Over a period of two weeks during July, five soldiers died by suicide. One of them survived the attempt but days later succumbed to his injuries.
These are not statistics. These are young lives, families in emotional pain, army units in shock, and a country struggling to absorb the psychological toll of a war that has not ended.
Since October 7, Israel has been under relentless attack, first from Gaza, then Lebanon, then Yemen, and most recently from Iran. However, not all threats are external. The question we now face is not only how to protect our borders, but also how to protect those who are defending them.
There have been several publicized cases recently where Nova survivors or soldiers had reached out for help. Some even asked to be hospitalized. That raises a hard, human question: Should asking to be admitted be enough? And why are some turned away?
In a moment like this, when the entire country is on edge, the instinct to say yes – to admit everyone, just to be safe – is deeply understandable. But is that always the right path? Is it always the safest one?
A hospital bed is not always the answer
In an ideal world, anyone with a suicide plan or clear intent to act would receive immediate, protective care. Indeed, many clinicians and researchers would argue that this is the ethical standard. But that ideal meets a difficult reality in Israel.
We have one of the highest psychiatric bed occupancy rates in the OECD – about 92%. One of the reasons for this strain is structural: psychiatric hospitals in Israel are also used to care for long-term patients who may not need high-intensity acute care.
In addition, about 10% of the beds are occupied due to court orders for hospitalization – either for a psychiatric evaluation or as an alternative to imprisonment due to mental illness.
Experts estimate that up to one-third of psychiatric inpatients could be treated in lower-intensity, community-based facilities, options that would not only cost less to the system but also free up beds for people in crisis. But such frameworks have not been created.
Unlike France or parts of the US, Israel – like the UK, the Netherlands, and Scandinavia – sets a higher threshold for psychiatric admission.
Involuntary hospitalization is legally reserved for those who are both an immediate danger to themselves or others and lack the capacity to make informed decisions, typically due to psychosis. Lucid individuals, including soldiers, are assessed on a case-by-case basis.
Who gets admitted?
Prof. Eyal Fruchter, chair of Israel’s PTSD National Council and director of medical and scientific affairs at ICAR Collective, puts it clearly:
“The fact that someone asks to be admitted should always be taken seriously, but it cannot automatically lead to hospitalization. We must balance compassion with clinical judgment and bed availability.”
Clinical judgment also means recognizing that hospitalization is not without risks. It can disorient, intensify feelings of shame, or leave individuals more vulnerable upon discharge.
This doesn’t mean we deny care when it’s needed. It means we have to make each decision carefully, and we must invest just as much energy in what happens when hospitalization is not the outcome.
Suicidal ideation is far more common than most of us realize – and most people who experience it are not on the brink of taking their own lives. A 2021 study estimated that lifetime suicidal ideation affects 7.8% of adults, while only 1.6 to 1.8% have ever made a plan or attempt.
That’s roughly one in 13 people with thoughts, most of whom will never act.
As Dr. Yossi Levi-Belz, chair of the Lior Tsfaty Center for Suicide & Mental Pain Studies at Ruppin Academic Center and a member of ICAR Collective’s Scientific Advisory Board, explains:
“Suicidality exists on a spectrum. Most people who experience suicidal thoughts do not want to die. They want the pain to stop.”
The goal must be to ensure that professionals are equipped to recognize who is most at risk and respond, even when admission isn’t possible. That means every person turned away should leave with a written safety plan, including input from their support system.
They should receive a follow-up call within 24 to 48 hours. They need to know what to watch for, when to return, and who to call.
We need real, accessible alternatives to inpatient care: safe, structured settings that can hold people in crisis, and help them regulate, reorganize, and reconnect with their families without requiring full psychiatric hospitalization.
Today in Israel, most step-down facilities (an alternative to psychiatric hospitals) and partial hospitalization programs (day treatment) will not accept suicidal individuals because they lack the staffing for continuous supervision.
An investment in facilities designed specifically for people at suicidal risk, with follow-up support after discharge, could save lives and reduce the revolving door of hospitalization.
The hard truth
What Israel is facing right now isn’t only a military emergency. It is a population-wide mental health crisis. We cannot hospitalize our way out of it. If this is the start of the post-war suicide wave that many experts have warned us about, more beds will not be enough.
In fact, over-admitting can stretch resources so thin that others, who are equally or more vulnerable, are left without any safety net. This is not a call to lower the threshold for care. It is a call to widen the lens.
If we are serious about protecting lives, we must look at every point of failure along the pathway of care. That includes rethinking how we allocate psychiatric beds, how we build and staff community-based alternatives, and how we follow through when hospitalization isn’t the outcome.
The bottlenecks are not only in the emergency room. They are upstream and downstream, across the entire system. We owe our soldiers and our citizens a response that is not only reactive but also responsible.
One that recognizes the full range of risk, the limits of the system, and the obligation to meet people where they are and with care that works.
Lives are at stake, and so is our moral clarity.
The writer is executive director of ICAR Collective.