Going on Assignment in Prague July 2023 – July 8, 2023
Ukraine: A Mental Health Crisis in the Making
By Juliana Zappitell
Czech organizations are providing psychological help to Ukrainian refugees, but the needs are great.
Like many refugees, 39-year-old Anna Savchenko still shivers at the thought that a Russian bomb could destroy her home at any moment, even months after she fled Kyiv to escape the war.
“Your state is constantly changing. One minute you are accepting the situation and the next you are crying. You understand everyone wants to go back home, but it’s too dangerous,” Savchenko said.
After crossing to Poland, Savchenko and her three kids ended up in Klatovy, a small city in the Czech Republic, where they found a help center for refugees and met Yuliia Zahurska, a Ukrainian psychologist.
Although Savchenko was fortunate enough to receive help from Zahurska, experts fear that many are struggling without such assistance as they prioritize immediate necessities like food and shelter over mental health.
The UN refugee agency reports that more than 6 million refugees from Ukraine are spread across Europe, with the director general of the International Organization for Migration (IOM), Antonio Vitorino, expecting up to 30% to experience mental health problems that may worsen as the war continues.
Experts report this as a mental health crisis in the making. The World Health Organization considers mental health a “very high risk” category for Ukrainian refugees, meaning it could “result in high levels of excess mortality/morbidity.”
The situation for Ukrainians was hardly ideal even before the start of hostilities. A 2017 study by researchers from Ukraine, the UK, and Georgia found that 74% of 2,203 Ukrainians did not receive the mental health care they may have required due to limited awareness of where to access care, the stigma of coming forward with their problems, and fear of not being able to afford care.
Petr Moravec, the director of Ledovec – the Czech mental health nonprofit that hired Zahurska to work with refugees – remembers being told that he must choose the right words when offering support to Ukrainians because of the culture’s stigma surrounding mental health.
“People from Ukraine are not used to asking for a therapist’s help and they think the help is only for people with very severe illness,” Moravec explained.
The Yale Institute for Global Health, in a detailed case study, concluded, “Ukraine carries a high burden of mental illness with a particularly high prevalence of depression in comparison to other countries. Mental disorders are the country’s second leading cause of disability burden … and are estimated to affect 30% of the population.” As noted above, the IOM and many other experts see the situation worsening since the invasion.
People in Need, one of the biggest Czech charities operating in Ukraine, also offers psychological assistance to Ukrainian refugees. Olena Kravtsova, originally from Ukraine, has worked as a psychologist for the organization since 2015, and now helps coordinate their counseling activities in Ukraine. In a comment published on the organization’s website, she noted that the number of calls to its hotline for Ukrainians in need of psychological help had increased 73% since the start of the invasion.
Children Most at Risk
Zahurska and others explain that children tend to be the most traumatized group as they are dealing with the effects of living in a war zone, the difficulties integrating into an unfamiliar culture if they flee home, and uncertainty about the future at such a young age.
“The five- to six-year-old group that I encountered were the most vulnerable. Based on my experience, boys and girls seemed to come in with different reactions: boys showed aggression while girls were apathetic and lost their appetite. Art therapy works very well for the children,” Zahurska said.
A group of students at the Architectural Institute of Prague agreed with that approach and started weekly art and architecture workshops for Ukrainian refugee children called Udesign.
One of the mentors at Udesign, Ketevan Gogodze, works with the 11- to 15-year-old group and gave them an assignment to make postcards of cities.
“Some of the kids express their heartache through their artwork. In one of the workshops, two girls crafted Ukrainian cities on fire,” Gogodze said.
“Some of them are moody, very blue sometimes, but it doesn’t show up during the activities,” Gogodze went on. “There is a drastic difference in the children at the beginning and at the end of the workshop. After the workshop they are more relaxed.”
For the refugees that have been able to receive help, these programs are making a difference. Savchenko is grateful that she no longer hears bombs at night and can get a good night’s sleep.
“The psychological support from Yuliia really helped me to have the right approach to my children and to get them in the right mindset. My family right now is in a normal psychological state thanks to the fact that we received this assistance,” Savchenko said.
Juliana Zappitell is a film and media studies student at the University of California, Santa Barbara with a particular interest in mental health. She participated in Transitions’ just-concluded foreign correspondent training course.