Nowhere to run, no one to care: Trauma in Arab society after October 7

The recent State Comptroller’s report thoroughly examines the mental health treatment system for the civilian population following the October 7th War. The report presents a troubling picture: widespread psychological harm among the Israeli population, both direct and indirect, and a mental health system overwhelmed by the demand, leading to the broadening and deepening of symptoms of post-trauma, anxiety, and depression. In addition to the complete lack of reference or data concerning the ultra-Orthodox community, almost absent from the report are Arab citizens who comprise 21% of Israel’s population. Despite its brevity,  the report’s mention of Arab society is revealing and deserves more profound analysis.

Data shows that a more significant proportion of Arab citizens report symptoms across all categories: post-trauma is at 54% in Arab society compared to 32% in Jewish society; depression is at49% in Arab society compared to 30% in Jewish society; Anxiety is at35% in Arab society compared to 19% in Jewish society. Within Arab society, the most vulnerable groups are women and individuals without family support networks.

Jewish (pink) and Arab (maroon) rates of those reporting signs of medium to high levels of post-trauma, depression, and anxiety.

A striking statistic emerges from the analysis: within the same residential areas, there is a significant difference in mental health outcomes between Arab and Jewish residents. In other words, the difference between Arab and Jewish society does not stem from living in different areas but from the fundamental differences between the communities.

The effects of anxiety, depression, and post-trauma are far-reaching: anger, dysfunction, lack of focus, and deterioration in family relationships and responsibilities. Some people stop working or looking for work, others become socially withdrawn. There is tension and violence within households. Some parents stop communicating with their children. These effects extend into employment, education, and higher education. There is no dispute that the mental health consequences of the war are exacting a heavy toll on the Israeli economy, particularly among marginalized populations — especially in Arab society. Why are the symptoms in Arab society so much higher than in Jewish society?

Arab society was less prepared for war compared to Jewish society, especially in terms of protective infrastructure. The lack of public shelters and a severe shortage of secure rooms (mamad/miklat) in buildings — due to the absence of urban renewal programs like Tama 38 — meant that in most Arab communities, there is simply nowhere to run during an air raid siren. We’ve all experienced being caught outside or on a highway during a siren, and we know how terrifying those moments can be. In many Arab communities, that is the norm during all sirens — there’s just nowhere to go or hide.

Within Arab society, the situation is worst in the Bedouin communities of the Negev. In the first months of the war, after countless rocket falls and direct hits in unrecognized Bedouin villages, it became clear that the Iron Dome system identified these towns as “open areas” (and therefore didn’t intercept incoming rockets).  Twelve Bedouins were killed by Hamas rocket fire — twelve human lives, citizens of Israel, half of them children — who could have been saved by a simple fix to the system’s interception algorithm. These villages also lack a siren warning system. Even when the Home Front Command application is installed on personal smartphones, it doesn’t alert for incoming rocket fire in these towns due to the “open area” classification. Imagine sitting in your home when a rocket explodes in your village with no prior alert or notification. Imagine the anxiety of sitting in your living room in the weeks following such an event. Only months into the war did the Home Front Command confirm that this issue had been fixed, and the Iron Dome no longer treats Bedouin villages as unpopulated.

Moreover, Arab society barely made use of government-arranged evacuations to hotels or alternative shelters, even in cases where Arab villages suffered long-term attacks while their Jewish neighbors were evacuated. There are several reasons for this lack of evacuation — among them, distrust in the state, fear of leaving homes and property behind, and more. Here, too, the result was increased exposure to fire and heightened trauma.

Another factor contributing to psychological distress is the fearful and suspicious treatment many Arabs received from Jewish friends, employers, and police after the massacre and during the war. Many report a fear of revenge from Jews and a sense of being treated with suspicion, as if they were part of the perpetrators of October 7th. At the beginning of the war, many Jewish employers fired Arab workers, and the closure of businesses led to a steep decline in Arab male employment. The rate of job loss after October 7th was highest in Arab society.

Job loss of (non-Haredi) Jews, Haredis, and Arabs.

Unemployment, deepening poverty, and uncertainty about the future following the loss of income all contribute to increased anxiety, depression, and post-trauma. In this regard, it’s important to consider that Arab society has already accumulated years of chronic stress, trauma, and depression due to crime and violence rates that are hundreds of percent higher than those in Jewish society.

Beyond issues of emergency preparedness (shelters, Iron Dome coverage) or direct causes (job loss, severe shortage of mental health professionals), there is a major multiplier for trauma, anxiety, and depression: Arab society lives in the reality of fighting two wars at once. Many Arab citizens — especially among the Bedouins but not only — have relatives in Gaza. The Arab community follows war coverage through Arabic channels and social media, where the content is not filtered as it is on Hebrew-language Israeli channels. The worry for relatives and images of destruction and corpses intensify anxiety and depression and lead to secondary trauma symptoms.

Finally, there is also silencing. Until October 7th, Arab citizens of Israel could — even if to a limited extent — express feelings and share emotions in public and online. Since the beginning of the war, many Arabs have been questioned, arrested, or fired for showing empathy with civilians in Gaza. The inability to express concern for one’s relatives in a social media post also leads to anxiety and depression.

To address such high rates of anxiety, depression, and post-trauma, a national program is needed to incentivize training within the Arab society in a range of therapeutic professions: psychologists, psychiatrists, social workers, and emotional care practitioners. The State of Israel’s avoidance of tackling these deep mental health issues will have severe consequences in employment, education, addiction, and domestic violence. As a society and as a state, we must not neglect the mental health crisis in Arab society.