Ukraine's mental health workers tackle war trauma and Soviet stigma in front-line regions

Yahoo

19-05-2025

Editor's note: In accordance with newsroom policy on reporting on children and the policies of organizations interviewed, the Kyiv Independent is not using the names of children under 18 or the last names of their parents who appear in this story.
When the children arrive at a basement shelter in the Savyntsi Community Center, psychologist Olena Husman, in her blonde bob and tortoise-shell glasses, stoops down to greet a young girl in pigtails with a high five.
As Husman and another psychologist lead the elementary school-aged children in dancing to children's songs on this cloudy April day, one by one, the kids warm up and remove their coats.
"Good morning, the sun says hello! Good morning, the sky is blue! Good morning, there are birds in the sky!"
The youngest is four years old, and the kids spin with airplane arms and hop around like frogs to music played from a Bluetooth speaker. A glowing space heater keeps the room warm, while sheets and hand-drawn cartoons hang from the pipes, decorating the cement walls that protect them from aerial attacks.
Savyntsi, a community 85 kilometers southeast of Kharkiv, survived heavy shelling and six months of occupation in 2022. Residents were tortured and disappeared, and many families fled. Home to around 10,000 before the full-scale invasion began, less than a quarter of the population remained when the occupation ended. Children who stayed behind spent much of the time hiding from Russian troops who occupied their town.
Many returned home since Ukrainian forces pushed back Russian troops during the Kharkiv counteroffensive. Today, Savyntsi has 5,850 residents, including 697 children.
"It is very important that our children still have a childhood, even if it was partially stolen by military aggression," says Liliia Novoselska, the village council's chief education department specialist. "The children were under occupation for a long time, sitting in basements."
"As the head of our military administration says: 'We were able to pull the children out of the basements, but it is very difficult to get the basements out of their heads.'"
'It is very important that our children still have a childhood, even if it was partially stolen by military aggression.'
Liliia Novoselska, Savyntsi's chief education department specialist, is seen during an interview at a school in Savyntsi, Kharkiv Oblast, Ukraine, on April 1, 2025. (Chris Jones / The Kyiv Independent)
Four days a week, teams from the global youth aid agency SOS Children's Villages bring mental health services to children in various rural settlements. These small communities closer to the battle lines often have the least access to mental healthcare in all of Ukraine, yet have been exposed to some of the most traumatic conditions of the war.
Although it's just after 10 a.m. during the team's weekly session in Savyntsi, it's impossible to tell this in the underground room with no windows. Behind the dancing children, a social worker meets with parents to tell them about their programs and ask if they need help obtaining things like dishes or rain boots, while another psychologist counsels parents individually and in groups nearby.
The children jump and clap their hands together, singing the worldwide mega-hit kids song "Baby Shark," while the shyest kids hide under a table until they're comfortable enough to join the group. One boy has walked an hour with his mother from an area with little public transport to attend. Later in the day, older groups of middle schoolers and teenagers will arrive.
More than 6 million Ukrainians are estimated to have left the country since the full-scale invasion, often leaving behind their homes and possessions while taking with them their talents and expertise.
The local government of Savyntsi, like those of many other communities in the country, has been working to encourage families to stay in the village and help rebuild their community and their homeland, Novoselska tells the Kyiv Independent. Bringing in child psychologists is part of this effort, as the community has none of its own.
"We will not be able to live another life, we will not get another chance," Novoselska says. "We adults must do everything as best as possible so that our children are happy."
Husman estimates she spends at least five hundred hours each year in the back of their white van stamped with the SOS Children's Villages logo. Her team members, a group of six psychologists and specialists, sway against one another on sharp turns and potholes in their native Kharkiv Oblast.
They pass buildings struck by glide bombs and through military checkpoints, until buildings give way to woods and then to fields of dark soil surrounded by small red signs warning of landmines.
Husman, now 53, spent nearly two decades as a teacher, then almost another decade as a private practice psychologist working with children with special needs. Her current work with SOS Children's Villages rings close to home as a mother and native of the region herself.
"I'm still not used to it," Husman says. "You see the eyes of these children. Here, there are displaced families, orphaned children, maybe someone's parents just died recently. You look at these children, and they are still living on the front lines. They have a chance for a different life, but they all hide when the Shaheds (kamikaze drones) fly. How can you get used to this?"
Addressing mental health problems will be one of Ukraine's biggest challenges in the coming years, the country's social policy minister told the Kyiv Independent in March.
A World Health Organization survey found in 2024 that psychological distress is the most prevalent health issue in the country. Nearly half of Ukrainians face some sort of mental health concern, according to WHO data. Those numbers rise to around three-quarters or more in regions closest to the front lines, including Kharkiv. According to Health Ministry data, the most common reasons for Ukrainians to seek mental health treatment are anxiety, sleep disorders, depression, and problems with memory.
Psychologists working with children and their caretakers say Ukraine's youth have also fallen behind on socializing with others their age, especially near the front lines, where schooling is held remotely and children in some communities spent months in hiding.
"There's a desire to communicate, but the skills are missing," says Husman. "And there is often another problem: they can't be organized." In large groups, children lag behind their usual age group's ability to follow directions, she explains: "They don't understand structure."
SOS Children's Villages has multiple teams working in different oblasts, making weekly visits to the villages they serve. With the help of glitter, clay, markers, music, and games, the team designs tailored activities for each group to help the kids communicate with one another and express their feelings.
The third group of children who visit the shelter in Savyntsi are teenagers. On this particular day, they are making collages depicting their dreams of the future and presenting them to the rest of the group. One boy, who dreams of visiting London, uses a glue stick to paste a British flag next to a cartoon of Big Ben. Two girls look at pictures of perfume, while another boy chooses an image of an expensive necklace. He wants to buy his future wife jewelry, he explains.
'In the Soviet Union, psychiatric hospitals and psychiatry in general were punitive. It was a way to combat people who were against the communists.'
Olena, a resident of Savyntsi with seven children, arrives at the basement to pick up her young daughter. After the war began, her eldest son, a teenager, closed himself off and "doesn't share much," she says. Her eight-year-old daughter began stuttering in class with fear, but "can't say what she's afraid of."
Since several of her kids began attending the weekly classes, she's seen them opening up more with their peers. "When the women began coming to us, (my kids) were afraid. They were hiding, scared. Now they're not as afraid," she says, before taking her daughter home.
Read also: Coming of Age Amidst War
"In the Soviet Union, psychiatric hospitals and psychiatry in general were punitive. It was a way to combat people who were against the communists," says Yuliia Okhmat, deputy coordinator for the mental health and psychosocial support division of the global medical aid organization International Medical Corps (IMC). "That's not the case now in Ukraine, but it takes time to dispel this myth — especially among older people."
Since the full-scale Russian invasion of Ukraine in February 2022, nonprofits, government ministries, and international agencies have joined forces to find new ways to treat Ukraine's unseen wounds. Therapists, psychologists, and social workers have been integrated into teams that deploy as rapid response to strike sites, one-time community health visits, and long-term outreach to remote areas with few services. Hundreds of mobile teams are currently deployed across the country, carrying out consultations with both children and adults.
Adults, however, are often more resistant to accepting services. While mental health support is stigmatized in many countries for many different reasons, Ukraine has the additional barrier of its past.
Researchers estimate that tens of thousands of people deemed to be dissidents were imprisoned in psychiatric "hospitals" during the 1960s to 1980s Soviet Union, where patients were beaten and given psychiatric medications like haloperidol as torture and control. Russian forces have recently revived the practice of punitive psychiatry in the occupied Ukrainian territories.
The IMC has been working to dispel shame and misconceptions around treatment both by visiting communities and gaining their trust over time and by supporting national communication campaigns. It has carried out more than 30,000 mental health consultations since the outbreak of the full-scale invasion and trains health care workers and community leaders in mental health techniques, from stress management to how to treat elder populations struggling with mental health.
"When we go to train educators and social workers, sometimes we see that they are scared to even utter the word suicide," Okhmat says.
Okhmat, who was working in the Donbas region of Ukraine prior to the full-scale invasion, says she's noticed that people are now more open to receiving mental health services than they were nearly a decade ago when Russian aggression began. "But there is still a long way to go to combat stigma," she adds.
The volunteers with the Israeli-Ukrainian nonprofit FRIDA have found creative ways to convince Ukrainians to take advantage of their mental health services.
The organization brings together doctors of various specialties on the weekends to staff one-day clinics in areas of Ukraine with limited access to medical care, including front-line communities. Many of their patients are elderly villagers with strong ties to the land or insufficient funds to relocate to safer places. The arrival of the energetic young team is often an important event for these villages: residents often dress up for the day.
When the FRIDA team arrives in Kamiane, a rural settlement in Zaporizhzhia Oblast about 38 km (24 miles) from the front line, a crowd of villagers begins to form outside the Soviet-style two-story cement brick building more than an hour before the clinic opens. Most are pensioners, milling about and catching up with neighbors.
— Do you have trouble sleeping? — Just when they're bombing us.
Inside, a team composed of more than a dozen specialists is a whirlwind of movement, transforming the space into an extensive hospital with the equipment from their ambulance. Stacked boxes of pills and prescription glasses are unloaded in a row to create a makeshift pharmacy. Signs are taped to different doors marking the doctors behind them — cardiologist, oncologist, gynecologist, neurologist are among them — and an intake area just inside the entrance is set up with laptops and forms to greet the arriving patients.
When the doors open, the first villagers approach the desks to fill out forms and list the doctors they are here to see. The most popular are the cardiologist and ophthalmologist, while practically no one shows up asking for mental health treatment.
But after patients complete their intake, the doctors wave them toward a soft-spoken young woman sitting on a wooden chair in the corner with a laptop across her knees. While waiting for their doctors, each patient is asked to answer a survey of ten questions, though its true purpose isn't advertised.
"Do you have trouble sleeping?" asks Anastasiia Tsyubchenko, a psychologist and therapist who specializes in trauma. 'Do you ever feel anxious or experience panic attacks?'
"Just when they're bombing us," responds an older woman with trembling hands in a white knitted cap.
Tsyubchenko was working in human resources when the full-scale invasion broke out, but watching her country rally for its survival motivated her to go back to school for a psychology degree. Now, during the work week, she treats veterans, civilians, and families of military personnel. Her visit to Kamiane is her sixth weekend volunteering with FRIDA, having also joined missions in Sumy, Donetsk, Kherson, and Chernihiv oblasts.
On the volunteer missions, they often encounter emotions of people in crisis, she says. "When relatives are on the contact line at the front, it's very difficult, especially for mothers and wives. They have constant stress. When a relative dies, they grieve. Here, too, people live in these front-line regions with constant explosions, constant threats. They see it all, hear it all. It is more acute for them."
When she asks one man in a worn brown cap whether there are events that intrude on his thoughts or that he can't stop thinking about, he begins to tear up. After he responds "yes" to more than four of the screening questions, she recommends he return for an individual counseling session with her later in the afternoon. Because mental health relief is rarely an immediate fix, FRIDA directs people to partner organizations that offer a course of 10-12 remote sessions at no cost to the patient.
"People sometimes do not entirely understand their situation themselves, or do not feel that they need psychological treatment, even when concerns are significant and affecting their health," says Olena Poskanna, who heads FRIDA's mental health division. "That's why we introduced the patient survey."
While FRIDA's work in Sumy and Zaporizhzhia is funded by the German Federal Ministry for Economic Cooperation and Development and carried out by GIZ Ukraine, other organizations are less lucky. Other mobile health clinics that were dependent on USAID money have halted their operations.
'Around 85% of patients come (to the neurologist) and they're sure that the problem is in the spine, that the problem is somewhere else, and not in their mental health.'
Last year, FRIDA volunteers treated more than 13,000 patients for different medical issues across 76 missions. The organization's mental health division screened more than 3,500 front-line residents. A preliminary data analysis by the organization found that just over two-thirds of respondents had symptoms that led its specialists to recommend additional counseling.
Olena Mazurenko, a neurologist who has participated in nearly three dozen FRIDA missions in two years, says many patients seek her out to treat physical symptoms without realizing their cause is depression or anxiety.
"Around 85% of patients come and they're sure that the problem is in the spine, that the problem is somewhere else, and not in their mental health," says Mazurenko. "The patient may not feel or recognize that they have anxiety, but will have issues with their nervous system."
With careful questions and physical evaluations, she teases out the underlying cause of the residents' ailments. If medication is needed, she will write an initial prescription and walk them through how to speak to their local doctors for follow-up treatment. The process can include coaching patients through their fears.
'I had 35 patients today, and somewhere around 28 or 29 had anxiety disorder. The most popular (medicine) boxes are mine.'
Over the course of the day in Kamiane, more than a hundred villagers cycle through the building, seeing an average of three doctors during their visit. The hallways are filled with elderly patients waiting for their turn to see the specialists.
Although few arrive seeking mental health treatment, when the volunteers begin taking down the signs and packing up boxes at the end of the day, Mazurenko points to the pharmacy. The pile of anxiety and depression medicines has dwindled.
'I had 35 patients today, and somewhere around 28 or 29 had anxiety disorder. The most popular (medicine) boxes are mine.'
Hi, I'm Andrea Januta, thank you for reading this article. Telling stories from hard-hit front-line communities, like Savyntsi and Kamiane, is meaningful but difficult work. To fund our reporting, we rely on our community of over 18,000 members from around the world, most of whom give just $5 a month. We're now aiming to grow our community to 20,000 members — if you liked this article, consider joining our community today.
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