ÌÇÐÄvlog

QuestionÌý What is the short-term outcome of the October 7, 2023, terror attack on suicidality in Israel?

FindingsÌý In this cohort study of 602 323 calls made to the Israeli Association for Emotional First Aid between January 1, 2022, and December 31, 2023, an increase was observed in the frequency of overall calls after October 7, 2023, followed by a gradual decrease, whereas the amount of suicide-related calls remained stable in the 3-month period after the attack. Therefore, the percentage of suicide-related calls decreased at first and then gradually increased.

MeaningÌý Results suggest that at least in the short term, suicide-related reactions appeared to be different than other emotional reactions to a national trauma.

ImportanceÌý Changes in suicide rates after a nationwide trauma may be different from changes in psychiatric symptoms or general distress after such events. However, very few studies have examined short-term suicide-related reactions after such an event.

ObjectiveÌý To evaluate the short-term outcome of the events in Israel on October 7, 2023, a large-scale terror attack and unfolding war, on changes in suicidality as reflected in percentages of suicide-related calls in relation to all calls to a national mental health first aid helpline, the Israeli Association for Emotional First Aid (ERAN).

Design, Setting and ParticipantsÌý The data included all interactions via the various ERAN helpline services between January 1, 2022, and December 31, 2023.

ExposuresÌý The October 7, 2023, terror attack on Israel.

Mean Outcomes and MeasuresÌý Changes in the numbers of overall calls and suicide-related calls to the ERAN helpline using an interrupted time-series analysis.

ResultsÌý A total of 602 323 calls were received by the ERAN helpline. The number of calls reflecting psychological distress in the 3 months before October 7, 2023, was 67 555 compared with 89 445 calls in the 3 months after. Analysis indicated that overall calls increased significantly on October 7 (β = 2089.16; 95% CI, 1918.97-2259.35). In addition, the daily trajectory of all calls changed significantly after October 7 (β = −22.77; 95% CI, −33.37 to −12.16), such that there was a decrease in the number of calls per day (β = −11.34; SE = 1.213; t = −9.35; P < .001). The number of suicide-related calls in the 3 months before October 7 was 1887, whereas 1663 suicide-related calls were registered in the 3 months after. Analysis showed that there were no changes in the daily number of suicide-related calls from before October 7 (β = −0.001; 95% CI, −0.005 to 0.03) or on October 7 (β = −0.22; 95% CI, −3.69 to 3.25). Therefore, the percentage of suicide-related calls decreased significantly on October 7 (β = −1.42; 95% CI, −1.92 to −0.92) and gradually increased in the following period (β = 0.016; 95% CI, 0.006-0.026).

Conclusions and RelevanceÌý The findings of this cohort study suggest that although short-term emotional distress increased after national trauma, the percentage of suicide-related calls decreased. These results support previous studies suggesting that suicidality is not one of the immediate reactions to such traumas.