An Evidence-Informed Framework for Treating National Mass Trauma During Ongoing War

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The October 7, 2023, attack on Israel and the ensuing war created widespread distress and an urgent need for trauma-informed mental health care. This article describes "Homiyah," a nationwide Israeli initiative led by local and international psychiatry, psychology, and trauma care experts to promote evidence-based treatment during ongoing mass trauma. The framework, developed in response to unprecedented events, began with nationwide training of public-sector mental health professionals (N=153) in evidence-based, trauma-informed care. Subsequently, experts refined training, expanded initial workshops into semiweekly clinical meetings, used a train-the-trainer model, and identified clinical leaders to guide teams with biweekly online peer consultation. Next, the initiative focused on developing evidence-based guidelines for trauma care centers and screening protocols to support a personalized approach to trauma care, integrating routine outcome monitoring to inform treatment decisions and improve effectiveness through patient-reported outcome measures and measurement-based care. Finally, national stakeholder engagement was achieved through a 2-day consensus conference and the dissemination and implementation of guidelines across the mental health system. This scalable, evidence-informed model demonstrates how interdisciplinary collaboration, rapid mobilization, and implementation science can translate research into practical clinical responses to strengthen recovery, resilience, and mental health system readiness under mass trauma conditions.

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