The ongoing military operation by Russia not only poses a threat to the physical health of Ukrainian civilians, but also poses serious risks to their mental health. and almost invisible. As such, mental health care resources are generally not a priority. This ignorance is wrong. A humanitarian response, including support from host countries, funders and intergovernmental organizations, must address the immediate and long-term mental health needs of Ukrainians.

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

According to UNICEF, families have been torn apart since February 24, displacing more than 5 million children from their homes. In other words, this means that two of her three Ukrainian children have been displaced. Bombing, loss or separation of loved ones, fleeing shelling and shooting are just some of the atrocities that characterize everyday Ukrainian life. The timing of the bombings often occurs at night, contributing to sleep deprivation. and anxiety that follows.

A recent study estimates that one in five people in conflict-affected areas will develop a mental illness such as bipolar disorder, schizophrenia or major depressive disorder. Given the far-reaching scope of this unwanted war, millions of Ukrainians, young and old, are at risk of developing mental illness in the future. Currently, Ukrainians continue to experience traumatic events such as exposure to sexual and physical assaults and violent deaths and injuries. , fear of isolation, tears, insomnia, nightmares, etc. In addition, adults and children with pre-existing mental health care needs and neurodevelopmental disorders such as autism are unfortunately not a priority in Ukraine. The lack of it is exacerbated exponentially by war.

Establishment of short-term and long-term mental health care solutions throughout Ukraine and in host countries is essential.

In addition to treating mental health distress, initiatives should also focus on enhancing mental well-being, including developing resilience and coping strategies. For example, Dr. Sergiy Bogdanov, an associate professor and clinical psychologist at the State University of Kyiv-Mohyla Academy, provides an excellent model. He and his colleagues have been grappling with these parallel issues for years, and have doubled down on their efforts in responding to war.Bogdanov’s group, in collaboration with Johns Hopkins University, tested applied tools and approaches to treat symptoms of depression, anxiety, and traumatic stress. Already providing mental health care in several centers across Ukraine, we recently opened a new treatment center in Bucha, a site of serious violence and killings near Kyiv, to address the urgent mental health needs of people in the region. At the same time, Dr. Bogdanov is training teachers and school psychologists in Safe Spaces, an intervention that promotes resilience and early intervention in children and adolescents, and is expanding its efforts across Ukraine. doing.

When considering long-term solutions to the mental health crisis in Ukraine, improving identification of mental health needs and preventing the onset of mental illness should be a top priority.

In Ukraine, long-term funding for the mental health response and coordination among national and international partners are needed to ensure that the psychosocial support provided to affected Ukrainians is sustainable. becomes important. Training of health professionals in evidence-based mental health approaches to trauma, such as long-term exposure and cognitive processing therapy, is also needed. Other efforts include providing training to teachers and pediatricians to improve their ability to screen for and recognize mental health distress in children.

For displaced Ukrainians, host countries must ensure access to affordable mental health care and work to minimize the social isolation of refugees. For example, social integration interventions that improve quality of life and adaptation can focus on language learning and establishing social support networks.

The pre-war Ukraine’s mental health crisis has been severely exacerbated by the current tragedy, and it is critical to deploy a coordinated response. Strong efforts to address mental health needs are gaining momentum. In particular, Ukrainian First Lady Olena Zelenska is a leader and advocate for strengthening Ukraine’s mental health and psychosocial systems and programs. In essence, advocating for the mental health and recovery of Ukrainians requires awareness and intervention both during the escalation of the war and after it is over.

Allies can help by maintaining both a sharp current perspective and a long-term perspective. This includes supporting specific care now and remaining involved in helping Ukrainians to recover, rebuild and expand mental health services beyond wartime.

Kimberly M. Hook, PhD, MA, teeth licensed psychologist WhoseSince 2018 — Working with Ukrainian academic and NGO partners in mental health care delivery and research. she also Fellow at the Harvard TH Chan School of Public Health.

Jacqueline A. Hart, Md.Basque Center on Homeless and Vulnerable Children, Families and YouthLocated in Needham, Massachusetts, it works with communities and organizations across the country to promote housing, health and other opportunities for individuals and families. She has over 20 years of experience in the fields of lifestyle, behavioral medicine and integrative medicine, applying these principles to vulnerable and marginalized communities.

This article has also benefited from contributions from: Mark C. Poznansky, MD, PhD., FIDSA,Vaccine and Immunotherapy CenterDivision of Infectious Diseases, Massachusetts General Hospital, Professor of Medicine, Harvard Medical School, and co-founder heel ukraine groupAlice Barocco, studying Medical Biosciences at Imperial College, London; Dmitriiy Dribinskiy, Founder and Director of Autism Unity. Eureka Forman, PhD, LHMC, Special Education Consultant and Advocate.