10. Psychiatric Care During Russia's War Against Ukraine

Changes in patient flow and staffing

Illustration (10. Care During the War)Zoom

In the first months of Russia's full-scale invasion, some people lost access to their usual hospital, some left with family, and others were evacuated from inpatient care. Observations from 30 psychiatric institutions in 2022 capture this disruption: average monthly admissions per institution fell from 432.2 in January to 333.7 in April, then rose to 360.9 in July. Meanwhile, the average number of psychiatrists fell from 34.9 to 29.6, and nurses from 142.6 to 122.9. [213, 214]

A two-year follow-up tracked 25 hospitals participating in every wave. In this group, monthly admissions rose from 433.4 per institution in January 2022 to 552.0 in April 2024; over the same period, the average number of psychiatrists declined from 40.0 to 30.9. Beds changed from 435.8 to 415.0, without a statistically significant difference. A larger patient flow thus met a smaller medical workforce. [215]¹⁸

By April 2024, displaced workers accounted for 21.7% of staff in the institutions studied. Patient transfers mainly originated in the east and south. Receiving hospitals assumed responsibility for continuing prescriptions, reconstructing records, and contacting relatives who might be in another region or abroad. [215]

Institutions in occupied territories and after evacuation

Russian occupation severed links among institutions, owners, families, and Ukrainian services. A National Social Service response published in June 2025 identified 15 psychoneurological residential institutions remaining geographically under occupation; almost 3,000 people had lived there on January 1, 2022. In Luhansk region, rapid occupation interrupted evacuation of 327 patients from Svatove Psychiatric Hospital. Moving large groups requires transport, accompanying staff, medication supplies, and prepared care placements.¹⁷ [171]

Within a month after Kherson's liberation in November 2022, 257 patients were evacuated from the regional psychiatric institution. Bakhmut's psychoneurological residential institution later resumed work in Poltava region with 100 beds. Each move required restoring daily care: who dispenses medication, where records are kept, how families find their relatives, and who continues clinical follow-up. [171]

Symptoms in the civilian population

A September 2023 online survey included 2,050 adults. Screening criteria for at least one of seven disorders were met by 36.3%; 16.2% met criteria for two or more. Generalized anxiety, prolonged grief, and post-traumatic symptoms were most common. Financial difficulties and disruption of ordinary life following Russia's 2014 invasion were associated with several symptom groups. Forced displacement after the 2022 full-scale invasion was separately associated with complex post-traumatic symptoms. [216]¹⁹

Anxiety and depressive symptoms were more common among women; alcohol- and cannabis-related problems among men. Positive screening for any studied disorder was 41.7% in the east and 30.5% in the west. This profile combines traumatic experience, loss, economic anxiety, and substance use; clinical interviews often address several at once. [216]

Home visits and family work

Illustration (10. Care During the War)Zoom

The initial experience of 14 community teams provides a detailed picture of work before the full-scale invasion. From April through December 2021, they supported 947 people with a mean age of 44. Schizophrenia-spectrum disorders predominated, accounting for 72.3% of those with relevant diagnostic data. On average, three of six recorded contacts took place in the community; home visits combined medication, psychosocial, and general medical care. [196]

Among 742 people with paired clinical assessments, 243 improved and 451 remained stable. Among 304 with paired WHODAS assessments, the median disability score fell from 62.50 to 58.33 over approximately ten weeks. More frequent family work and support for community inclusion were associated with better functional change. Clinical improvement was less likely in the region affected by hostilities. [196]²⁰

The next development stage is mental health centres at general hospitals with outpatient and outreach work. An evaluation program published in 2026 plans to measure reach, clinical outcomes, professional adoption, and sustainability. In everyday practice, these questions are concrete: how many people maintain contact, how symptoms and functioning change, how often the team makes visits, and how it transfers a complex case to hospital. [217]

Reorganizing a regional ward

In Ward No. 8 of Kirovohrad Regional Psychiatric Hospital, average length of stay fell from 41.5 days in 2022 to 32.0 in 2023, 31.5 in 2024, and 19.6 in the first quarter of 2025. The discharge case mix also changed: schizophrenia-spectrum disorders fell from 54.94% to 15.15%, neurotic and stress-related disorders rose from 8.43% to 25.59%, and substance use disorders from 8.43% to 30.30%. [218]

Together, these changes imply a different pace of admission, diagnosis, and discharge. For the first quarter of 2025, the article reports mean stays of 35.72 days for organic disorders, 39.33 for affective disorders, and about six for substance use disorders. The overall average combines clinically distinct pathways. After a short treatment episode, post-discharge contact, continued addiction treatment, and rapid reassessment become especially important. [218]

Continuity of addiction treatment

On January 1, 2026, the Public Health Centre recorded 32,975 recipients of maintenance substitution therapy; 21,739 were treated in municipally owned institutions. Seven facilities in Donetsk, Zaporizhzhia, and Kherson regions continued caring for 1,616 people. The program operated through the simultaneous opening of new sites, patient transfers, and institutional reorganization. [151]

In 2025, the approaching front forced the Kostiantynivka site to close; patients transferred to Sloviansk. Patients from Dobropillia were referred to Kramatorsk and facilities in Pavlohrad and Dnipro. According to the Public Health Centre, transfers from the two closed Donetsk-region sites preserved treatment. In Krasnopillia, proximity to the front and shelling damage caused closure; other Sumy-region facilities continued care. [151]

During such moves, clinical continuity rests on confirming the last dose, arranging the next dispensing, and transferring information on concurrent medication. For someone with HIV or tuberculosis, the same pathway must preserve disease-specific treatment. The medication site becomes a daily source of stability that must move with the patient. [120, 151]

Military personnel, veterans, and physical rehabilitation

After injury, psychiatric care may develop within surgical and rehabilitation pathways. Pain, sleep disturbance, traumatic brain injury consequences, depression, and post-traumatic symptoms affect physical recovery and family relationships. WHO reported that by the end of 2024, multidisciplinary teams from 28 non-specialized inpatient rehabilitation departments in eleven regions had received training. [219]

A Ministry of Veterans Affairs program also serves veterans and specified categories of family members: social-psychological support, specialized psychological care, and comprehensive medical-psychological rehabilitation. Providers in the official register can be approached directly or through physician referral; care is outpatient, inpatient, or remote. Psychiatric treatment under the Medical Guarantees Program and veterans' psychological support provide two possible entry points according to clinical need. [220, 190]

Rights and everyday treatment conditions

Article 14 of the Law on Psychiatric Care links involuntary hospitalization to severe mental disorder, a need for inpatient assessment or treatment, and immediate danger or inability to meet basic life needs. After admission, a panel of psychiatrists examines the person within 24 hours; where grounds exist, the facility applies to the court. Continued detention involves repeat examinations and judicial oversight. [204]

During a July 31, 2026 visit to Cherkasy Regional Children's Hospital, the National Preventive Mechanism documented an operating mental health centre, playroom, emotional decompression space, and equipped shelter. However, a room called an isolation room in the psychiatric ward was used for observation with a video camera contrary to regulatory requirements; medical staffing was insufficient. Equipment and protected space coexisted with specific problems of privacy and workload for the team on duty. [221]

Housing after hospitalization and evacuation

The strategy for deinstitutionalizing adult care through 2034 provides for community social services, including supported living. Its 2025 to 2027 operational plan links this to needs assessment, development of local services, and transition from large residential institutions to more individualized care. [192]

As of July 23, 2026, a pilot for internally displaced older people and people with disabilities included 91 providers; since August 2024, contracts had been signed with 675 recipients across two services combined: residential care and supported living. A separate 2026 plan envisaged about 3,000 supported-living recipients. In its 2025 report, Kharkiv region described starting this service for eight people at one centre and preparing premises in other municipalities. [222, 223]

After evacuation, accommodation determines the accessible pharmacy, route to the physician, and circle of people who can help. A stable address allows a team to arrange a visit, a family to distribute care, and the patient to rebuild an ordinary day. Long-term recovery consists of these repeated actions.