Since the escalation of war in Ukraine, Czechia has welcomed over 350 000 Ukrainian refugees. With so many people seeking safety, the country’s health system – already stretched due to the COVID-19 pandemic – faced new challenges, especially in responding to mental health needs. About 45% of the refugees were experiencing depression, anxiety and trauma. The situation required immediate and effective action to make sure they had the support they required – and that’s where WHO and national partners stepped in.
Building bridges for mental health
As an influx of refugees crossed the border, it became clear that the Czech health system needed extra capacity to care for them. Local mental health centres, or CDZs, were doing their best, but soon became overwhelmed. WHO/Europe and the WHO Country Office in Czechia worked closely with the Czech Ministry of Health to remedy what was quickly becoming a concerning situation. Together, they formed a working group of 27 organizations, including CDZs, nongovernmental organizations, government ministries and international partners. What was their goal? – to figure out how to bring accessible mental health services to refugees in the fastest, most coordinated way possible.
Ukrainian specialists join the efforts
Building trust and communicating effectively is at the heart of any relationship between a patient and a medical professional. However, one cannot exist without the other – and this was evident as a major obstacle to care.
“The main challenge was the language barrier, so we added Ukrainian specialists to the existing teams; mainly psychologists and interpreters. This was very important because, without them, the relationship between the therapist and the refugee didn’t work at all,” says Gracián Svačina, Head of the CDZ centre in the city of Ostrava.
This wasn’t just about translating words – it was about offering support in a way that felt safe and familiar. As the programme progressed, multidisciplinary teams, including psychiatrists, nurses and social workers, were able to offer both mental health care and social support. The work of the CDZs extended beyond the walls of their premises and out into communities, as teams visited schools, homes and temporary housing where refugees lived.
Reaching out to schools and families
Children were particularly affected by the crisis and one of the project’s key successes was working directly in schools. Regular psychologist visits to classrooms helped address bullying and eased the integration of Ukrainian children into the learning environment.
Adolescents, in particular, had a tough time fitting in due to language issues, and some started skipping school to find work. WHO-supported teams focused on keeping teenagers engaged, offering group activities, such as art and sports, where they could interact with Czech peers and build friendships.
Many mothers who had fled Ukraine were struggling emotionally but were so focused on their children that they hadn’t sought help for themselves. “We often found that once we started working with the children, we realized their mothers needed support too,” explained Hana Bolinová, Project Manager, Mental Health and Psychosocial Support Projects, for the Alliance of CDZs.
Making a lasting difference
The project has facilitated over 7000 interventions for Ukrainian refugees in 7 regions of Czechia, while more than 215 000 refugees have benefitted from wider WHO- and partner-supported services, including information campaigns.
The results have been life-changing. For example, some mothers on the verge of losing custody of their children were able to get the mental health care they needed to stabilize their situations, keeping their families together.
The inclusion of Ukrainian specialists has been one of the project’s biggest achievements. Many of these professionals have integrated into the Czech health system and are now permanent staff members in the CDZs. “Without these Ukrainian psychologists, we would have lost the chance to help so many people. They’ve truly been lifesavers,” notes Hana.
Moving forward together
Even though the programme has seen great success, challenges remain. Czechia’s mental health system still has capacity issues, especially for psychiatric care, and the demand for services continues to grow. WHO and its partners are focused on expanding community-based services and finding new ways to reach vulnerable groups, such as youth, who are particularly at risk.
Looking ahead, WHO and local organizations plan to keep building on the foundation they’ve created, making sure that refugees can access the support they need – both now and in the future.
As Gracian says, “We’ve seen how well this system can work, and now it’s about making sure we maintain progress to ensure everybody that needs us is encouraged to access the services they need.”
Background
WHO/Europe has taken swift action to mobilize and coordinate mental health and psychosocial support (MHPSS) for both refugees and local health systems in response to various crises, ranging from conflicts to natural disasters, that have disrupted health services across the Region. In Ukraine, WHO/Europe has played a key role in coordinating MHPSS efforts and enhancing mental health services. Across Armenia, Bulgaria, Czechia, Hungary, Israel, Poland, the Republic of Moldova, Romania, Slovakia, Türkiye and Ukraine, the organization has deployed 16 MHPSS experts, provided assistance to over 700 humanitarian workers, and trained more than 2500 health workers in MHPSS skills.