Almost three years into a war that has touched nearly every family in this country, the Jewish philanthropic and communal funding world has done something it should be proud of: it has shown up for mental health.
Tens of millions of dollars have flowed into treatment programs for soldiers, evacuees, bereaved families and first responders dealing with diagnosed PTSD. Clinics have opened. Therapists have been trained and deployed. Emergency response teams have been built almost from scratch. And yet, sitting inside this system every day, I have come to believe we are making a critical, expensive and ultimately unsustainable mistake.
Illustrative
It makes sense that the majority of public mental health resources in Israel are devoted to treating people who have already developed significant psychological conditions such as post-traumatic stress disorder, acute anxiety disorders, compassion fatigue among the helping professions and burnout among reservists and social workers who have not had a real break in three years. This is necessary, important work, and I am not arguing to take a single shekel away from anyone who needs intensive, ongoing treatment.
But behind the population that has crossed the threshold into diagnosis sits a far larger group: Israelis adults and children living with moderate, sub-clinical symptoms. Sleeplessness. Hypervigilance. Irritability. The low hum of dread that hasn’t yet organized itself into a diagnosable disorder. According to the 2025 State Comptroller of Israel Report on Mental Health, approximately 3 million Israeli adults — roughly 30% of the adult population — were experiencing anxiety, depression or symptoms of PTSD in the wake of the Oct. 7 attacks and the war. Some of them will recover on their own, but many will not — not because their distress is inevitable, but because nothing is currently designed to catch them before it worsens.
Here is the uncomfortable math the Israeli government and funders need to sit with: it is dramatically cheaper, faster and more effective to help someone with moderate symptoms build resilience and cope than it is to treat that same person two years later once their symptoms have calcified into full-blown PTSD. Early, brief, evidence-based interventions — somatic experiencing, psychoeducation, group support, resilience training, digital and telehealth screening — can often be delivered at a fraction of the cost of long-term individual trauma therapy, and they work. Treating one person with PTSD or can cost tens of thousands of shekels annually depending on the severity of symptoms and the level of care required, while providing early intervention for anxiety and trauma before symptoms they become chronic is significantly less expensive.
This isn’t a controversial claim in the global mental health field — it’s the entire logic behind stepped-care models used at disaster-response systems worldwide. We are simply not applying that logic here in Israel at a time when we need it the most. And we need it urgently, because the numbers ahead of us are simply not sustainable under the current model
Israel does not have, and will not soon have, enough licensed clinicians to provide individual trauma therapy to a meaningful fraction of 3 million people. If we continue directing the overwhelming share of funding toward treating people only after they reach a diagnostic threshold, we are not building a system that can absorb what’s coming; rather, we are building a system that guarantees a growing population will wait, untreated, until their moderate symptoms become severe ones. We will have our way into a larger crisis rather than spending our way out of it.
Unlike the treatment of individuals with severe mental health conditions, which require licensed clinicians, moderate symptoms can often be addressed through evidence-based interventions delivered by trained non-clinicians. This distinction is especially important given that Israel has only about 17,000 mental health clinicians — far too few to meet the needs of a population facing prolonged war-related stress. If we do not expand the pool of people equipped to provide early support, the country risks being overwhelmed by a mental health tsunami.
I am not saying pull funding from treatment. I am saying the ratio is broken. A mental health funding strategy for a country at war for three years straight cannot be almost entirely reactive. It needs to be one that is accessible, low-cost, high-volume and has the hallmark of early intervention, one that catches people before they need the expensive, specialized care that our clinical workforce cannot possibly deliver to everyone who will eventually need it.
To the foundations, federations and individual donors who have been so generous to organizations like ours, I am asking you to ask a hard question the next time you evaluate a grant for mental health services in Israel: not just how many people did this program treat, but how many people did this program keep from needing treatment in the first place. That second number is where the real return on investment — human and financial — is waiting to be found.
We built an emergency response for this war. Now we need to build its prevention arm, before the wave in front of us becomes the wave that breaks the system entirely.
Cathy Lawi is CEO ofEmotionAid, an Israeli organization focused on mental health resilience and early intervention
