Even before full-scale war broke out in Ukraine in February 2022, the country’s prevalence of depression disorders, at 5.2%, was among the highest in Europe. As people have lost homes, loved ones and livelihoods since the Russian invasion, the rate of depression has risen exponentially—to about 44%. There is an overwhelming need for mental health care.
In response, International Medical Corps is helping by delivering psychosocial support services and mental health case management throughout the country. In frontline areas, we have used mobile units to ensure that people get the support they need. We also build local capacity by training health and social workers in basic psychosocial skills, as well as in how to detect, and provide referrals for, more severe mental health cases. And we provide training on evidence-based scalable interventions, such as the World Health Organization’s Self-Help Plus (SH+) as well as the Mental Health Gap Action Programme (mhGAP) intervention guides.
In December, our Ukraine team partnered with Columbia University to offer training on interpersonal therapy (IPT), which includes both an evidence-based psychological intervention that can be used for common mental health conditions, as well as a group format published by WHO that both specialized and non-specialized providers can offer for people experiencing moderate to severe depression.
During IPT, a person with depressive symptoms has an initial one-on-one session with a practitioner, who assesses the client’s level of depression, explains the symptoms of depression and helps them to understand the role of recovery.
“We explain that if you have depression symptoms, you are like a person with a broken arm: you need proper treatment and support,” says Yuliia Okhmat, Mental Health and Psychosocial Support Coordinator in Ukraine. “We ‘normalize’ their state when we explain that many people have an experience with depression during their lives, and that many are able to recover. We also explain that the process of recovery takes time and has its ups and downs.”
If the person meets the criteria for IPT, he or she can participate in eight group-therapy sessions, which are tailored to participants’ needs and focus on one or more of four areas: loss (including loss of home and loss of loved ones), role transitions and changes in life, social isolation, and disputes with other people. The groups meet weekly for 90 minutes. At the beginning of each session, participants assess their own level of depression, enabling the practitioner to see whether they are making progress from week to week, and adjust the session’s content accordingly.
“What is beautiful about the group is that every client will have a different problem area, and they can learn from and support each other,” Yuliia says. “They also can build networks of support and continue supporting each other outside of the group.”
With Columbia University staff and faculty, International Medical Corps trained an initial cohort of 18 IPT practitioners chosen because they would be the most likely to use IPT in their everyday work—including people who work in public services, who work as university teachers or who work in university mental health centers.
Since the five-day training took place in December, these practitioners—most of whom are from Kyiv oblast—have been undergoing a lengthy certification process that will permit them to practice IPT. Over the course of five months, they will have weekly supervisory meetings with the Columbia trainers and will complete two individual IPT cases—to build their confidence—and one group case before being certified to deliver IPT independently.
Yuliia says that IPT is an important new intervention for Ukraine for several reasons.
“Because it’s a group format, we are able to support multiple people at the same time,” Yuliia explains. “Given the high prevalence of depression in Ukraine, there is a need to expand the number of professionals trained to deliver evidence-based intervention. With IPT, we will be able to support more people with an intervention that is safe and effective.”