Treatment System Adaptations during War: Lessons from Ukrainian Addiction Treatment Providers

Alexandra A Deac; Irina Zaviryukha; Julia Rozanova; Oleksandr Zeziulin; Tetiana Kiriazova; Sheela Shenoi; Anna Peycheva; Renata Solórzano de Souza; Harry Skipper; Asmau A Abubakar; V Benjamin Gustilo; Graham Thornicroft; Paula Dellamura; Katherine M Rich; Valerie Earnshaw; Daniel J Bromberg; Elmira Mamedova; Volodymyr Yariy

doi:10.1080/10826084.2023.2212377

Treatment System Adaptations during War: Lessons from Ukrainian Addiction Treatment Providers

Alexandra A Deac, Irina Zaviryukha, Julia Rozanova^*, Oleksandr Zeziulin, Tetiana Kiriazova, Sheela Shenoi, Anna Peycheva, Renata Solórzano de Souza, Harry Skipper, Asmau A Abubakar, V Benjamin Gustilo, Graham Thornicroft, Paula Dellamura, Katherine M Rich, Valerie Earnshaw, Daniel J Bromberg, Elmira Mamedova, Volodymyr Yariy

^*Corresponding author for this work

Research output: Contribution to journal › Comment/debate › peer-review

2 Citations (Scopus)

27 Downloads (Pure)

Abstract

Background: The war in Ukraine has posed significant challenges to the healthcare system. This paper draws upon expert consultations, held between December 2022 and February 2023, focused on HIV/AIDS, addiction, and mental health service delivery during the first year of this war, and following the Global Mental Health Humanitarian Coalition panel discussion in May 2022. Objectives: This commentary presents the experiences of frontline healthcare workers in Ukraine, challenges, and local adaptations to meet the increased mental health needs of healthcare providers. We aimed to document the adaptations made in the addiction healthcare system and to acknowledge the changes in vulnerabilities and lessons learned. Results: Burnout among healthcare providers delivering addiction, HIV/AIDS and mental health services became more visible after the second half of 2022. Challenges included increased workload, contextual threats, lack of job relocation strategies, and money-follow-the-patient policies. Recommendations: The lessons from the first year of war in Ukraine hold significant generalizability to other contexts. These include enabling bottom-up approaches to tailoring services and allowing healthcare providers to respond to the dynamics of war in an effective and active manner. Other recommendations include departmental-specific resources and strategies, particularly as vulnerable groups and challenges are unstable in humanitarian contexts. Conclusions: Globally and in Ukraine, healthcare workers need more than applause. Along with monetary incentives, other strategies to prevent burnout, ensure sustainable capacity building, job relocation opportunities, and bespoke adaptations are imperative to protect healthcare providers' wellbeing and overall public health.

Original language	English
Pages (from-to)	1447-1450
Number of pages	4
Journal	Substance Use and Misuse
Volume	58
Issue number	11
Early online date	15 Jun 2023
DOIs	https://doi.org/10.1080/10826084.2023.2212377
Publication status	E-pub ahead of print - 15 Jun 2023

Keywords

Humans
Acquired Immunodeficiency Syndrome
Delivery of Health Care
Mental Health Services
Health Personnel/psychology
Mental Health
Ukraine

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1080/10826084.2023.2212377

Treatment System Adaptations_DEAC_Accepted18April2023_GREEN AAM (CC BY)Accepted author manuscript, 207 KBLicence: CC BY

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Deac, A. A., Zaviryukha, I., Rozanova, J., Zeziulin, O., Kiriazova, T., Shenoi, S., Peycheva, A., Solórzano de Souza, R., Skipper, H., Abubakar, A. A., Gustilo, V. B., Thornicroft, G., Dellamura, P., Rich, K. M., Earnshaw, V., Bromberg, D. J., Mamedova, E., & Yariy, V. (2023). Treatment System Adaptations during War: Lessons from Ukrainian Addiction Treatment Providers. Substance Use and Misuse, 58(11), 1447-1450. Advance online publication. https://doi.org/10.1080/10826084.2023.2212377

@article{34a324aa39b146df8173db657edc377c,

title = "Treatment System Adaptations during War: Lessons from Ukrainian Addiction Treatment Providers",

abstract = "Background: The war in Ukraine has posed significant challenges to the healthcare system. This paper draws upon expert consultations, held between December 2022 and February 2023, focused on HIV/AIDS, addiction, and mental health service delivery during the first year of this war, and following the Global Mental Health Humanitarian Coalition panel discussion in May 2022. Objectives: This commentary presents the experiences of frontline healthcare workers in Ukraine, challenges, and local adaptations to meet the increased mental health needs of healthcare providers. We aimed to document the adaptations made in the addiction healthcare system and to acknowledge the changes in vulnerabilities and lessons learned. Results: Burnout among healthcare providers delivering addiction, HIV/AIDS and mental health services became more visible after the second half of 2022. Challenges included increased workload, contextual threats, lack of job relocation strategies, and money-follow-the-patient policies. Recommendations: The lessons from the first year of war in Ukraine hold significant generalizability to other contexts. These include enabling bottom-up approaches to tailoring services and allowing healthcare providers to respond to the dynamics of war in an effective and active manner. Other recommendations include departmental-specific resources and strategies, particularly as vulnerable groups and challenges are unstable in humanitarian contexts. Conclusions: Globally and in Ukraine, healthcare workers need more than applause. Along with monetary incentives, other strategies to prevent burnout, ensure sustainable capacity building, job relocation opportunities, and bespoke adaptations are imperative to protect healthcare providers' wellbeing and overall public health.",

keywords = "Humans, Acquired Immunodeficiency Syndrome, Delivery of Health Care, Mental Health Services, Health Personnel/psychology, Mental Health, Ukraine",

author = "Deac, {Alexandra A} and Irina Zaviryukha and Julia Rozanova and Oleksandr Zeziulin and Tetiana Kiriazova and Sheela Shenoi and Anna Peycheva and {Sol{\'o}rzano de Souza}, Renata and Harry Skipper and Abubakar, {Asmau A} and Gustilo, {V Benjamin} and Graham Thornicroft and Paula Dellamura and Rich, {Katherine M} and Valerie Earnshaw and Bromberg, {Daniel J} and Elmira Mamedova and Volodymyr Yariy",

note = "Funding Information: This work has been supported by the award from the Fund for Lesbian and Gay Studies at Yale University (PI: Rozanova); the National Institute on Drug Abuse (K01DA047194: Rozanova), the National Institute on Aging (R21AG072961 and R21AG072961-02S1, MPI: Rozanova, Shenoi), and the National Institute of Mental Health (R34MH130260, PI: Rozanova). Publisher Copyright: {\textcopyright} 2023 Taylor & Francis Group, LLC.",

year = "2023",

month = jun,

day = "15",

doi = "10.1080/10826084.2023.2212377",

language = "English",

volume = "58",

pages = "1447--1450",

journal = "Substance Use and Misuse",

issn = "1082-6084",

publisher = "Taylor and Francis",

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Deac, AA, Zaviryukha, I, Rozanova, J, Zeziulin, O, Kiriazova, T, Shenoi, S, Peycheva, A, Solórzano de Souza, R, Skipper, H, Abubakar, AA, Gustilo, VB, Thornicroft, G, Dellamura, P, Rich, KM, Earnshaw, V, Bromberg, DJ, Mamedova, E & Yariy, V 2023, 'Treatment System Adaptations during War: Lessons from Ukrainian Addiction Treatment Providers', Substance Use and Misuse, vol. 58, no. 11, pp. 1447-1450. https://doi.org/10.1080/10826084.2023.2212377

TY - JOUR

T1 - Treatment System Adaptations during War

T2 - Lessons from Ukrainian Addiction Treatment Providers

AU - Deac, Alexandra A

AU - Zaviryukha, Irina

AU - Rozanova, Julia

AU - Zeziulin, Oleksandr

AU - Kiriazova, Tetiana

AU - Shenoi, Sheela

AU - Peycheva, Anna

AU - Solórzano de Souza, Renata

AU - Skipper, Harry

AU - Abubakar, Asmau A

AU - Gustilo, V Benjamin

AU - Thornicroft, Graham

AU - Dellamura, Paula

AU - Rich, Katherine M

AU - Earnshaw, Valerie

AU - Bromberg, Daniel J

AU - Mamedova, Elmira

AU - Yariy, Volodymyr

N1 - Funding Information: This work has been supported by the award from the Fund for Lesbian and Gay Studies at Yale University (PI: Rozanova); the National Institute on Drug Abuse (K01DA047194: Rozanova), the National Institute on Aging (R21AG072961 and R21AG072961-02S1, MPI: Rozanova, Shenoi), and the National Institute of Mental Health (R34MH130260, PI: Rozanova). Publisher Copyright: © 2023 Taylor & Francis Group, LLC.

PY - 2023/6/15

Y1 - 2023/6/15

N2 - Background: The war in Ukraine has posed significant challenges to the healthcare system. This paper draws upon expert consultations, held between December 2022 and February 2023, focused on HIV/AIDS, addiction, and mental health service delivery during the first year of this war, and following the Global Mental Health Humanitarian Coalition panel discussion in May 2022. Objectives: This commentary presents the experiences of frontline healthcare workers in Ukraine, challenges, and local adaptations to meet the increased mental health needs of healthcare providers. We aimed to document the adaptations made in the addiction healthcare system and to acknowledge the changes in vulnerabilities and lessons learned. Results: Burnout among healthcare providers delivering addiction, HIV/AIDS and mental health services became more visible after the second half of 2022. Challenges included increased workload, contextual threats, lack of job relocation strategies, and money-follow-the-patient policies. Recommendations: The lessons from the first year of war in Ukraine hold significant generalizability to other contexts. These include enabling bottom-up approaches to tailoring services and allowing healthcare providers to respond to the dynamics of war in an effective and active manner. Other recommendations include departmental-specific resources and strategies, particularly as vulnerable groups and challenges are unstable in humanitarian contexts. Conclusions: Globally and in Ukraine, healthcare workers need more than applause. Along with monetary incentives, other strategies to prevent burnout, ensure sustainable capacity building, job relocation opportunities, and bespoke adaptations are imperative to protect healthcare providers' wellbeing and overall public health.

AB - Background: The war in Ukraine has posed significant challenges to the healthcare system. This paper draws upon expert consultations, held between December 2022 and February 2023, focused on HIV/AIDS, addiction, and mental health service delivery during the first year of this war, and following the Global Mental Health Humanitarian Coalition panel discussion in May 2022. Objectives: This commentary presents the experiences of frontline healthcare workers in Ukraine, challenges, and local adaptations to meet the increased mental health needs of healthcare providers. We aimed to document the adaptations made in the addiction healthcare system and to acknowledge the changes in vulnerabilities and lessons learned. Results: Burnout among healthcare providers delivering addiction, HIV/AIDS and mental health services became more visible after the second half of 2022. Challenges included increased workload, contextual threats, lack of job relocation strategies, and money-follow-the-patient policies. Recommendations: The lessons from the first year of war in Ukraine hold significant generalizability to other contexts. These include enabling bottom-up approaches to tailoring services and allowing healthcare providers to respond to the dynamics of war in an effective and active manner. Other recommendations include departmental-specific resources and strategies, particularly as vulnerable groups and challenges are unstable in humanitarian contexts. Conclusions: Globally and in Ukraine, healthcare workers need more than applause. Along with monetary incentives, other strategies to prevent burnout, ensure sustainable capacity building, job relocation opportunities, and bespoke adaptations are imperative to protect healthcare providers' wellbeing and overall public health.

KW - Humans

KW - Acquired Immunodeficiency Syndrome

KW - Delivery of Health Care

KW - Mental Health Services

KW - Health Personnel/psychology

KW - Mental Health

KW - Ukraine

UR - http://www.scopus.com/inward/record.url?scp=85161851403&partnerID=8YFLogxK

U2 - 10.1080/10826084.2023.2212377

DO - 10.1080/10826084.2023.2212377

M3 - Comment/debate

C2 - 37317994

SN - 1082-6084

VL - 58

SP - 1447

EP - 1450

JO - Substance Use and Misuse

JF - Substance Use and Misuse

IS - 11

ER -

Treatment System Adaptations during War: Lessons from Ukrainian Addiction Treatment Providers

Abstract

Keywords

UN SDGs

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