Dynamics of hospitalizations and staffing of Ukraine's mental health services during the Russian invasion

Abstract

Background: Since February 2022, the people of Ukraine have experienced devastating losses due to the Russian invasion, increasing the demand for mental healthcare across the nation. Using longitudinal data on mental health facilities across the nation up to summer 2022, we aimed to provide an updated picture of Ukrainian mental health services during the 2022 Russian invasion.

Methods: We conducted a nationwide longitudinal study on Ukrainian inpatient mental health facilities during the Russian invasion since February 2022. We obtained responses from the heads of 30 inpatient mental health facilities, which represent 49.2% of all psychiatric hospitals in Ukraine. Information on hospitalizations and the number, displacement, and injuries of staff in April and July-September 2022 was obtained from each facility.

Results: Facilities across Ukraine reported similar staff shortages in both April and August-September 2022, despite an increase in the number of hospitalizations in July 2022 and a similar percentage of hospitalizations related to war trauma (11.6% in July vs. 10.2% in April, Wilcoxon signed-rank test P = 0.10). Hospitalizations related to war trauma became more dispersed across the nation in July 2022, likely reflecting the return of internally and externally displaced persons to their original locations.

Conclusions: The mental health needs and services changed drastically in the first half-year of the Russian invasion of Ukraine, with those in need more dispersed across the country over time. International aid may need to be scaled up to stably provide mental healthcare, given the displacement of the mental healthcare workforce.

Keywords: Global health; Global mental health; Health policy; Health services research; Humanitarian health; 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) percentages of hospitalizations related to war trauma in each the two waves (%), (B) percentages displaced workers out of total medical workers in each of the two waves (%), and (C) percentages of new employees out of total medical workers in the follow-up survey (%). For the follow-up survey, facilities reported information on hospitalizations in July 2022 and information on the number and displacement of staff at the time of the study (August-September 2022). Each circle represents the percentages aggregated by region. Shaded areas (in grey) represent regions that are or have been under Russian occupation as of August 16th, 2022. All hospitals with more hospitalizations in the first survey or the follow-up survey than January 2022 are shown to have no reductions in hospitalizations (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

Sankey plot of percentages of hospitalizations related to war trauma, by region. Regions are aligned from east to west. Facilities reported hospitalizations in April and July 2022 for the first and follow-up surveys, respectively

Fig. 3

Sankey plot of percentages of displaced workers out of total medical workers, by region. Regions are aligned from east to west. Facilities reported numbers of displaced workers in April and August to September 2022 for the first and follow-up surveys, respectively