Ukrainian psychiatry in times of war

We speak every evening on the phone. Partially to lift the spirits, partially to make sure that he is still OK. As I write these lines the well-known Ukrainian psychiatrist Semyon Gluzman is sitting in his apartment on the fifteenth floor of an apartment building in the Kyiv suburb Obolon. It is in the North of Kyiv and thus very close to the frontline. The whole day the sound of rocket barrages is heard in the distance, and occasionally a rocket gets off course and lands nearby. A few days ago an apartment block down the road took a direct hit and was almost completely destroyed.

Gluzman is not only founder and President of the Ukrainian Psychiatric Association, but also a former political prisoner who spent ten years in camp and exile for exposing the Soviet political abuse of psychiatry. Many people have asked him to leave his flat, but in vain. He refuses to go and give up his “freedom space” because of some Russian invaders, as he puts it. Instead, he is working day and night, writing blogs and organizing aid to Ukrainian colleagues and victims of the Russian aerial bombardments. Several institutions have been bombed, some completely destroyed, like the psychiatric hospital in Chernigiv where 280 patients are now residing in the cellars together with staff.

I have been working in Ukraine for over thirty years, together with Semyon Gluzman, and in the course of years, we have implemented hundreds of projects, big and small. I have seen all corners of the country and know and befriend many Ukrainian psychiatrists, nurses and other staff, as well as consumers and residents of social care homes in the country. The whole day I am on my phone, checking whether they are OK and when they are close to the front line, whether they are still alive and safe.

Watching what is happening now makes my heart bleed, and keeps me awake at night. I am worried about my friends and about the fate of the consumers of mental health services who are terrified by the indiscriminate bombing that over the weeks has only grown in intensity. And, I am very concerned about the short-term and long-term psychological effects of this war. At the same time, I am so proud of my friends, who in spite of everything keep up their spirits, maintain a sense of humour and do everything possible to help their fellow countrymen survive this horrible onslaught on their lives and livelihood. Watching them, working with them, makes me convinced that they are unbeatable – this nation cannot be conquered. But the price of freedom will be immense, and the after-effects will reverberate for generations to come.

From the very start of the war we have been working on developing a psychological aid program for the Ukrainian population. We were in a way lucky, because after the rigged Presidential elections in Belarus in August 2020 and the massive repression of protesters that followed, we developed a safe Russian-language online psychological aid program for victims of state repression. The program, called 'samopomoch' (self-help), provides advice on how to maintain your mental health in times of great psychological duress, how to help yourself and where to go for professional help once you are not able to help yourself. In the course of the first year, we managed to provide 600 free consultations to human rights defenders and victims of torture by certified and Russian-speaking mental health professionals with specialisation in psychotrauma. We had almost 30,000 active users of our website and some two million views on Facebook.

Within days, our Ukrainian-language 'samopomoch' program (samopomoch being Ukrainian for self-help) was in the air. We are on social media (Facebook, Telegram, Instagram) and are developing our Ukrainian-language website. Within two weeks Facebook had four million views, showing the enormity of the crisis. A team of Ukrainian mental health professionals answer all the calls for help that come in, and those are many, literally many dozens a day. We see what is happening, we see the increasing despair. Messages include a mother in a bomb shelter of whom the children are in an uncontrollable panic, or the wife of a man who committed suicide. Horrible stories summarised in two lines, innocent victims of a totally unjustified war inflicted on a people for the sole reason that they want to be free and independent.

At the same time, we are developing a program to bring aid to mental health institutions. The program is run by a young and indomitable Ukrainian psychiatrist, Tetyana Dergach, who in 2014 was forced to flee from Donetsk and is now a second-time refugee with her daughter and mother in Lviv. She is for me the embodiment of the Ukrainian fighting spirit, which will lead this nation to victory, I have no doubt.

Together with the vice-President of the Ukrainian Psychiatric Association, Irina Pinchuk (also a second-time refugee, first from Donetsk and now from Kyiv), and `Semyon Gluzman we are developing a program to rebuild mental health care after the war. This might sound optimistic, but we are convinced that the moment will come, and that the crisis can be turned into an opportunity. 'Build Back Better' is the title of a WHO program, and in this case it is not only a slogan but pure reality. We know much will be destroyed, much more than is now already the case, but we are determined to help our Ukrainian colleagues and friends to make Ukrainian mental health care a full and honourable part of Europe. They have the fighting spirit that Britain had during the Second World War.

You can help us, by donating to the special fund that has been set up, by visiting our website (separate website, opens in new window)

Alternatively, contact the Hilversum secretariat via rvvoren@gip-global.org for more information.

Robert van Voren,

Chief Executive of the Federation Global Initiative on Psychiatry

Honorary Member of the Ukrainian Psychiatric Association and Honorary Fellow of the British Royal College of Psychiatrists.