This piece is part of a series of articles about Ukraine’s humanitarian crisis triggered by the on-going war with Russia-backed rebels in the East of the country.
In countries like Ukraine – where the population has not experienced war for many years and suddenly finds itself in the midst of bloodshed – when people talk about humanitarian aid, one usually pictures queues of IDPs, or refugees awaiting the distribution of material items – food parcels, medical and hygiene kits, non-food items etc. The “soft stuff” is often overlooked but, in a conversation with a specialist, non-material assistance is sometimes much more helpful than a piece of bread when dealing with emotional distress, panic attacks and sudden mood changes. What is meant here is that the provision of psychosocial support (PSS) or mental healthcare to people who have experienced the horrors of war is of vital importance. Whether they recognise this or not, shelling, seeing human remains lying where you would usually go for a run, or hearing explosions and gunfire every night is something that a person never forgets and which often haunts you your entire life.
The sooner the conflict affected population receives psychological support the better, as the unsolved personal or situational crises will be overcome, allowing that individual, family and community to move in a positive direction. Hence, this type of assistance is regarded as humanitarian and is incorporated into the emergency portfolio of services that humanitarian actors usually provide during emergency programmes.
Ukraine’s humanitarian crisis is not an exception to the above – while the humanitarian community comprising national and international actors is constantly flagging this under-assisted sector with the authorities, the latter seem to be focused on the “visible” aid: shelter, food, non-food items etc. Even worse is the situation with the parallel structures in the non-government controlled areas in the East of Ukraine, where rebels are putting major constraints on operations in “non-material” areas: education or psychosocial care is may as well be non-existent.
Having inherited an outdated Soviet model in the treatment of mental healthcare and provision of psychosocial support (PSS) – with an almost immediate re-direction to medical interventions and treatment – Ukraine’s capacity to deal with the increasing numbers of people in need of support in this area is dangerously low. At this time of massive displacement and on-going military action, the absence of a state PSS system becomes especially vivid.
Back in 2003, a law on social services was adopted in Ukraine, however it held major shortcomings, namely by establishing a system of financing institutions rather than services. State support to victims of violence and armed conflict, including internally displaced people and other vulnerable groups, is not sufficient while state structures do not prioritise PSS. In 2014 the Government took the decision to cut 12 000 social workers throughout Ukraine, aiming to economize the state budget. Experts comment that 141 000 families are at this time relying on social support, whilst about 75 000 children, who are brought up in foster care, will be deprived of psychosocial services.
With state authorities struggling to adequately respond to the increasing PSS and mental health care needs of the population, civil society is stepping in to provide this assistance. The majority of PSS interventions are being implemented by either private structures or specialised NGOs and non-governmental institutions. Ukrainian psychologists have shown remarkable enthusiasm since the initial 2013 uprising by directly engaging and voluntarily assisting with PSS and mental healthcare throughout the conflict.
What is clear: psychosocial support – neither being visible nor measurable – is yet another sphere that needs special attention in any humanitarian crisis, especially in Ukraine today. Hopefully, this crisis will eventually lead to a radical reassessment and alteration to the psychological and mental health domain within Ukraine by applying best practice from European and world health system.
 La won social services 19.06.2003, № 966-IV
 №31-07340-14-5 / 4958 “On Amendments to the Cabinet of Ministers of Ukraine of December 8, 2010 1149” from 06.03.201