Volunteering for Ukraine: scoping the operational experiences and impacts among UK and US veterans

<b>Background:</b> Since the armed conflict in Ukraine escalated in 2022, UK and US military veterans have volunteered in substantial numbers to support the Ukrainian Armed Forces. They are operating in an exceptionally intense and technologically advanced environment, often exposed to high levels of combat. Little is known about the health impact of this voluntary service.<b>Method:</b> We carried out a mixed-methods observational study of UK and US military veterans who self-reported travelling to Ukraine to support the Ukrainian Armed Forces. Participants were recruited between October and December 2025. Measures assessed probable post-traumatic stress disorder (PTSD), common mental health disorders (CMD), alcohol misuse, moral injury, and health-related quality of life. Open response items were used to qualitatively explore motivations for volunteering, experiences of service in Ukraine, and access to healthcare.<b>Results:</b> Thirty-one UK and US military veterans completed psychometric measures and 21 provided qualitative data. High levels of probable PTSD, CMD alcohol misuse, and moral injury-related distress were identified, alongside low health-related quality of life. Veterans described extremely intense combat exposure, including drone warfare and trench fighting, and frequent physical injury. Physical healthcare was often described as poor or inadequate. Mental health care was widely sought but rarely accessible, both in Ukraine and after return home, with veterans reporting being turned away from support services. Consequently, emotional support primarily came from peers rather than formal care systems.<b>Conclusions:</b> This study provides early evidence on the experiences and health needs of UK and US veterans who volunteered in Ukraine, an under-researched group falling outside existing military care structures. Many report significant unmet mental and physical health needs and face barriers to care both in Ukraine and after returning home. Without targeted support, these veterans risk remaining invisible within health systems, highlighting the need for coordinated pathways and prioritised clinical care.