Event Summary – “PTSD in War Veterans in Ukraine: Insights and Initiatives”

This webinar event, “PTSD in War Veterans in Ukraine: Insights and Initiatives” was held on 26. October 2023. Guests tuned in to hear how war-related traumas including Post Traumatic Stress Disorder (PTSD) are being addressed in Ukraine, as well as to understand what steps still must be taken to create robust mental health treatment networks for those impacted by war in Ukraine. Four speakers were invited to share their perspectives: Martin Poliačik, Deputy Director of GLOBSEC Kyiv Office; Andrej Vršanský, Chief Executive Officer of the League for Mental Health Slovakia; Borys Khmilevskyi, combat medic and human rights activist; and Liubov Matveichenko, General Advisor and Head of Legal Department at Ukrainian charity organization. The panel was moderated by Olena Sprinsian.

The main focuses of each speaker are as follows:

• In presenting GLOBSEC’s new report, “Scars on Their Souls: PTSD and Veterans of Ukraine,” Mr. Poliačik opened his presentation by putting the mental health crisis into perspective: now, 15 million people in Ukraine will require psychological support, with 3 to 4 million of these requiring medical intervention. These numbers are significant, given that most of the combat personnel sent to the frontlines were not prepared to be soldiers, and that the existing body of specialised medical professionals dealing with war-related traumas and PTSD in Ukraine is insufficient. Moreover, not only combat veterans are at risk of developing war-related PTSD. These traumas can also influence internally displaced people (IDPs), civilians subjected to capture and/or torture, humanitarian volunteers and the families of combatants. On the medical side, Mr. Poliačik addressed the positive impact of Ukrainian First Lady Zelenska’s mental health campaign but stressed the need for a scientifically and specifically neurobiologically based consensus on the development, diagnosis and treatment of PTSD and complex PTSD, as well as more financial help from the EU, NATO and the broader international community.

• Delving deeper into the world of healthcare, Mr. Vršanský shared his understanding of the mental health care sector as a pyramid, with a small number of specialized professionals of PTSD treatment at the top, greatly outnumbered by nonspecialized community support and awareness at the bottom. While maximizing nonspecialized community support is vital to the handling of PTSD – and something Ukraine has triumphed in – it must be supported by a greater degree of specialized care which is not yet available. This is called “integration of services.” Finally, Mr. Vršanský pointed out that the mentality and perception of PTSD and complex traumas must change in society through the recovery approach to mental health, the first step of which is recognizing that a trauma occurred and that impacted individuals can move forward from it. Ultimately, it is important for nonspecialized people to be aware and listen to individuals who suffer from PTSD or traumas, which creates a safe space in which they can gain the support and courage to ask for help and specialized care.

• Mr. Khmilevskyi offered his firsthand experience of soldier mobilization and frontline combat by emphasizing the lack of psychological preparation afforded to new combatants, despite extensive pre-deployment training in combat and engineering, for example. His anecdotes indicated that, while many deal with short-term combat stress, like insomnia, paranoia and anxiety, there must be more adequate preparation and decompression from combat to prevent PTSD from setting in. Adequate decompression from service could include time (at least several months) away from the location of the factors that cause trauma, therapeutic assistance and support networks that can help to readjust to life away from combat. Still, Mr. Khmilevskyi suggested that these factors are merely educated suggestions and anecdotal, since there appear to be no established procedures for pre-emptive psychological preparation or post-conflict decompression yet.

• Finally, Ms. Matveichenko offered a compelling firsthand account of the ways in which both soldiers’ traumas and war-related societal anxieties can influence entire families, especially young children. In Ms. Matveichenko’s experience, it is not possible to separate PTSD as a psychological condition from the process of mending a family dynamic that was changed by war – or indeed attempting to create a new family dynamic that takes into account that deep traumas have occurred in different ways to different members. Ultimately, Ms. Matveichenko stresses the need to also consider cases of PTSD as family-wide struggles, and the need for NGOs to work together to base their efforts on the needs of communities which are most in need.

Overall, Ukraine should be applauded for its efforts to fight this growing mental health crisis. However, there is room for improvement in the following areas:

• Establishing preemptive psychological preparation as well as decompression for soldiers and veterans
• Increasing the number and availability of healthcare professionals specializing in trauma care
• Normalising and validating asking for (and receiving) psychological help on a societal level
• Generating greater unity among NGOs and among international actors to financially and otherwise support the push for trauma reduction in Ukraine

Watch the recording of the event below.