Mental health services in Ukraine during the early phases of the 2022 Russian invasion

Abstract

Background: In February 2022, Russia began its invasion of Ukraine. War increases the demand for mental healthcare among affected populations, but with devastating losses across the nation, it is unclear if Ukrainian mental health services are able to meet the needs of the people.

Aims: We aimed to evaluate the state of Ukrainian in-patient mental health services, which remains the backbone of the nation's psychiatric services, early in the 2022 Russian invasion.

Method: We conducted a nationwide cross-sectional study on Ukrainian in-patient mental health facilities during the 2022 Russian invasion. Using an online questionnaire, we obtained responses from the heads of 32 in-patient mental health facilities across Ukraine, representing 52.5% of all in-patient mental health facilities in the nation. We gathered information on hospital admissions, staff, humanitarian aid received and the additional needs of each facility.

Results: Hospital admissions were reduced by 23.5% during the war (April 2022) compared with before the war (January 2022). Across facilities, 9.6% of hospital admissions in April 2022 were related to war trauma, with facilities reporting percentages as high as 30.0%. Facilities reported reductions in staff, with 9.1% of total medical workers displaced and 0.5% injured across facilities. One facility reported that 45.6% of their total medical workers were injured. Although facilities across Ukraine have received humanitarian aid (such as medical supplies, food, volunteers), they reported additionally needing equipment as well as more staff.

Conclusions: The mental health service structure in Ukraine has been severely damaged during the 2022 invasion, with staff shortages despite a significant number of hospital admissions related to war trauma.

Keywords: Epidemiology; human rights; in-patient treatment; low and middle income countries; military psychiatry.

Fig. 1

Proportional symbol maps of changes in mental health services in Ukraine during the 2022 Russian invasion. Proportional symbol maps were created for (a) percent of hospitalisations related to war trauma (%), (b) reductions in number of hospitalisations (%) and (c) displaced workers out of total medical workers (%). Each circle represents the percentages aggregated by region. Shaded areas (in grey) represent regions that have been or are under Russian occupation as of 2 May 2022. All hospitals with more hospitalisations in April than January 2022 are shown to have no reductions in hospitalisations (0%). Note that percentages of displaced workers out of total medical workers could exceed 100% as some workers may not have been medical workers. Statistics for regions with unavailable data are not shown.

Fig. 2

Maps of the needs and humanitarian aid received during the 2022 Russian invasion. Maps were created for (a) humanitarian aid received by mental health facilities and (b) additional needs of mental health facilities, aggregated by region. Shaded areas (in grey) represent regions that have been or are under Russian occupation as of 2 May 2022. Other aid received and needs are shown in Table 1. Statistics for regions with unavailable data are not shown.