Not all alerts from Zabbix come through as tickets as that would be a nightmare.
In order to send alerts, the CRST IT Helpdesk user on Zabbix needs to be added to a group that contains the hosts needing to be monitored via tickets.
As you can see below the CRST IT Helpdesk user has "[email protected]" as a media type meaning emails should get sent to it when problem arise with hosts:
Note: In addition to being in the correct groups, only High and Disaster severity alerts are enabled on this user.
However, the user must have explicit permissions to the hosts requiring helpdesk tickets. Click onto the helpdesk group and add the host groups containing the host with read permissions.