, led by Prof. Yair Bar-Haim, head of Tel Aviv University’s National Center for Traumatic Stress and Resilience, showed a rise in PTSD symptoms from 0.5% at enlistment to 12% during the current war. Factors such as burnout, long deployments, and social and economic strain contributed to a decline in reservist participation, with turnout dropping to 75%-85%.

“Far from surprising, these figures are consistent with what is known about post-traumatic symptoms following high-intensity warfare, in both the IDF [Israel Defense Forces] and other armies,” Bar-Haim said. “The data also contribute to the understanding that Israel’s mental health system is in a state of emergency. Decision-makers must act urgently to devise long-term solutions for treating a large number of veterans with PTSD.”

PTSD is a mental health condition triggered by experiencing or witnessing a terrifying event. Symptoms may include flashbacks, nightmares, severe anxiety, and uncontrollable thoughts about the event. People with PTSD may avoid situations or things that remind them of the traumatic event, and they may have negative changes in beliefs and feelings. The condition is typically managed with therapy and medication.

Bar-Haim presented his research on Tuesday in Tel Aviv at the Future of Israel Conference.

The study tracked 579 soldiers from an infantry brigade to gauge the psychological impact of active service and post-discharge periods, as well as the influence of the October 7 war. “The war has intensified psychological distress, and the number of respondents reporting significant post-traumatic stress symptoms rose to approximately 12%,” Prof. Bar-Haim said.

The researchers utilized a Hebrew version of the gold standard questionnaire for PTSD self-reporting, where participants rated the severity of their symptoms. Although the results are not a replacement for a formal PTSD diagnosis, the correlation between self-reports and clinical interviews has been well-established.

The study tracked the soldiers at five intervals: enlistment, after 15 months of service, after 27 months, six months after honorary discharge, and 18 months post-discharge.

Initially, at enlistment, fewer than 0.5% of soldiers displayed pre-existing PTSD symptoms. However, as their service progressed, the number of those reporting clinically significant PTSD symptoms steadily increased. After 18 months of service, including six months of combat training and nine months of active duty, the rate of PTSD symptoms had risen to 2.6%. By the end of their regular service, after several combat deployments, 4.4% of soldiers showed significant PTSD symptoms.

Surprisingly, the symptoms worsened after discharge. Six months after leaving the army, nearly 8% of participants reported PTSD symptoms at clinical levels, despite the period being relatively calm, without significant military operations.

“We hoped that the severity of symptoms would diminish after leaving the army, but instead, the rate rose,” Prof. Bar-Haim noted. This increase could be linked to the loss of the social support system and sense of belonging that the military environment provides. “The cause of this rise is unknown, but it stands to reason that the social support and sense of belonging provided by the military environment diminished considerably once the soldiers returned to their individual lives.”

As the study progressed into the October 7 war, the psychological toll of combat became even more evident. Approximately 85% of the participants were called up for reserve duty during the conflict. By the time the study was conducted several months into the war, the percentage of soldiers reporting PTSD symptoms had climbed to about 12%.

PTSD is not limited to soldiers. A Ben-Gurion University study released in March found that nearly half of young Israelis showed symptoms of war-related PTSD. That research revealed that individuals ages 18-30 were particularly affected due to their high rate of military service, personal losses, and displacement from their homes.

Bar-Haim emphasized the need for long-term solutions to support veterans suffering from PTSD, pointing to the necessity of accelerated therapist training and the creation of specialized trauma clinics.

The study’s results may also help explain the recent decline in reservist turnout. Although initial turnout exceeded 100%, current reports show a drop to around 75%-85%. Several factors contribute to this decline, including the impact on reservists’ livelihoods, families, and the perceived inequality in the burden of service. Additionally, the mental strain of repeated combat deployments, especially those involving traumatic experiences, is taking its toll on the soldiers’ resilience.

“Reservists suffering from multiple symptoms are often unable to report for additional service,” Bar-Haim said, adding, “The greatest pressure of all falls on the veterans and their families.”

At least 1,180 people were killed, and 252 Israelis and foreigners were taken hostage in Hamas’s attacks on Israeli communities near the Gaza border on October 7. Of the 58 remaining hostages, 36 are believed to be dead.

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