Mental health needs of Ukrainian refugees in Scotland
Feniks launches the UK’s first research report exploring the mental health needs of Ukrainian refugees welcomed in Scotland
Feniks’s background and experience in providing mental health support to the Central and Eastern European Community inspires a responsibility to advocate for the most significant and pressing needs of the Ukrainian refugee community.
Within the first few months since the beginning of the illegal invasion of Ukraine, Feniks mobilised resources and employed a Ukrainian Community Development Worker in June 2022. Their aim has been to address the immediate needs of the arriving refugees and the development of a mental health response by Feniks. Over time the organisation has aligned their mental health project with the Crisis Response Network in Edinburgh. The study aimed to understand the mental health and integration needs of the newly arrived Ukrainians settling in Edinburgh, with an intention to address experiences of extreme distress and risks of trauma, suicide and depression and to explore the need for formal and community-based interventions. This was achieved through a reallocation of the funding we had secured through the Equalities and Human Rights Fund provided by the Scottish Government and administered through Inspiring Scotland.
Our research showed that over 55% of Ukrainian refugees experience clinically significant stress and anxiety, with nearly 10% having suicidal thoughts and a threat of the situation deteriorating with the continuing war in Ukraine and instability and uncertainty of the living conditions in Scotland.
The demand for therapy, psychological interventions, and psychiatric treatment also prove the level of need despite the high degree of mental health stigma in the community. Urgent, targeted, and culturally sensitive mental health interventions will prevent the further development of depression, Complex-Post Traumatic Stress Disorder, and the risk of suicide.
Out of 85 participants, 79 responded to the mental health part of the survey based on CORE-10, an evidence-based assessment tool to monitor and evaluate the level of clinical distress.
- 30% of respondents presented severe clinical distress
- 9% required medical intervention at the time of the survey
- 25% were in moderate distress
- Combined, 55% of respondents were in the range of clinically significant psychological distress
The survey received a high level of participation from respondents; the level of engagement combined with the responses to particular questions supports the case for effective mental health interventions. A significant proportion of respondents were willing to engage in community-based interventions, including yoga, outdoor pursuits, and social activities. The importance of formal interventions was highlighted by the severity of clinical distress amongst respondents, evidenced by the CORE-10 assessment, despite the cultural stigma against mental health support.
Despite the fact that Ukrainians in Scotland are safe, they need psychological support. Ukrainians fleeing the war and finding themselves in a foreign country have received enormous support from the state and local residents, but they are facing a new problem [adaptation to the new life in Scotland] and secondary traumatisation.
The older a person is, the more difficult adaptation is. A new challenging life and the uncertainty of when you can return home are superimposed on the traumatisation from the war.
Many Ukrainians are in a suspended (frozen) state, waiting to return home to start living their usual past life. And here the psychologist’s task is to help start living today, start feeling not only pain, longing, anger, but also positive emotions, allow yourself to be happy and enjoy life here and now, without postponing life for later.
– Julia Sviatenko, Mental Health Volunteer, Feniks
Magda Czarnecka, Chief Executive Officer at Feniks, said:
“Since the beginning of the invasion of Ukraine, Feniks staff and volunteers observed the situation at the Polish border and engaged in supporting the initiatives of sending goods to Poland and Ukraine.
Once it was certain that Ukrainian refugees would be welcomed in Scotland, Feniks mobilised its resources and expertise to respond to their anticipated needs. Having the experience of supporting the Central and Eastern European community and understanding barriers to accessing mental health support in Scotland, Feniks has implemented an approach developed over the last fifteen years. By employing a Ukrainian Community Development Worker and mobilising the skills and expertise of ten Ukrainian mental health professionals to volunteer in our Ukrainian Community Mental Health Project, while waiting for the UK validation of their qualifications.
This timely research aimed to identify the level of need and the kinds of mental health interventions refugees would be willing to engage with. It has led us to organise popular groups on board MS Viktoria and in the Ukrainian Club in Edinburgh. The levels of stress and suicidal ideations are alarming. They indicate the urgent need for counselling and psychiatric support, which require long-term solutions. We are working with EVOC and statutory partners on developing the appropriate response locally. The problem, however, might be universal for other parts of Scotland too .”
Other significant concerns amongst the Ukrainian refugees included: access to healthcare and clarity in the system of GPs as primary care providers; concerns around stable finances and gaining employment, particularly for those with significant language barriers or single parents with childcare concerns; support and advice in navigating the legal framework for immigration, welfare, and education systems; and long-term, independent housing solutions.
The participants indicated six other significant challenges and needs. These were:
- Access to healthcare
- Poor knowledge of English
- Temporary accommodation
- Finances
- Help in navigating the system
- Help with childcare and children’s mental health.
Natalya Ditkivska, Ukrainian Community Development Worker, shared:
“Many refugees shared with us their stories of traumatic experiences of war and violence in their home country. Their experience and pre-existing mental health conditions are often exacerbated by the many concerns linked with housing, employment, language barriers, school enrolment, access to NHS and so on. However, first and foremost, the biggest source of distress for them remains a totally uncertain future. Many of them are in desperate need of mental health support whether through regular counselling or other forms of support that are often too difficult for them to access.”
John Beaton-Hawryluk, Ukraine Crisis Response Programme Coordinator from Edinburgh Voluntary Organisations Council (EVOC), said:
“Ukrainians arriving in Edinburgh have fled a war zone, many having seen the atrocities of Russia’s invasion early last year.
We welcome Feniks’s latest report that explores in detail the mental health needs of Ukrainian refugees who have settled here in Scotland. While many refugees have shown a strong resolve to resettle in Scotland and establish themselves with priorities such as education, employment and healthcare, we are particularly concerned about the finding ‘Over 50% of the respondents reported feeling tense, anxious or nervous often or most of the time’ which is an indication that while many refugees may carry themselves well in the face of adversity, many are carrying the trauma of war.
Thank you to Feniks, alongside partners from NHS Lothian, Thrive Edinburgh and the Edinburgh Health & Social Care Partnership, for the work they’ve undertaken to ensure wrap-around care and support of the Ukrainian community. As we approach the first anniversary of Russia’s illegal full-scale invasion against Ukraine, this report will support us in advocating for longer-term support and increased capacity within Mental Health services through the lifetime of the Ukraine response programme.”
