“In recent years, it has become increasingly evident that primary care physicians are encountering a growing number of patients presenting with symptoms of anxiety and depression,” says Dr. Marina Mor Shalom, deputy head of Maccabi Healthcare Services’ medical division and initiator of a comprehensive 12-year study examining mental health trends among insured patients.
“We wanted to determine whether this pattern reflected a broader phenomenon across the entire member population.”
Findings confirm a significant rise in mental health-related presentations. Between 2013 and 2024, the number of individuals seeking care from primary care physicians for depression and anxiety rose by 94%—from 146,000 to 284,000 patients. While total visits to primary care increased by 82% during that period, visits specifically by patients with these conditions surged by 117%, from 1.6 million to 3.5 million annually.
Dr. Mor Shalom attributes part of this growth to increased psychological distress following the Gaza War. “Many of the patients I now see had no prior history of mental illness. The war changed that. And I believe we’ve yet to see the full psychological ramifications,” she notes.
Although the study did not examine causality, researchers suggest that the surge reflects rising demand for care, compounded by systemic limitations, such as insufficient availability of mental health professionals and extended wait times for psychiatric and psychological services. “Primary care physicians are often the most accessible point of contact,” Dr. Mor Shalom adds.
Data also show individuals with depression and anxiety utilize medical services at higher rates, with an average of 14.2 visits per year to a primary care physician in 2024, compared to 9.8 visits among the general population. These patients accounted for roughly one-quarter of all primary care visits that year. Additionally, the proportion of members purchasing psychotropic medications has increased by 35% since 2013.
Gender disparities are also notable: 64% of patients seeking care for anxiety or depression in primary care settings are women. The study, conducted by Maccabi’s medical division in collaboration with its Applied Research and Evaluation Department, analyzed records of all adult members, aged 18 or older, from 2013 to 2024. The 2015 mental health reform, which transferred responsibility for mental health services from the Health Ministry to the HMOs, appears to have contributed to the growing number of individuals accessing support within primary care.
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According to Dr. Mor Shalom, the system must evolve to meet this growing demand. “We need to stratify care more effectively and train additional providers to deliver brief, targeted interventions for mild to moderate mental health conditions, particularly anxiety and depression,” she explains. “Primary care physicians are already authorized to initiate treatment, prescribe psychiatric medication, and refer patients when appropriate. But they should also be equipped to deliver short cognitive-behavioral interventions within the primary care visit itself.”
Dr. Mor ShalomPhoto: Maccabi Healthcare ServicesThe study further found that patients with depression and anxiety experience higher rates of comorbid chronic conditions compared to the general population. Approximately 84.2% of those presenting with these mental health concerns also require secondary care (excluding psychiatric services). They are more likely to visit emergency departments and to be admitted to internal medicine wards.
“Primary care physicians are well-positioned to address mild psychiatric conditions,” Dr. Mor Shalom concludes. “Expanding their capacity to do so can also reduce stigma. Despite mental health reforms, some individuals still feel uneasy about seeking care from a psychiatrist. Receiving support from a trusted primary care physician may provide a more approachable first step.”