Improving access to mental health services for war-impacted population

Abstract Russia's war against Ukraine has caused an alarming increase in psychological harm and distress, with estimates projecting that at least half of the Ukrainians require mental health and psycho-social support (MHPSS) of varying intensity, including for acute stress, anxiety, depression, and post-traumatic stress disorder. Stigma and an outdated mental health system in Ukraine limit access to timely and effective mental health support. Building on the results of the needs assessment and service mapping, Pact partnered with community partners to co-create an MHPSS service delivery model known as “Taking Care of Myself” (TCM) spaces. The spaces serve as strategic entry points for integrating essential elements of MHPSS service delivery, including non-stigmatized, barrier-free access to individual psychological counseling; group sessions focused on self-help techniques and peer support; and flexible access to higher-intensity care, either in person or online. In 2024, Pact and local partners established 11 TCM spaces embedded within existing facilities and institutions, such as PHC centers, centers for social services, veterans’ spaces, and CSOs, reaching nearly 3000 individuals with services. The first assessment results of improvements in mental health, economic and social well-being showed an increase in clients’ well-being: 86% reported improvements in mental health and social well-being; the average number of inefficient working days per month decreased from 7.1 to 2.6 days. Clients reported being very satisfied with services (4.4 out of 5 scores). Engaging service providers, decision makers and residents via co-creation sessions reduced stigma and generated demand for services. The “one-stop-shop” model for MHPSS services, combining self-help, peer support, individual counseling, and pathways to higher-intensity care, met people where they were and facilitated access tailored to clients’ needs and preferences. Key messages • Training existing providers on evidence-based interventions and incorporating MHPSS services into non-hospital facilities strengthens local capacity while expanding and sustaining access to services. • Embedding MHPSS services within trusted community spaces and engaging community members and providers in service design contribute significantly to mental health stigma reduction.