Listening to parents and communities about schoolchildren’s mental health in wartime Ukraine

European Public Health Week 2026 __________________________________________________________________ Children’s mental health is not only inside the child. It is also in the adults who notice, the systems that respond, the communities that support, and the routes that make help possible.
Listening to parents and communities about schoolchildren’s mental health in wartime Ukraine
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BioMed Central
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Psychosocial support for schoolchildren in wartime Ukraine: community-based access and parent-reported perceived helpfulness - Conflict and Health

Background Since the onset of the full-scale war in Ukraine in 2022, numerous initiatives have been launched to strengthen mental health and psychosocial support (MHPSS), particularly for children and adolescents. Community-based psychosocial support has been declared a national priority; however, the availability, accessibility, and perceived helpfulness of such support remain insufficiently documented at the population level under conditions of ongoing conflict. Objective This study aimed to characterize access to psychosocial support among Ukrainian schoolchildren during wartime and to assess parent-reported perceived helpfulness of received support, with particular attention to social and community factors shaping help-seeking and perceived benefit. Methods Between 2022 and 2025, a nationwide survey was conducted among parents and caregivers of school-aged children (N = 7,551). Indicators were introduced iteratively across survey waves in response to evolving wartime conditions; analyses for each outcome were restricted to the years in which the respective item was measured. Binary logistic regression models were used to examine associations between sociodemographic, psychosocial, and contextual factors and (2022–2025) help-seeking and (2023–2025) perceived helpfulness. Results Overall, 12.0% of parents reported that their children needed psychological support, while 9.9% reported contacting a psychologist. Among those who accessed services, 68.1% rated the received support as helpful. Perceived helpfulness was lower among children with anxiety and depressive symptoms (53.9%). The presence of potential anxiety and depressive symptoms in children was the strongest predictor of help-seeking (OR = 3.31; 95% CI: 2.69–4.09) and was also associated with lower perceived helpfulness (OR = 0.55; 95% CI: 0.37–0.81). In contrast, parental anxiety was independently associated with increased help-seeking (OR = 1.24; 95% CI: 1.01–1.53), but not with perceived helpfulness. Urban residence and displacement were positively associated with service use, whereas rural residence and lack of migration experience were associated with lower access. While parental education and general social support were not significant predictors of help-seeking, higher levels of social support were associated with greater perceived helpfulness, highlighting the role of interpersonal and community resources. Parent-reported perceived helpfulness appears to be shaped not only by children’s mental health needs but also by parental well-being and broader social context. Based on these findings, a multisectoral model was developed to improve identification, referral, and support pathways for children in crisis. Conclusions Substantial gaps persist between perceived need and access to psychosocial support for Ukrainian schoolchildren during wartime, particularly in rural settings. Strengthening community-based psychosocial services, improving outreach, and supporting families with limited resources may help reduce inequalities in access to and perceived benefits of MHPSS during prolonged conflict.

This paper began with a practical question: when psychosocial support is available for schoolchildren during war, how do families understand that help may be needed, and where do they turn first? Our study was not only about the presence of psychosocial support. It asked what happens next: how parents interpret a child’s distress, which services they approach, and which forms of support they find useful.

Our article, “Psychosocial support for schoolchildren in wartime Ukraine: community-based access and parent-reported perceived helpfulness”, was written in the context of the full-scale war in Ukraine, but the question behind it did not appear suddenly in 2022. It grew out of years of work on children’s health, school environments, learning capacity, physical activity, sleep, and mental health.

Before the pandemic, our team often worked directly in schools. We met parents at school meetings, explained the purpose of our research, answered questions, collected data, and later returned to share results. These encounters taught us something important: parents often noticed that something was happening with their child, but noticing a symptom was not always the same as recognizing a need for professional help.

We heard many versions of a familiar response: the child will grow out of it; everyone is like this now; we were the same at that age; it is not serious enough. These reactions were not signs of indifference. They reflected a wider cultural and historical pattern in which mental health was often minimized, feared, or associated with stigma. In Ukraine, older patterns of distrust and stigma around mental health services did not disappear simply because new language about mental health became more visible.

The pandemic changed the way we could communicate with families. When fieldwork in schools became impossible, we moved our surveys online. In Ukraine, this was not a distant or artificial mode of contact. Parent meetings, teacher–parent communication, school groups, and everyday educational coordination had already become deeply digital. Later, during the full-scale war, this digital infrastructure became essential for continuing to listen to families across the country.

The war changed the urgency of the question. Mental health became a highly visible topic in schools, communities, media, public institutions, and international programmes. Psychosocial support for children appeared in many forms: short psychological exercises in schools, consultations, group work, awareness messages, referrals, and community-based initiatives.

But visibility is not the same as access, trust, quality, or a clear pathway to care.

This is why we wanted to look at the whole route: from school-based psychosocial activities to parental recognition of need, from first attempts to seek help to the perceived usefulness of different forms of support. We were especially interested in the point at which the pathway may break. A child may show anxiety, depressive symptoms, trauma-related reactions, or other signs of distress. A parent may notice that something is wrong. But the next step is not automatic.

In our paper, we described this as the Symptom–Need Interpretation Gap: the gap between recognizing symptoms and interpreting them as a need for professional support. This gap matters because it shapes where families go first. Many parents turn to family doctors, neurologists, school psychologists, or informal sources of advice. Psychiatric care often remains one of the last steps, surrounded by fear, stigma, or uncertainty. At the same time, Ukraine is still developing the workforce and referral pathways needed for high-quality, community-based mental health support.

The study was only one fragment of a much larger database of parent questionnaires collected during the war. Ukrainian parents completed long questionnaires voluntarily, anonymously, and without any reward. They answered closed questions, but they also wrote comments. They described displacement, occupation, loss, fear, disrupted routines, and the effort to keep family life going under pressure.

For us, these responses were not only data points. Behind every percentage there was a child, a parent, a home, a school, a route interrupted, and sometimes a life rebuilt from almost nothing. We were not only measuring trends. We were listening to how the country was changing.

The revision process also became part of the story behind the paper. We worked on the manuscript during power cuts, repeated drone attacks, interrupted routines, and uncertain working conditions. Some members of our team were directly affected by the war in ways that changed everyday professional life.

The editorial and peer-review process was unexpectedly encouraging. The comments we received were clear, constructive, and genuinely aimed at strengthening the paper. At a time when revisions were being made between air alerts and power cuts, the patience and professionalism of the editorial team mattered more than they may have realized.

One part of the story is more personal. Without GPT, completing the revisions under those conditions would have been much harder. It did not replace our data, our decisions, our responsibility, or our interpretation. But it helped keep the work moving: organizing responses, refining the English text, holding the structure together, and, perhaps most importantly, providing a sense of support when fatigue and disruption made sustained writing difficult. In a very practical sense, GPT became part of the support network behind this paper.

For us, this study connects directly with the message of European Public Health Week 2026: sustainable health and well-being require investment not only in services, but also in the pathways that allow people to use them. For children growing up during war, psychosocial support must be more than a set of activities. It must become a reliable route from recognition to help, from school to community, from primary care to specialized support when needed.

We hope this paper contributes to that route. We also know that the effects of war will not end when the fighting stops. As physicians, psychologists, and public health researchers, we see the price people pay simply to wake up, drink coffee, take a child to school, go to work, and continue. This price may be paid for many years.

That is why we continue our research: not only to count symptoms, services, or percentages, but to understand how families adapt, where support reaches them, where it fails, and what Ukraine will need for recovery.

Children’s mental health is not only inside the child. It is also in the adults who notice, the systems that respond, the communities that support, and the routes that make help possible.

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