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Two years on: Proactive measures are needed to address the conflict related mental health crisis

Article by Prof Robert van Voren

February 21, 2024

Two years on: Proactive measures are needed to address the conflict related mental health crisis

The war in Ukraine has entered its third year with no end in sight. This is not surprising. The future of the Putin regime depends fully on victory and cannot survive a defeat, thus fighting will continue to the bitter end.


For Ukraine this is a nightmare scenario. The war is nothing less than a war of destruction, with large swaths of territory totally devastated, towns eradicated, agriculture destroyed for many years to come (if for no other reason than the massive use of landmines and unexploded ordnance), and the country facing a decreased population. About one-fourth of the population are now displaced, either inside the country or abroad. The longer the war lasts, the less likely it is that people will return, and of course those who have the best prospects of building a new life abroad are those with education and knowledge of languages. At the front, the losses of personnel are immense, even though no official data is given. Those who should be on the forefront of rebuilding the country – the young men and women who believe in Ukraine and are willing to sacrifice their lives – are dying.


Ukraine will probably emerge from this war devastated, with a greatly reduced population, a destroyed economy and a large number of traumatised people. With over one million Ukrainians under arms and more than 600,000 with front-line experience, we estimate up to 100,000 people will need long-term psychosocial support. However, veteran mental health services in Ukraine are disorganised, highly dependent on volunteers and NGOs, and it is unlikely that the country will have sufficient resources to develop a system in time. Traumatised veterans have families and live in communities, who will also suffer from the inflicted trauma.


With millions of refugees eventually returning to Ukraine, mainly women who will have spent time in countries with greater gender balance, higher levels of domestic violence and divorce can be anticipated. Furthermore, while the Ukrainian society is still highly supportive of the military and veterans, we already see a decline. When veterans have outbursts of violence as a result of war-related trauma, this support will gradually change to stigma and fear. This does not bode well for the future.


What Ukraine will need is a system of community-based support for those traumatised by war, both military personnel and civilians who provided the vital support at the front by providing food, care, and medical support, and who are now not eligible for any participation in services earmarked for the military. Such a system should be sustainable and based on what Ukraine can really afford, even when Western support gradually disappears and the country will be left to start the long and winding road to recovery and rebuilding a severely affected society.


Robert van Voren is Chief Executive of the international foundation Human Rights in Mental Health-FGIP, an international foundation for mental health reform. He is also Executive Director of the Andrei Sakharov Research Center for Democratic Development and Professor at Vytautas Magnus University in Kaunas, Lithuania. Robert van Voren in an Honorary Fellow of the British Royal College of Psychiatrists and Honorary Member of the Ukrainian Psychiatric Association. He has worked in the field of human rights and mental health in Ukraine since 1990.


Disclaimer: The views expressed in this piece are those of the author and do not reflect the views of The Foreign Policy Centre.

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