"Sometimes we have an air alarm at night... a mental health specialist says, 'Me too.'"
Psychiatrist Antonina Pushko and six other mental health specialists from Ukraine recently visited Armidale, New South Wales, as part of a government-funded program aimed at sharing knowledge and improving crisis care.
The Scale of the Crisis
The International Rescue Committee estimates that 15 million people in Ukraine need psychological support due to the ongoing war. Dr. Pushko emphasized that the entire territory of Ukraine is suffering, and that moral injuries among civilians are high, as many have family members serving in the army.
Armidale's Unique Context
Armidale is a designated refugee settlement area, home to refugees from Iraq, Syria, and the Democratic Republic of the Congo, including a significant Yazidi community. Local clinicians in Armidale treat patients for trauma related to drought, fires, and floods—events which they may also experience themselves.
Clinical Challenges in Ukraine
Clinicians in Ukraine operate in profoundly unsafe environments:
- Air alarms at night disrupt both providers and patients.
- Dr. Pushko noted a "pathological normalization" of the war situation among the population.
- Specialists encounter unprecedented situations, including soldiers with histories of captivity and intergenerational trauma.
"Supporting people holistically... relies on collaboration, trust and strong relationships."
Lessons from Armidale
Dr. Pushko highlighted the critical importance of building trust between provider and client. She noted that stigma can arise if the specialist has not personally witnessed the traumatic events their patients describe.
Social worker Eaowyn Vaughan-Johnson emphasized that community building and coordination among services—including housing, domestic violence support, drug and alcohol services, and refugee services—are key to effective rehabilitation.
Telehealth was identified as a potentially useful tool for Ukraine, especially for reaching isolated patients in remote or dangerous areas.
"We have a huge gap between social services and medical treatment... you have highly developed this community support here."
Social worker Olena-Kvitoslava Yatskiv observed a significant gap in psychosocial support within Ukraine's system. Compared to Australia's multidisciplinary team approach, Ukraine's medical and social services operate in isolation, leaving a void in holistic care.