New Member Spotlight: Kristina Bohdanova Brings Proactive Mental Health Care to Ukrainians

“We see Sane Ukraine's work as preventative against PTSD, depression, anxiety, and all the outcomes of prolonged traumatic stress.” - Kristina Bohdanova, Ukraine Catholic University 

The war in Ukraine has devastated the country for over a year now, and data is frequently being updated to account for the number of lives lost as well as the toll on Ukrainians’ physical wellbeing. To date, the Office of the United Nations High Commissioner for Human Rights (OHCHR) estimates over 9,000 deaths and over 17,000 injuries for civilians. What is often harder to quantify, however, is the war’s immense toll on the psychological wellbeing of troops and civilians in Ukraine.

Enter Sane Ukraine, a pilot program created by Ukrainian psychologists and activists, including SSN member Kristina Bohdanova. The program, which was started in March of 2022 by Mark Walsh and colleagues from the Ukrainian Crisis Psychologists Group, harnesses an innovative approach of proactively providing mental health support to Ukrainians who are exposed to the trauma of living in a war zone, rather than the traditional approach of waiting for symptoms before providing care. More specifically, the program involves mental health professionals training non-professionals in coping mechanisms in response to trauma – with the non-professionals then taking these skills back to their communities. 

The initial 60 trainees at the start of the program were taught mental health task sharing, a model in which both mental health professionals and non-therapists are trained in providing information about traumatic stress and recovery and are also given the skills to create trauma-informed support groups of their own. Of the initial 60 trainees, half went on to actively train others, creating what Bohdanova calls “a cascade of interventions”. Many of these trainings have served internally displaced eastern and southern Ukrainian people who had fled to western Ukrainian cities like Lviv.

As of now, over 160 trainers have been trained and approximately 30-40 trainers are working full-time within the project – all of whom see the benefits this program is providing to Ukrainians coping with the reality of living in a war-torn country. 

“We see Sane Ukraine's work as preventative against PTSD, depression, anxiety, and all the outcomes of prolonged traumatic stress,” said Bohdanova, who lives in Ukraine as a medical doctor and a graduate student in clinical psychology at Ukraine Catholic University. 

For her, the program has been deeply fulfilling. “I was choosing between enlisting in the army versus doing psychological first aid, with these trainings.” And she doesn’t regret the path she selected, as she has witnessed the impact the program is already having. “Understanding that the harm can be reduced and our army and society are more robust and better fighters in this war with stable mental health makes me do what I am doing.”

But for Bohdanova – as well as SSN members Samantha Weckesser and Marina Weiss, who are involved in disseminating the findings of the Sane Ukraine project – the program carries broader implications for the future of mental health: it has become a research model for a form of proactive mental health care, versus the reactive mental health care system that is typically the norm in Western nations. Studying the results of Sane Ukraine is allowing Bohdanova and her team to examine ways in which proactive mental health care can be pioneered. The preliminary findings (collected in the fall of 2022) already show significant benefits: In pre-and post-assessments of subjective well-being in 148 teachers participating in training, those with high and moderate anxiety demonstrated a significant reduction in anxiety and a 9% increase in self-reported subjective well-being. 

Bohdanova is hopeful that this evidence-based research can help spawn other programs and other projects in places that have similar characteristics – whether they are war zones or any kind of space where trauma exists. In the meantime, she hopes to garner the attention of the public, health practitioners, and potential funders for the current project in Ukraine. Alongside Weckesser and Weiss, she has published two briefs – one explaining the program and another highlighting the preliminary results – as well as an OpEd in STAT that emphasizes the importance of this work. 

Bohdanova feels optimistic. “I can see the revolution of mental health services in my country. Even more – my colleagues and I are a part of this revolution right now,” she said. “A lot more needs to be done for the de-stigmatization of psychological help. But we are on the way.”