Over 5.6 million people have fled Ukraine since Russia invaded in February. Many still think they will be able to go back home.

The ongoing conflict forced many to leave the country and seek refuge in neighboring European countries. There have been almost 570,000 border crossings from Ukraine into Slovakia since the war began. About 80,000 of those who left Ukraine are living in Slovakia under temporary protection, leaving other family members and friends in their home country.

Slovak health officials say support for Ukrainian refugees has shifted from immediate necessities like food and shelter to health, housing, and job support. As the war continues, the opportunity for Ukrainians to return home decreases and the need for stability in their new country increases. In a non-traditional method of support, the League for Mental Health created a mental health program for Ukrainians, by Ukrainians.

As refugees began to enter Slovakia, the League published announcements on social media and with local news sources about a mental health helpline for Ukrainian refugees. The League has a similar hotline for Slovak residents in need of immediate help.

As calls began to come in, League executives said they realized they needed to build trusting relationships with Ukrainian refugees to make a difference.

Andrej Vršanský, executive director of the League, said Ukrainian refugees have been hesitant to communicate with Slovak doctors as they navigate the emotional reactions of trauma: anxiety, guilt, panic, depression, and difficulty believing what has happened. So, they began to search for Ukrainian psychologists to speak with the incoming Ukrainian refugees. Some of those hired had emigrated from Ukraine during the 2014 Russo-Ukrainian War.

“If I’m a Ukrainian and I’m displaced from my country and they come to a different country, of course, I don’t trust the new environment. I don’t want to be here,” he said. “So, whom do I trust? I trust my own people.”
Viktoria Mariniuk coordinates the groups of psychologists across Slovakia’s eight regions. There are about 35 Ukrainians working within the program now and another 30 in training.

The League’s goal is to reach at least 100 and officials say they have been willing to volunteer their time even without being processed through the system. “They’re talking to people, asking about their needs and why? Because they really care,” Mariniuk said. “They’re their compatriots. And this is really a very wise choice to invite Ukrainian psychologists to help Ukrainian people, because (of) this compassion.”

Most of those who have fled Ukraine are women and children. Most men were required to stay in the country at the risk of being enlisted to fight in the war. The League has mostly worked with teens and young adults, but they expect more Ukrainian refugees at the end of the summer as the war worsens and weather conditions change.

Mariniuk said that most of the Ukrainians who call to ask for help believe that they will be able to go back to Ukraine in a few weeks. The disbelief of their new reality is troubling to League employees like Mariniuk, who say the refugees will be better off once they feel independent within their new country.

“They’re getting jobs, they’re getting their lives back on track. They’re sending their kids to school and they can care about themselves, so they need to be stable,” she said. “And what we are doing, we’re helping people to become able to care about themselves, about their basic needs. And this is very important from the psychological point of view.”

The League for Mental Health’s status as a nongovernmental organization allows it to streamline traditional hiring practices. Ukraine’s lack of membership within the European Union and different academic standards has affected labor contracts and prevented some from finding employment. However, with help from international organizations like UNHCR, Direct Relief, and MHPSS, the League can build the local capacity of services by hiring Ukrainian mental health professionals to work with Ukrainian refugees.

Supporting non-EU members with health and housing support that isn’t offered to all Slovak people is a contentious topic for some. However, Vršanský said it’s a natural human response to help those in need. He thinks of the program as mutually beneficial because he doesn’t think that Slovakia has enough mental health support on its own.

“Because we care,” he said. “We should take care of their mental health because we don’t want them to suffer. In Slovakia, we want to create an environment that will enable them to integrate and to be a full member of our society.”

Vršanský said it’s a non-traditional method, but he believes this strategy will decrease the risk of personal harm, crime, and mental instability long term. Ukrainian refugees in Slovakia are currently eligible for healthcare, food and housing support, but Vršanský said that many don’t feel in control of their own lives in the current context.

The League hopes that if refugees are able to communicate with someone who has been in a similar circumstance, support them with their mental health needs, and feel in control of their lives that they will see better health outcomes.

“They would be able to control their own lives, at least a little bit,” he said. “It’s a very different perspective.”

Direct Relief supported the League of Mental Health with a $750,000 grant to support mental health and psychosocial support for Ukrainian refugees in Slovakia.