Israel’s rate of PTSD has nearly doubled since the war that began on October 7th, and in the three years since, a treatment industry has grown up around that need. But a lack of regulation has turned goodwill into potential harm.
The Back on Track Forum, a coalition of more than 50 treatment organizations and military-unit veteran associations, coordinated by NATAL – Israel Trauma and Resiliency Center, has published an online self-assessment tool that allows nonprofits to evaluate their suitability for treating people with PTSD. The tool helps organizations recognize areas that need improvement and make adjustments, while giving patients access to information about the organizations where they’re seeking treatment.
In a seminar on trauma hosted by American Friends of NATAL, Professor Rivka Tuval-Mashiach, a clinical psychologist, presented data showing that the proportion of Israelis suffering from PTSD symptoms surged from 16.2% before October 7 to 29.8% after. That number represents nearly eight times the global rate of 3.9%, according to research by Levi-Belz et al. (2024) and World Health Organization data cited in her presentation. PTSD often impairs adults’ ability to work and reduces productivity. Beyond the workplace, it drives broader harm, including road accidents, serious illness, addiction, and domestic violence, resulting in societal costs. Roughly 80,000 people are currently at high risk of losing their jobs.
GuideStar Israel, the official, government-approved online database and registry for nonprofit organizations in Israel, operated directly by the Israeli Ministry of Justice, found that 215 new nonprofits targeting soldiers, reservists and discharged soldiers in trauma, mental health and resilience have registered since 2023. Of the total, 141 were established in the past two years, and only 60 have received Israel’s certificate of proper management.
Ella Bokovza, director of the Back on Track Forum, highlighted the risks of alternative therapies to Calcalistech reporter Shahar Ilan. Bokovza pointed out that activities such as trauma-informed yoga, acupuncture, breathing workshops, therapeutic gardening, animal-assisted therapy, surfing, and sailing often take place without a clinician nearby. Bokovza noted that if a participant experiences an acute episode like a flashback in the middle of a surfing session, there is no clear line of responsibility for their safety, either in the moment or after they return home.
Shaked Arieli, director of the Personal Development and Career Unit at NATAL, told Calcalistech: “If a group of people with PTSD spends several highly emotional days in the Alps, reaches an emotional peak, and is then dropped back at home without support or follow-up, some will end up harmed. Sometimes lifting someone up without taking responsibility can also cause harm.”
The lesson emerging from three years of crisis is that good intentions and available funding are not substitutes for professional oversight. A booming field of well-meaning providers, without clear standards for training, supervision, or follow-up care, can leave patients no better off than before treatment, and in some cases actively harmed. The very scale of the response to widespread trauma has outpaced the guardrails needed to make that response safe.
Closing that gap will take action on three fronts. Patients and families can use tools like the Back on Track Forum’s self-assessment resource to evaluate a provider before beginning treatment, and to ask whether a program includes follow-up support once an intensive intervention ends, not just what happens during it. Organizations need to define the limits of what they’re qualified to treat, match practitioners’ training to the specific intervention they provide, maintain ongoing supervision, refer patients elsewhere when a case falls outside their expertise, and safeguard the sensitive information they collect. And governments need to close the regulatory gap, including formal criteria for who is authorized to diagnose and treat PTSD, standards for treating vulnerable populations, and oversight that extends beyond licensing individual professionals to the nonprofits and private programs currently operating outside the public system.
