Blog
As Ukrainians grapple with ongoing war, Pact focuses on accessible, effective mental health care
More than two and a half years after Russia launched its full-scale war in Ukraine, I cannot comprehend the scale of the damage. When we are surrounded by word of causalities, of territory lost and regained, of homes and community spaces destroyed, it can be easy to forget about the impacts we don’t see. Yet they are immense. One I think of constantly is how the trauma of this war is affecting our mental health.
As Pact’s Ukraine country director and the project’s chief of party, I lead implementation of the USAID-funded Public Health System Recovery and Resilience Activity, or PHS R&R. A large portion of our efforts focus on mental health, so I am aware of the estimates, which are based on research supported by PHS R&R: About half of the country needs some level of mental health and psychosocial support services, or MHPSS. How are we to tackle a problem of such enormous scale, even as it continues to grow?
For Pact and our partners in Ukraine, the answer has been to think deeply about and truly understand communities’ needs, and then try to meet them as quickly, broadly and effectively as possible. A few approaches have been key: We have focused on destigmatizing mental health, on building upon what already exists in Ukraine, and on providing an array of options close to communities to meet people where they are, including in remote and rural areas. I am proud to say that I believe we are making a real difference in the face of what can seem like overwhelming need.
A strong example has been the Taking Care of Myself concept. We brought together Ukrainian and international best expertise and evidence and have worked with local partners to test, document and package various implementation models. This is how we came up with Taking Care of Myself, a community-based model of MHPSS service delivery that includes several core elements such as individual counseling by a psychologist, group sessions to build self-help skills and peer support, and referrals to higher intensity level interventions.
We supported the establishment of 11 Taking Care of Myself spaces in various locations such as at primary health care centers, centers for social services, veterans’ spaces, universities and civil society organizations. The centers have been tremendously successful in reaching those in need, including people who otherwise might not have sought care.
In general, Pact supports access to mental health services of various levels of intensity through subgrants to Ukrainian organizations that have experience in MHPSS services, and we focus on both in-person and online platforms, as communities told us this was important to them. As of the end of June, more than 19,000 individuals had received evidence-informed MHPSS services addressing critical needs.
We work in close partnership with the National Mental Health Coordination Center to support the implementation of the All-Ukrainian Mental Health Program, initiated by First Lady Olena Zelenska. In particular, we support the communication campaign “How are you?” which is aimed at decreasing mental health stigma and generating demand for MHPSS services. To date, more than 76 million contacts have been made, reaching Ukrainians with messages and information promoting conversations about mental health and well-being and encouraging the uptake of MHPSS services.
We also invest into strengthening the capacities of service providers through trainings to scale up evidence-informed interventions, and have so far trained nearly 3,300 providers.
Together with the College of Public Health at Temple University in the United States, we launched an academic partnership initiative to develop new cadres of MHPSS providers. Nursing and social work departments at the college are partnered with three Ukrainian universities and have been collaborating to update their training curricula to integrate skills building and competencies to enable future nurses and social workers to become MHPSS service providers.
We are not re-inventing the wheel and we are not building a parallel mental health system. We are building on what already exists in Ukraine and have been working hand in hand with Ukrainian national and local partners to support Ukraine’s efforts toward the development of a people-centered, evidence informed, comprehensive and sustainable mental health ecosystem. This is vital for Ukraine today within the ongoing war context, but it is also critical for Ukraine’s post-war recovery and sustainable economic growth.
As it does everywhere, mental health stigma continues to challenge us in Ukraine. Many people are still hesitant to use mental health services because of it. But our biggest challenge is that the war continues, and it impacts everyone. Healing trauma when you live in trauma is hardly possible, but healing in the moment is.
I believe this is what we are supporting, day by day: We are helping to build a strong system of mental health services that is empowering Ukrainians to heal even as the war goes on.