Now based in Los Angeles, Savchuk co-founded TeleHelp Ukraine to provide virtual health services to people in her home country, where, in many areas, the conflict with Russia has destabilized public health systems. Working with members of Stanford’s Ukrainian Students Association, she and her peers began recruiting providers, interpreters and volunteers across the globe, creating a network that has grown into a free, worldwide virtual health service that any Ukrainian with an internet-connected device can access. Nearly 16 months on, TeleHelp Ukraine has facilitated over 1,400 virtual consultations, from cardiology to neurology to reproductive health, in sessions often conducted by providers thousands of miles away.
Over 800 of those consultations have been specifically for mental health issues, an often invisible repercussion of the conflict. It is estimated that one in four Ukrainians — some 10 million people — may suffer from mental health issues because of the ongoing crisis, with more than 60 percent of Ukrainian soldiers said to be experiencing post-traumatic stress disorder (PTSD). The public health implications of this threaten to upend Ukraine’s social and economic stability while the war grinds on, and its ability to rebound after it’s over. As such, an array of parties, from international aid groups to Ukraine’s presidential office, are mobilizing to prevent what could become a nationwide mental health crisis.
Yet a crucial obstacle remains: Ukraine simply doesn’t have enough mental health providers, and those that it has, because of the war, can’t always get to the people who need help.
Amid this scenario, a solution has, as they say, entered the chat. As the Covid pandemic subsides, a medical landscape transformed by telehealth is emerging in its wake. Across the world, patients are meeting with doctors in the virtual realm for a host of reasons, from pain management to mammograms. And online therapy is no exception. The remote mental health market is estimated to have expanded by more than 27 percent over the past year. Now, through TeleHelp Ukraine, patients there are able to meet with mental health professionals in other parts of Europe, the US and beyond.
Perhaps unsurprisingly, mental health disorders run rampant in war zones. Rates of anxiety, depression and PTSD are up to three times higher among people exposed to armed conflict, and more than one out of five people living in these areas grapple with a mental health condition. Yet due to the very nature of conflict zones, mental health services in these places are often insufficient, disrupted or difficult to access.
“We’ve seen folks that have served in the military and on the frontlines, and in local volunteer groups,” says Savchuk. “We’ve had patients from the occupied territories. A ton of folks who have had their houses destroyed, have had to move to a small village somewhere in western Ukraine, and have found it tough to adjust. Sometimes these folks may have family members in the military and are working through the anxieties of that. Some are just dealing with previously diagnosed mental health conditions that they’ve been working through, and the war has just exacerbated them.
“This is a very challenging environment in which Ukrainians have to live through and continue to work and support themselves and their families, but with a war going on.”
TeleHelp Ukraine is part of a wider movement to mitigate these problems, and ensure Ukraine’s recovery from the war isn’t hindered by a lack of mental health resilience across the population. For example, the workforce development team of USAID has compiled a database of free psychological aid providers and resources all over Ukraine, and shared it with students and teachers at Ukrainian educational institutions. The World Health Organization is working with the Ukrainian government to provide mental health training to 10 percent of the country’s primary health workforce by the end of this year. And Ukraine’s First Lady, Olena Zelenska, has been at the forefront of a robust campaign aimed at “promot[ing] the formation of a culture of caring for mental health in society.”
“Against the background of daily alarming news, missile attacks, human grief and trouble, it doesn’t seem appropriate to ask yourself ‘How are you?,’” the First Lady said in a statement. “But in fact, psychological well-being and understanding of what is happening in our inner world is more timely than ever.”
“The leadership of Ukraine is very aware of how critical and essential the mental health of the nation is to the victory,” says Savchuk. “If you want to help Ukraine, which every Ukrainian does, you have to maintain that capacity and strength. The government is supporting multiple initiatives to bring awareness to mental health and to create the infrastructure for folks to be able to access it. We hope we are part of that puzzle.”
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Ironically, the war may ultimately help catalyze a broader positive shift toward mental health, increasing awareness and reducing stigma among the public. Before now, discussing mental health was somewhat taboo in Ukrainian society, and just two percent of Ukrainians polled last year planned to seek professional support. But seeing popular, influential figures like First Lady Zelenska talk about the issue may be changing that. Savchuk and her team have seen bookings steadily increase as word continues to spread across the country.
“For a lot of these folks, this might be the first time they have sought mental health support, and we might be their first encounter with that,” says Savchuk. “What we see among veterans especially is that they sometimes see [seeking support] as a sign of weakness, and see it as their duty to help themselves, and just aren’t used to accepting help in that way. So this is something to work through.”
For the providers working with TeleHelp Ukraine, speaking with patients who are in a war zone can be challenging in its own way. When a video consultation suddenly cuts out, is it simply because of an unstable internet connection, or something more dangerous?
Dr. Anaid Atasuntseva, a clinical instructor at Stanford University’s Department of Psychiatry and Behavioral Sciences, who has been a volunteer therapist with TeleHelp Ukraine from its inception, has experienced this. She recalls a session with a Kharkiv-based ADHD patient that cut out halfway through the call, just as they were going through an organizational skills exercise.
“An explosion happened near his house. I could see a flash of light, then everything went dark. In those moments, you anticipate the worst. Thankfully, we have a wonderful staff of health navigators and other volunteers who are there to reach out to the patient and make sure they’re okay. So I learned very quickly from them as they were able to contact him that everything was fine,” says Dr. Atasuntseva.