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Near the St. Panteleimon Hospital in Lviv, which until recently was an emergency medical care hospital on the street Mykolaychuka, the National Rehabilitation Center «Nezlamni» (Unbreakable) is planned. Its construction requires 77 million euros, so far 2.1 million euros have been collected. Following the Center’s idea, it must be capable of providing assistance to 50,000 Ukrainians.
The construction and opening of the Nezlamni rehabilitation center, which was announced in Lviv at the Donors’ Forum, is planned to be completed in two to three years. But since the war continues and help is already needed, a psychiatric ward has been operating in the Saint Panteleimon Hospital since the beginning of February.
As Yurii Yevchenko, head of the psychiatric department of the hospital, told in a comment for us, help is provided here to those who were evacuated due to injuries caused by the war, military personnel who returned from the war, as well as anyone who needs psychological counselling or treatment.
The department is designed for 26 beds, but, as Yurii Yevchenko assures, there are actually more patients. The fact is that not everyone needs inpatient care, often people go to the department for advice or to receive certain manipulations.
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Most often, according to the head of the psychiatric department, people come with acute mental disorders related to stress, in particular to the war.
«Now, there are many patients with mental disorders whose symptoms have worsened since the beginning of the war. There are displaced persons who arrive by evacuation trains and need psychological help. There are also patients who experienced reactive states – acute panic attacks, psychoses associated with war, mobilization of loved ones, frequent negative information in the mass media. People come in every day,» – says the interlocutor.
He adds that 26 beds is very little. Considering the fact that the war is not over yet, more and more people will need help. The new rehabilitation center will be able to provide much more powerful psychological and psychiatric help. For now, people who need such help can call 063 299 02 31.
We asked Oleh Berezyuk, a psychiatrist, a psychotherapist, the head of the department of psychological and psychosocial rehabilitation at the future National Rehabilitation Center, about what kind of psychological help is already provided in the hospital, who will need it in the future, and what fears Lviv residents are dealing with most often nowadays.
There is a war going on in Ukraine. Hundreds, thousands of wounded civilians and soldiers are being taken to Lviv. Tell us please, has the number of patients seeking psychiatric care actually increased, especially among the military?
The number of those with acute psychological trauma is increasing. Also, in the fourth month of the war, there are already many patients with post-traumatic stress syndrome. But this is a natural situation, because war, hostilities, the idea that there may be air raids or bombardment with cruise missiles is disturbing. Acute stress, disorder, trauma can be the body’s reaction to a threat. In particular, because of the danger to health and life. After all, the very understanding that such losses can be is already one of the most powerful psychological factors.
Up to 20% of people who experienced the horror of war may have symptoms of varying degrees of severity.
What is the prevention and treatment of war-related psychological trauma?
Treatment protocols for post-traumatic stress syndrome are extensive. This is psychosocial support: a person must find a safe place, be surrounded by attention, close people, that is, he must be safe and comfortable. Also, pharmacological support: treatment with drugs. The most important thing is long-term psychological support through various forms of psychological rehabilitation.
How many people who come to us for treatment from other regions of Ukraine have psychological problems?
Not all people have psychological problems. Yes, all of them are under stress, because they had a powerful threat to their lives or the lives of their relatives. Some of them lost loved ones, friends, perhaps their homes, or suffered serious physical injuries.
Whether this stress develops into a problem, an acute condition or a disorder depends largely on all of us and our support. We are talking about social, psychoanalytic and medical support.
We are not in a war zone, but Lviv and the Lviv Region are often bombarded with missiles. Do Lviv residents have psychological disorders?
Air-raid sirens due to the launch of cruise missiles, which can reach targets even 1,200 kilometers away, can become a source of stress. People worry that it can lead to the death of loved ones. The very thought of it is already stressful, and if you add constant negative information, photos, videos, then you are ready. So yes, a relatively large number of people have stress-related disorders.
From what fears or traumas Lviv residents and those who came from the occupied territories are dealing with during this war. Are our fears very different from theirs?
War is about survival. If you want to be free tomorrow, you have to survive. It’s a human instinct.
In the first acute period of the war, there were few requests for psychological help. War always mobilizes all the body’s resources for survival, keeps the body in a critical situation. People often said to themselves or to someone else, «I’m not sick,» «I’m fine,» «it’s been worse,» «I’m alive, and that’s fine.» Over time, we can say that people have developed a habit of war, because we generally easily adapt to everything.
In the background of military operations and news from social networks, Lviv residents often experience stress, after which asthenia worsens, blood pressure rises, and heart problems begin. Some manage to deal with this on their own, because when they see the war in other regions, the injuries of those who are being brought, they say: «No, not everything is so bad with us.» Others need qualified help.
Suppose the war ends today or tomorrow. How many more years will we feel this stress?
It will always be with us. We have the experience of World War II, for example. Our grandmothers often remembered how everything was, they had a habit of saving food just in case, because for many years they had the fear that the war would come and there would be nothing to eat again. Also, many men who went through the war in Afghanistan still suffer from post-traumatic syndrome, and only because they were not provided with adequate support in time. Because the sooner we provide people with support, including psychological and psychosocial support, the less likely they will suffer throughout their lives.
We have the experience of foreign colleagues from Iraq, Afghanistan, Syria, who say that stress is a very powerful factor, because it disrupts the balance of the psyche, when one’s well-being deteriorates, various negative symptoms appear. And if all this is aggravated by physical trauma, then the probability of mental pathology increases many times.
Many men have been fighting since 2014, some of them were wounded, and yet, since the beginning of a full-scale war, they again, without thinking, went to the front. Do you think such people should go back to war?
This is the nature of a warrior, we cannot tell them. If a man is healthy, why can’t he go to war? He will only need our support and respect. And we should be honoured to help such people.
In my practice, there was a patient, among the military, who fought in 2014 and took part the current war, was injured. On the 40th day after the injury, he developed a full-scale post-traumatic stress disorder with night terrors, social attacks, and convulsions. Without a doubt, he needed serious medical treatment. But later he admitted that what helped him the most was that doctors came, took care of his health and communicated with him.
This once again proves that boys and men who went to war or have already returned from it need our support: we should listen to them, talk to them, if necessary, cry together, laugh, but not feel sorry!
The war has been going on for the ninth year, and in Lviv, the authorities have only just started talking about the new National Rehabilitation Center «Unbreakable». Tell me, how quickly will they be able to receive patients?
The project has two parts, one of which is today and now. We already provide comprehensive psychological assistance to our patients. And in the process of creating a new rehabilitation center, we will improve the internal infrastructure and learn.
Such a center will be needed in the next decades as well. This war is brutal, cruel, misanthropic on the part of the neighbours. But those neighbours always fought with us like that.
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Moreover, this is not a war of troops against troops, but troops against people. That is why we have a large number of wounded and injured ordinary citizens. The current number of injured is almost the same: both military and civilian. Therefore, a feature of the new center will be that everyone will be able to apply here – both military and civilians, including children.
We must remember that even if this war stops tomorrow, it will not end for the people who got hurt. 20% of them will have serious problems.
This is via vita – the way of life. We have a powerful enemy that we underestimate. Ukrainians are very kind, trusting people who are used to work, but they have one flaw – they think that the enemy is like them, humane, and one must find an approach to him. But it is not so.
Our mistake is that we did not prepare for war, but it is not our fault.
How should each of us behave and what should we do during war?
Hope involves action: the more action, the less fear. That is, we all need to do something.
Olha Shveda, translated by Vitalii Holich
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