Making mental health part of emergency and recovery solutions

October 11, 2022
Photo: Shutterstock

Since February 2022, all Ukrainians have been living in constant stress, facing anxieties and fears because of the war. Every day, the war continues to demolish entire cities and villages, leading to massive destruction, deaths, and displacement.  Every day, Ukrainians must make hard decisions, deal with new challenges and uncertainties, cope with grief, and comfort their loved ones. Many have witnessed hostilities and atrocities, haunted by images of war staying even when they reach safe havens. Being heavily traumatized, they need peace, support, and time to heal.

The delayed response to psychological trauma can have severe and long-lasting impacts on the emotional and physical well-being of a person, often leading to even more sufferings.

The UN Secretary-General António Guterres in his message to High-Level Event on Mental Health Interventions for Peacebuilding in Conflict and Humanitarian Settings stressed that untreated emotional traumas can potentially create a vicious cycle.

“Peacebuilding, mental health and psychosocial support are deeply interconnected.  People who have suffered losses, attacks, family separations and gender-based violence carry grievances and wounds that can perpetuate repetition and cycles of violence,” the Secretary-General said in his message. “Mental health and psychosocial support must be seen as integral, cross-cutting components in all our humanitarian, peacebuilding and development programmes.”

That is why, timely, accessible, and effective psychological help should be a part of emergency humanitarian response and early recovery solutions.

Considering that mental health is a prerequisite for physical well-being, the right to psychological help should be treated as a right to health, one of the fundamental human rights. Besides, its role for sustainable growth was also recognized in 2015, when mental health was included in the UN Sustainable Development Goals (SDGs) and was declared as a priority for global development for the next 15 years.

It is crucial for reduction of poverty (Goal 1), for decent work and economic growth (Goal 8), for safe and resilient cities and settlements (Goal 11), and it is also a crosscutting issue for other development priorities. Furthermore, many scholars have stressed the interlinkages between mental health and social and economic growth, stating that for a fairer, just, inclusive, and human rights-based society, mental healthcare approaches should be scaled-up and strengthened.

Understanding the complexity

With the onset of the full-scale war in Ukraine, UNDP joined the global call to action providing immediate humanitarian and development assistance to the Government and communities. Psychological assistance has been at the forefront of this response.

For many Ukrainians, in-person appointments with psychologists remain unsafe in places where hostilities continue. Furthermore, even in those regions that are relatively safe, mental support remains unavailable – or, if it is, many traumatized persons might not realize they need help or are not willing to ask for it.

We should also remember that the war disproportionately affects women and girls, especially women from marginalized groups since they are more exposed to gender-based violence, human trafficking, and the extra burden of caregiving which is intensified by the displacement. According to the Gender Analysis of the Situation in Ukraine conducted by the NGO Working Group on Women, Peace and Security, women head 93 percent of all single-headed households in Ukraine.  They also generally bear the primary burden for taking care of children and other dependents. Thus, in-person psychological support often remains an unaffordable luxury for women and girls.

By analyzing and understanding all the context complexity, it became clear to us at UNDP that only bold and holistic solutions can help to address a growing demand for psychological help.

Leveraging an advanced digital system

In July and August 2022, UNDP Ukraine supported a number of solutions aimed to make psychological assistance immediate and accessible for people who for different reasons don’t feel safe getting it in person. This would be impossible without our long-lasting partners who have swiftly adapted their work to the new context and needs.

Specifically, UNDP teamed up with the Ministry of Digital Transformation to launch a cycle of educational online courses on psychological self-help on the platform Diia.Education.* These courses have been developed with the financial support of UNDP’s partners in Ukraine, the governments of Denmark, and Sweden.

Each course covers a specific issue and demonstrates various technics that people can use to soothe emotional trauma.

The course Psychological support for civilians: how to help yourself and your loved ones  offers psychologists’ advice to help everyone maintain their mental well-being under stressful conditions and explains how people can help their family and close friends maintain sound mental health during the war.

The second course, Treating emotional burnout, helps one to recognize and deal with emotional exhaustion. This course was designed for all Ukrainians juggling between multiple tasks and roles: working full-time jobs, caring for family members and attending their needs, volunteering and helping others in need. The course provides guidelines to understand the consequences of working until exhaustion and how to deal with psychological fatigue.

The last course, “Rapid assistance to deal with the first PTSD symptoms,” helps to identify the first symptoms of post-traumatic stress disorder and is aimed to bring relief until in-person help becomes available.

These educational series of videos have been viewed already by more than 3,700 men and women, providing them with immediate support and tips on helping their loved ones.

Immediate support

In July, with EU funding, UNDP Ukraine supported the launch of a hotline to provide psychological assistance to Ukrainians affected by the war. Initiated and implemented by the National Psychological Association of Ukraine, the line employs professional psychologists with many years of experience who have previously undergone special training to work with complex crisis situations. The line, with the number 0-800-100-102, works every day from 10:00 a.m. to 8:00 p.m. Calls from Ukraine are free of charge.

The line also accepts calls from citizens of Ukraine who are currently residing in other countries, namely in Czech Republic (+420 800 012 058), Poland (+48 800 088 141), France (+33 805 080 466), Portugal (+351 800 780 756), Sweden (+46 20 160 46 46), Ireland (+353 1800 817 519), Austria (+43 800 017 967), Great Britain (+44 808 164 2432), Italy (+39 800 939 093), Romania (+40 800 400 597), Slovakia (+421 800 182 399) and Hungary (+36 68 098 1580).

 

Accelerating local capacities

To provide immediate psychological support and relief at local level, UNDP partnered with the SpivDiya platform, an aid provision coordination mechanism. The "SpivDiya" platform was initiated by the Coordination Staff for Humanitarian and Social Issues at the Office of the President of Ukraine and supports synergy between civil society organizations, ministries and businesses. The aid provision is decentralized and channeled through the 23 humanitarian aid centers, including Kyiv and Kharkiv, with targeted delivery through a vast network of partners. SpivDiya Hubs are regional spaces run by a community service organization and operating on the basis of youth centres and active volunteer organizations throughout the country which work in partnership with local authorities. The hubs perform a variety of logistical functions, while providing a wide range of services to support the civilian population affected by the war in Ukraine.

To support the work of the Spivdiia Platfrom and its hubs, UNDP purchased and delivered 34 computers and 182 pieces of furniture and equipment worth a total amount of over 1 million UAH.  With this equipment, the hubs are better able to organize trainings and workshops, and offer psychological and legal assistance, both offline and online.

In May-August 2022, experts engaged with UNDP support provided psychological counselling in online and offline formats to over 6,000 men and women, and legal support was provided to over 1,000 men and women from all oblasts of Ukraine (excluding temporarily occupied territories).

Improving the response to the needs of ex-combatants

Before the full-scale war started in February 2022, Ukraine was already experiencing an increase in prevalence of post-traumatic stress disorder among ex-combatants who were returning home from the zones of active hostilities in the east of the country. To fill a gap in evidence-based interventions in Ukraine, UNDP has organized trainings for 60 mental health professionals and introduced them to the gold-standard intervention for trauma, cognitive processing therapy (CPT). The effectiveness of CPT for military traumas has been extensively documented in various studies worldwide. As the war unfolds, the number of ex-combatants with post-traumatic stress disorder is expected to go way up and scaling-up the usage of CPT instruments will help to cover the needs of the new ex-combatants and provide them with targeted mental health support.

Advancing the work of psychologists in wartime for civilians

The need for quality mental health support related to the military trauma has expectedly increased among civilians. This intense exposure to the atrocities of war does not just disappear unnoticed. Only professional mental health specialists can facilitate proper recovery.

Nearly every community in the west is hosting at least a few hundred Ukrainians who have been displaced from their traditional homes because of hostilities. In these communities, there is a lack of psychologists who can properly unpack the trauma these people have experienced and help them navigate through the very challenging and often quite time-consuming process of recovery. To address this issue, UNDP has partnered with school phycologists from local communities in Zakarpattia and Ivano-Frankivsk oblasts and has organized educational trainings for them so they can adopt their working routine to better address the needs of IDPs – both children and adults.

Each day the number of people affected by the war grows and the demand for accessible, timely, and effective psychological assistance steadily rises, exceeding the supply. Currently, we are dealing with a very complex context which requires holistic and multifaceted approaches. UNDP is working closely with its partners to develop comprehensive and innovative solutions to address the most urgent needs of all Ukrainians, including psychosocial help. We do this with a strong belief that eliminating all forms of discrimination, stigmatization, and inequality should be the bedrock of all recovery plans that leave no one behind.

*Editor’s Note: The courses may not be accessible at this moment as the Ministry of Digital Transformation is currently reviewing their content.