Mental health of rural communities in wartime conditions

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Mental health of rural communities in wartime conditions

Vitalii Dankevych Vitalii Dankevych Doctor of Economics, Professor, Dean of the Faculty of Law Public Administration and National Security, Polissia National University, Zhytomyr, Ukraine, Tetiana Kolomiiets Tetiana Kolomiiets Ph.D. in psychology, Associate Professor, Head of Psychology Department, Faculty of Law Public Administration and National Security, Polissia National University, Zhytomyr, Ukraine,

Alla Lytvynchuk Alla Lytvynchuk Ph.D. in psychology, Associate Professor, Psychology Department, Faculty of Law Public Administration and National Security, Polissia National University, Tetiana Mozharovska Tetiana Mozharovska Ph.D. in psychology, Associate Professor, Psychology Department, Faculty of Law Public Administration and National Security, Polissia National University, Zhytomyr, Ukraine

Аннотация

Психическое здоровье сельских общин в условиях военного времени

Виталий Данькевич, Татьяна Коломиец ,

Алла Литвинчук, Татьяна Можаровская

Психическое здоровье сообществ является чрезвычайно важным аспектом во время войны, поскольку это время, когда люди сталкиваются со стрессом, тревогой и травмами. Военные конфликты оказывают негативное влияние на психологическую устойчивость и благополучие населения. В этой исследовательской статье мы рассмотрим психологические термины, используемые для анализа психического здоровья сообществ во время войны и влияющие на него.

Для обеспечения психического здоровья сообществ во время войны также необходимо обращать внимание на факторы, способствующие посттравматическому росту. Посттравматический рост - это процесс, когда человек, несмотря на травмирующие события, находит потенциал для развития, самосовершенствования и трансформации своей жизни. Стимулирующие факторы посттравматического роста могут включать поддержку социального окружения, способность перестроить историю своей жизни и поиск смысла и значительности в травмирующих событиях. Также важно помнить о влиянии войны на детей и молодежь. Они могут быть особенно уязвимы к психологическим последствиям военного конфликта. Для обеспечения их психического здоровья необходимо разработать и внедрить специальные программы, которые оказывают поддержку детям и молодежи, обучают их стратегиям преодоления стресса и развития жизнестойкости, а также способствуют их социальной интеграции и нормальному развитию.

Наконец, необходимо учитывать важность постконфликтной реабилитации и восстановления после войны. Это означает обеспечение доступа к психологической помощи, программам реинтеграции и ресурсам для психологического восстановления членов сообщества. Постконфликтная реабилитация направлена на облегчение перехода от военного положения к нормальной жизни, восстановление социального функционирования и укрепление сообществ.

Ключевые слова: психическое здоровье, стресс, жизнестойкость, психологическая стабильность, психологическая поддержка.

Abstract

The mental health of communities is an extremely important aspect in times of war, as it is a time when people face stress, anxiety and trauma. Military conflicts have a negative impact on the psychological resilience and well-being of the population. In this research paper, we will look at the psychological terms used to analyze and influence the mental health of communities in war.

In order to ensure the mental health of communities in war, it is also necessary to pay attention to the factors that contribute to post-traumatic growth. Post-traumatic growth is a process when a person, despite traumatic events, finds the potential for development, self-improvement and transformation of his or her life. Stimulating factors of post-traumatic growth may include the support of the social environment, the ability to rebuild one's life story, and the search for meaning and significance in traumatic events. It is also important to remember the impact of war on children and youth. They can be particularly vulnerable to the psychological consequences of military conflict. To ensure their mental health, it is necessary to develop and implement special programs that provide support to children and youth, teach them strategies for coping with stress and developing resilience, and promote their social inclusion and normal development.

Finally, the importance of post-conflict rehabilitation and recovery from war must be taken into account. This means providing access to psychological assistance, reintegration programs, and resources for the psychological recovery of community members. Post-conflict rehabilitation is aimed at facilitating the transition from martial law to normal life, restoring social functioning, and strengthening communities.

Keywords: mental health, stress, resilience, psychological stability, psychological support.

Introduction

Formulation of the problem. The war, which has been going on in Ukraine for almost ten years, has caused a number of irreversible transformational processes of varying complexity that have affected absolutely all areas of the national economy.

The conditions of a full-scale invasion, such as active hostilities, occupation, rocket terror of civilians, ecocide, etc., in addition to very real risks to life and health, have caused irreparable damage to the mental health of every Ukrainian citizen. In this context, the issue of taking care of the mental health of communities at the state level is quite acute in order to at least minimize the consequences of living in a situation of prolonged trauma for every Ukrainian, which, in our opinion, can be achieved most effectively only if the challenges that arise in a particular community of the country are taken into account and promptly responded to.

Such an approach can avoid leveling the discriminatory and unethical approach to the distribution of more or less affected areas and systematize the provision of effective psychological assistance based on the actual needs of each community member. Thus, targeted and localized mental health care at the level of individual communities is a critical aspect of national importance not only in times of war, but also in the prospects of post-war reconstruction and peacebuilding.

Analysis of recent research and publications. The study of mental health in wartime is a subject of interest to many scholars: empirical studies of mental health in wartime (Carballo et al, 2004; Murthy & Lakshminarayana, 2006; Karamushka & Karamushka, 2022); research on technologies for restoring mental health in war conditions (Titarenko, 2019); psychological support for people with disabilities in war conditions (Degtyarenko, 2023), studying the principles of psychological support for educators in war conditions (Slyusarevsky, 2022), etc. Stress and trauma, post-traumatic stress disorder, adaptation, resilience, social support, psychological assistance and prevention, education, psychological safety are just some of the psychological terms that are being actively studied by scientists today and whose research results can be extrapolated to the level of mental health of communities in wartime. Studying these phenomena and understanding the variations in their impact on individuals and society as a whole will help researchers, practitioners, and government agencies understand the magnitude of the impact of military conflicts on the psychological resilience and well-being of people in communities.

The purpose of the article is to theoretically analyze the principles of supporting the mental health of communities in wartime.

Presenting main material

War is a highly stressful experience that can have a significant impact on the mental health of communities. This can include stress and trauma-related disorders, including post-traumatic stress disorder (PTSD), as well as mood disorders, anxiety disorders and, in some cases, various forms of psychosis.

The path to building psychologically resilient and healthy communities in times of war requires a combination of efforts from different sectors of society, cultural and contextual sensitivity, psychological care and interventions, social support and psychological safety, and prevention and education.

Understanding the mental health of communities in wartime paves the way for the development and implementation of effective strategies for psychological support, recovery and rehabilitation.

This may include strengthening existing psychological care systems, providing access to psychotherapeutic services and pharmacotherapy, supporting group sessions and developing social support mechanisms, and other psychological and non-psychological interventions (Caplan, 2013; Jacobs et al., 2016; Mollica et al., 2004) [10, 12, 13].

For example, in the Zhytomyr region, the Malyn and Narodytska communities suffered the most damage from shelling by Russian troops. According to data as of

April 1, 2022, the Narodytska amalgamated territorial community suffered the most because it was actually on the line of fire. The Malynska territorial community, which borders on the Kyiv region and also suffered from constant air raids and artillery strikes. Official sources say that these two communities in Zhytomyr Oblast suffered the most during the first 37 days of the war.

If we analyze the scale of the destruction, this information is obviously quite fair. But if we analyze the psychological aspects, the number of people who had relatives and friends under occupation in these territories, the number of people whose property (housing, land, etc.) was destroyed or lost, the number of people whose relatives, friends, and acquaintances were killed in action or taken prisoner while defending these territories, the number of victims increases many times over. To all this, we must add the intensive information campaign about the risks of an attack from Belarus or the threat of destruction of the Chornobyl sarcophagus, which has definitely affected the mental health of people living in close proximity to these areas due to the constant expectation of events that directly threaten life and health.

In terms of psychological assistance, the effectiveness of each type of assistance will vary (Nelson et al., 2001; Wainberg et al., 2017; Patel et al., 2018) [15, 16, 17]. If, for example, psychotherapy and psychological support groups have proven to be quite effective for people from the de-occupied territories (as well as for people who are experiencing loss or uncertain loss), then psychological education will be more effective for people from the latter group.

Therefore, the prompt organization of the work of the mental health sector in communities would optimize large-scale, but extremely scattered, unsystematic and unmoderated activities and thus increase their effectiveness at the local level.

The attention paid to mental health in communities remains relevant, especially in times of war, and is gaining particular importance in the postwar period. psychological mental health crisis population

To date, a number of measures have already been taken to improve the level of economic and social development, particularly in the Zhytomyr region. For example, according to the Program of Economic and Social Development of Zhytomyr Region for 2022, ways to solve problems and challenges in the healthcare sector have already been implemented.

Thus, the following measures are currently being actively implemented: ensuring the provision of high-quality, comprehensive, continuous and patient- oriented medical care based on evidence-based medicine and best medical practices; modernization of healthcare facilities; formation of modern medical infrastructure in rural areas at the level of territorial communities; improvement of the unified operational dispatch service of the emergency medical care and disaster medicine center based on modern technologies to improve the efficiency and quality of emergency medical care [19].

All of this requires joint work, coordination and engagement of all stakeholders to ensure the psychological well-being of communities in difficult war conditions.

An important aspect of the mental health of communities in war is the understanding and management of stressful situations. Stress causes the body's response to danger and can have a negative impact on psychological well-being. Understanding stress and developing effective coping strategies are important steps to ensure the psychological resilience of communities.

One way to cope with stress is to develop resilience. Resilience is the ability to adapt to stressful situations, overcome negative events and return to normal functioning. There are several factors that contribute to the development of resilience, including social support, positive self-esteem, emotional intelligence, and flexibility in thinking.

Social support plays an important role in maintaining the mental health of communities. This can be through the provision of emotional support, practical help, and a sense of belonging. Group sessions and psychological groups can be useful tools for supporting and sharing emotions among community members. Researchers also note the important role of intersectoral cooperation in wartime (Nechyporuk, 2022) [5].

Psychological assistance is essential in wartime, when people experience emotional trauma and need support from professionals. Psychotherapeutic approaches such as cognitive behavioral therapy and emotionally focused therapy can be effective methods to reduce psychological symptoms and contribute to the psychological recovery of communities.

Psychological prevention is another important aspect of supporting the mental health of communities in wartime [18]. It involves taking measures to prevent psychological problems and stressful reactions, as well as to maintain the psychological resilience of community members. This may include conducting educational programs, trainings on coping and stress management skills, informing the community about psychological reactions and psychological protection strategies.

In addition, it is important to emphasize the importance of psychological education, which contributes to raising awareness of psychological reactions to military conflict, developing coping skills and building resilience. Informing the community about the psychological factors of armed conflict and providing tools to support psychological well-being can help reduce stress and disorders during these experiences.

Community mental health education is a necessary component to ensure awareness and a conscious approach to psychological well-being. It can include training programs for teachers, parents, and community leaders that provide information on psychological reactions to war, strategies for psychological protection and support, and practical skills to help community members. There are also studies of specific social groups that need support: social and psychological support for female combatants (Faidiuk, 2022); mental health of students in war (Vlasova-Chmeruk, 2023) [9, 1].

In order to ensure the mental health of communities in war, it is also necessary to pay attention to the factors that contribute to post-traumatic growth. Post- traumatic growth is a process when a person, despite traumatic events, finds the potential for development, self-improvement and transformation of his or her life. Stimulating factors of post-traumatic growth may include the support of the social environment, the ability to rebuild one's life story, and the search for meaning and significance in traumatic events. It is also important to remember the impact of war on children and youth.

They can be particularly vulnerable to the psychological consequences of military conflict. To ensure their mental health, it is necessary to develop and implement special programs that provide support to children and youth, teach them strategies for coping with stress and developing resilience, and promote their social inclusion and normal development.

Finally, the importance of post-conflict rehabilitation and recovery from war must be taken into account. This means providing access to psychological assistance, reintegration programs, and resources for the psychological recovery of community members.

Post-conflict rehabilitation is aimed at facilitating the transition from martial law to normal life, restoring social functioning and strengthening communities. Researchers note a significant number of problems faced by community residents (Trubavina, 2022) [8].

To determine the main areas of work to support mental health in the context of war, a survey was conducted with students living in different territorial communities of the Zhytomyr region. The study of the challenges of supporting mental health among students showed the existence of certain areas that require special attention (Fig. 1).

Fig. 1 Main challenges in times of war according to the survey

The need for psychological help and intervention (21.1%) was ranked first among all the challenges for the students surveyed, followed by the need for psychological safety (18.1%), social support (14%), and the development of adaptability and resilience skills. Stress prevention and work with the consequences of trauma also turned out to be important for the respondents (11.7%, 11.1%, and 10.5%, respectively).

In general, the following main psychological challenges in the context of war were identified:

1. Stress and trauma.

Stress and trauma are considered an integral part of military conflict. Individual stress can be caused by the loss of loved ones, the constant threat of death or injury, uncertainty about the future, and the experience of hypervigilance. Trauma can be physical, psychological or emotional. It is important to distinguish between stress and trauma, as their effects and approach are different.

2. Post-traumatic stress disorder (PTSD).

Post-traumatic stress disorder is one of the most common psychological disorders that arise as a result of war. It includes symptoms such as recurring memories of events, nightmares, psychological tension, nervousness, and isolation. Treatment for PTSD includes psychotherapy, pharmacotherapy, and social support.

3. Adaptation and resilience.

Adaptation is the process by which people change their cognitive, emotional, and behavioral strategies to adjust to the new conditions of war. Adaptation may include finding new sources of support, changing internal perceptions of the situation, and developing new skills to manage stress.

Resilience is the ability of an individual or community to maintain mental health, adapt to stressful situations, and return to normal after experiencing trauma. Resilience is enhanced by social support, positive interpersonal relationships, emotional stability, and flexible thinking.

4. Social support

Social support is an important factor that affects the mental health of communities in times of war. It includes support from family, friends, coworkers and the community. Social support reduces feelings of loneliness, maintains a sense of security, and facilitates recovery from traumatic events.

5. Psychological assistance and interventions

Psychological assistance and interventions are essential to ensure the psychological well-being of communities in times of war. This may include psychotherapy, group sessions, development of coping strategies and training in self-regulation skills. It is important to take into account the cultural, social and contextual characteristics of the community when providing psychological assistance.

For example, taking into account religious beliefs, traditions, and values can ensure a more effective intervention. In addition, it is important to consider the status of vulnerable groups, such as children, veterans, women and the elderly, and provide them with appropriate support and assistance.

6. Prevention and education

Preventive measures and education are important aspects of ensuring the mental health of communities in wartime. These can include coping training, psychoeducational measures to legitimize emotional states and manage emotions, communication skills and building supportive relationships. Education promotes awareness and understanding of one's own psychological needs, which contributes to strengthening psychological resilience and resilience.

7. Psychological safety

Psychological safety is an important aspect of the mental health of communities during armed conflict. This means creating a safe environment where people can feel protected and secure. It is important to ensure access to psychological help and support, and to reduce the stigma associated with mental health problems.

Ensuring psychological safety is another key component of supporting the mental health of communities in wartime. This includes creating a safe physical environment where people can feel protected from danger and violence. Psychological safety also means reducing the stigma associated with mental health problems and creating a supportive atmosphere where people can talk openly about their emotions and experiences without fear of judgment.

Government agencies and organizations should consider the mental health of communities as a priority in planning and implementing actions in times of war. This may mean designing and implementing psychological support programs, providing financial support for psychological services, establishing a network of psychological centers, and ensuring adequate education and training for psychological care professionals, as experts emphasize the need to promote appropriate conditions for children's development in war (Mostova et al., 2022) [4].

Finally, it is important to note that community mental health is a multidisciplinary issue that requires cooperation between different sectors of society, such as health, social, education, military and civil society organizations. Close cooperation and coordination between these sectors can ensure efficient use of resources and maximize the impact on the psychological well-being of communities.

Key aspects to consider when working with community mental health in military settings:

Education: Informing the community about the possible psychological impacts of war, as well as available resources and coping strategies, can help reduce stigma and ensure timely access to care.

Timely intervention: It is important to quickly identify and intervene in cases of trauma or psychological stress to prevent further mental health problems.

Supporting resilience: Promoting coping skills and communication support can help a community recover from traumatic events. This also includes strengthening social networks and supporting cultural and spiritual practices.

Collaboration with local communities: Involving local leaders and communities can help to better identify and respond to psychological problems. They can also help to adapt psychological care approaches to the local context.

Long-term care: Especially for those who have experienced profound trauma, long-term support and treatment is needed.

Multi-level approach: Effective care requires consideration of different levels of influence, including individual, family, community and social.

Psychological assistance and support initiatives that take these aspects into account in a targeted and meaningful way can help communities not only cope with the consequences of war, but also restore their resilience and health in the long term.

To summarize, the mental health of communities in war is a complex and multifaceted problem. Military conflict has a significant impact on the emotional, psychological and social state of people. However, the use of psychological terms and concepts, such as stress, trauma, adaptation, resilience, social support, psychological assistance and prevention, education, and psychological safety, helps responsible structures and professionals understand and manage these complexities.

Conclusions

The mental health of communities in war is a complex and extremely important issue that requires a broad understanding, a systematic approach and comprehensive measures. Military conflict has a serious impact on people's emotional, psychological and social well-being, and can cause stress, trauma and mental health disorders.

The use of psychological terms and concepts such as stress, trauma, adaptation, resilience, social support, psychological assistance and prevention, education, and psychological safety helps to understand and implement effective strategies to ensure the psychological well-being of communities in difficult war conditions.

Achieving psychologically resilient and healthy communities in times of war requires close cooperation between different sectors of society, including healthcare, social services, education, military structures and civil society organizations. Coordination and interaction between these sectors will allow for optimal use of resources and maximum impact on the psychological well-being of communities.

Understanding and managing stressful situations, building resilience, providing social support, psychological assistance, prevention and education are key components to ensuring the mental health of communities in war. It is also important to take into account the specifics of children and youth who may be particularly vulnerable to the psychological consequences of military conflict. They should be provided with special support, including training in coping strategies, resilience development and social inclusion.

Post-conflict rehabilitation and recovery are key stages after a war. It includes providing access to psychological assistance, reintegration programs, and resources for the psychological recovery of community members. This helps to facilitate the transition from martial law to normal life, restore social functioning, and strengthen psychological resilience.

Thus, the mental health of communities in war is an extremely important component of sustainable development and recovery of society. A wide range of psychological terms and concepts helps in understanding, analyzing and implementing effective strategies to support and ensure psychological well-being. This requires joint efforts of different sectors of society and a comprehensive approach to addressing the problems related to the mental health of communities during armed conflict. Ensuring the mental health of communities is an important task that contributes to the development of a sustainable, resilient and healthy society.

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