AN ANXIETY AS A RESPONSE TO DISTRESS AND AS A SYMPTOM OF STRESS DISORDERS IN WARTIME.

OBJECTIVE: The aim: A comprehensive analysis of anxiety as an emotional state and pathopsychological symptom in the situation of a massive humanitarian catastrophe in wartime. PATIENTS AND METHODS: Materials and methods: A systematic search was conducted up to April 2022 in the following databases: Google Scholar, PubMed, DOAJ, and CORE. Three reviewers independently assessed full-text articles according to a predefined aim. We used a quantitative and qualitative approach to infer. The range of mental reactions to the intensive stress with a pooled prevalence of anxiety was estimated. Anxiety as an independent structural psychological phenomenon or incorporated into more complicated mental states, including mental disorders, was assessed. CONCLUSION: Conclusions: The anxiety features as an expected mental reaction to the threatening environment are established, the analysis of anxiety development trajectories was shown, and the basic principles of psychological care in anxiety states are considered. The criteria of pathological anxiety, the characteristic of the anxiety symptom as a structural element of psychiatric diseases, and the modern methods of treatment of anxiety disorders are presented. Many specialists in the different areas work with anxious people and patients with anxiety disorders in the Ukrainian current situation, so it was concluded that understanding and being aware of the differentiation of anxiety states will improve psychological care and, if necessary, will lead to providing of a full spectrum of specialized medical care.

Developing a capacity-building programme to support a mental health service modernisation pilot project in Lviv region of Western Ukraine.

This paper reflects on the development of a capacity-building programme to support a mental health service modernisation pilot project based in the Lviv region of Western Ukraine. National programmes that aim to modernise mental health services now have the experience of other countries on which to draw. The challenges faced by such modernisers have much in common. Nevertheless, although there are lessons to be learned from what has worked well elsewhere, we caution that the local context can have a profound effect on the successful implementation of plans based on best practice.

Mental health stigma in Ukraine: cross-sectional survey.

BACKGROUND AND STUDY OBJECTIVES: This study aimed to assess among Ukrainian adults: (1) knowledge of mental disorders; (2) attitudes towards people with mental health disorders, and to the delivery of mental health treatment within the community; and (3) behaviours towards people with mental disorders. METHODOLOGY: A cross-sectional survey of Ukrainian adults aged 18-60 was conducted. Stigma-related mental health knowledge was measured using the mental health knowledge schedule. Attitude towards people with mental health disorders was assessed using the Community Attitudes towards Mental Illness scale. The Reported and Intended Behaviour scale was used to assess past and future intended behaviour towards people with mental health disorders. RESULTS: Associations between gender, age, and educational level and the knowledge and attitudes measures were identified. There was evidence of a positive association between being male and positive intended behaviours towards people with mental health disorders [mean difference (MD) = 0.509, 95% confidence interval (CI) 0.021-0.998]. Older age was negatively associated with positive intended behaviours towards people with mental health disorders (MD = -0.017, 95% CI 0.0733 to -0.001). Higher education was positively associated with stigma-related mental health knowledge (MD = 0.438, 95% CI 0.090-0.786), and negatively associated with authoritarian (MD = 0.755, 95% CI 0.295-1.215) attitudes towards people with mental health problems. CONCLUSION: Overall, the findings indicate a degree of awareness of, and compassion towards, people with mental illness among Ukrainian adults, although this differed according to gender, region, and education level. Results indicate a need for the adoption and scaling-up of anti-stigma interventions that have been demonstrated to be effective.

Transitioning to community-based mental health service delivery: opportunities for Ukraine.

Background and objectives: Ukraine's mental health system has been found to be inadequate and unresponsive to the needs of the population, in view of its emphasis on inpatient service delivery. This study sought to identify potential changes to the organization and financing of mental health services within the Ukrainian health system that would facilitate the delivery of mental health services in a community-based setting. Methodology: A systematic literature review was undertaken to identify organizational and financing features that have been successfully used to enable and incentivize the delivery of community-based mental health services in Central or Eastern European and/or former Soviet Union countries. Results: There was limited literature on the organizational and financing features that facilitate the delivery of community-based care. Key facilitators for transitioning from institution-based to community-based mental health service delivery include; a clear vision for community-based care, investment in the mental health system, and mechanisms that allow health funding to follow the patient through the health system. Conclusions: Ukraine should adopt strategic purchasing mechanisms to address inefficiency in the financing of its mental health system, and prioritize collaborative planning and delivery of mental health services. Ongoing reform of the Ukrainian health system provides momentum for instituting such changes.

Understanding and building resilience to early life trauma in Belarus and Ukraine

In 2018 and early 2019, the WHO Regional Office for Europe’s cultural contexts of health and well-being project worked alongside the University of Exeter’s WHO Collaborating Centre on Culture and Health, the Minsk Regional Centre for Psychiatry and Addiction, and the Institute of Mental Health of the Ukrainian Catholic University to engage researchers, practitioners, health-care workers and other relevant stakeholders in a series of workshops on the cultural contexts of early life trauma in Belarus and Ukraine. The initiative built on previous collaborative work to support the development of culturally informed mental health care in central and eastern Europe. This report reflects the content of the workshops through a collection of participant essays highlighting key cultural contexts and opportunities for fostering more protective and health-enhancing environments for young people in Belarus and Ukraine. It highlights the important role of subjective forms of evidence within culturally nuanced approaches to health and wellbeing enhancement, and aims to open up further interest in and opportunities for collaboration to address this under-researched area of mental health in the WHO European Region.