Welfare Ministry in Israel Allocates Mere $12 a Month for Post-Trauma Treatment per Survivor of the Nova Massacre

Survivors of the October 7 massacre at the Nova Rave are entitled to funding from the National Insurance Institute to pay for individual psychological treatment, but experts agree that this solution does not suit everyone. To deal with the problem, the Welfare Ministry has allocated 1.2 million shekels (around $320,000) for nine months – which is supposed to fund a comprehensive administrative and treatment plan for 3,000 survivors and their families. The ministry argues that the paltry sum is because this is just a ‘complementary plan,’ but given the absence of any other government plan, it’s not clear what it is complementing. A Shomrim exposé

Survivors of the October 7 massacre at the Nova Rave are entitled to funding from the National Insurance Institute to pay for individual psychological treatment, but experts agree that this solution does not suit everyone. To deal with the problem, the Welfare Ministry has allocated 1.2 million shekels (around $320,000) for nine months – which is supposed to fund a comprehensive administrative and treatment plan for 3,000 survivors and their families. The ministry argues that the paltry sum is because this is just a ‘complementary plan,’ but given the absence of any other government plan, it’s not clear what it is complementing. A Shomrim exposé

Survivors of the October 7 massacre at the Nova Rave are entitled to funding from the National Insurance Institute to pay for individual psychological treatment, but experts agree that this solution does not suit everyone. To deal with the problem, the Welfare Ministry has allocated 1.2 million shekels (around $320,000) for nine months – which is supposed to fund a comprehensive administrative and treatment plan for 3,000 survivors and their families. The ministry argues that the paltry sum is because this is just a ‘complementary plan,’ but given the absence of any other government plan, it’s not clear what it is complementing. A Shomrim exposé

Two survivors of the massacre walking between the burnt-out vehicles. The people depicted are not related to the article. Credit: Reuters

Fadi Amun

in collaboration with

November 22, 2023

Summary

Shomrim has obtained a copy of an internal government document which reveals that the Welfare Ministry has allocated a total of 1.2 million shekels – around $320,000 – over nine months to provide welfare services for the survivors of the massacre at the Nova rave October 7. However, the government will only  offer half of this paltry sum, with the rest coming from Mifal Hapais – Israel’s national lottery.

It is important to note that survivors of the party are entitled to between 12 and 24 one-on-one meetings with a psychologist through the National Insurance Institute and the Health Ministry. These meetings are funded separately and independent of the budget approved by the Welfare Ministry. However, various mental healthcare professionals, including those working for the ministry itself, believe that only some of the survivors are entitled to these meetings, while the Welfare Ministry’s plan is supposed to provide a solution to all those who do not qualify and their families. Given the paltry sum that has been allocated to the strategy, it is hard to escape the conclusion that the government assumes that psychological treatment will be provided by volunteers and organizations that get their funding through donations – as is the case today.

The ministry claimed in response that its plan was just “complementary,” but it is hard to understand precisely what it is complementing. Shomrim discovered that apart from the individual funding provided by the National Insurance Institute – which, as mentioned, only covers some survivors – no government ministry has any plan other than to hope that volunteer psychologists will continue to provide treatment. The complete Welfare Ministry response appears below.

The scene of the Nova festival, just days after the massacre and the removal of dozens of bodies. Credit: Reuters
Dr. Hadas Sharabani-Saidon: “Offering them 12 sessions is like offering a cancer patient one round of chemotherapy or telling someone who has had a leg amputated that they’re getting 10 sessions of physiotherapy.”

Relying on Volunteer Psychologists

The gulf between people’s needs on the ground and the government’s inadequate plan is obvious from the very first lines of the document. Funding of psychological treatment, the authors say time and time again, is extremely urgent if the government wants to avoid long-term harm to the survivors. The meeting to approve the plan, however, was only held on November 1, some three and half weeks after that murderous Saturday. On the agenda was approval of an exemption from tender for contracts with the Israel Trauma Coalition – a long-established NGO that serves as an umbrella organization for a long lost of organizations and which specializes, among other things, in treating trauma caused by terror attacks.

It was at this meeting that the official figures from the massacre at the party were first revealed. According to the figures, some 4,000 people were at the party, most of them between 23 and 35 years old. The average age was 27. According to figures released by the police, 364 people were murdered at the party and dozens more were kidnapped and taken into Gaza.

“More than 3,000 participants survived,” the document states. “Most of them went though extremely traumatic experiences, including tangible fear for their lives, witnessing extreme violence and scenes of death and destruction. Some of the trauma that they are suffering from is due to a sense that they were not protected, that no one came to save them and that they were abandoned by the state – something that will intensify their sense of crisis.”

Although the document does not address the issue directly, the situation is even more complex than described above. Some of the participants at the party consume hallucinogenic drugs and given the lack of research into the subject it is a mystery what effect this could have on how they process the trauma. On the one hand, it could intensify the trauma or it could help deal with it. A preliminary and rudimentary study is now underway, with some of the party survivors taking part.

Either way, all of the professionals and experts involved understood right away that the problem needed to be addressed urgently and, with the government seemingly unable or unwilling to help, volunteers, NGOs and donors stepped up to the plate. Almost immediately after October 7. Volunteer psychologists – most of them from the private sector – started to provide treatment for survivors of the Nova party at a number of centers that were set up with money from donors. Other survivors have started individual treatment, either privately or funded by the National Insurance Institute. Yet it is clear to all those involved that not all the survivors are getting treatment at this time and that, even if not all of them are in a high-risk group for developing PTSD, the lack of treatment of any kind could have far-reaching implications in the future.

As previously mentioned, it took the Welfare Ministry three and a half weeks to get involved. Why the Welfare Ministry? The document itself explains that “there is a policy decision, supported by the deputy head of the government’s Shalem Rehabilitation Administration, Mr. Amos Yishai, and the director-general of the ministry, Mr. Yinon Aharoni, to provide treatment for the young people who survived the party.” In other words: Given the lack of a more appropriate government framework, the Welfare Ministry was drafted in to treat the Nova survivors.

The document details exactly what treatments were approved in the budget: “Operating an intervention program for the young survivors who need urgent psychosocial intervention, including focusing on their needs, coordinating responses with local authorities, the healthcare system, the National Insurance Institute, and others helping them get everything they are entitled to, constructing a group and community therapy framework and integration within the treatment frameworks set up by volunteers.”

The document mentions the so-called “anxiety protocol” used by the National Insurance Institute and the Health Ministry, which affords survivors between 12 and 24 individual therapy sessions. This protocol, the document stresses, is not suited for everyone, which is why the Welfare Ministry is “complementing” the solutions on offer.

The document goes on to list some of the elements that make up the treatment on offer: Twelve group sessions for each survivor; Employ additional officials to locate the survivors and coordinate their treatment; Use of treatment tools such as art or music; Arranging parties in the future (which will help the survivors return to the source of the trauma – F.A.); Setting up treatment zones in the local authorities. Elsewhere, the document mentions the families of survivors, who are entitled to 15 group sessions.

Welfare Minister Yaakov Margi. Credit: Danny Shem-Tov, Knesset Spokesperson’s Office
Reading the document, it is hard not to get the impression that the Welfare Ministry expects these NGOs, volunteers and donors to continue providing treatment that the government should give – until local authorities can be brought in to help.

All for 1.2 Million Shekels ($320,000)

One would hope and assume that even senior officials from the Welfare Ministry understand that the budget they have approved for nine months of treatment will not cover even a fraction of this list. But where will the money come from? The document does not address this question directly, but there may be a hint in the repeated mention of NGOs, donors, volunteer psychologists, party organizers who have volunteered their time, local authorities and other government ministries. Reading the document, it is hard not to get the impression that the Welfare Ministry expects these NGOs, volunteers and donors to continue providing treatment that the government should give – until local authorities can be brought in to help.

Dr. Hadas Sharabani-Saidon, a clinical psychologist and the director of “Otef Lev,” a volunteer organization within the civil situation room that was set up to help residents of the Israeli communities attacked on October 7, tells Shomrim that, irrespective of the question of budgets, the document is completely disconnected from reality in terms of the scale of treatment needed. “Offering them 12 sessions is like offering a cancer patient one round of chemotherapy or telling someone who has had a leg amputated that they’re getting 10 sessions of physiotherapy,” she says. “The state has to offer a basket of services and recognize that every individual will need individually tailored treatment.”

At first, the Welfare Ministry chose not to respond to this article, but a source in ministry said that despite “the policy decision that was mentioned in the document and with the support of the director-general of the ministry, responsibility for survivors of the family does not rest with the ministry, but with other ministries.” The source added that the approved budget was merely for “a complementary framework” to provide “group interventions for survivors and their families, training the teams, strengthening cooperation with groups in the local authorities and so on.”

Following publication of this article, however, the Welfare Ministry had a change of heart and submitted the following response.

“Mental health care for survivors of the party is funded entirely by the state, through the National Insurance Institute and the Health Ministry, using qualified professionals, through recognized organizations and at no cost to the individual.

“The complementary plan drawn up by the Welfare Ministry, the Union of Local Authorities in Israel and Mifal Hapais is designed to locate survivors who have not yet come forward for treatment and, in addition, to provide a framework of support for their families, such as parents and other relatives, with workshops and group therapy. Calculating the cost per patient misrepresents reality and misleads the public.”

Asked whether the sum allocated is sufficient for this complementary framework of support, the ministry declined to comment.

This is a summary of shomrim's story published in Hebrew.
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