Correlates of suicidal ideation and behaviour among psychologists in Ukraine’s security and defense sector

Abstract Background Psychologists in Ukraine’s security and defense sector deliver mental health care, including suicide prevention, to military and law-enforcement personnel while living through the same war, yet their own risk of suicidal ideation and behaviour is unknown. We examined suicidal ideation and behaviour and their correlates in this workforce. Methods In a cross-sectional online convenience survey (April–May 2024) of 795 psychologists serving in Ukraine’s Armed Forces, National Guard, and National Police, the co-primary outcomes were lifetime suicidal ideation and recent suicidal/self-harm thoughts (past two weeks). For each outcome we fitted hierarchical logistic regression: a first block of trauma exposures, demographic characteristics, and protective factors, and a second block adding depression. Because item 9 of the PHQ-9 overlaps with the recent-thoughts outcome, depression was measured with the PHQ-8; sensitivity analyses used the full PHQ-9, Firth penalized models, and a PHQ-independent past-year active-ideation outcome. Results Lifetime suicidal ideation was reported by 8.2% of participants and recent suicidal/self-harm thoughts by 4.9%; 2.5% had ever made a suicide plan and 0.5% had ever attempted. After adjustment for depression, childhood adversity and lifetime trauma remained associated with the outcomes; lifetime trauma was the most consistent correlate across both (adjusted OR 1.63 for lifetime ideation, 1.82 for recent thoughts), whereas childhood adversity was associated only with lifetime ideation (OR 1.49). Depression was the strongest correlate (adjusted OR 2.1–3.2), and compassion satisfaction was associated with lower odds of recent thoughts (OR 0.60). Male sex was associated with higher odds of lifetime ideation; internal displacement and age were not associated with either outcome. Models discriminated well (area under the curve 0.81–0.92). Conclusions A non-trivial proportion of providers in Ukraine’s security and defense sector reported suicidal ideation or behaviour. Cumulative trauma, especially lifetime trauma, remained associated with these outcomes after adjustment for current depression, and compassion satisfaction was associated with lower odds of recent thoughts. Safeguarding this workforce calls for confidential, organization-embedded support attentive to trauma history and formative work to reduce barriers to help-seeking.