Mental health services during the war in Ukraine: 2-years follow up study

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BACKGROUND: Chronic war exposure causes resource shortages, disrupts care for existing health issues, and heavily impacts mental health, increasing the risk of trauma-related psychiatric disorders. Using longitudinal data collected from psychiatric hospitals across Ukraine between January 2022 and May 2024, we aimed to evaluate the functioning and role of these institutions in delivering mental health care during the ongoing war. METHODS: We conducted a second follow-up nationwide longitudinal study of Ukrainian inpatient mental health facilities during the Russian invasion that began in February 2022. Responses were obtained from the heads of 34 inpatient mental health facilities. This paper focuses on 25 facilities that participated in all three consecutive surveys, representing 41% of all psychiatric hospitals in Ukraine. Information on hospitalizations, as well as data on the number, displacement, and injuries of staff as of April 2024, was gathered and compared with findings from previous surveys. RESULTS: The number of psychiatric hospitalizations increased two years after the onset of the full-scale war in Ukraine compared to both the pre-war period and six months after the invasion began (433.4 in January 2022, 397.5 in April 2022, and 552.0 in April 2024 per month, respectively). The average proportions of hospitalizations attributed to psychological war trauma across the study waves were 12.2% (January 2022), 13.5% (April 2022), and 17.3% (April 2024), with the differences not reaching statistical significance. The average number of psychiatrists, social workers, and junior nurses per facility declined steadily over the study period. As of April 2024, 21.7% of medical workers in the surveyed facilities had been displaced, and 0.5% had sustained injuries. CONCLUSIONS: The number of psychiatric hospitalizations two years into the full-scale war in Ukraine has risen, exceeding both pre-war levels and those recorded six months after the invasion. While hospitalizations related to war trauma have increased, their proportion has remained relatively stable, indicating a sustained demand for trauma-related care.

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