How to live with PTSD in Ukraine

Mental care for war-related trauma

MSF teams in Vinnytsia soon realized there was a need for specialized mental health care for people living with post-traumatic stress disorder (PTSD) as a result of the conflict. In September 2023, MSF opened a trauma center in Vinnytsia for people with war-related PTSD. 

“Most of the patients are displaced people who have seen and survived unbelievably horrific events," said MSF doctor Lilia Savchenko. "They experience hopelessness, nightmares, recurrent flashbacks, anxiety, and detachment from other people. These are all normal reactions to abnormal events. But if these conditions persist for more than three to six months, then this is an indication that the person has PTSD. From then on, it is likely to get worse every day." 

MSF psychologists currently see around 30 patients for weekly consultations. Patients undergo an initial assessment, in the form of a consultation with the doctor and one of the psychologists, who make a diagnosis based on tests and clinical observation, and devise a treatment program. 
 

"The treatment program depends on the mental state in which the person comes to us, but involves an average of 10 to 15 consultations," said Dr. Savchenko. At consultations, MSF psychologists use evidence-based practice divided into three phases—stabilization, trauma processing, and reintegration into social life—and tailored to patients’ needs. 

The stigma of mental health care 

It’s common for people with PTSD to be reluctant to seek help. This is often exacerbated by the stigma that exists around mental health care. "There is a lack of understanding of how psychotherapy works and this can discourage people from seeking help,” said Andrii Panasiuk, MSF psychologist and mental health supervisor. “This is where raising awareness plays a key role.” 

To raise awareness of PTSD and inform people about its symptoms, MSF teams conduct sessions with general practitioners and with veterans' associations. We also work with local organizations to run creative workshops and art activities on the signs of PTSD for people displaced from regions like Mariupol or Kherson. During these activities, health promoters sit and talk with each participant individually in order to build trust, identify people who could benefit from psychological support, and empower them to seek care. 
 

“I often draw parallels between physical and mental injuries,” said Mariana Rachok. “If you don’t disinfect or treat a wound, but simply cover it up and try to ignore it, the wound just gets worse. It’s not in the psychologist's power to bring back your home or your loved one, but it is in their power to help you find ways to live with trauma, learn to understand your emotions, cope, and find ways to help yourself.”

Starting to live again

Lidia Bazualyeva, 74, was displaced from her home in Kherson and received mental health support from MSF for PTSD. “All these creative activities helped me psychologically, as did the consultation with the psychologist. Slowly I came out of this very difficult post-traumatic state. Now this is my only family and I have never missed an event facilitated by the health promoters,” she said with a smile. “When I communicate and share information, I slowly start to live.”

Alina Rosheva recently completed MSF's PTSD program. "I went to a lot of therapy sessions,” she said. “It was difficult. Recovery does not happen overnight—it's a long and complicated process. But three months after I started treatment, I stopped having panic attacks; they went away. At last, I had learned to control them and to deal with them.” 

Today, Alina is in charge of organizing cultural activities for I'Mariupol, a support organization for people displaced from Mariupol. She has built up a new group of friends in Vinnytsia and faces the future with confidence again.  
 

About our work in Ukraine

MSF first worked in Ukraine in 1999, providing treatment for HIV/AIDS, tuberculosis, and hepatitis C. Between 2014 and 2019, MSF teams worked in the conflict-affected Luhansk and Donetsk regions, running mobile clinics, providing peer support to local health care workers, and training them to provide mental health care. In the two years since the war in Ukraine escalated dramatically, MSF has expanded activities to include: organizing evacuations and referrals of patients; and providing medical and mental health care, including surgical, emergency, intensive care, physiotherapy, and psychological treatment for PTSD. 

In September 2023, MSF teams started providing specialized psychotherapeutic services for people with war-related PTSD in a new, custom-designed mental health center in Vinnytsia. Since then, MSF has conducted close to 1,400 consultations and run 4,400 awareness sessions at the clinic or at partner organizations’ facilities. To date, 81 patients have been discharged from the program after completing therapy.