Addressing the mental health crisis for Ukrainians in war and peace

Russia’s ongoing military operations pose not only a threat to the physical health of Ukrainian civilians, but also a serious threat to their psychological well-being. Psychological consequences of trauma are often overlooked and are mostly invisible. Therefore, mental health care resources are generally not prioritized. This neglect is a mistake. Humanitarian responses, including support from host countries, donors and intergovernmental organizations, must address both the immediate and long-term mental health needs of Ukrainians.

Before the war, mental illnesses such as depressive disorders and post-traumatic stress disorder (PTSD) were the second leading cause of disability in Ukraine, affecting about 30 percent of the population. The country already had one of the highest suicide rates in the world. Access to evidence-based mental health care, lack of trust in the mental health care system, and stigma surrounding mental health were serious barriers even before the war.

Since February 24, families have been torn apart and over 5 million children have been forced from their homes, according to UNICEF; in other words, these are two out of three Ukrainian children who were displaced. Bombings, the loss or separation of loved ones, and fleeing shelling and gunfights are just some of the atrocities that characterize the daily lives of Ukrainians today, including the timing of these bombings, which often take place at night and contribute to sleep deprivation and ongoing anxiety.

Recent studies have shown that in conflict zones, an estimated one in five people will develop psychiatric conditions such as bipolar disorder, schizophrenia and major depressive disorder. Given the far-reaching scale of this unsolicited war, millions of Ukrainians, young and old, are at risk of potentially developing mental illnesses in the future. At present, Ukrainians continue to experience traumatic events such as sexual and physical assaults or violent deaths and injuries. Psychological distress in individuals exposed to conflict can manifest as anxiety, fear of isolation, tearing, insomnia, nightmares, and more. Additionally, unfortunately, adults and children with pre-existing mental health needs or neurodevelopmental disorders such as autism have not been prioritized in Ukraine. Therefore, the lack of access to care provided by well-trained professionals is exponentially amplified by the war.

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Establishing short- and long-term mental health solutions across Ukraine and in host countries is essential.

In addition to addressing mental stress, initiatives should also focus on strengthening mental well-being, which includes developing resilience and coping strategies. For example, Dr. Sergiy Bogdanov, associate professor at Kyiv-Mohyla National University and clinical psychologist, offers an excellent model; He and his colleagues have worked on these parallel issues for years, and have redoubled their efforts in response to the war. dr Bogdanov’s group applies tools and approaches they tested in collaboration with Johns Hopkins University and treats symptoms of depression, anxiety and traumatic stress. Although they already provide mental health care in several centers across Ukraine, they recently opened a new treatment center in Bucha, the site of significant violence and killings near Kyiv, to meet the urgent mental health needs of people in that region to become. At the same time, Dr. Bogdanov, teachers and school psychologists in Safe Space, an intervention to promote resilience and early intervention for children and young people, and is expanding his efforts across Ukraine.

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When considering long-term solutions to the mental health crisis in Ukraine, improving mental health needs assessment and preventing the development of psychiatric disorders should be given high priority.

In Ukraine, long-term funding for mental health interventions and coordination between national and international partners will be important to ensure that the psychosocial support offered to affected Ukrainians is sustainable. There is also a need to train health professionals in evidence-based approaches to mental health that target trauma, such as B. prolonged exposure or cognitive processing therapy. Other efforts could include providing training for teachers and pediatricians to improve their ability to identify and recognize mental distress in children.

For displaced Ukrainians, host countries must work to ensure access to affordable mental health care and minimize social isolation among refugees. For example, social inclusion policies that improve quality of life and adjustment could focus on language learning and building social support networks.

Developing a coordinated response to the pre-war mental health crisis in Ukraine, which has been greatly exacerbated by the current tragedy, is crucial. Strong efforts to address mental health needs are gaining momentum; in particular, the First Lady of Ukraine, Olena Zelenska, is at the forefront and is committed to strengthening Ukraine’s mental health and psychosocial systems and programs. In essence, promoting the mental health and recovery of Ukrainians requires recognition and intervention both during and after the war.

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Allies can help by maintaining both the current acute perspective and a long-term view; This includes supporting special care now and remaining committed to helping Ukrainians recover, rebuild and expand mental health care beyond the time of war.

Kimberly M Hook, PhD, MA, is a licensed psychologist who – ssince 2018 – has collaborated with academic and NGO partners in Ukraine on mental health care delivery and research. She is one too Research Fellow at Harvard TH Chan School of Public Health.

Jacqueline A. Hart, MD, is Director ofBassuk Center for homeless and vulnerable children, families and youthin Needham, Mass., which works with communities and organizations nationally to advance housing, health and other opportunities for individuals and families. She has over 20 years of experience in lifestyle, behavioral and integrative medicine, applying these principles to vulnerable populations and marginalized communities.

This guest post also benefited from contributions from: Mark C. Poznansky, MD, PhD., FIDSA, Director ofCenter for Vaccines and ImmunotherapyDepartment of Infectious Diseases, Massachusetts General Hospital, Professor of Medicine at Harvard Medical School and co-founder of Heal the Ukraine group; Alice Barocco, Medical Biosciences student at Imperial College, London; Dmitriiy Dribinskiy, Founder and Director of Autism Unity; Yulika Forman, PhD, LHMC, Counselor and Special Education Advocate.

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