From Distress to Systemic Resilience: Strengthening MHPSS in Conflict Settings – Insights from Ukraine

Introduction: The full-scale war in Ukraine has significantly increased the need for coordinated and accessible mental health and psychosocial support (MHPSS) services. However, there remains limited empirical evidence on how civilians experience psychosocial distress during conflict and how institutions are responding to these needs across different service sectors. Purpose: This study assesses the psychosocial well-being of civilians and the institutional capacity to deliver MHPSS in conflict-affected such as the Kharkiv region. The research seeks to inform both national and international actors on existing gaps and opportunities for strengthening support systems in wartime contexts. Methodology: A cross-sectional survey was conducted in July 2023 across Kharkiv oblast. Data were collected from 13,343 service recipients and 3,183 service providers working in the healthcare, education, social protection, and NGO sectors. Quantitative analysis focused on indicators of emotional well-being, coping strategies, service satisfaction, institutional capacity, staff well-being, and information trust. Results: Findings revealed high levels of psychological distress among civilians, including symptoms of panic, apathy, and hopelessness. Service satisfaction varied by sector, with non-governmental organizations receiving higher ratings. While basic MHPSS services were moderately available, primary and specialized care remained limited. Institutional staff reported significantly increased workloads and limited access to psychological support or supervision. Most respondents trusted official government sources and professionals for mental health information. Conclusion: The results indicate an urgent need to expand low-threshold, community-based psychosocial services and to improve institutional readiness across sectors. Strengthening workforce well-being, integrating MHPSS into sector-specific practices, and aligning communication strategies with trusted channels are key to building a sustainable response. The proposed conceptual framework offers a multilevel roadmap for MHPSS system development in conflict-affected settings.