Survivors and families of the victims arrive at the grounds of the Supernova music festival, January 5, 2024, Kibbutz Re'im, Israel. (Ilia Yefimovich/picture alliance via Getty Images)
Israeli hostages, soldiers, and war survivors face severe trauma and inadequate support. Experts urge systemic reforms and expanded rehabilitation programs.
Carmit Palty Katzir hasn't yet had the chance to mourn her father, who was murdered on October 7 at Kibbutz Nir Oz.
Her mother and brother were kidnapped and taken hostage in Gaza on the same day. While her mother was eventually released in the first hostage exchange in November, she returned in critical condition. Hospitalized for seven months, she was placed in a medically induced coma and hooked up to a respirator. She came close to death many times.
Throughout her recovery, Katzir and her sister took turns keeping vigil by her bedside.
Her brother, Elad Katzir, was later confirmed murdered in captivity in Gaza. His body was returned in April.
There's just been so much loss. Our lives are on hold.
"The ability to live any kind of normal life -- to mourn, to fight for my brother -- there's just been so much loss," Katzir told The Media Line. "Our lives are on hold."
She explained that she hasn't been able to return to work. A rehabilitation professional herself, she asked, "How can I focus on rehabilitating others when I'm consumed with the fight for the hostages still in Gaza, as well as my mother's recovery -- and even my own?"
Even with her brother's body back home, Katzir said she still feels trapped in the fight. Despite having no immediate family left in Gaza, she cannot let go. "With 100 hostages still there, they are my extended family," she said. "There's a very real risk to the mental health of the entire public."
Katzir's experience is not unique.
Earlier this month, the Hostages and Missing Families Forum released a report highlighting the ongoing struggles of returned hostages. The report described them as being in a "twilight zone," trapped in a never-ending nightmare. It revealed the severe physical and psychological toll of captivity while also exposing gaps in Israel's system for monitoring and rehabilitating survivors.
Based on medical evaluations, expert opinions, documented findings, and interviews with former hostages and their families, the report examined the health impacts of captivity and the challenges in rehabilitation. It called for a comprehensive response to address the needs of survivors, their families, and affected communities.
The findings were grim.
Many hostages returned with extreme malnutrition and significant weight loss. Unsanitary conditions during captivity led to widespread gastrointestinal issues, including chronic diarrhea and intestinal infections. Contaminated water and poor hygiene only worsened these problems. Skin ailments such as rashes, sores, and lice infestations were common, underscoring the absence of basic care.
For those with chronic illnesses like diabetes, hypertension, or respiratory conditions, captivity made their health worse.
"Survivors continue to face challenges in stabilizing their health, with some experiencing irreversible damage," the report stated.
Physical injuries, including untreated fractures and nerve damage, left many with lasting disabilities. Survivors require extensive medical care, from surgeries to physical therapy, just to manage pain and regain basic functionality.
Yocheved Lifshitz, who was held captive for 17 days, shared her harrowing ordeal at a press conference on Tuesday.
"I returned in a very ill state," she said. "My illness actually became the reason they decided to release me, as they feared I would infect others. During captivity, I lost 5 kilos, and my blood pressure plummeted. Had I stayed for 50 days, I would have returned in a coffin. My contagious illness and their fear of keeping me there saved my life."
The trauma, however, goes far beyond physical scars. According to the report, released hostages are grappling with severe psychological wounds. Many have PTSD, with symptoms like intrusive thoughts, nightmares, hypervigilance, and emotional numbness. Survivors often describe feeling as though their minds are still trapped in Gaza. Survivor's guilt is also a common burden.
The plight of those still held hostage is equally haunting.
The hostages are losing their identity, becoming 'walking ghosts'
"The hostages are losing their identity, becoming 'walking ghosts,'" said Dr. Einat Yehene, a rehabilitation psychologist with the Hostages Families Forum. Speaking to the president, she warned, "Their mental state puts them at high risk for suicide -- they might lose hope of rescue. The families, meanwhile, are trapped in emotional limbo, torn between hope and fear for their loved ones."
Yehene emphasized the ripple effects of the trauma on hostage families.
"Families experience flashbacks, traumatic stress, and severe anxiety," she explained. "Their lives are frozen -- they've lost their pre-October 7 identities and face strained relationships. Our research found no difference in emotional distress levels between those who know hostages and those who don't. Nearly 50% of the public's emotional distress is tied to the uncertainty around the hostages' fate and the trauma of their kidnapping."
For many, the aftermath of captivity has made returning to everyday life impossible. Adults struggle to resume their careers, while children face academic setbacks and social challenges, leaving them feeling disconnected and isolated.
"We tried to collect information from all sources to put together the report," lead author Prof. Hagai Levine told The Media Line.
However, he acknowledged that much of the available information is anecdotal, gathered from the fragmented treatment of hostages and their families or through interviews, often conducted by volunteers. Despite these limitations, he said, the findings reveal a grim picture of how care is being provided to those who have likely endured the most significant suffering.
Levine shared examples of families dealing with physical injuries who were informed after a year that they would no longer receive specific services. "But after a year, their needs did not change," he said.
Additionally, Levine highlighted gaps in legal and systemic support. For instance, a family member -- such as a sister -- might quit her job to care for a loved one, perhaps a released hostage, but receive no compensation for her own children's needs. "There are many stories like this," Levine said.
The report's authors advocate for significant changes, such as establishing a national rehabilitation program, expanding rehabilitation services, implementing systematic monitoring, and strengthening family support systems. Levine emphasized that without systematic health monitoring for released hostages, it will be impossible to gather the clear evidence needed to create informed policies. Health care providers cannot tailor interventions to meet evolving needs without proper data collection.
"A national program would offer multidisciplinary services, including physical therapy, mental health support, family counseling, and vocational training," the report advised. "This holistic approach would address the interconnected challenges of physical recovery, psychological healing, and social reintegration."
Levine underscored that the situation post-October 7 is "unprecedented, so you cannot expect that your regular tools will apply in this situation."
He argued that the government must "change priorities and give priority to health and rehabilitation. I reject the claim that there is no money. There is a lot of money. The government is choosing not to fully care for the people and neglect their health and recovery."
Lone soldiers lack support
It is not only the hostages who are facing these challenges.
Last week, the IDF disclosed during a meeting of the Knesset's Immigration, Absorption, and Diaspora Committee that only 500 out of 13,000 lone soldiers serving in the reserves since the war began have received the psychological support they need.
Tragically, some have taken their own lives while waiting for help. Sgt. 1 Class Vladislav Sergienko, a paratrooper and lone soldier, died by suicide during his reserve service in November. He left behind a wife and a 1-½-year-old child.
A recent article in the Hebrew daily newspaper Maariv recounted Sergienko's story, which was also shared at the committee meeting. His widow, Anna Belashov, revealed that she had called the IDF's mental health support center in July to request assistance. Months later, she was still waiting for a response.
"In the meantime, my spouse is no longer with us," Belashov said. "Soldiers feel that they can't unload their mental burdens in front of a uniformed psychologist, so it's important to allow soldiers with psychological distress to receive help outside of the army."
The Maariv article also quoted Lt. Col. Dr. Michal Lipshitz, head of the IDF's psychiatric department, said the IDF's mental health system has been expanded during the war, including the addition of a new branch to support soldiers with PTSD symptoms. Over 500 soldiers have been treated at this clinic so far. Additionally, soldiers experiencing immediate distress can contact the IDF's mental health support hotline by dialing *6690.
Suicides among Nova Festival survivors
Another group deeply affected by the war is the young survivors of the Nova open-air music festival. Their struggles came into sharp focus in October when survivor Shirel Golan died by suicide. Her family blamed the government for failing to provide adequate support for her battle with PTSD.
Although there have been claims of dozens of suicides among Nova survivors, these reports remain unverified. Golan's brother, Eyal, told the Jewish Telegraphic Agency that there had been several suicides within the Nova community, citing one estimate that his sister's death was the 53. During a Knesset hearing in April, Nova survivor Guy Ben Shimon made similar allegations, stating that as of February, "almost 50 suicides among the Nova survivors" had occurred, and he believed the number had since risen.
However, the Health Ministry has contested these figures. At the hearing and in subsequent statements, Gilad Bodenheimer, director of the ministry's Mental Health Division, said the ministry was aware of "only a few cases of suicide." The ministry also told Haaretz that, based on its records, Golan's death remains the only confirmed case of suicide among Nova survivors.
In October, researchers from Sheba Medical Center and Ben-Gurion University of the Negev published a study in World Psychiatry evaluating the effects of alcohol and drug use on the mental health of Nova survivors. However, Prof. Mark Weiser, who led the study, noted that no comprehensive tracking of festivalgoers' physical and mental health outcomes has been undertaken.
Weiser cautioned against drawing conclusions about Golan's death.
"Every suicide is a tragedy, but it is very premature and inappropriate to say [Golan committed] suicide because of her experience at Nova," Weiser told The Media Line. "This does not mean it is not true, but suicide is a multifactorial event, and we don't fully understand why one person may end their life while another does not."
For survivors, their families, and mental health advocates, the debate over exact numbers is secondary to a larger truth: hundreds of individuals who escaped the Nova festival -- or other October 7 traumas -- are suffering from severe mental health challenges. They argue that the state's services are woefully inadequate to meet the overwhelming need.
"There is this feeling that a year has passed, and everyone needs to get better and rehabilitate," Katzir told The Media Line. "This period is not enough."
There is not one answer, but we all need to be more sensitive and give us the resources and time to rebuild our lives
"There is a real feeling of loss and trauma," she continued. "There is not one answer, but we all need to be more sensitive and give us the resources and time to rebuild our lives."