Real-time emotional distress during a national trauma: Changes in suicidality, depression, and loneliness among helpline users in the aftermath of October 7, 2023 terror attack in Israel

Importance: Digital chat-based helplines provide a real-time view of population distress during mass trauma. Few studies have tracked how suicidality, depression, and loneliness evolve when crisis strikes. Objective: To quantify help-seeking for suicidality, depression, and loneliness among Israeli helpline users before and after the October 7, 2023, terrorist attack and the subsequent war, using time-series text data from a national digital mental-health platform. Design, Setting, and Participants: We conducted an observational cohort analysis of 17,523 anonymized text chats at the Sahar helpline across two 8-month periods: pre-crisis (Oct 7, 2022–May 31, 2023; n = 6,020) and crisis (Oct 7, 2023–May 31, 2024; n = 11,503). All chats occurred during identical service hours. We used Facebook's Prophet model, chi-square and z-tests, and segmented linear regression. Main Outcomes: Proportions of chats classified as suicidality, depression, or loneliness; deviations from expected pre-crisis forecasts; and demographic shifts by age and gender. Results: The crisis period saw a decrease in the share of suicidality-related chats (17.8 % → 12.9 %; Δ = –4.9 pp) and depression-related chats (17.8 % → 8.2 %; Δ = –9.6 pp; both p < 0.001). Loneliness-related chats, however, rose (14.7 % → 19.0 %; Δ = +4.3 pp; p < 0.001). Prophet forecasts trained on pre-crisis data under-predicted crisis loneliness peaks and depression troughs, indicating major departures from baseline. Regression confirmed an initial spike followed by gradual adaptation in help-seeking. Conclusions and Relevance: National trauma reshapes not only overall help-seeking volume but also the content of distress: acute loneliness surges even as suicidality and depression expressions recede. These findings argue for real-time digital surveillance to guide targeted loneliness-reduction and social-connection interventions during crises.