What can be done to ease their suffering when the country is eventually able to rebuild?
The current Russian war against Ukraine is a tragedy of epic proportions, which undoubtedly causes serious psychological damage and inevitably leads to long-term consequences for combatants and civilians, not to mention refugees. “In my research, I describe how to organize the provision of psychological assistance for Ukrainian veterans,” – notes Royal Medical Corps (RAMC) expertMartin P. Deal. Details – in the material prepared by the author for Vox Ukraine.
Most research on military veterans, which has been conducted primarily in the US and UK, is not relevant to the Russian-Ukrainian war, which is an existential conflict and a struggle for national identity. Unlike US and UK veterans, Ukrainian veterans return to a devastated country still in the midst of an existential struggle for its own survival, and to a home where loved ones are equally traumatized by war.
More than a million men and women of working age are military veterans, and this significant number makes any special provision for them impossible, especially given the enormous burden of war-related mental health problems in the general population (World Economic Forumem >, 2022). What can be done to ease their suffering when the country is eventually able to rebuild? Physical infrastructure is easy to restore, but tormented souls are; much more complicated.
Prevention efforts should begin with military personnel: as Americans discovered during World War II (see Jones et al. (2010), Killgore et al. (2008)), except for those with a clear history of mental illness, screening recruits to identify individuals , which are likely to break, are ineffective. However, reducing or abstaining from alcohol consumption among combatants has been shown to be effective in reducing the incidence of nervous breakdowns during service. Commanders must be trained to recognize mental health problems in combatants. Because regardless of any medical advice, at the end of the day it is up to them to decide whether a soldier is “sick” or not. and needs treatment (and, if necessary, evacuation from the battlefield), or a “coward” who deserves punishment.
When I attended a course for future British Army commanders, I spent three days learning how to discipline and discipline soldiers, but learned nothing about their mental health. Such training does not take much time and could easily be incorporated into existing courses designed for senior officers preparing to assume a command position for the first time. They must recognize that placing mentally disturbed soldiers on the battlefield (whose actions may be worse than inaction) can not only reduce the overall combat effectiveness of the unit, but also create administrative, medical and, often, legal burdens that distract the commander from the specific mission.
Mental health disorders and suicide are more likely to occur among young, single male military personnel who are also less likely to seek help (Crawford et al., 2009). Stigma and men's reluctance to admit they have mental health problems is still a common barrier to treatment. The conversion of suffering and anger into alcohol, drugs, domestic and sexual violence is a common occurrence upon return from combat operations, as is the so-called “risk taking”. behavior (reckless driving, gambling, fighting, promiscuity, etc.). All of this, of course, is fueled by excessive alcohol consumption (Thomson et al., 2011).
Certain signs of a serious and emergency mental health situation among war veterans in Ukraine are already visible. A 2020 study by the Ukrainian Public Health Foundation showed that 57% of veterans needed psychological support.
In 2021, Deputy Minister of Veterans Affairs Inna Draganchuk reported that since 2014, 700 Ukrainian veterans had committed suicide and admitted that tracking former military personnel had been difficult and the number of suicides had increased. . . “may be quite underestimated.” The psychological impact of war extends beyond those directly involved. Thus, many US and UK veterans, including older veterans of previous wars, experienced worsening symptoms while watching media coverage of the fighting in Ukraine.
After the war, psychological support for injured veterans is likely to be quite limited, given the large number of them. Consequently, coordination of efforts to provide psychological support (especially by non-governmental and humanitarian organizations) is necessary to avoid duplication of efforts, as well as to promote equal access to such support according to need(although coordinating these efforts may be a challenge for authorities) . Such resources are scarce, so they should be used wisely and effectively. For example, local self-help groups for veterans and their families, when coordinated and supervised by mental health professionals, are a more effective use of resources than attempting to provide individual therapy for a few. Practical support (food, warmth, shelter, safety and protection) is a necessary condition for the effectiveness of any psychological support. and are ready to work with complex cases. At the national level, efforts to reduce stigma and make it easier to seek help should be promoted through the media to reach as many people as possible. Raising awareness and promoting openness and discussion about mental health issues is half the battle in encouraging veterans to seek help. While medical education is an obvious platform for this, using drama and fiction to address real-life situations, and engaging opinion leaders to talk about their own mental health issues while legitimizing. the suffering of others is a potentially powerful tool for influencing the behavior of many people. Politicians (including the President) and key opinion leaders in the country must demonstrate leadership on this issue. They are role models who can do a lot to reduce stigma and encourage open discussion about mental health issues. Movie and television producers should be encouraged to highlight mental health issues faced by returning veterans in films, television films and series. Everyone can help the veteran community, not just doctors and psychologists.
Soldiers and military personnel suffer far more from stress and overexertion than from bombs and bullets. Understanding this can make any treatment or psychotherapeutic intervention much more effective. There are many destroyed buildings in Ukraine that need to be restored, but restoring the damaged souls of a large part of the veteran community will be an immeasurably more difficult task. Therefore, citizens, politicians and professionals of all kinds must try to understand the problems faced by those who risked their own lives to protect and preserve the way of life of their countrymen.
References
Authors:
<img title="Healing the soul& Providing mental health needs for military veterans in Ukraine" src ="https://baltimorechronicle.com/wp-content/uploads/2024/02/97a7e2202d2f37805610b422f3719634.jpg" alt="Healing the soul… Providing for mental health needs’
Martin P. Deal, Royal Medical Corps (RAMC)
«Vox Ukraine»
«VoxUkraine» – analytical center that studies the development of the economy, public administration, social and reform processes
* Author's opinion may not coincide with the agency’s position
