We saw firsthand the tragic behavioral health crisis in Ukraine

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Within days of arriving in Poland after the 20 hour trip from Seattle, we were hearing the stories.

A newly arrived grandmother from Kyiv who cried in panic when she saw a plane flying overhead. Ukrainian students who spent their days in their new school with their heads on their desks, unable to cope.

The mother who fled Mariupol who grabbed her two young children and jumped out of a moving van because she saw barbed wire on top of a fence. The driver transported them to a warm and safe place filled with caring volunteers. But unable to understand his language, she became convinced that they were being taken to a concentration camp.

Our group consisted of three psychologists and a mental health counselor from Seattle, joined by a psychologist and child psychiatrist from Maryland. We were ready to offer a disaster behavioral health curriculum developed by two of us based on many years of disaster preparedness and response activities.

The situation of Ukrainian refugees in Poland is similar in some respects to that of others in the rest of the world; they have a fierce desire to return home, a sense of despair over what has been lost, and a sense of hope over what may come in the future. But unlike previous refugee groups we worked with, these were almost exclusively mothers and children. Husbands, brothers, grandfathers and uncles stayed to fight. There is a different sense of fragility and trauma when families are separated in this way, and it was evident on the faces of the mothers who carry such a burden of caring for themselves and their children in such a place. close and yet so different from their home.

Unlike our previous missions in Haiti and Jordan, the 2 million refugees who initially entered Poland (almost all women and children) were not accommodated in refugee camps or centers, but were quickly absorbed by Polish foster homes. Many people within the general population were engaged in support of one kind or another, and it was inspiring to see.

Although we worked directly with Ukrainian mothers and children, our primary mission was to train as many Polish and Ukrainian volunteers as possible. In turn, their job was to train others in the techniques we taught them: fostering connection through active listening, effective de-escalation strategies, suicide prevention, triage to appropriate levels of care and tools to help with acute stress symptoms. Later, under the direction of Dr. Sharon Hoover, director of the National Center for School Mental Health at the University of Maryland, we also trained educators on how to implement effective behavior management strategies and elements of behavior management. a trauma-informed classroom.

By “training the trainers” we could reach many more affected people. In any major disaster, behavioral health providers are quickly overwhelmed and unable to handle the influx. Our Health Support Team training was designed to train community members to fill the void, providing basic behavioral health support. With more ‘hands on deck’, capacity is freed up for behavioral health to help those with the most serious issues.

We trained librarians and staff of cultural centers who could organize activities for Ukrainian children and mothers, most of whom did not speak Polish. Staff from charities such as Caritas, already responsible for massive material assistance in the form of clothing and food, are now providing psychological support to refugees and their own staff. In our first training in Lublin, Capuchin friars and nuns from the Priory of Lublin were part of the training group, having found themselves in the role of disaster responders.

In total, the team delivered more than 20 sessions over eight working days in Lublin, Firlej and Warsaw, training several hundred volunteers. Every night and every morning we met to eat, debrief, coordinate and plan the day. Sometimes we could find the time to eat a real meal in a restaurant. Other times it was bread and cheese or chips and candy from a nearby grocery store.

We were very fortunate to have a team environment of mutual support and encouragement. Such support was invaluable in the face of the harsh realities of what people were going through.

This team culture also extended to our Polish colleagues who organized, supported, translated the trainings, and were as tired and sleep deprived as we were. Of these, none was more loyal than Dr. Robert Porzak, a psychologist and professor at the University of Economics and Innovation in Lublin, Poland. Dr. Porzak contacted one of us within two days of the Russian invasion, knowing that the needs in his country would be great.

At the start of our first session with Ukrainian mothers, we introduced ourselves and where we were from: Seattle and Baltimore, a simple and oft-repeated convention. The third semi-circle mother took her turn to introduce herself and where she’s from, adding, “But, of course, it’s destroyed now.” The whole group nodded in sympathy and the translator just shrugged. For us, it was as if we were hearing that Tukwila, or Monroe, or Port Townsend – or any number of similar towns nearby – had simply disappeared and there was nothing left. There are few things that can prepare someone for the best way to deal with something so indescribable.

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