It is hard to fathom that the experiences of mental health professionals in war-torn Ukraine could be comparable to those working in rural areas of New South Wales.
- Ukrainian mental health professionals are working with NSW counterparts on support strategies
- They visited Dubbo Hospital to take in practical methods of treating patients with fewer resources
- Dubbo’s evidence-based tools could be repurposed to help Ukrainians suffering various disorders
But Kyiv-based psychiatrist Viktoriia Kolokolova said she learned a lot during a visit to Dubbo, taking in strategies used there for working with patients who have limited access to face-to-face treatment.
“In Ukraine it’s very hard to get specialists to the rural areas,” she said.
“It’s very interesting how the doctors [in Dubbo] do their practice remotely, how they build this interdisciplinary work, how they build this good teamwork, and how they manage the problems.”
Dr Kolokolova is part of a group of seven Ukrainian psychiatrists and psychologists visiting Australia from Lviv’s Ukrainian Catholic University and Kyiv-based mental health NGO Bezbaryernist on a training fellowship through the Department of Foreign Affairs and Trade.
The group is based at the NSW Service for the Treatment and Rehabilitation of Torture and Trauma Survivors in Sydney, but was hosted by the Western NSW Local Health District to look at strategies on working with fewer resources and less access to clinical settings.
Dr Kolokolova said the clinical approaches she saw at Dubbo Hospital’s Mental Health Unit inspired her more than other urban-based services she had seen so far.
“We didn’t talk even about medications, we talked a lot of about art, a lot about safe spaces, a lot about light, a lot about how important it is to bring in carers, children and families, and engage them through this treatment process,” she said.
“I think that’s a very powerful discussion and insightful for my group.”
Dr Kolokolova said demand in Ukraine for mental health support is increasing as Russia’s large-scale invasion of the country continues for a second year.
The war has been marked by widespread bombing of Ukraine’s civilian areas and infrastructure with almost 27,000 civilians killed or injured since February last year.
Dr Kolokolova said generational trauma was a concern with this conflict not being Ukraine’s first war.
She said her and her peers’ work equated with the intergenerational trauma of Indigenous patients.
“This experience of the doctors in the way they respect the culture, they respect the history, and use art and resources for healing other than psychotherapy, other than pharmaceuticals, it’s very powerful we saw this,” Dr Kolokolova said.
Practical tools urgently needed
Dubbo Hospital is in a local government area of 55,000 people but reaches almost three times that number as the primary hospital hub.
Dr Kolokolova said one of the highlights in visiting its mental health clinic was seeing how it uses technology to treat patients who live far away.
“We can do really complex monitoring at a distance with a highly trained nurse at one end and an adopter at another end, and deliver care that we never could deliver before,” said Dubbo’s mental health clinical director Warren Kealy-Bateman.
He hoped an online tool that the Dubbo clinic has used successfully with remote patients suffering from depression, anxiety, sleep disorders, or PTSD could be translated and repurposed for Ukrainians.
“What the Ukrainian contingent talked about is that, for some people, there’s a great shame in presenting and being a burden on the health system, particularly with mental health problems, while they’re happy to present with physical health problems,” Dr Kealy-Bateman said.
“So sometimes maybe the interface of the internet might be a much, much more accessible way to deliver effective mental health care when it’s most needed.”
Dr Kolokolova said seeing things already being put in practice in Australia was invaluable.
“We don’t have time for experiments,” she said.
“We really are very short in resources because most of our resources are going directly to our military — that’s why we’re so much seeking help.”