In wartime situations, it’s one thing to rebuild damaged buildings – it’s another thing to rebuild a damaged society’s well-being.
As the war on Ukraine approaches its 1,000th day, there are robust and hopeful discussions underway about Ukraine’s recovery and reconstruction, which the World Bank has estimated at some $700 billion. Under consideration are important questions about how to finance the huge cost involved, including leveraging seized Russian assets, and which infrastructure to prioritize, including the some 2,000 health and educational institutions destroyed or damaged. These discussions are, of course, important and not before their time.
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However, there is much less discussion about the human dimension – or how to support Ukrainians’ emotional and psychological recovery. Though Australia’s own mental health system is by no means perfect, it has real strengths that can help.
The baseline that Ukraine is starting from is, in a word, daunting. The latest studies show that around 20 percent of Ukrainians – including both those in the country and those who have temporarily left, including 4,000 people in Australia – have symptoms typical of Post-Traumatic Stress Disorder (PTSD). That is up to six million people, or a group larger than the respective populations of Sydney, Melbourne or Kyiv.
Among the war’s many impacts, there is that of family separation. Studies have determined that approximately 17 percent of Ukrainians have lost contact with relatives and do not know about their destiny. A particularly heinous element of that is the to-date single war crime that Putin is charged with by the International Criminal Court: some 20,000 children have been forcibly deported to Russia.
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Even more imposing is the fact that the situation is not static or resolved. In October, as observers know, there were 30 air raid attacks on Ukraine in 31 days; nearly 4,000 missiles, rockets and drones were fired on Ukrainian cities. As an academic psychologist recently said to me over a coffee in Lviv: “It’s more a question of Continuous Traumatic Stress Disorder.” As we sipped our cappuccinos, we simultaneously kept checking our phones for air raid alerts; 99 percent of Ukrainians report having experienced them.
And, while the picture is challenging, there is some related good news. Ukraine is actually below the established international benchmark when it comes to the prevalence of PTSD in wartime societies, which is closer to 26 percent. This potentially reflects the remarkable resilience that so many Ukrainians have shown – a resilience arguably based on their lengthy lived experience and acceptance of struggle against colonizers’ ambitions. As many in Ukraine say, there’s no choice but to carry on.
Over the last two years in particular, following the personal initiative and intervention of First Lady Olena Zelenska, Ukraine has rapidly moved to both destigmatize mental health and to build more mental health capacity. Before the war, it was unheard of to see public service announcements for mental health; now, various hotlines and resources are advertised on virtually every train station and thoroughfare.
And, with government encouragement, a great many community-based organizations have been established or have scaled up to help those in crisis or need. That includes suicide prevention and crisis support hotline Lifeline Ukraine, which was based on the Australian model, and is now answering 4,000 calls from help-seekers per month (with unmet demand from 2,500 more).
During my recent working visit to Ukraine, I spoke with dozens of mental health professionals, including: lecturers preparing a new generation of mental health professionals; clinicians conducting ketamine trials with traumatized servicemen; Police psychologists who provide immediate support during crisis situations; and military psychologists serving on the 1,400-kilometer-long front line.
They strongly agree that the number one priority for helping Ukraine’s emotional and psychological recovery is training and deploying more mental health professionals. The lack of resources compared to burgeoning community demand is acute; there is a shortage of 3,000 mental health nurses alone. One analysis has determined that there are 8 mental health professionals per 100,000 of population in Ukraine, while there are 40 per 100,000 in the US and 43 per 100,000 in Germany.
In this respect, Australia can make a specific positive difference. As a welcome precedent, in 2023, the Department of Foreign Affairs and Trade, through its fellowship program, supported professional development on mental health policy, governance and practice for 10 young mental health leaders from Ukraine. They all report the exchange has been powerful for their efforts to improve their own system; one applies learnings in Ukraine’s Presidential Administration. It would be very worthwhile for the relevant fellowship to be made regular and recurrent.
Also, Australia’s university sector is first-rate in mental health education. It attracts thousands of international students. Now, it is well placed, with government support, to educate Ukrainians, whether in situ in Ukraine or Australia, or even online. The human ties would, no doubt, be highly rewarding for those on both sides.
Relatedly, Australia is a world leader in digitization of mental health services, including innovative, evidenced-based ways to access information, self-help tools and even clinical treatment in a digital context. Such approaches are suited to the extreme reality of wartime. There is the opportunity to apply expertise through DIA, the Ukrainian government’s own world-leading app, which is ubiquitously used by its citizens, including training in “mental health first aid,” where, again, Australia is a leader.
A volunteering program for Australian mental health professionals who want to acquire life-changing personal and professional experience can also be considered.
Whenever Australia is mentioned in Ukraine, Ukrainians start by saying thank you. There is great regard for the help that’s been given to date to defend Ukraine. Now, we should give the help that’s needed to heal Ukraine.
This article was previously published in Spectator Australia and reprinted with the author’s permission. Read original here.
The views expressed in this opinion article are the author’s and not necessarily those of Kyiv Post.
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