Ukraine: the impact of conflict on mental health
The conflict that began on 24 February this year on Ukrainian territory has exacerbated the vulnerabilities of populations already psychologically weakened by eight years of conflict in the Donbass region. In a matter of weeks, mental health has only worsened, requiring urgent care and follow-up.
Medical visit to Krasnohorivka in Donetsk Oblast, Ukraine, © Sadak Souici I Première Urgence Internationale
ACTION IN MENTAL HEALTH SINCE 2015
Première Urgence Internationale has been present in Ukraine for seven years now, initially to support the populations most affected by the war in the Donbass. The distress of the population caused by the conflict and exacerbated by the Covid-19 pandemic over the last two years has only aggravated the lack of access to mental health and psychosocial support services, despite the high demand. People who were receiving psychological care before the Russian attack in February saw their access to quality care diminish or even be completely cut off. In such a context of insecurity, vulnerable people are more likely to develop mental health problems.
Initially present in the Donetsk region, along the line of contact separating the areas not controlled by the Ukrainian government from those still controlled by it, Première Urgence Internationale must now extend its field of operation in the face of the sudden and massive intensification of the conflict. Our global approach in the country places a strong emphasis on several sectors, including health, access to water, hygiene and sanitation in health infrastructures, and mental health services.
The availability and access to mental health and psychosocial support services is essential. This is confirmed by Ukrainian psychologist Natalia Kotsar, who is part of the Première Urgence Internationale team in the Donetsk region:
“It is important to help survivors express themselves, react to intense emotions, support themselves, understand the new reality and find the resources and strength to make decisions.”
PSYCHOLOGISTS IN ACTION IN THE FIELD
Today, five psychologists from Première Urgence Internationale intervene at their level, via telephone support from a distance to their former patients. Some of them manage to organise some activities with children and their parents in the shelters and bomb shelters.
Natalia Kotsar testifies to the actions undertaken by psychologists in the field, particularly in the town of Kostiantynivka in the Donetsk region in the east of the country:
“We contact local authorities, social services and volunteers, clarify needs, provide support to the displaced and the population of the town, work with adults (staff of public institutions, refugees, teachers, medical staff), lead support groups where everyone can talk without judgement, work with children using art therapy methods, in the form of play”.
Andrei, another psychologist currently working in eastern Ukraine in the town of Bakhmut, describes his activities since the beginning of the conflict:
“Recreational sessions are organised in Bakhmut to support children and their parents, to create a small island of safety and celebration. We hold sessions with play dough and offer refreshments and sweets. The children started to open up and show their abilities, they became more free, it is easier to interact, although the composition of the group changes all the time. The main thing was emotional support. Parents were given advice not only on how to interact during a crisis, but also on how to understand the child’s world correctly on a psychological level, less criticism and aggression, and more love, attention, support and interaction”.
INCREASED VULNERABILITY DUE TO THE CONFLICT
Since the Russian military offensive, the number of people in need of psychological support has increased dramatically. Women, the elderly, the homeless, people with disabilities and health workers are particularly in need of mental health services, according to a UN report. Indeed, health workers face a specific health context and an often difficult working environment, due to the fear of transmitting Covid-19 to relatives or friends, the lack of protective equipment or witnessing large numbers of deaths since the beginning of the war, especially in the Donetsk region, in the heart of Donbass.
Première Urgence Internationale’s actions specifically consist of technical support and awareness-raising on mental health issues for health facility staff in order to prevent psychosocial risks among them through basic training in stress management and psychosocial support. Teams of target health and social institutions in governmental areas of eastern Ukraine are also strengthened in their capacity to provide emotional and psychosocial support to patients and residents.
However, with the increase in fighting in this region, interventions are increasingly complicated to implement, communication systems (telephone and internet) are unstable and more and more people are evacuating the region. Première Urgence Internationale is adapting its activities on a daily basis to meet the needs of a maximum number of vulnerable people.