Mental Health – October 12 2022

Overcoming the trauma of war

What SOS Children’s Villages in Ukraine and Poland do to protect the mental health of children affected by war

“Mental health support is an absolute necessity”

Nearly half of Ukraine’s population is in urgent need of humanitarian assistance as a result of the full-scale invasion that started on 24 February 2022. Since then, 7 million people have been internally displaced and another 7 million, including 2,5 million children, have left the country[1].

“Mental health support is an absolute necessity,” says Yevgeniya Rzayeva, SOS Children’s Villages’ emergency response manager who moved from Kyiv to Warsaw following the invasion. “Ukrainian people are still shocked and under tremendous stress. They do not know what to do or how to move forward with their lives. Many are traumatized by the war itself and by the losses they have suffered when their relatives or friends were injured or killed and their homes destroyed.”

Experiences of war during childhood and adolescence can have long-term psychological and social consequences. There are clear disparities between the mental health of war-affected people and the general population[2]. Children in war conditions experience, witness or are threatened with staggering violence and abuse. They often lose loved ones, are forced to flee their homes and separate from their families. Lack of access to basic services and education threatens their development.

Every child has the rights to live, have a family and a safe home, as stated in the Convention on the Rights of the Child[3]. War violates these rights on multiple levels with serious consequences for children’s mental health. Post-traumatic stress disorder and depression are the mental disorders most common among children exposed to conflict. Other reported conditions include acute stress reactions, attention deficit hyperactivity disorder, panic, anxiety and sleep disorders[4].

MHPSS in Ukraine

Mental health and psychosocial support (MHPSS) has been a high priority in the emergency response of SOS Children’s Villages in Ukraine. For the past months, mobile teams of psychologists have reached more than 2,000 people in different parts of the country. Specialists have worked with children to teach them techniques that reduce stress, fear and anxiety. This summer, almost 2,000 children took part in therapeutic camps. Yevgeniya Rzayeva says: “The camps gave children an opportunity to enjoy nature, swim and play together. In this friendly environment, psychologists organized group activities focused on overcoming the trauma of war.”

In social services centers across western and central Ukraine, over 7,000 internally displaced children and families have received daily care, counseling and other forms of individual support. For the past six months, SOS Children’s Villages Ukraine have kept scaling up their emergency response. All the family strengthening activities and support for internally displaced people contributed to protecting the mental health of children. The total number of people supported crossed 82,000 in August 2022.

For children in parts of Ukraine, war has been the everyday reality since 2014. UNICEF estimated that nearly half a million children caught up in the armed conflict in eastern Ukraine were facing grave risks to their physical and mental health and needed psychosocial support. Acute stress, nightmares, social isolation and panic attacks were among the reported symptoms[5].

SOS Children’s Villages Ukraine began supporting foster families in the Luhansk region in 2012, and kept providing them support throughout the Donbas War. In mid-February 2022, some of the children and their foster parents moved to western Ukraine. Once the full-scale invasion started, foster families were evacuated abroad.

“Living in eastern Ukraine was terrifying already since 2014, but what we have been going through for the past six months is very different,” says Nataliia Herasymenko, acting head of the unit for foster family care from SOS Children’s Villages in Ukraine. “This time, children had to leave everything behind and move to a different country. They kept asking why. They could not understand why they cannot go back home.”

Arriving in Poland

Nataliia Herasymenko and her child were among the foster families from Luhansk who moved to western Ukraine in mid-February 2022 because of the tension building up in the region. “Once we arrived to Truskavets, we all felt relieved. We could rest and enjoy our time in the Lviv region. Everything was going well until 24 February. When we heard the sirens that Thursday, we understood the invasion had started. Everyone was simply terrified.”

Nataliia and the other families were evacuated to the SOS Children’s Village in Krasnik, Poland. “We arrived very early in the morning, but everything was already prepared: our bedrooms, food and clothes. All the staff members were there waiting to welcome us.”

Since the beginning of the invasion, SOS Children’s Villages in Ukraine and Poland have been working together in their emergency response. At first, the focus was on relocation assistance: providing transport, accommodation and basic necessities. The foster families have been welcomed in four SOS Children’s Villages. SOS Children’s Village Poland also welcomed children evacuated from residential institutions.

“We tried to care for them in the same way we would like to be cared for: to make them feel secure in all possible ways,” says Barbara Michota, deputy director of the SOS Children’s Village in Krasnik. “From day one, we were working around the clock to organize the reception. We wanted to make sure the Ukrainian families had someone they could come to day and night. And we listened to stories: someone’s husband was still in Ukraine, someone left a dog behind, someone else cried every time they saw a cat because their own cat died under the rubble. The relationships that started with these emotional conversations will last a lifetime.”

Healing through movement

Once the basic needs of the arriving families were met, the planning of regular MHPSS activities started. For years following the outbreak of the Dobnas war, SOS Children’s Villages in eastern Ukraine offered mental health and psychosocial support to families and children traumatized by conflict, family separation and neglect. Psychological care and speech therapy were provided to children who developed speech disorders, had problems socializing and self-expressing and suffered other consequences of the trauma of war. In social centers in Luhansk, where the families living now in Krasnik come from, mental health-related services were a vital part of the holistic support for families.

In Poland, Nataliia Herasymenko started with movement-based group activities for children and young people so they could get to know one another and take their minds off the situation in Ukraine, even for a moment. Physical activity plays a big role in protecting the mental well-being of children and caregivers. In Krasnik, Barbara Michota leads fitness classes for foster mothers so they can bond and reduce stress. Children train in jiu-jitsu and play other sports that help them integrate and stabilize their emotions.

Aleksandra Sikorska, SOS Children’s Villages’ psychologist, is currently adding TeamUp to the range of MHPSS activities in Poland. This method of working with refugee children, developed by War Child Holland, has already been used by SOS Children’s Villages in Greece and Italy. During their summer camp stay in Caldonazzo, Italy, Polish and Ukrainian children took part in TeamUp sessions.

“Through movement activities, non-competitive sports and play, children practice their psychosocial skills. The use of language is minimal, so everyone can join in. TeamUp boosts integration in international groups: children who at first approach one another hesitantly get encouraged to socialize when they see they can have fun together,” says Aleksandra, the psychologist. “The power of TeamUp lies in humor, genuine laughter and positive emotions that activate other parts of the brain than those responsible for fear, stress and sense of danger. On top of that, by observing children during the sessions, we are able to identify those that need more specialist care.”

Targeted mental health support

In all the Polish programmes, children, foster parents and other caregivers have access to psychological care. Some of them still meet online with the specialists they worked with in Ukraine, some attend in-person meetings. Psychiatric care is organized as needed for children who suffer from more severe mental disorders.

Psychologist Aleksandra Sikorska says: “Therapy and medical interventions are one part of MHPSS services we provide - not all Ukrainian children and families need it. What everyone needs is a secure environment and day to day support. We must make sure the refugees have the feeling of agency, are listened to and well-informed. What also helps is the sense of community between the families that share similar experiences. Finally, there is the importance of mental health support for foster parents. When caregivers are scared or worried, children are scared and worried even more”.

Children in alternative care are among the most vulnerable groups in armed conflicts – their situation and threats to their mental health are different than for children who grow up with the support of a family. Mental health services must address these complex, specific needs. Beata Kulig, SOS Children’s Villages’ advocacy advisor, says: “Ukrainian children in SOS Children’s Villages have lived through what Polish children in alternative care have experienced as well: complex developmental trauma. On top of that, some of them cope with war trauma. Those who were evacuated before the war, were suddenly ripped from their worlds and had to leave everything behind. They know that their homes, the places where they left people they care for, may no longer exist. We must assess every child’s individual mental health needs, looking not only at the war trauma but at what has traumatized them in their childhoods and their relationships with other people”.

Learning to live in a new country, with a different language and culture is challenging both for children and their caregivers. The receiving community also needs to learn to help in the right way. Beata Kulig says: “It took us some time to understand the Ukrainian alternative care system and work through our differences. Classes with intercultural trainers would be an important part of the mental health support. They would address the most basic need of Ukrainian refugees: feeling that they arrive in a place where someone understands them.”

Looking toward the future

SOS Children’s Villages in Poland is working to create a network of mental health centers for Ukrainian refugees, in which they will have access to psychological and psychiatrist care, rehabilitation and therapy in their language. The first center near Warsaw will launch by the end of 2022. Tomasz Wodzynski from the emergency response team of SOS Children’s Villages Poland says: “We asked ourselves: what is our core competency? Giving children long-term support and the best possible environment to grow up in. Children arriving from the war-torn Ukraine might have seen things no child should ever witness. To move forward with their lives, they need psychological care, a specialist they can talk to about their traumas. This is what the mental health support centers will provide for everyone, not only for the refugees in our direct care.”

During his visit in Poland, Dereje Wordofa, President of SOS Children’s Villages International, had the opportunity to talk to Ukrainian families and discuss the next steps of the emergency response with both national teams.

“What the people of Ukraine need is peace. They want to go back to their lives. They want to care for their children back in their home country and send them to Ukrainian schools. They want to meet again with their friends and families. I know they will continue with the same resilience and ambition to rebuild their country and we will be there to support them,” says Mr.Wordofa.

Ukrainian refugees are waiting for the war to end, so they can reclaim their lives and continue overcoming the traumas of war back home. Nataliia Herasymenko says: “Everything in Krasnik is beautiful and well-organized. We are living through ups and downs supported by people we already feel very close to. Still, every time I go back to the moment I left Ukraine, I realize how much I miss my country. We are all waiting for the moment when it will be safe to go back. We all want to be at home, living our lives to the fullest surrounded by people we love.”

Text and photos by Magdalena Sikorska