Reflections on Ukraine: Guidance on How Best to Respond to a Mental Health Emergency

By Fahmy Hanna of WHO

WHO is working closely with our offices in Ukraine and neighbouring countries, as well as partners to rapidly respond to the health emergency triggered by the conflict and to minimise disruptions to the delivery of critical healthcare services.

A key element of this work is responding to the mental health and psychosocial needs of the affected population in Ukraine and those now living in other countries.

With a wide range of organisations now planning and delivering mental health and psychosocial support activities, it is helpful to remember some basic guidance in responding to the mental and psychosocial needs of people – whether they are in their own homes or are refugees and temporarily housed elsewhere.

1. Follow the guidelines established by recognised, professional organisations.

Safe and effective mental health and psychosocial support requires sensitive, trained professionals who are experienced in emergency settings to design and lead service delivery. The guidelines developed with the inputs of organisations with years of experience are freely available here from the Inter-Agency Standing Committee on MHPSS. It is critically important to ensure safeguarding policies and practice are stringently followed.

2. Ensure that any response is coordinated with other responding organisations and the local authorities.

In emergencies multiple different organisations may wish to respond and offer their support. This is only effective if it is well coordinated to ensure there is no duplication or overlap with others and, alternatively, a critical gap in services and support for those in need. The MHPSS coordination group (known as the MHPSS cluster) will map and track who is operating where and ensure that offers of support are allocated to a population’s needs. In the case of the Ukraine crisis, you can find this mapping here covering not just Ukraine but all countries hosting refugees. See here. And to submit activities for the mapping of activities in Ukraine and neighbouring countries, please contact Valeria Florez at: valeria@mhpss.net with mhpss.refgroup@gmail.com in the copy.

3. Use recognised and widely supported resources.

All MHPSS responses require publicly available resources to communicate with the affected populations and provide health information. These resources will be developed by the MHPSS cluster. It is best to use these to ensure consistent messaging and consistent terminology, rather than produce different, potentially conflicting, messaging that could confuse the affected populations and those supporting them. See here for the latest resources for Ukraine.

4. Avoid an assumption that PTSD is the primary – or even most prevalent – mental health condition requiring a response.

While some people will experience Post-Traumatic Stress Disorder (PTSD) some months after an event, most people (men, women and children) who have immediate mental health needs will be those with pre-existing mental health conditions who may be lacking their regular medication and unable to employ their usual coping strategies. In addition, others with immediate needs will be people in mental health facilities and people experiencing new cases of anxiety or depression. It is wrong to assume PTSD is the condition that a large percentage of a population is experiencing - this can lead to misdiagnosis, inappropriate treatment, and/or a lack of much needed support for other conditions across the affected population. PTSD, by definition, can only be diagnosed 3 months after a trauma occurs. Other conditions require immediate support. See here to learn more.

5. Ensure the sustainability of the response.

Mental health services and support typically continue to be required for months and even years after an emergency. Any responding organisation needs to consider how the response will be sustained and people continue to receive the support that they need. This is why coordination among responders and with the local authorities is so important: for those looking to support mental health services, please try to identify a partner who is able to explain the longer-term plans for care. Members of the MHPSS cluster will be working to ensure a sustainable response. See here to learn more.

As we respond to the situation in Ukraine, we are also responding to many other mental health emergencies including in Afghanistan, Yemen, Ethiopia. All require a coordinated response, based on proven guidance, that can provide vital support over many months if not years.

To learn more, join the webinar on May 17th, 2022 at 09:00 EDT/14:00 BST/15:00 CEST with Fahmy Hanna (WHO) and others working to respond to mental health emergencies.

For more information on mental health emergency responses see here.