Mental Health Rehabilitation After a Major Crisis: A Longitudinal Study of Service Recipients

The authors examined the impact of the October 7, 2023, attack on Israel on individuals receiving community-based psychiatric rehabilitation services, a population highly vulnerable to disruptions in structured mental health support.

Data were obtained from the Israeli Psychiatric Rehabilitation Patient-Reported Outcome Measurement program. A total of 19,461 rehabilitation service recipients completed self-report questionnaires between January 2023 and September 2024. Respondents were categorized by geographic risk based on evacuation status and proximity to conflict zones. The outcome domains assessed included goal setting, community involvement, general medical health, service experience, and quality of life. Analyses were conducted across four periods and three levels of exposure.

Significant temporal and regional differences in the studied variables were observed. In high-risk southern areas, goal setting significantly (p=0.011) declined immediately after the attack but rebounded within months. In contrast, service recipients in high-risk northern areas had a significant increase in goal setting (from 91% to 96%, p=0.011). Community involvement tended to decrease in the southern region (from 32.1% to 27.1%) but significantly improved in the north (reaching a score of 3.12, p=0.014). Scores on service experience and quality of life fluctuated significantly in high-risk areas, with signs of recovery and improvement over time.

These findings indicate both vulnerability and resilience among recipients of psychiatric rehabilitation services during wartime. The results underscore the importance of adaptable, community-based mental health rehabilitation systems and support the development of policies focused on service continuity, preparedness, and psychosocial recovery in conflict-exposed regions.