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Mental health volunteers after the Oct 7 Gaza border crisis in Israel: silent warriors

2023; Elsevier BV; Volume: 11; Issue: 1 Linguagem: Inglês

10.1016/s2215-0366(23)00369-3

2215-0374

Zohar Elyoseph, Dorit Hadar‐Shoval, Tal Angert, Noam Yitshaki, Eden Hol, Oren Asman, Inbar Levkovich,

Disaster Response and Management

Amid the death and devastation inflicted by Hamas' horrific attacks on Israel on Oct 7, 2023,1Paluch-Shimon S Popovtzer A Leibowitz R An urgent call for the immediate release of Israeli hostages.Lancet. 2023; (published online Oct 13.)https://doi.org/10.1016/S0140-6736(23)02288-2Summary Full Text Full Text PDF PubMed Scopus (6) Google Scholar a powerful story of humanity emerged. In the face of many lives being lost—over 1400 at this counting—and 222 abducted, Israel's mental health community has mobilised. Without governmental direction or resources, teams of psychologists, psychotherapists, and social workers voluntarily established emergency trauma centres nationwide. Driven by compassion, they devoted their time and expertise to support terrified civilians who had been taken to safe spaces to shelter from violence. These professionals created therapeutic frameworks, support groups, and children's activities to address diverse trauma needs. Their efforts brought hope to this population when it was most desperately required. This aid was provided under the looming shadow of continued violence and threats.2Givaty G Ovadia YS Saban M Insights from the nearest Israeli hospital to the Gaza Strip.Lancet. 2023; (published online Oct 18.)https://doi.org/10.1016/S0140-6736(23)02334-6Summary Full Text Full Text PDF PubMed Scopus (2) Google Scholar The ethos of generous service and unwavering commitment in the darkest of times is central to the mental health profession. A hotel at the Dead Sea, as well as Yezreel Valley College dormitories repurposed as volunteer centres, epitomise this spirit. By highlighting the voluntary mobilisation of Israel's mental health community amid harrowing tragedy, we underscore how human solidarity and goodness can emerge. The people of kibbutz Be'eri, a communal settlement near Israel's southern border, endured profound trauma during the attacks. The kibbutz was subjected to rocket fire and the brutal massacre of over 130 of its members by infiltrating Hamas terrorists. Dozens more were declared missing or kidnapped, including children, women, and older people. By Oct 8, hundreds of massacre survivors were evacuated to a Dead Sea hotel. Mental health therapists voluntarily joined them, establishing a trauma therapy centre to provide immediate support amid continuous distress. Upon confirming the identity of those killed, the teams of therapists supported the community in their mourning and participated in the funeral ceremonies. For the first time, a dedicated team was established to inform family members and children about the tragic loss, absence, or abduction of their loved one. They also conducted hundreds of short-term individual interventions and group interventions to help this population develop resilience, and also established a support group for a Filipino community that had been living in the kibbutz, who were equally overwhelmed by the horror. The therapeutic approaches primarily involved processing trauma narratives, eye movement desensitisation and reprocessing (EMDR), and resource-strengthening.3Levkovich I Swisa A Shared traumatic reality: coping among educational counselors living and working in Israeli communities on the Gaza Border.J Loss Trauma. 2022; 27: 565-582Crossref Scopus (4) Google Scholar Crucially, Be'eri's communal solidarity and existing mental health expertise enabled collaborative efforts between volunteers and residents to rapidly mobilise integrated psychosocial support attuned to kibbutz needs and customs. The Be'eri case shows how cooperative efforts between trauma specialists and community members with mental health experience can swiftly establish targeted, culturally sensitive systems to aid healing after catastrophic events. The towns of Sderot, Netivot, and Ofakim also endured missile threats and the infiltration of Hamas, who fortified themselves in residents' homes. By October 10, the college dormitories of Yezreel Valley College accommodated 300 people, including 108 children. Immediately, a voluntary mental health therapeutic unit was established by psychology faculty members of the colleges. This system relied on 20 volunteers specialising in psychology—clinical social workers who specialise in trauma and live near the college. This group was built without governmental intervention, creating its own ethical rules and setting team meetings and training. The team focused on three intervention domains: door-to-door screening to identify populations unable to access services, short-term trauma-focused interventions, and group resilience workshops for evacuees and volunteer staff. A shortage of spaces for psychological intervention meant that most interventions were conducted outdoors. The story of the therapeutic centres for massacre survivors emphasises that a country like Israel, despite its vast clinical knowledge in psychological trauma interventions, still relies on volunteers to provide immediate, quality responses. This reliance allows for high-quality service by experienced, senior professionals on the one hand, but it is problematic as a national strategy on the other. The volunteers, who received their training in the public service,4Brunner J Amrami GP Emotionalising the Israeli–Palestinian conflict: on the civil society engagements of Israeli mental health professionals in response to the Palestinian uprisings.Emotions and Society. 2021; 3: 115-132Crossref Scopus (2) Google Scholar, 5Diab M Veronese G Abu Jamei Y et al.Psychosocial concerns in a context of prolonged political oppression: Gaza mental health providers' perceptions.Transcult Psychiatry. 2023; 60: 577-590Crossref PubMed Scopus (8) Google Scholar built multidimensional organisational structures within hours, implemented intervention practices, supported the team, provided training, and established ethical protocols without governmental directives. Their dedication and professionalism underpin the success of these initiatives. In the future, Israel and other countries should consider activating volunteer teams in a reserve-like format during emergencies—deploying a senior team of psychologists and social workers who can function as a unit and provide quality responses to trauma events at the national level. When the formal authorities did not yet have time to organise, the mental health volunteers—the silent warriors—were the providers of resilience and hope. We declare no competing interests. Editorial note: The Lancet Group takes a neutral position with respect to territorial claims in published text and institutional affiliations. Israelis in support of mental healthWHO declared Oct 10, 2023 as World Mental Health Day, an opportunity for people and communities to unite behind the theme that mental health is a universal human right.1 This campaign came just days after the atrocious attack by Hamas on Israel, in which many people, including older people, children, and women, were killed, wounded, and kidnapped.2 Thousands of families, and Israel as a whole, mourn their agonising losses. Despite the large-scale mobilisation of volunteer mental health professionals, hospitals and mental health services are overwhelmed, and this situation will only worsen as the trauma unfolds. Full-Text PDF Urgent call for protecting health-care workers in Palestine#NotATarget is a worldwide campaign that calls for politicians and policy makers to protect civilians from harmful military action, particularly front-line workers such as journalists and health-care workers who are an easy target for such action. Since the mass displacement and dispossession of Palestinians (also referred to as the Nakba) in 1948,1 health-care workers have been killed, and health-care facilities have been destroyed. Since Oct 7, 2023, Israeli military bombing of the Gaza Strip (or Gaza) has resulted in 73 health-care workers being killed, with 57 health-care facilities attacked as of Oct 24, 2023. Full-Text PDF A Palestinian and an Israeli physician speak out for medical ethicsAs Palestinian and Israeli medical professionals impacted by the unfolding catastrophe in the Gaza Strip (or Gaza) and Israel, and who remain deeply committed to medical ethics, we feel it is our duty to speak out against the crushing of all the humanistic values that we vowed to uphold. We call on the international medical community and Israeli and Palestinian national medical associations, such as the Israeli Medical Association and the Palestinian Nursing Association, to follow our lead and ensure that we do not forsake that vow. Full-Text PDF Mental health first aid for health-care workers during crisesThe Hamas terrorist attack on Israel on Oct 7, 2023, resulted in at least 1400 people killed, more than 4600 injured,1 and over 230 kidnapped—an unprecedented crisis for the Israeli health-care system2 tasked with addressing physical and psychological injuries among a large population, which has exposed them to distressing scenes. Full-Text PDF