Reforming Undergraduate Psychiatry Training in Ukraine

Predictors of Satisfaction and Value of Advanced Training for Mental Health Professionals in Wartime Ukraine

The full-scale escalation of Russia's war against Ukraine in 2022 created a surge of mental health issues, requiring urgent, evidence-based interventions to reduce trauma and mitigate stress. Reflecting recommendations from leading specialists in the field, Ukrainian mental health professionals sought to develop appropriate skills and knowledge for working in wartime through advanced training programs. This study aimed to investigate the experiences of Ukrainian mental health professionals having completed advanced training in mental health topics in wartime. A survey design was adopted, using the purposefully developed, and validated 'Wartime Learning Satisfaction Scale'. Regression analysis assessed the hypothesized contribution of four scales (Education, Educator, Learner, and War) to the perceived value of advanced training and learners' satisfaction. Respondents (n = 271) were trained in up to 30 courses (M = 4.27, SD = 3.03) lasting from two to over 120 h. Regression analysis revealed different predictors for satisfaction and value of the courses. Advanced training resulted in higher satisfaction with learning if it matched professional goals of mental health professionals and perceived higher value when relevant to societal demand, consistently constructed, practically useful, and not solely focusing on war-related issues. Respondents who completed all advanced training courses they were interested demonstrated significantly higher confidence in working in wartime. These findings are essential for effective mental health practice during wartime.

Mental health care in Eastern Europe and Central Asia: An analysis of needs and a call for greater investment

Over the past decade, there has been increased attention to global mental health, which emphasizes improving access to quality mental health care in order to reduce the worldwide treatment gap. However, Eastern European and Central Asian countries and their specific mental health needs have largely been under-emphasized, evidenced by a dearth in literature and funding. Here, we provide an overview of the mental health needs in Ukraine and its challenges with quality care provision as a key example in highlighting these gaps, then broaden our discussion to include parallels with other countries in the Eastern European and Central Asian region. We describe the unique strengths relative to mental health care provision that are present in Eastern Europe and Central Asia and suggest the importance of post-graduate training, regional collaboration, and capacity building specific to research management as strategies to address the current challenges. We stress that greater investment from funders, government, and the global mental health community are needed to improve the current mental health situation in Ukraine, specifically, and Eastern Europe and Central Asia, broadly. We argue that greater attention to Eastern Europe and Central Asia is needed to fully advance the agenda of the global mental health field.

The Implementation of the WHO Mental Health Gap Intervention Guide (mhGAP-IG) in Ukraine, Armenia, Georgia and Kyrgyz Republic

Despite the increasing burden of mental disorders, a lot of people worldwide suffer a gap in receiving necessary care in these countries. To close this gap, the WHO has developed mhGAP training modules aimed at scaling up mental health and substance use disorders services, especially in low- and middle-income countries. This article presents the experience of implementing the Mental Health Gap Action Programme (mhGAP) in Ukraine, Armenia, Georgia, and Kyrgyz Republic. Data were gathered from an electronic questionnaire administered to representatives from higher educational institutions where the Mental Health Gap Action Programme Intervention Guide (mhGAP-IG) was implemented in existing curricula for medical students, interns, and residents in family medicine and neurology, practicing physicians, and master's program in mental health students. More than 700 students went through the programs that provided the feedback. Evaluations of program effectiveness mainly involved standard discipline tests or pre- and post-tests proposed in the mhGAP trainer manual. This finding suggested that mhGAP-IG can be successfully adapted and implemented both on undergraduate and on postgraduate education levels and among medical and nonmedical specialists. Future evaluations need to more definitively assess the clinical effectiveness of mhGAP-IG implementation.

Enhancing mental health pre-service training with the WHO mhGAP Intervention Guide: experiences learned and the way forward

There is currently a high global demand for mental health professionals, including child and adolescent mental health professionals. In 2020, the World Health Organization (WHO) published "Enhancing mental health pre-service training with the mhGAP-Intervention Guide: experiences and lessons learned" to address the proposition of implementing Mental Health Gap Action Programme Intervention Guide (mhGAP-IG) materials and principles as a component of pre-service training. By integrating the mhGAP-IG within pre-service training, future healthcare providers will acquire theoretical knowledge and early exposure to practical knowledge and will be better prepared for their future work.Examples demonstrate that mhGAP-IG pre-service training can be successfully implemented in diverse settings and in various pre-service training programs. It can be used in small group learning activities and short courses, taught through lectures, used as a clinical tool to teach students (i.e. medical, nursing students) and medical doctors in training. We can enhance pre-service training with the mhGAP-IG and contribute to a learning environment, which nurtures knowledge and skills required to help people with mental health needs.