Attachments
Executive Summary
Since February 2022, Ukraine has been facing extensive challenges due to Russia’s invasion, resulting in violence, displacement, suffering, forced evacuations, property damage, and traumatic experiences. As of May 2023, 17.6 million people need humanitarian assistance and, according to the World Health Organization (WHO), it is estimated that 9.6 million Ukrainians may be experiencing mental health problems today as a result of the conflict. Given the constant changes in the development of the conflict, the displacement movements, the affected areas, and the availability of services, it is crucial to reassess the impact of this conflict on the population’s mental well-being and psychosocial needs today — 18 months after the beginning of the war — to help address new gaps in services and provide support that is context-relevant and informed by the targeted population. HIAS and Girls collaborated on a nation-wide mental health and psychosocial needs assessment undertaken between July and August 2023.
Key findings
Eighteen months after the onset of the war, most respondents report living in a state of anxiety, moral exhaustion, and fatigue: 35% of respondents present with poor well-being and quality of life, with 26% presenting a very low score, indicative of depressive symptoms (WHO-5 scale). Categories with the lowest scores include women, respondents from the south and east regions, respondents over 46 years old, and respondents with low financial resources.
Although the concepts of mental health and stress seem to be known and understood by the population, stigma is still present. Although 85% of respondents mention life events as the main factor for psychosocial distress, 38% still think the main cause is a flaw of character, such as weakness.
The primary stressors for Ukrainians include uncertainty about the future, economic hardships, concerns for the safety of their loved ones, and separation from family and friends.
For men, there also is the possibility of being drafted to the army and the fear of not being able to provide for their family. Notably, 46% of the respondents have a loved one currently mobilized, and over 10% have relatives who have died in the conflict, or have relatives who have been wounded, or loved ones who are missing or held in captivity. Women struggle with an increased daily workload, challenges in positive communication with their children, caregiving responsibilities, and a shortage of childcare services. Adolescents, on the other hand, mention conflicts within their families, and indecision and guilt about whether to stay in Ukraine or leave.
Ukrainians commonly experience stress reactions such as sleep issues, sadness, hypervigilance, fatigue, difficulty concentrating, mood swings, body aches, and apathy. Women tend to have more physical symptoms than men. Parents also notice behavioral changes in their children, such as increased sadness, sleep problems, decreased school engagement, excessive fear, and phobias. Nearly half (45%) of parents report that they struggle to support their children during this crisis. Adolescents also report concerning signs of distress, such as impulsive behavior, social withdrawal, emotional numbness, or cognitive issues.
People with disabilities or chronic diseases, the elderly population, and internally displaced people (IDPs) were mentioned as particularly vulnerable groups, however, all sub-groups in the population (men, women, children, adolescents, etc.) were mentioned as vulnerable to psychological distress. People in helpers’ positions (volunteers, teachers, social workers,
etc.) were also described as vulnerable due to long-lasting fatigue and lack of internal resources to support other people. The assessment showed that 13% of respondents did not have enough resources to cover their basic needs, and 31% consider their own household as vulnerable.
Ukrainians’ preferred coping mechanisms include spending time and talking with their loved ones, along with outdoor activities and relaxation.
Parents believe that keeping children busy and distracted helps to prevent their stress.
Community support mechanisms include volunteering (cooking for the military, weaving camouflage nets), family events (concerts, fairs), and humanitarian aid for displaced persons (shelters, food distributions, hygiene kits, etc.).
When in need of psychosocial support, Ukrainians tend to turn first to family members or friends, and as a last resort to a professional. Adolescents often choose to turn to the school psychologist if they need support.
Barriers to seeking mental health support include beliefs of being able to cope by oneself, concerns about being negatively perceived, thinking that others might need help more, and the stigma around such services. Most respondents never attended mental health and psychosocial support (MHPSS) activities, and 42% do not know how to access professional help. Many mention a lack of general knowledge regarding mental health and availability of services.
The respondents find it challenging to mention specific psychosocial services that would help the population, but frequently mention initiatives promoting social connections, peer support, and feelings of safety, or free professional psychological services. Around a third of them mentioned community-based recreational activities and individual counseling sessions as valuable MHPSS services, along with childfriendly spaces, peer support groups, stressmanagement training sessions, or psychiatric support with medication.
Overall, there is a lack of knowledge regarding MHPSS support provided by NGOs: most respondents are unable to name NGOs operating in their area, or their services, and there is a general perception that their services are for IDPs only.