Ukraine faces mental health crisis as country braces for third winter of attacks by Russia
By Lottie Kilraine, ITV News Deputy Content Editor
As Ukraine braces itself for a third winter under attack from Russia, an additional invisible crisis is emerging.
There are already an estimated 10 million people at risk of mental health problems in Ukraine, ranging from mild to severe, according to the World Health Organisation (WHO).
Around 44% of Ukrainian children show signs of post-traumatic stress disorder (PTSD), a study by the Olena Zelenska Foundation - funded by foreign donations and the Kyiv School of Economics - revealed earlier this year.
However the figure is thought to be almost double that, according to Beyond Conflict, a mental health charity for victims of war.
"These statistics are both harrowing and disturbing but sadly unsurprising," Edna Fernandes, the charity's founder and executive director, told ITV News.
"In June this year, Beyond Conflict co-hosted an international panel event on the mental health impact on children of warfare, where an expert from Ukraine’s PTSD taskforce said 80% of Ukrainian kids suffer some form of post traumatic stress.
“PTSD can manifest in a range of symptoms from panic attacks and depression to self harm and suicidal thoughts.
"This is a shocking indictment of the war in Ukraine and other conflicts waged upon children, as well as adult civilians."
Ukraine's national mental health programme, led by the First Lady and supported by WHO, has been scaling up rapidly, but demand still far outweighs supply.
About 300,000 Ukrainians complained about mental health to primary care doctors in the first seven months of 2024, according to data released by the Ukrainian Health Ministry last week.
From January to July, around 276,926 patients received medical assistance under the package 'support and treatment of adults and children with mental disorders at the primary level of medical care' - and of that, 42,458 of them are children under the age of 17.
The most common complaints and diagnoses reported were feelings of anxiety, nervousness, or tension (117,037 patients); sleep disorders (76,548 patients); depression (16,170 patients); and memory impairment (10,274 patents).
"Despite the immense challenges of the ongoing war, Ukraine has demonstrated remarkable resilience," Kateryna Bulavinova, a UNICEF medical expert in Ukraine, told ITV News.
"Anxiety is also driven by the uncertainty people face in the third year of war. A major focus of our work is loss and grievance – as people lose loved ones, homes, life as they knew it before."
But factors including stigma around mental health means the data is most likely skewed - with figures expected to be far higher, according to Valeria Kovtun, a Ukrainian misinformation specialist.
"Many older generations of Ukrainians struggle with identifying and discussing their emotions," Ms Kovtun said.
"The legacy of the Soviet era has particularly impacted men, who often view expressing emotions as a sign of vulnerability and 'unmanliness'.
"This mindset can lead to respondents being less honest about their experiences or unable to accurately identify their feelings, making it difficult for them to articulate what they are going through."
Russia has made gains in the east of Ukraine since its initial invasion in February 2022, but last month saw the launch of an unexpected incursion by Kyiv into Russia's bordering Kursk Oblast.
The morale boost of the assault is already faltering, with the harsh conditions of winter approaching and still no clear end in sight for Ukraine's exhausted population.
Charities are calling for mental health to become a "frontline priority" both on the battlefield and in civilian spaces, claiming it is a vital building block for future peace.
Among the solutions are Community Mental Health Teams (CMHTs), consisting of a psychiatrist, psychologist, social worker and a nurse. While charities like Beyond Conflict and other NGOs are also using techniques including music, art and talking therapies.
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Since the beginning of the war, hospitals hosting CMHTs have shown better preparedness to support their patients due to their mobility and innovation, according to WHO.
"When I visited Kyiv in July 2023, I saw first hand how art therapy and talking therapy can help those who’ve faced unimaginable horrors, from witnessing the killing of loved ones to rape," Ms Fernandes said.
"Mental health must become a frontline priority for humanitarian aid in all wars. That means training more local frontline workers and mental health workers to address the vast and urgent need.
"We must also break the stigma attached to mental health, so civilians feel able to reach out for help in war zones."
Edna Fernandes, who founded the charity Beyond Conflict, told ITV News that without dealing with the psychological fallout of conflict there can be no enduring peace
UNICEF has reported that they are now starting to see a gradual shift, with a slight reduction in feelings of shame around discussing mental health issues in the region.
"It is encouraging to see that people seek mental health support, moving away from the previous tendencies to dismiss mental health concerns with comments like 'I’m coping' or 'I can handle it on my own'," Ms Bulavinova said.
"The number of people requesting mental health support indicates that Mental Health and Psychosocial Support Services (MHPSS) in Ukraine are starting to work and are scaling up.
"After all, mental health services at the primary healthcare level is a recent addition to the scope of services."
However, these efforts and the mental health care available has been described as a "drop in the ocean" compared to the need for more services on the ground.
"War trauma is handed down from one generation to the next. This is not only about Ukraine’s children’s future - it is for all our futures,” Ms Fernandes added.
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