10 October marks World Mental Health Day, an opportunity to reflect on the profound impact conflict can have on an individual’s mental health and wellbeing. In Ukraine, the war has continued unabated for 960 days since the full-scale invasion, leaving millions at risk of developing mental health conditions from anxiety to PTSD.
Dmytro, a psychologist and UK-Med Mental Health and Psychosocial Support (MHPSS) Supervisor in Ukraine, explained:
“In Ukraine, many people have experienced trauma and stress as a result of the war, especially those who have been displaced. Things like explosions or missile attacks cause anxiety, and persistent anxiety leads to depression. There’s also a lot of grief and loss, because losing loved ones on the front line is sadly not uncommon. Peoples’ wives and husbands die, and we also work with people to navigate this.”
Dmytro works with the mobile medical units (MMUs), which UK-Med uses to reach areas close to the frontline in Zaporizhzhia and Kharkiv, where access to mental healthcare is otherwise limited or non-existent. In these small, remote villages the only residents are those who either refuse to leave or are unable to. Almost all are older people.
“We see missiles flying overhead heading for Kharkiv every single day. There are also daily artillery exchanges going over us from both directions. They sound different so we can tell quickly and act accordingly. We are still smiling; life must go on.
“But when we are grieving, and we do a lot of that, we can’t smile. We don’t get hit really at all, but the villages next to us – only three kilometres away - are hit all the time.”
“We are so happy UK Med is here. This area is very remote, and the young people leave. There are no jobs here. Before the war there were around 500 people living in this village, now we are 153.”
Nearly half of all those who received mental health support from UK-Med since April 2022 have been displaced at one time or another. 75 per cent of them are also women.
Tetiana, a psychologist working with the MMUs in Kharkiv, has seen her fair share of trauma among communities impacted by the relentless conflict. She explains:
“We visit locations and communities that need help from doctors, psychologists, and social workers. A lot of people need psychological help – they are in a very bad state. They are experiencing difficult emotional and mental states, poor sleep, bad feelings, and anxiety. That is why we help. We visit them and provide psychological assistance.”
According to global estimates from the World Health Organization (WHO), one in five people living in an area affected by conflict is estimated to have a mental health condition, from anxiety and depression to PTSD. If the same estimates are applied to Ukraine, that means nearly a staggering 10 million people may be suffering from some form of mental health condition.
For older people in particular, the conflict can have dire consequences for their mental health and wellbeing. Often less able to travel long distances and with many more unwilling to leave the homes they have lived in for decades, there is a higher proportion of older people in front line areas. Many are also isolated from support networks, with 44% of people over 70 living alone.
Ivan and his wife Valentina travelled seven kilometres to reach the MMU.
“My wife has been unwell since the beginning of the war because of all the stress. She is very nervous. The shelling has had a terrible effect. We are here to see the doctor,” he said.
“The shelling has been worse recently. Only about 200 people live in our town now – they live in basements. We have moved to my mother’s old house in the village which is where we rear poultry. My mother built the house with her bare hands after the Second World War.
“More soldiers are passing through our town now as the fighting increases. There is heavy shelling all the time and many houses have been destroyed. Many people have died.”
After 960 days of violence and with no end in sight, the conflict in Ukraine continues to exact a terrible toll on individuals’ mental health. Older people like Ivan and Valentina are particularly at risk, as their lives are now dictated by the changing fortunes of war.
While bullet and blast wounds are more visible, mental health often creates silent casualties of war, leaving deep emotional scars that are in some ways more difficult to heal. Dmytro explained:
“Central to UK-Med’s approach is that a person needs to be treated as a whole; you can’t separate the psychological from the physical. A person is holistic, and they need to be treated as such. Therefore, a psychologist is a necessary member of the MMU. And frankly, I don’t know how it’s possible to deliver that kind of holistic service without mental health support in place.”
