Keywords: mental health; duty of care; primary healthcare; health workforce; Ukraine

Introduction:

The goal of this assessment was to evaluate the impact of prolonged conflict-related stress on the mental health and well-being of the health workforce in the ten most conflict-affected regions of Ukraine. The assessment was focused on understanding the severity of mental health symptoms, exploring potential negative coping strategies already adopted by healthcare workers (HCW) and identifying specific mental health and psychosocial support (MHPSS) services needed. The assessment aimed at further shaping the International Rescue Committee’s (IRC) MHPSS program and serve as a stepping stone for a deeper understanding of and response to mental health concerns among HCWs in Ukraine.

Method:

A mixed-methods needs assessment was conducted between May-September of 2024 across ten of Ukraine’s most conflict-affected regions. Quantitative data were collected via an anonymous online well-being survey (n=1,552 HCWs, 35 items across four domains: personal, interpersonal, capacity, workplace). Qualitative insights were obtained through 12 focus group discussions with 72 HCWs. Data were analyzed by demographic and professional variables to identify resilience patterns and risk groups.

Results:

Overall, 20% of respondents demonstrated “negative coping.” The greatest challenges were reported in personal well-being (30% negative coping) and workplace environment (26%). Medical doctors, younger professionals, and those working alone or in small teams were the most affected. Stressors included air alarms, unsafe hospital environments, staff shortages, and uncertainty about the future. Stigma and fear of professional consequences were major barriers to seeking formal psychosocial support. Informal peer support emerged as the primary coping mechanism, though not always sufficient.

Conclusions:

The findings highlight a severe and under-recognized mental health burden among Ukraine’s health workforce. Without intervention, this may undermine both individual well-being and the resilience of the healthcare system. Tailored MHPSS strategies, practical self-care training, stigma reduction, and national staff care programs are urgently required to protect and sustain the healthcare workforce during protracted conflict.