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1 – 8 of 8Viktoriia Gorbunova, Vitalii Klymchuk, Olha Savychenko, Valeriia Palii, Zemfira Kondur, Viola Popenko and John Oates
This paper aims to explore the prevalence of depression, anxiety symptoms and suicidal ideation among the Romani population in Ukraine and their connections with various social…
Abstract
Purpose
This paper aims to explore the prevalence of depression, anxiety symptoms and suicidal ideation among the Romani population in Ukraine and their connections with various social health determinants: age, gender, household characteristics, employment and living conditions.
Design/methodology/approach
For measuring mental health conditions, GAD-7 and PHQ-9 were used. Individual interviews were conducted by trained volunteers of the International Charitable Organization “Roma Women’s Foundation Chirikli”. Data were gathered from January to March 2020.
Findings
The overall level of depression found in the sample was 8.08, while the mean for anxiety was 7.22. In general, 32.7% of respondents scored positively for signs of depression and 29.6% for anxiety. The two-week prevalence of suicidal ideations was 26.9%. Compared to the general population, the prevalence of depression among the Romani research participants was twofold higher, and anxiety was 2.5-fold higher. Signs of depression and anxiety in women were significantly higher (36% vs 28.6% for depression and 33.9% vs 24.2% for anxiety) than in men. Signs of depression and anxiety were higher for people without education than for university students (9.32 vs 3.04 for depression and 8.26 vs 3.00 for anxiety). The lowest levels of depression, anxiety and suicidal ideation were among officially married persons (6.61, 6.36 and 0.23, respectively). Significant small positive correlations were found between all measurements and the number of household members (0.149 for depression, 0.124 for suicidal ideation and 0.175 for anxiety; p < 0.001) and the number of children (0.303 for depression, 0.224 for suicidal ideation and 0.243 for anxiety; p < 0.001). In terms of employment, the highest scores for depression, anxiety and suicidal ideation were found among those who are employed seasonally (9.06, 8.25 and 0.61) or irregularly (9.09, 8.12 and 0.57) in contrast with self-employed (4.88, 4.90 and 0.19) and full-time employees (5.86, 5.51 and 0.18). Living place (city, village or camp) showed no relation with mental health, except for suicidal ideation: those living in villages had higher levels of suicidal ideation than those living in cities (0.49 vs 0.31).
Research limitations/implications
The study has some limitations. Data were gathered from January to March 2020, and since then, the situation in Ukraine has drastically changed due to the full-scale Russian invasion. While this study’s data and conclusions might serve as a baseline for further research, they do not represent the real-time situation. While many social factors were analysed, the effects found for them do not necessarily represent causality, given the statistical methods used. Interactions among factors were not studied; therefore, no firm conclusions can be made about the effects of those interactions on mental health.
Originality/value
To the best of the authors’ knowledge, this paper is original in terms of its topic, as the first-ever in Ukraine quantitative study of mental health and social determinants of mental health of the Romani population.
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Valeriia Palii, Mariana Velykodna, Marcio Pereira, Rosaleen McElvaney, Sam Bernard, Vitalii Klymchuk, Oleg Burlachuk, Alexander A. Lupis, Nadiia Diatel, Jane L. Ireland, Kimberley McNeill, Janina L. Scarlet, Ana L. Jaramillo-Sierra, Bassam Khoury, Diana Rocio Sánchez Munar, Sarah L. Hedlund, Tara Flanagan, Jeanne LeBlanc, Diana Maria Agudelo Velez and Yvonne Gómez-Maquet
This paper aims to discuss current work and further steps of the psychological hotline launched by the National Psychological Association of Ukraine (NPA), along with a call for…
Abstract
Purpose
This paper aims to discuss current work and further steps of the psychological hotline launched by the National Psychological Association of Ukraine (NPA), along with a call for action to mental health professionals worldwide.
Design/methodology/approach
This paper describes the training and support of the NPA’s hotline staff as well as reflections on the hotline’s work from June 2022 to April 2023.
Findings
With broad international support, the NPA’s psychological hotline currently operates in 21 countries providing psychological assistance and referrals to other service providers within Ukraine and abroad. The authors propose further steps of its work, including international collaboration.
Originality/value
Providing citizens of Ukraine with broad public access to evidence-based remote psychological support through NPA’s hotlines is a high priority considering the war’s negative impact on mental health diverse and the limited capacity of the state mental health system.
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Céline Dujardin, Vitalii Klymchuk and Viktoriia Gorbunova
The purpose of this paper is to explore the perception of the mental health problems of the homeless population in a high-income country (Luxembourg) by social service providers…
Abstract
Purpose
The purpose of this paper is to explore the perception of the mental health problems of the homeless population in a high-income country (Luxembourg) by social service providers and to develop proposals for better inclusion of homeless people into the mental health services and homeless people with mental health issues into society.
Design/methodology/approach
The study was of qualitative design and conducted using a semi-structured interview method (in person). The semi-structured interviews (seven participants) were conducted to analyse the challenges, practice approaches and prospects of stakeholders or decision-makers working in housing exclusion and homelessness. A secondary thematic analysis of this content regarding mental health issues was performed.
Findings
Three main themes in the social providers’ perception were identified related to mental health and homelessness: the general view on the mental health problems of homeless people (accent on substance use disorders [SUDs], overshadowing of other mental health conditions by the SUDs); the positive impact of housing and social services on the mental health of the homeless per se (role of social rhythms, social connectedness and multidisciplinary approach are emphasised); and the need for improvement of mental health services in the country (need for the long-term timely continuing mental health support and recognition of the importance of complex intersectional and multidisciplinary solutions).
Research limitations/implications
Mental health themes were not the primary focus while research was planned and conducted. They were revealed as results of secondary qualitative data analysis. Therefore, additional mental health-focused mixed methods research is needed to verify the conclusions. The paper is written on the results of the research project “Social Housing and Homelessness” (SOHOME), implemented at the University of Luxembourg with the financial support of the Fonds National de la Recherche of Luxembourg (FNR12626464). The sponsor had no involvement in the study design, the collection, analysis and interpretation of data or the preparation of the paper.
Practical implications
The study brings together different perspectives from social workers, stakeholders and decision-makers. The results show that there are cross-field connections between homelessness and mental health that require specialised and coordinated services. The first existing approaches seem to be promising in their continuation but need to be promoted by social policy.
Social implications
To promote social cohesion in the Luxembourgish society and also to include one of the most vulnerable people, the study points to the importance of the link between homelessness and compromised mental health. Appropriate support and service provision as well as social and affordable housing play a central role.
Originality/value
To the best of the authors’ knowledge, this study is the first of its kind, revealing several social work stakeholders’ perspective on the mental health of homeless people in Luxembourg.
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Viktoriia Gorbunova, Natalia Gusak, Vitalii Klymchuk, Zemfira Kondur, Paliy Valeriia, Viola Popenko and John Oates
The purpose of this study is to characterize the social and cultural context of the social construction of mental health (MH) by members of Romani communities in Ukraine.
Abstract
Purpose
The purpose of this study is to characterize the social and cultural context of the social construction of mental health (MH) by members of Romani communities in Ukraine.
Design/methodology/approach
The research collected qualitative data to gain a better understanding of how Romani communities in Ukraine view the social and cultural factors influencing mental health. This paper analyzes data from focus groups in Romani communities in Ukraine (from six different oblasts) from February to March 2020. A total of 49 persons 19–75 years of age participated in the research, including 17 men and 32 women.
Findings
This study identifies four clusters of perceived social determinants of Romani mental health, these being employment, financial difficulties, level of education and discrimination. The findings indicate specific cultural characteristics of the Romani community that are seen as helping to support mental health. Family values, mutually supporting and referring to other members of the community are seen as especially important. Such social cohesion is believed to have a positive effect on the mental health of members of the Romani community. This paper discusses the implications of the study and suggests possible avenues for future data-driven policymaking in the area of mental health that take account of the culturally-specific meanings of mental health for these communities.
Originality/value
Given the significant gaps, shortages and, in some cases, complete lack of data on Romani ethnic and cross-cultural psychology, research is urgently needed to fill this gap. Lack of understandings of how Romani construct mental health can lead to badly-matched, misplaced or ineffective actions and distrust. This paper aims to support better understandings of Romani among MH service providers and enhancing the mutual engagement of Romani and MH services, supporting the broader agenda of social inclusion of Romani people.
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Vitalii Klymchuk, Krystyna Vysotska and Viktoriia V. Gorbunova
The purpose of this paper is to explore how conflict-affected communities in Ukraine (the Lugansk region) can develop sustainable mental health services in decentralised settings…
Abstract
Purpose
The purpose of this paper is to explore how conflict-affected communities in Ukraine (the Lugansk region) can develop sustainable mental health services in decentralised settings. The main interest focuses on community stakeholders’ perception of their problems and solutions that communities can create to achieve better mental health coverage.
Design/methodology/approach
A series of roundtables (RTs) (4 RTs, 62 participants overall), accompanied by interactive brainstorming techniques, were conducted with communities’ representatives/stakeholders from the East of Ukraine (Lugansk region, a government-controlled area) during the year 2021. Participants (health, mental health, social care workers and administration representatives) were provided with the opportunity to discuss mental health services’ development challenges and create affordable solutions for their communities. Results of discussions were submitted to qualitative analysis and offered for review by participants.
Findings
Decentralisation in Ukraine led to allocating funds alongside responsibilities for developing the services to communities. Most of the communities appear not to be ready to acknowledge the role of mental health services, entirely relying on the existing weak psychiatric hospital-based system. Awareness-raising interactive capacity-building activities for the community leaders and decision-makers effectively promote community-based mental health services development. Five clusters of challenges were identified: leadership, coordination and collaboration problems; infrastructure, physical accessibility and financial problems; mental health and primary health-care workforce shortage and lack of competencies; low awareness of mental health and available services and high stigma; war, crises and pandemic-related problems. Communities stakeholders foresaw seven domains of action: increasing the role of communities and service users in the initiatives of governmental bodies; establishing in the communities local coordination/working groups dedicated to mental health service development; developing the community-based spaces (hubs) for integrated services provision; embedding the mental health services in the existing services (social, administrative and health care); mental health advocacy and lobbying led by local leaders and service users; increasing capacity of communities in financial management, fundraising; developing services by combining efforts and budgets of neighbouring communities.
Research limitations/implications
The study has potential limitations. Participants of the roundtables were mostly appointed by local authorities, so some of them didn`t have a motivation for mental health services development. Service users were involved only from the facilitators` side, not from the side of communities; therefore, it was impossible to include their view of problems and solutions. Obtained data were limited to the opinion of local professionals, administration workers and other local stakeholders. The human rights aspect was not clearly articulated in the tasks of the roundtables.
Originality/value
To the best of the authors’ knowledge, the paper is original in terms of its topic (connecting decentralisation and local stakeholders’ engagement for understanding the challenges of mental health services development) and research strategy (engagement of Ukrainian communities, qualitative analysis of the discussion results and applying the best practices and international recommendations to the local context).
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Eleanor Quirke, Vitalii Klymchuk, Nataliia Gusak, Viktoriia Gorbunova and Oleksii Sukhovii
The ongoing armed conflict in Ukraine has had wide-ranging health, social and economic consequences for the civilian population. It has emphasised the need for comprehensive and…
Abstract
Purpose
The ongoing armed conflict in Ukraine has had wide-ranging health, social and economic consequences for the civilian population. It has emphasised the need for comprehensive and sustainable reform of the Ukrainian mental health system. The Ukrainian Government has approved a vision for national mental health reform. This study aims to draw on the lessons of mental health reform in other conflict-affected settings to identify areas of priority for applying the national mental health policy in conflict-affected regions in the direction of better social inclusion of people with mental health conditions (Donetsk and Luhansk regions, directly affected by the conflict).
Design/methodology/approach
A literature review was conducted to identify lessons from implementing mental health reform in other conflict-affected settings. Findings were summarized, and best practices were applied to the national and regional policy context.
Findings
The literature described emergencies as an opportunity to build sustainable mental health systems. A systematic and long-term view for reform is required to capitalise on this opportunity. For better social inclusion, implementation of the concept for mental health and mental health action plans in Donetsk and Luhansk regions should prioritise raising mental health awareness and reducing stigma; developing the capacity of local authorities in the development and coordination of services; tailoring mental health service provision according to the availability of services and population need; targeting the needs of particularly vulnerable groups and embedding the activities of humanitarian actors in local care pathways.
Research limitations/implications
This study summarises the literature on mental health reform in conflict-affected settings and applies key findings to Eastern Ukraine. This study has drawn on various sources, including peer-reviewed journals and grey literature and made several practical recommendations. Nevertheless, potentially relevant information could have been contained in sources that were excluded based on their publication in another language (i.e. not in English). Indeed, while the included studies provided rich examples of mental health reform implemented in conflict-affected settings, further research is required to better understand the mechanisms for effecting sustainable mental health reform in conflict-affected settings
Originality/value
The paper describes opportunities for developing a local community-based mental health-care system in Ukraine, despite the devastating effects of the ongoing war.
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Viktoriia Gorbunova, Natalia Gusak, Vitalii Klymchuk, Valeriia Palii, Vitalina Ustenko, Zemfira Kondur, Viola Popenko and John Oates
The purpose of this paper is to explore senses of powerlessness and empowerment among Romani in Ukraine in relation to such social circles as the extended family, the Romani local…
Abstract
Purpose
The purpose of this paper is to explore senses of powerlessness and empowerment among Romani in Ukraine in relation to such social circles as the extended family, the Romani local community and the whole Ukrainian society. The main research interest is focused on situations and factors that make people feel powerless or empowered.
Design/methodology/approach
The study was conducted using a semi-structured interview method via telephone. Romani NGO experts approved the interview content. Trained Roma-facilitators were interviewers. Every interview was transcribed for further thematic analysis.
Findings
The most prominent empowerment factors for Romani people are located within their families and local communities, while the bigger society (Ukrainians themselves and Ukrainian public institutions) is a main source of powerlessness. At the same time, the rigid role of family and community expectations is seen as detrimental for both males and females.
Originality/value
The paper is original in terms of its topic (senses of powerlessness and empowerment among Romani in Ukraine as social determinants of mental well-being) and research strategy (engagement of Roma-facilitators as interviewers).
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