Introduction:
The ongoing conflict in Ukraine has exposed children to violence, displacement, disruption and trauma. While the physical impact of the war is evident, the psychological and social consequences are often less visible but equally devastating. Children and adolescents, who make up about a third of the affected population, are particularly vulnerable to the effects of violence, displacement, disruption of education and social services, and exposure to trauma and stress.
According to UNICEF, nearly every child caught up in the conflict in eastern Ukraine is now thought to be in need of psychosocial support. Many children suffer from post-traumatic stress disorder (PTSD), anxiety, depression, nightmares, social isolation and panic attacks.
Some also exhibit aggressive or self-harmful behaviors, or have difficulties with learning and concentration. The mental health and psychosocial well-being of children in Ukraine is a critical issue that requires urgent attention and action from all stakeholders.
In this article, we will explore some of the factors that affect children's mental health in Ukraine, some of the challenges and gaps in providing adequate support and services, and some of the promising initiatives and recommendations to address this issue.
Common symptoms of war trauma in children:
We may have lasting and devastating effects on children's psychological functioning, especially when they experience repeated or prolonged exposure to violence, loss, separation and displacement.
Some of the common symptoms of war trauma in children include:
• Intense fear, helplessness, anger, sadness, horror or denial
• Physical complaints such as headaches, stomach aches or fatigue
• Sudden and extreme emotional reactions such as crying, screaming or aggression
• Problems with sleeping, eating or concentrating
• Withdrawal from social activities or peers
• Regression to earlier developmental stages such as bedwetting or thumb-sucking
• Dissociation or emotional numbing to block the pain and trauma
• Re-experiencing the traumatic events through flashbacks, nightmares or intrusive thoughts
• Avoidance of reminders of the trauma such as places, people or sounds
• Negative beliefs about oneself, others or the world such as guilt, shame or distrust
• Hyperarousal or hypervigilance to potential threats such as loud noises or sudden movements.
These symptoms can impair children's ability to cope with daily challenges, form healthy relationships, learn effectively and enjoy life. They can also increase the risk of developing other mental health problems.
The Caregiver's role:
Caregivers play a crucial role in providing emotional security, comfort and guidance to children who have experienced trauma.
They can help children by:
• Listening to their feelings and concerns without judgment or criticism
• Validating their emotions and reassuring them that they are not alone or to blame
• Encouraging them to express themselves through words, drawings or play
• Maintaining routines and structure as much as possible to create a sense of normalcy and stability
• Providing opportunities for fun and relaxation such as games, sports or hobbies
• Seeking professional help if the symptoms persist or worsen over time.
However, caregivers themselves mostly also be affected by the war trauma and face multiple challenges such as poverty, insecurity, displacement or grief. They may struggle to cope with their own emotions and needs while caring for their children. Therefore, it is essential that caregivers also receive adequate support from family, friends, community or humanitarian organizations.
Challenges and gaps in providing mental health and psychosocial support for children:
Despite the high need for mental health and psychosocial support (MHPSS) for children in Ukraine, there are many challenges and gaps in providing adequate support and services for them. Some of these challenges and gaps are:
• Limited availability and accessibility of MHPSS services: There is a shortage of qualified MHPSS professionals (such as psychologists, psychiatrists or social workers), especially in rural areas or near the contact line. There is also a lack of specialized MHPSS services for children with specific needs (such as those with disabilities or developmental disorders) or for those who have experienced severe trauma. Moreover, many MHPSS services are not easily accessible for children and families due to distance, cost, transportation or security issues.
• Low awareness and utilization of MHPSS services: Many families are not aware of the availability and benefits of MHPSS services, or do not seek them due to stigma, fear or lack of trust. Some may also prefer to cope with their problems on their own or with the help of their relatives, friends or religious leaders. Additionally, some MHPSS services may not be culturally appropriate or sensitive to the needs and preferences of different groups of children and families.
• Poor coordination and integration of MHPSS services: There is a lack of coordination and integration of MHPSS services among different sectors (such as health, education, social protection and humanitarian) and among different actors (such as government, non-governmental organizations and civil society). This can result in duplication, fragmentation or gaps in service delivery, as well as inefficiency, inconsistency or confusion for children and families. Furthermore, there is a lack of standardized tools and guidelines for MHPSS assessment, monitoring and evaluation.
• Insufficient funding and sustainability of MHPSS services: There is a lack of adequate and sustained funding for MHPSS services in Ukraine, especially from domestic sources. Most MHPSS services depend on external donors or humanitarian agencies, which may have limited resources or changing priorities. This can affect the quality, continuity and scalability of MHPSS services, as well as their long-term sustainability.
Initiatives and recommendations for improving mental health and psychosocial well-being of children in Ukraine:
There are also some promising initiatives and recommendations for improving the situation. Some of these initiatives and recommendations are:
• Strengthening the capacity and availability of MHPSS professionals: There is a need to train more MHPSS professionals (such as psychologists, psychiatrists or social workers) in Ukraine, especially in rural areas or near the contact line. There is also a need to provide them with regular supervision, mentoring and support to ensure their quality and well-being.
• Strengthening the capacity and availability of non-specialized "frontliners": there is a need to involve more non-specialized staff (such as teachers, health workers or community volunteers) in providing basic MHPSS interventions (such as psychological first aid or life skills education) for children and families under the guidance of MHPSS professionals in addition to increase their capacities in identification and referral.
• Integrating MHPSS interventions in other services to reach children and caregivers including through education, health, protection, gender-based violence and other community services.
• Increase the level of coordination between the main actors such as government, non-governmental organizations and civil society, a good example of this coordination is the recent initiative of IOM in collaboration with Cabinet of Ministros of Ukraine "Path of Resilience", this kind of initiatives plays also a very important role in mobilization and advocacy at different levels.
Conclusion:
The war in Ukraine has had a profound impact on the mental health and psychosocial well-being of children living in the affected areas. The exposure to violence, loss, disruption and trauma has caused various psychological symptoms that can interfere with their development and functioning. Caregivers play a vital role in supporting children's recovery and resilience but they also need support themselves.
There are some promising initiatives and recommendations for improving the situation, such as strengthening the capacity and availability of MHPSS professionals, increasing the awareness and utilization of MHPSS services, improving the coordination and integration of MHPSS services, and securing sufficient funding and sustainability of MHPSS services.
By these initiatives and recommendations, we can help protect and improve the mental health and psychosocial well-being of children in Ukraine and support their resilience and recovery.
References:
Comments