Mental health needs of civilians rise as Ukraine war drags on

Kramatorsk – Nastya, huddled in the back of a cafe near the train station where dozens of people were killed by missiles a year ago, took slow, deliberate breaths to calm herself. was bombed again, and she couldn’t take it anymore.

The 20-year-old listened to her parents’ advice and visited a nearby psychiatric hospital that morning. The hospital was also a site of war scars after repeated bombings, including one from a missile that destroyed part of the building last September. But staff continued their work, cleaning up shattered glass, shoveling debris, and determined to stay in Kramatorsk, in eastern Ukraine’s Donbass region, to help those in need.

It was a lifeline for Nastya.

“After today’s bombardment, I can no longer handle the anxiety and constant danger,” said a speech therapy student last month, giving only her first name, about the difficult decision to seek mental health care. rice field. Psychiatry from a time when dissidents were imprisoned in psychiatric facilities as punishment still remains.

“I realized that my psychological health was much more important,” she said.

Experts say there are hundreds of thousands of people like Nastya in Ukraine, and the number of people needing spiritual help is expected to grow as the war continues. In December, the World Health Organization said one in five women in countries experiencing conflict in the past decade would suffer from a mental health condition, and about 9.6 million people in Ukraine could be affected. I assumed there was.

Russian invasion In February 2022, millions of people were forced from their homes, widowed, and forced into cellars for months to endure constant shelling and harrowing journeys from Russian-occupied territories.

For Nastya, like many people, the war changed everything overnight. It used to be a life of simple pleasures, going out for coffee and laughing with friends. And after.

“I wake up feeling like I’m surrounded by fear and anxiety and constant air raid sirens, flying planes and helicopters,” she said. “You are just in a closed circle filled with great fears, not in the happy times you were before. Fear of the unknown, fear of dying here and now.”

A worker at the Zaporizhia nuclear power plant, hundreds of kilometers to the west, 38-year-old Tatyana lived in the town of Enerkhodar for four months under Russian occupation. And how her family endured a 24-hour ordeal to escape to Ukrainian territory.

A few months ago, when she visited a support center in Boyarka, south of Kiev, to register for help, she broke down in tears. The staff called a psychologist.

Tatiana also asked not to use her last name to openly talk about seeking mental health care. No. She’s trying to deal with the feelings of living in war.

“This fear comes when you realize you can lose everything in an instant,” she said. “Life is like a light switch. Once you turn it off, you can never turn it on again.”

Experts say the need for mental health treatment is growing across Ukraine.

“The demand is there,” says psychotherapist Pablo Holbenko, who has been treating war-affected people at his center in Kiev since 2014, when Russia annexed Crimea and established two proxy secession states in eastern Ukraine. It’s very big and unfortunately it’s only going to increase.”

He noted a significant increase in patients seeking treatment for sexual violence, bereavement, and suicidal ideation. “Previously he would have one or two requests a week, now he can request up to 10 a day.”

Judging by other conflict-afflicted countries, the need for psychological treatment rises sharply after the fighting ends, Hoevenko said.

For now, people are focused on survival. “But when the war is over… you can afford to relax. And when you can relax, the symptoms you’ve been accumulating will show up,” he said.

Like a soldier wounded in battle who doesn’t feel pain until the immediate danger is gone, “That’s when the wound starts to hurt. This is the case with psychological trauma.”

Khorbenko said the number of mental health professionals has increased in Ukraine since 2014, but more are needed. “Demand still far exceeds capacity,” he said.

Authorities are trying to increase mental health services across Ukraine.

Lebanese psychiatrist Dr. Maya Bizri recently visited Ukraine at the request of the Ministry of Health as part of a program run by medical assistance organization MedGlobal to assess the needs and mental health problems of both colleagues and patients. trained doctors and nurses to recognize

“The people who are really affected are… health workers,” said Bizuri. “There is a lot of training on how to deal with trauma patients and physical injuries, but no one is addressing the health care of medical professionals.”

Under the MedGlobal program, doctors and nurses are trained to help themselves and their colleagues cope with psychological pressure, and thus others.

“There is serious suffering that is not being addressed and urgent needs that are not being met. If we want a resilient health system, we have to take care of our own people,” Bizuri said. “And I think the Ministry of Health is very much aware of it because they are so involved in doing this.”

Dr. Ludmila Sevastyanova, director of the Kramatorsk Psychiatric Hospital, said mental health specialists needed to help them cope.

War “affects us as much as it affects patients,” she said. I am doing my medical duty and helping.”

Psychiatrist Sebastianova has made it her mission to “save hospitals so that people can continue to work, and so that they can provide care to their patients.” This is the goal and it helps. ”

However, she holds no illusions about the potential for long-term effects.

“Things don’t pass without a trace. A cut hand, a scar. That’s what our psyche is,” said Sevastianova.

“Now we have to adapt, survive, provide support, work. … We will see what impact this has.”


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