Mental health of nurses and doctors in Ukraine during wartime: nationwide cross-sectional survey

BACKGROUND: Since the full-scale Russian invasion in 2022, health facilities and healthcare workers in Ukraine have been systematically targeted. Despite growing calls to prioritise their mental health, robust evidence on the magnitude of the problem and its determinants remains limited. AIMS: To estimate the prevalence of mental health problems among doctors and nurses in Ukraine, and examine their association with key exposures. METHOD: We conducted a cross-sectional survey between May and September of 2025, in a non-probabilistic sample of doctors and nurses working in Ukraine. The survey included validated self-report instruments to assess depression (Patient Health Questionnaire-9), anxiety (Generalised Anxiety Disorder-7) and suicidal thoughts, as well as workplace risk factors (bullying, sexual harassment, violent threats, physical violence) and protective factors (social support, purpose and meaning at work). Associations were examined using multilevel regression models with extensive sensitivity analyses, including Bayesian models and survey raking weights. RESULTS: Among 23 805 respondents, 1 in 3 doctors and 1 in 4 nurses reported symptoms compatible with probable depression, 1 in 4 doctors and 1 in 6 nurses reported symptoms compatible with probable anxiety, and about 1 in 10 doctors and nurses reported suicidal thoughts. Workplace violence - particularly bullying - was strongly associated with depression and anxiety, whereas physical violence showed the strongest association with suicidal thoughts. Purpose and meaning at work were consistently associated with better mental health. Associations were overall high and similar across regions with different levels of active conflicts. Estimates were robust across analytic approaches. CONCLUSIONS: Elevated prevalences and strong associations with workplace factors support a zero-tolerance approach to violence and the implementation of scalable mental health strategies that also strengthen protective factors.