The Mental Health Impact Of War On Ukrainian Refugees
One million refugees have fled Ukraine since the war began. Amidst the many stories of hope and resilience, there is still the unavoidable trauma of war and its vast mental health implications. Psychologist and epidemiologist Dr. Manuel Carballo has pioneered much of our understanding in refugee mental health. As Executive Director of the International Center of Migration, Health and Development in Geneva and consultant to the WHO and the European Center for Disease Control, his interest in refugee mental health isn’t purely theoretical. Carballo was born in a refugee camp and spent his early childhood there. He shares his perspective on what this moment means for the one million Ukrainians who have fled their homeland.
The Visible and the Invisible
For Ukrainians, the process of becoming refugees has been defined by their resilience in the global media. “As we look at the images of the war in Ukraine, we may be inevitably impressed by what seems to be resilience, strength, and courage. Yet behind every image and video shared on social media, there is a history of profound pain and anguish,” says Carballo. He encourages us to look beyond what’s immediately visible. “The physical injuries of the Ukrainian refugees can be easily seen. We see the wounds, bandages and ambulances,” he adds, “But the mental health aspects of becoming a refugee are less visible and perhaps even more profound.”
As more Ukrainian refugees cross the border in coming weeks, millions of families will be disrupted. “Each of those separations is traumatic and influences the individual,” says Carballo, “Within a space of hours, many Ukrainians have lost their physical belongings. But its not just a loss of physical memories, they’ve also lost the living memories of close family and relatives. What Ukrainians are really being forced to leave behind as they flee is an investment in the future.”
The Loss of Control
According to Carballo, one fundamental aspect of mental health is a sense of control. Yet as Ukrainian families are separated through their refugee experience, control is in short order. “This is demoralizing,” says Carballo, “A lack of control takes away our power and undermines the extent to which we feel equipped to care for ourselves in the future.” He adds, “We’re deeply influenced by our feelings of control and when we lose that control, we become vulnerable to a wide spectrum of dangers and threats to our mental and physical health.” Specifically, Carballo heeds us to pay close attention to vulnerable populations among Ukrainian refugees like the elderly and disabled. “Many were vulnerable before this began,” he says, “Some weren’t physically healthy, others had psychological problems, some were undergoing treatment which has been interrupted. This group is being caught up in this violent moment along with everyone else.”
Another group Carballo is especially concerned about are the Ukrainian children who have been forced to flee. “The first thing that needs to be done for these children is to provide structure for playing together and eating together,” he says, “We should be careful not to lose sight of the fact that these children may not be crying. We may witness a scene of children already playing on the playground. But let’s not underestimate what’s going on in their minds. We should understand that the impact of mental health will not be immediately visible and we cannot expect it to be.”
A Brighter Future Ahead
In spite of the many challenges Ukrainian refugees face, Carballo is still hopeful. Having worked with the United Nations in building refugee camps in Macedonia and Albania and working in war torn Bosnia, Carballo has been heartened by the openness with which many European countries are welcoming Ukrainian refugees. “To see how Europe is responding to the needs of the Ukrainian refugee population is a testimony to the fact that we have, in fact, learned,” he adds, “We have a much deeper understanding of how we can help now.”
Carballo is optimistic about what the future holds for Ukrainian refugees, “It’s been a long time since we’ve seen a response as hopeful- not for each individual, of course, but hopeful for mankind. It’s a reminder of how the world can come together in solidarity for refugees. As a global community, we’ve learned that when crisis comes, we can stand up and share not only in the pain but also in the future.”
This piece was originally published in Forbes in March 2022.