Yana Derzhak is a psychologist who specialises in mental health and psychosocial support (MHPSS) in humanitarian contexts. She has been working for Help in Ukraine since 2023, carrying out psychosocial activities.
Psychosocial support
Mental health in crisis response
Psychologist Yana Derzhak explains why mental health belongs in humanitarian assistance from the first day of a crisis — not after it.
An underestimated dimension of humanitarian assistance
Among people who have lived through war or conflict in the past decade, roughly one in five is living with a mental health condition. In the general global population, that figure is one in fourteen. Of every dollar spent on international humanitarian assistance, on average 0.5 % reaches mental health and psychosocial support.
I have spent years working as a psychologist in Ukraine, and that gap is the shape of my working days.
Lana Dmytrenko
When we talk about humanitarian aid in wartime, we most often mention the essentials: food, medicine, shelter, warm clothing and hygiene products. Without them, physical survival cannot be guaranteed. But surviving is not the same as returning to a life. After losing a home, being forced to move, living under constant danger or being separated from the people you love, a person needs more than supplies. They need to sleep. They need to be able to leave the house. They need to believe there is something ahead of them worth planning for.
That is why mental health and psychosocial support must be an integral part of humanitarian aid in crisis situations. The Ukrainian experience clearly demonstrates that without attention to people’s psychological well-being, it is impossible to speak of the full recovery of society.
The invisible consequences of war
The psychological consequences of war are not always apparent to those around us. A person may be receiving humanitarian aid, working, smiling and supporting others, yet at the same time living every day with anxiety, exhaustion, a sense of loss or a constant fear of danger.
In my practice, I have worked with people who have survived occupation, evacuation, the loss of their homes, forced displacement, separation from loved ones and months of fear for their own lives. Despite their different life stories, they have one thing in common — the war has left a psychological mark on almost every one of them.
One case that stayed with me involved a mother who arrived with her two children after the evacuation. Her elder son had almost stopped speaking: he sat alone at school and remained silent at home. His mother was in constant distress and told me she no longer knew what to do.
We began meeting once a week. In the early sessions, we just talked, and at times we sat in silence. With the children we drew, played games and played simple exercises to help them regulate their stress. Alongside this, his mother and I worked on letting go of self-blame for what had happened.
Several months later, she arrived and said: “Today he asked me whether he could invite a friend over.” To an outsider, this may seem minor, but at that point it was a significant breakthrough
Not everyone needs psychiatric treatment or has a clinical diagnosis. But today it is extremely difficult to find a Ukrainian who has never experienced intense anxiety, helplessness, emotional exhaustion or uncertainty.
Many have become so accustomed to living under constant stress that they regard it as the norm. People often say: ‘Everyone lives like this’, ‘You just have to hang in there’, ‘Others have it even harder’. However, psychological pain does not disappear simply because it is pushed aside. Over time, it affects physical health, relationships, work performance and the ability to build a new life.
Internally displaced people: safety does not mean the end of trauma
Uzhhorod, a city in Western Ukraine, has become home to thousands of internally displaced people. For many, it was the first place where they could fall asleep without the sound of explosions. However, people did not arrive here with just their suitcases. They brought with them memories of loss, fear, pain, feelings of guilt towards those left behind, and uncertainty about the future.
Similar words are often heard during counselling sessions: ‘It’s as if I’ve started a new life, but I can’t really settle into it.’ It is at moments like these that psychological support becomes a vital part of the adaptation process, helping people gradually regain a sense of control over their own lives.
Psychological support as a component of the humanitarian response
According to the World Health Organization, one in five people (22%) who have experienced war or conflict in the previous ten years has depression, anxiety, post-traumatic stress disorder (PTSD), bipolar disorder or schizophrenia. In 2007, the United Nations’ Inter-Agency Standing Committee (IASC) published the IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings to give humanitarian workers and local communities a clear, practical framework to protect mental health and set up coordinated, multi-sector support during major crises and emergencies.
However, the reality demonstrates that psychological activities are not sufficiently promoted within the humanitarian sector. A research study by The MHPSS Collaborative published in 2021 reveals that on average, less than 0.5% of international humanitarian funding was allocated to child and family MHPSS over the analyzed period.
Lana Dmytrenko
Ukraine’s experience shows that humanitarian aid cannot be limited to material support alone. A person who is in a state of constant anxiety or is suffering the consequences of traumatic events finds it much harder to adapt to new circumstances, find work, study, build social connections and plan for the future.
Psychological support does not erase painful memories or change the past. Its aim is to help people find the inner resources to carry on living despite what they have been through and restore their ability to build a future.
Sometimes this results in the first peaceful night’s sleep after many months of insomnia. Sometimes, it means being able to go outside without fear. Sometimes, it means the restoration of trust between parents and children. These changes – which may seem small at first glance – mark the beginning of the recovery of entire communities.
In our projects, psychological support is always tailored to the individual. For some, a few sessions are enough to calm down, manage stress and regain control of their situation. For others, however, long-term support is needed to come to terms with difficult experiences. On average, this amounts to around five counselling sessions, but we always prioritise the individual’s condition and needs above all else. Until mid-2026, Help has provided psychosocial support to 10,625 people in Ukraine, including 3,702 children. In addition, 5,011 people have received psychosocial support through our partners.
Special attention for children and children with disabilities
Children remain among the most vulnerable during wartime. They are often unable to put their experiences into words, but their emotional state is reflected in their behaviour: anxiety, sleep disturbances, fear of separation from their parents, and difficulties with learning or communication.
These challenges are particularly difficult for children with disabilities and their families. Such families often face several challenges at once: forced relocation, disruption to rehabilitation, loss of their familiar living conditions, and difficulties accessing medical, educational and social services.
For children with autism, Down’s syndrome, cerebral palsy, or intellectual or sensory impairments, a sudden change of environment, constant air-raid sirens, evacuation and disruption to their usual routine can become an additional source of severe stress. Their parents face no less psychological strain, as they are often forced to juggle ensuring the family’s safety, their child’s treatment and their own emotional well-being.This is why psychosocial support must extend not only to the child but to the whole family.
Investing in the future
Experience of humanitarian crises in various countries around the world shows that the need for mental health and psychosocial support does not end when hostilities cease. Very often, it is only after the acute phase has ended that people begin to fully realise the extent of the losses they have suffered.
Ukraine’s recovery is impossible without the recovery of its people. Investment in psychological support is an investment in the resilience of families, the wellbeing of children, support for older people and people with disabilities, community cohesion and society’s ability to develop after the war.
We can rebuild cities, schools, hospitals and roads. But it is people who will bring them to life. Mental health care is neither a luxury nor a concern to be postponed until the crisis is over. It is one of the cornerstones of human resilience, and it belongs in every humanitarian response from the outset — planned and budgeted for from the first day, not added once the acute phase has passed.
Daria Trampolets has been working for Help since 2023 and is currently a Senior MEAL Officer. She monitors, evaluates and improves the quality of our projects in Ukraine.
Last edited on