From the Frontlines: Words From a Mental Health Expert in Ukraine

In the first days of the war, “we were actively focused on sharing and communicating self-help protocols to prevent panic and high levels of anxiety, with special attention to children.”

COMMENTARY

My name is Valeriia Palii; I am the president of the National Psychological Association of Ukraine. I was born in 1986, 6 months after the Chernobyl accident. I spent my childhood in the rusting Soviet Union, and my age of conscience passed in the Independent Ukraine.

At the age of 18, I participated in the Orange Revolution, widespread protests against election fraud organized by a pro-Russian presidential candidate. I, a first-year student, volunteered and delivered warm clothes to the protesters.

Then we won.

In 2014, I, along with most of the country, took part in the Revolution of Dignity (so-called Maidan) protests against the abolition of European development courses and the suppression of democracy. At the time I was preparing for my dissertation defense, and I was providing free psychological counseling to the victims of the protests and blocking military bases that the former fugitive president wanted to use against the protesters.

Then we won.

Today is March 5, 2022. I am once again taking part in events that will determine the future of my country and my personal future. Together with colleagues from the National Psychological Association, we are doing everything to ensure that our society survives and recovers.

And we will win.

It is not gratuitous that I begin this letter with my story. We Ukrainians are optimistic and joke that our resilience and coping strategies are incredible. Middle-aged Ukrainians have already gone through historical changes, economic and political crises, wars, and COVID-19. Sometimes it seems to me that our stress resilience is made of steel, and the best coping strategy for us is to unite. I think our volunteer movement is one of the strongest and most incredible in the world. Today, almost every Ukrainian who is relatively safe is doing something to win: defending, accepting refugees, transporting, cooking for the army, buying important items, and donating to the Ukrainian army. Even 10-year-old children are trying to block Russian propaganda sites and channels. We really want to live free in our country. We feel that we are part of Europe—we share European values ​​of democracy and freedom.

Psychologists do not stand aside from the initiatives. From the first day of the war, we have chosen a strategy for responding to current requests and forming an action plan for the future. Current activity is focused mainly on the crisis psychological assistance. This is an online format, because people are rapidly changing locations due to the increased risk to life, and it is not allowed to leave homes, even in relatively quiet places, due to wartime restrictions.

In fact, during the first days of the war, there were not many requests, because people were in conditions of immediate danger and life threat. The most common requests during the first days centered around humanitarian problems such as lack of food and water, and houses being destroyed by the bombing. When your house is shelled and you are sitting in a bomb shelter with others without communication, light, or often water and you do not know if you will survive, talking to a psychologist is not an option for everyone.

That is why we were actively focused on sharing and communicating self-help protocols to prevent panic and high levels of anxiety, with special attention to children: how to talk about war, how to support the children of parents who are deployed, how to prepare a child for forced relocation, and even what games to play with children in a bomb shelter. The latest materials were especially relevant for parents who were exhausted, sitting in basements and bomb shelters for several days under fire.

Now that more individuals are moving to safer cities, we expect more requests, because the basic safety needs will have been met and people will be more focused on their emotional experiences. In addition, the number of calls for help with grief are growing.

Our friends and partner associations from other countries are launching psychological support networks with Ukrainian-speaking psychologists who are already working in Czech Republic, Poland, Lithuania, and Latvia. We know that similar initiatives are being launched in Portugal and Canada. I hope that other countries will also set these initiatives very soon.

After our victory, we plan to launch an extensive training in trauma therapy and crisis counseling. Many colleagues already have relevant skills, because the war in Ukraine did not begin on February 24, 2022—it began 8 years ago with the annexation of Crimea and the occupation of our territories in the East. But today, our goal is to have the appropriate professional knowledge and skills from every psychologist in Ukraine.

In the future, we expect a growing number of individuals with shock reactions, post-traumatic stress disorder (PTSD), depression, acute stress, and other psychiatric disorders. A large number of victims will also have brain injuries, so our activity will be focused on neurocognitive recovery and rehabilitation. If anyone reading this article are ready to help my colleagues in Ukraine with their education, we will be glad to receive that help.

I would like to end my letter by saying that although we are suffering greatly now—we are being killed, our homes are being destroyed, and we are exhausted from 10 days of stress—we have a strong desire to win and support each other. And we are ready to fight.

March 5, 2022

Kyiv

Beautiful and Free Ukraine

Dr Palii is president of the National Psychological Association of Ukraine. She has a private psychological practice and heads the Ukrainian Publishing Company UA-TEST.

The opinions expressed in this article are those of the author and do not necessarily reflect the opinions of Psychiatric TimesTM.