Common Elements Treatment Approach Helps Addressing PTSD in Veterans in Ukraine

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Common Elements Treatment Approach Helps Addressing PTSD in Veterans in Ukraine

The war in eastern Ukraine started by Putin in 2014 under the pretence of protecting the Russian-speaking population in the Donetsk and Luhansk regions has reached a stalemate, largely resulting in a situation that is best described as a “war of attrition.”

United States stands with the people of Ukraine providing assistance in this difficult time. In particular, the FY 2021 National Defense Authorization Act (NDAA) includes $250 million in security assistance for Ukraine, of which $125 million is designated specifically for lethal assistance, an increase of $75 million from FY20. Additionally, the bill includes a clause requiring the DoD to develop a strategy for increasing the capacity of the Ukrainian military forces and a clause on NATO’s Enhanced Opportunity Partner program, a crucial step toward Ukraine achieving full NATO membership. According to co-founder and co-chair of the Senate Ukraine Caucus Senator Portman, “this bill … sends a clear message that America stands with the Ukrainian people in their struggle to secure a democratic, prosperous, and independent future in the face of Russian aggression…The United States Congress will continue to make sure the Ukrainian military has the capabilities it needs to defend its sovereign territory—on the land, sea, and air.”

(read his full press release here: https://www.portman.senate.gov/newsroom/press-releases/portman-senate-passed-fy-2021-ndaa-includes-key-improvements-americas)

However, other needs remain to be addressed, in particular on physical and psychological rehabilitation of war veterans. As the fighting with Russia goes on in the Eastern front of Ukraine, the rest of the country suffers from deteriorating economy affected by COVID pandemic, deterring foreign direct investment, unemployment, and corruption. Ukraine’s own resources for assistance to combatants upon their return are extremely limited. For example, while the French foreign legion spends about 1,000 euros per person on post-traumatic syndrome disorder (PTSD) treatment, Ukrainian budget cannot afford covering more than $50 per one person.

The Ministry of Veterans Affairs and civil society volunteers try to find other sources to address the need yet hit another wall. While over 60,000 veterans have received psychological rehabilitation, according to Justice Report, the mental health assistance in Ukraine remains ineffective, being rooted in Soviet-era mentality. Currently, the psychological assistance to veterans largely entails prescription drugs. Other treatment methods remain ignored, since the rehabilitation system has not changed since 1991. The government of Ukraine works on developing a new program to adopt in 2022, however the efforts for its introduction lack unity. Presently, the Health Ministry, the Ministry of Social Policy, and the Ministry of Veterans all are assisting veterans with mental health issues. The divergence of interests between these three governmental bodies and the lack of clear communication algorithm between them threatens to delay the new state program for veteran rehabilitation.

The Post-Traumatic Stress Disorder (PTSD) is especially prevalent among the combatant veterans. Its adverse symptoms- including anxiety, hypervigilance, nightmares, insomnia, anger, and violent outbursts - are often compounded by feelings of shame, survivor’s guilt, and feelings of negative self-worth. It can also result in emotional withdrawal and isolation, particularly when the veteran feels that close others cannot relate to his or her feelings.

These symptoms extend beyond individual’s emotional struggles. PTSD results in a variety of problems associated with reintegration – maintaining in family life or at job – that may stem from a related adjustment disorder. According to the American Psychological Association (APA), the “symptoms cause significant distress or problems functioning in important areas of someone’s life, for example, at work, school or in social interactions.

To address the problem, the Ukrainian Ministry of Veterans Affairs spoke with US Chargé d'Affaires in Ukraine, a. i. Kristina A. Kvien, USAID’s Mission Director in Ukraine James Hope and representatives of the US Embassy in Ukraine about additional cooperation on veteran-related projects with a specific focus on psychological assistance. Specifically, the Ministry of Veterans Affairs encouraged drifting away from Soviet-era stigma surrounding PTSD and strengthening veteran social protection in the country for their full reintegration back into peaceful life.

The conversation also extended to talking about increasing the effectiveness of the Common Elements Treatment Approach (CETA) psychological program in Ukraine. Currently, the program has projects in five regions: Donetsk, Luhansk, Kharkiv, Dnipropetrovsk, and Zaporizhzhya. It aims to provide psychological support to veterans on a community level. Just last year, the program held forty online seminars which were attended by 180 veterans and their families from all across Ukraine. The program is supported by the Ministry of Education and Science of Ukraine, Ministry of Social Policy of Ukraine, World Health Organization, UNICEF, the John Hopkins University, and International Medical Corps. CETA’s efforts stem from a general sentiment that Ukraine needs to move away from the Soviet model focusing solely on veteran social protection.

The US assistance in projects on veterans is particularly valued in Ukraine and the world.  US-based organizations and universities have developed approaches of PTSD treatment that have been proven efficient in military conflicts such as those in Iran, Afghanistan, and Burma. Therefore, Ukrainian and U.S. cooperation is crucial.