Dr. Tatiana Zalozhin, director of the mental health system of Klalit Haifa and Western Galilee, tells about the most challenging year in the history of the health system in Israel
"We had to learn the complex situation on the fly, and really, we found a lot of creative solutions. The teams are dedicated above and beyond, and gave much more than 100 percent of themselves"
On the morning of October 7, the health system in Israel entered the most challenging period in its history, the likes of which it has never known. "For years we have been preparing for emergency situations, but the current state of emergency, which began on October 7, 2023 and continues to this very day, with the war in the background, is unprecedented," says Dr. Tatiana Zalozhin, director of the mental health system of Klalit Haifa District "We had to learn the challenging situation on the fly, and really, we found a lot of creative solutions. The teams were dedicated above and beyond, they reached every point in Israel, where they were needed, and gave much more than 100 percent of themselves."
Dr. Zelozhin, a specialist in psychiatry, has treated difficult cases during her many years of work, but nothing, she says, prepared her for the current situation. Although the corona virus that broke into our lives at the end of 2019 was a kind of promo, since even then there was an increase of approx. 50 percent of the number of people applying for mental health, and yet, the horrors of October 7 presented the system with much more complex challenges.
Dr. Zolzhin: "The events of October 7 brought with them a wave of applications from Nova survivors, family members of the murdered, family members of IDF martyrs, families of abductees, abductees who returned. These are populations that in normal times would not have come to us, and now they have come in droves. In all of this it is important to remember that our teams also experienced, and some of them are still experiencing, a difficult period, and we were also required to 'take care of caregivers'. In some of the families, the owners were drafted into the reserves for a long time, not all the children have frameworks now, and for them Klalit opened summer camps for the children of the workers."
Tell us a little about the activity of the mental health system with the evacuees.
"At the beginning of the war, Eilat received the largest number of evacuees, and there was only one unified clinic (of all the funds) for mental health. Since the number of referrals was so large, they asked us for reinforcements and help. This required us to organize a bit, because we had to cancel appointments, And in the end we sent to Eilat, and later to the Dead Sea, delegations of therapists, mainly psychotherapists, and two doctors. The delegations worked there every week from seven in the morning to five in the afternoon. At first the treatments were carried out in hotels and even by the pool , and later an organized clinic was established, so that all applicants received torture."
Dr. Zolzin tells about Dr. Anatoly Krainin, a specialist in psychiatry, who these days you can meet him at the mental health clinic in Ibn Sina in Haifa. According to her, when the many evacuees from the north started arriving at the hotels in Haifa, Dr. Krainin reached them. "In the beginning we did a tour to characterize the needs. It should be remembered that more than 10,000 evacuees arrived at the hotels in Haifa at the beginning of the war. Some of them could not leave the hotel, for one reason or another, most of them did not know the surroundings at all. Dr. Krainin visited each patient up to his hotel room."
Another activity by the teams of Klalit's mental health system was carried out at Kibbutz Mishmar Ha'Emek. Dr. Zolzin: "Evacuates from the south arrived at Mishmar Ha'emek already on Tuesday night, where we sent teams of psychologists and a child psychiatrist to assess the situation. There were quite a few difficulties, for example, elderly parents staying in nursing homes in the south, when the whole family is actually here."
The general rule of thumb in recent years has been a huge technological transformation, especially in everything related to the digital field. Consultations with a doctor online and receiving treatment remotely have become a matter of routine, with the introduction of the best innovations. The digital platform also proves itself in times of war, and Dr. Zolzin says: "We performed many treatments by telephone or video call. My computer has the patient's entire medical file, and in this way I can also issue him prescriptions. We performed a lot of psychotherapy online, and it proved itself. This eliminates the need for the patient to go to the clinic."
The care of the Nova survivors
A complex patient population is that of Nova Party survivors, who experience severe post-traumatic stress. Some of them lost friends and family members, and they themselves experienced moments of unimaginable horror. For them, the mental health system of Klalit Haifa and Western Galilee established a rapid treatment track.
Dr. Zolzhin expands: "Nova survivors are in a complex mental state. They cannot wait in line for a psychiatrist, psychologist or occupational therapy. They need the treatment here and now. Therefore, each Nova survivor first enters three immediate intervention sessions. He undergoes a psychiatric evaluation, according to which the psychiatrist builds a plan for him Treatment - whether it's medication, psychological therapy, psychotherapy, etc., and another path is group therapy."
About the situation of the Nova survivors, Dr. Zolzin says: "Some of them are in a very difficult situation. They refused to leave the house for the first few weeks, and this required remote therapeutic interventions. The families of the patients didn't really know how to deal with the difficult situation either, and it should be remembered that many families went to the badlands to look for their loved ones, and not all of them were found alive. The Nova survivors are accompanied by a lot of guilty feelings of 'why did I survive, but my best friend was murdered'. They suffer from complex post-traumatic stress disorder, can't sleep, not even with the medication."
In Ma'al-Tarshiha, Dr. Zolzin's hometown, there is a mental health clinic, many of whose patients these days are members of the security forces, who live in the nearby Druze villages. For them, the clinic runs therapeutic groups, with each group numbering between eight and ten patients. homogeneity," explains Dr. Zolzin, "although each of the patients experienced a different traumatic event, but the symptoms and coping are very similar. It greatly strengthens a patient to know that he is not alone, that he is not the only one and that there are other people with the same coping. The group is led A psychologist whose specialty is trauma treatment. Currently, there is one such group in Ma'al-Tarshiha, and soon we will open such groups in other clinics. Another advantage of the group therapy is that there are waiting lists, because this way you don't receive one person for treatment, but ten together It's a very comprehensive, empathetic and comprehensive treatment."
Cooperation with the "Peg Program"
A legal unit operates in the general district of Haifa and Western Galilee, the core of which is drafting opinions for courts. The team of the legal unit includes clinical criminologists, who are all psychotherapists specializing in the treatment of populations at risk, extreme populations and populations of dual morbidity. Since the outbreak of the war, the members of the unit have been working on another level, and Dr. Zolzin explains: "We joined the 'Yidd Program', which is a national program that helps young men and women in risk situations aged 26-18, in various fields such as employment, housing, recruitment, insurance national etc. Many times these are young people who have dropped out of the various frameworks and do not have the ability to use medical services or mental health services, the process does not include waiting, there are no queues and there is no unnecessary bureaucracy."
According to Dr. Zolzin, the treatment of post-trauma is extremely important, and these days it is nothing less than a national effort. More than once, post-trauma causes separation between spouses, because not everyone knows how to deal with it, and it's a shame, because there is a treatment for it. No person should be left alone with post-traumatic stress disorder."
In conclusion, what do you wish us for next year?
"May it be a different year than the last five years, since since 2019, when the corona epidemic broke out, we are in a different reality. I wish that our plans did not depend on external environmental factors, that we would finally have a boring routine, and that our only concern would be where we would fly on vacation."