Mental health care utilisation among internally displaced persons in Ukraine: results from a nation-wide survey
Open accessAbstract
AimsThere are an estimated 1.5 million internally displaced persons (IDPs) in Ukraine because of the armed conflict in the east of the country. The aim of this paper is to examine utilisation patterns of mental health and psychosocial support (MHPSS) care among IDPs in Ukraine. METHODS: A cross-sectional survey design was used. Data were collected from 2203 adult IDPs throughout Ukraine between March and May 2016. Data on mental health care utilisation were collected, along with outcomes including post-traumatic stress disorder (PTSD), depression and anxiety. Descriptive and multivariate regression analyses were used. RESULTS: PTSD prevalence was 32%, depression prevalence was 22%, and anxiety prevalence was 17%. Among those that likely required care (screened positive with one of the three disorders, and also self-reporting a problem) there was a large treatment gap, with 74% of respondents who likely required MHPSS care over the past 12 months not receiving it. For the 26% (N = 180) that had sought care, the most common sources of services/support were pharmacies, family or district doctor/paramedic (feldsher), neurologist at a polyclinic, internist/neurologist at a general hospital, psychologists visiting communities, and non-governmental organisations/volunteer mental health/psychosocial centres. Of the 180 respondents who did seek care, 163 could recall whether they had to pay for their care. Of these 163 respondents, 72 (44%) recalled paying for the care they received despite government care officially being free in Ukraine. The average costs they paid for care was US$107 over the previous 12 months. All 180 respondents reported having to pay for medicines and the average costs for medicines was US$109 over the previous 12 months. Among the 74% had not sought care despite likely needing it; the principal reasons for not seeking care were: thought that they would get better by using their own medications, could not afford to pay for health services or medications, no awareness of where to receive help, poor understanding by health care providers, poor quality of services, and stigma/embarrassment. The findings from multivariate regression analysis show the significant influence of a poor household economic situation on not accessing care. CONCLUSIONS: The study highlights a high burden of mental disorders and large MHPSS treatment gap among IDPs in Ukraine. The findings support the need for a scaled-up, comprehensive and trauma-informed response to provision of MHPSS care of IDPs in Ukraine alongside broader health system strengthening.
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The PCL-5 cut-off score used in the paper has not been validated for Syrian refugees.
“Fourth, the cut-off score of the PCL-5, which has been used in this paper, has not been validated for Syrian refugees but has been used in other studies among male veterans in the USA (Bovin et al., 2016) and among conflict-affected populations in Ukraine (Roberts et al., 2017).”
From Treatment gap and mental health service use among Syrian refugees in Sultanbeyli, Istanbul: a cross-sectional survey (2020) · cites this paper as Roberts et al., 2017
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Self-citationBarriers to Mental Health Help-Seeking Amongst Refugee Men
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- Authors
- Roberts, B., Makhashvili, N., Javakhishvili, J., Karachevskyy, A., Kharchenko, N., Shpiker, M., & Richardson, E.
- Affiliations
- London School of Hygiene & Tropical Medicine (GB)
- Ilia State University (GE)
- Kyiv International Institute of Sociology (Ukraine) (UA)
- European Observatory on Health Systems and Policies (BE)
- Corresponding author
- Roberts, B.
- Venue
- Epidemiology and Psychiatric Sciences
- Publisher
- Cambridge University Press (CUP)
- Published
- 2017-07-27
- Volume
- 28
- Issue
- 1
- Pages
- 100-111
- ISSN
- 2045-7960 (ISSN-L)
- 2045-7979
- PMC
- PMC6998949
- OpenAlex
- W2741266280
- Cited by
- 177
- References
- 8
- Citations by year
- 2026: 22 · 2025: 29 · 2024: 20 · 2023: 38 · 2022: 28 · 2021: 13 · 2020: 12 · 2019: 11 · 2018: 2 · 2017: 2
- FWCI
- 9.16
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Epidemiology and Psychiatric Sciences (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Health Professions › General Health Professions › Health and Conflict Studies
- Keywords
- internally displaced persons, psychosocial support, treatment gap, post-traumatic stress disorder, depression, anxiety, barriers to care, out-of-pocket costs, family economic hardship, stigma, armed conflict, Eastern Ukraine, non-governmental organizations, access to mental health care, community mental health services
- MeSH terms
- Adolescent, Adult, Anxiety, Community Mental Health Services, Cross-Sectional Studies, Depression, Female, Health Services Accessibility, Humans, Male, Middle Aged, Patient Acceptance of Health Care, Refugees, Socioeconomic Factors, Stress Disorders, Post-Traumatic, Ukraine, Warfare, Prevalence
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