The more psychologists delve deeper into the symptoms and causes of mental health disorders, the more we begin to understand that adults are not the only ones at risk. At a global scale, one in five teens struggles with a diagnosable mental health disorder, but this number is growing at an alarming rate in Israel. In spite of being at the forefront of medical research and healthcare innovation, Israel is in the midst of a mental health crisis and students are one of the most vulnerable groups.
According to a study published in the Palestine-Israel Journal of Politics, Economics and Culture, Israel has one of the most advanced public outpatient mental health service systems in the world, but there is a huge discrepancy between the way teens and adults use these services. With just 12% of the underage population benefitting from outpatient services, psychologists are concerned that the needs of teenagers are not met and that the current generation is at risk. But in order to draft a long-term plan that promotes teen mental health, it’s important to understand where Israel stands compared to the rest of the world and what socio-economic factors are behind this alarming trend.
Teenage suicide attempts are on the rise in Israel
A 2017 report by the Israel National Council for the Child revealed that the number of children under the age of 14 who tried to commit suicide has increased by a whopping 40% in the past decade. Every year, over 750 children are admitted to the emergency room because they attempted to take their own lives. 306 of them are under the age of 14 and 608 of them are girls.
This means that there are twice as many children at risk of suicide than there were in 2000 and the National Council for the Child explains that, in most cases, the risk cause stems from the family. Neglect, physical abuse and sexual abuse are the main causes why Israeli teens are experiencing mental health issues, but, at the same time, we should also keep in mind that one in three children in Israel lives below the poverty line. Living in poverty poses two major challenges for good mental health: on the one hand, mental health awareness tends to be lower in poor communities, so teens may be struggling for years without anyone acknowledging them, and, on the other hand, families with limited income prioritize other treatments to the detriment of counseling or anxiety/depression medication.
Schools fail to meet the demand for educational psychologists
In most countries, the role and attributions of the school counselor are fairly limited, but in Israel, they play a vital role in the child’s education and mental wellbeing. The educational psychologist can diagnose children with behavioral disorders, provide initial treatment, provide treatment advice to parents, help teachers deal with sensitive cases and collaborate with school management to create a safe environment that boosts mental health.
In February 2018, Education Ministry director talked about the increasing incidence of violence, suicide attempts, anxiety and depression among children and teenagers, and it became obvious that educational psychologists are the first line of the defense. Only a few families are up to date with the latest treatments for anxiety and depression and can afford to buy them. Others must wait months until their appointment in the public healthcare system and during this time, the school’s educational psychologist is the closest option to treatment.
Unfortunately, the regulations put in place more than 10 years ago allow only for one educational psychologist per 1,000 children in 2nd to 12th grade and one per 5,000 children in preschool. The department is severely understaffed and most psychologists cannot handle each case with the attention it deserves. To make things worse, 68% of positions are filled, which leaves the average educational psychologist in Israel handling more schools at a time and allocating a mere one or two days a week for each. One educational psychologist in Sharon explains that they do not have time to carefully analyze every child in the classroom because the obvious violent, “problem child” cases get all the attention. Meanwhile, there can be many other silent children who struggle with social anxiety or suicidal thoughts, but, because the psychologist doesn’t have time to talk to them, the issue goes unnoticed and worsens.
The ministry is currently trying to fill this gap by hiring an additional 100 educational psychologists per year, but, even so, that might not be enough without a change in regulation and a change in public perception.
As long as there is stigma, there will be no progress
Israel has an advanced healthcare system, state-of-the-art mental health facilities, modern treatments and the role of educational psychologists in schools is better defined compared to other countries. In theory, this should be a recipe for progress, but as long as parents aren’t aware of the existence and importance of educational psychologists, teen mental health problems will continue to be a problem. Moreover, Israel is still dealing with a stigma surrounding mental illness.
In a study called Stigma, Discrimination, and Mental Health in Israel: Stigma against People with Psychiatric Illnesses and against Mental Health Care, funded by the National Institute for Health Services and Health Policy Research, only 13% of respondents said they would seek professional treatment if they felt anxious or tense, but instead, they would seek help immediately if they experienced a symptom associated with severe psychiatric illnesses. In other words, the public is generally aware of severe mental health disorders, but less aware of the subtler symptoms leading up to those.
Another interesting finding is that Israeli respondents are generally good at identifying the symptoms of depression in hypothetical situations, but, in reality, not only are they less perceptive of depression symptoms, but also likelier to respond to them with anger.
Teen mental health is affected by the Israel-Arab conflicts
Israel has been involved in military conflicts with neighboring countries almost since its formation and this constant tense atmosphere has taken its toll on teen mental health. According to a study published in the Journal of Traumatic Stress, teens growing up between 1998 and 2011 were affected by the acute violence between Arabs and Israelis. During periods of terrorism, suicide bombings and fear of the Iranian nuclear threat (the peak being the Palestinian uprising between 2001 and 2003) there was also a surge in teen anxiety, depression, OCD, paranoia, and sleep disorders.
Psychologists suggest that the Israeli public health services should acknowledge the major impact that military conflicts have on the growing generation and provide continuous support both during intense periods of conflict and between the quiet times between them.