War And Mental Health – What The Conflict In Ukraine Means For All Of Us

SAFMH News Room


These masks we wear and the stuff we spray on our hands to kill the germs… Do you think they’re going to protect us when they start dropping those big bombs on us? We’re all worried about this little virus, but there’s a much bigger problem coming!

David*, an attendant at a petrol station, looked at me that Sunday morning in early March with a mixture of frustration and fear in his eyes, just barely visible above his mask. I realised that COVID-19 was no longer the thing that David, and possibly his friends, family and colleagues, were worried about. The news of the situation in the Ukraine had made its way into David’s world, and his concerns that the conflict might escalate and spread across the globe had instantaneously rendered COVID-19 virtually irrelevant to him, especially as the potential use of nuclear weapons had also just started creeping into media reports. David kept looking up at the sky and waving his arms around while talking to me. Eventually he stopped and looked at me with fearful resignation completely dominating his demeanour. “What are we supposed to do, hey?

*name changed in the interest of confidentiality

This brief but powerful encounter touched me deeply because it made me realise that, regardless of whether anything David said was factually correct or not, we urgently needed to start talking about how people’s mental health was being affected by events such as the Ukrainian conflict, which may be causing increased levels of stress, anxiety and other mental health problems. Even if they’re on the other side of the world. The other thing that struck me was that – for people like David – COVID-19 was apparently no longer the greatest threat because of the bigger threat of war. I wondered to myself whether this type of mindset, if it spread and grew, could in itself have a domino effect, leading to people dropping their guard [for example not wearing masks and disregarding other COVID-19 preventative measures] because they were potentially resigning themselves to larger threats over which they had little to no control over. This was in itself another potential threat as we were heading into winter in South Africa, meaning that COVID-19 infection rates may start to rise again.

That morning, David felt hopeless, helpless and defenseless, and this was undeniably impacting on his mental health. The work we do as SAFMH should be for people like David and his family, colleagues and friends; to raise awareness about the very real links between war and/or violence and mental health, and to spread the message that it is understandable that people are fearful, and importantly, that they are not alone in these troublesome times.

But what do the experts and the literature say about war and mental health? I reached out to a number of experts and did some research of my own. It seems that the concern I felt for David that morning was justified as you don’t need to be on the frontlines of war, in the firing line, to suffer the mental health consequences of conflict. But for those who are directly affected, the impacts are even worse.

Mental health problems have been shown to be major secondary consequences of armed conflicts, potentially leading to short and long-term negative effects on the well-being of those living in areas affected by war. In 2019, three years prior to the Ukrainian crisis, the World Health Organisation already stated that, according to estimates by the United Nations, there were approximately 132 million people in 42 countries from across the globe who were in need of humanitarian aid, directly resulting from conflict or disaster. At the time, nearly 69 million people had been forcibly displaced globally by conflict and violence; the highest number since World War II.

A 2006 review of research findings related to the mental health consequences of war found that amidst all the consequences of war, the impact thereof on the mental health of the general population was one of the most significant, with studies showing a definite increase in the rates and prevalence of mental health disorders. Women were generally more affected than men, along with other vulnerable groups such as the elderly, persons with disabilities and children. The prevalence rates of mental health disorders were linked to the degree to which trauma had been experienced, coupled with the availability of emotional and physical support. In 2019, estimations from the World Health Organisation [WHO] stated that there were significantly more persons living with mental health disorders in areas affected by conflict than had previously been thought, with one in five persons being affected by some type of mental health disorder, [ranging from mild depression or anxiety to psychosis] to one in ten being affected by a moderate or severe mental health disorder. Additionally, because of exposure to traumatic events, there is also an increased risk of persons developing Post-Traumatic-Stress Disorder and poorer life outcomes as adults during war. The WHO stated that access to care and treatment for these individuals was not only a matter of improving their mental health, but that it was also a matter of survival in many cases.

Prof Crick Lund, a renowned mental health academic from the University of Cape Town, shared the following perspective when I asked him about his views on the Ukrainian situation:

As mental health advocates, we join with the voices of people around the world to condemn the Russian invasion of Ukraine. Acts of war and violence are not only morally abhorrent. They destroy the mental health and wellbeing of victims and perpetrators alike. Epidemiological evidence from diverse cultures around the globe has shown the negative impact of war and violence on the mental health of populations. These adverse mental health consequences can last for years, and often have inter-generational sequelae. We therefore call for a speedy resolution of the conflict and support all peaceful means to facilitating a resolution to the current situation in Ukraine. We also call on all countries of the world to provide mental health care and support to the victims of violence and war and give greater priority to mental health.”

The impacts of war on mental health are thus far-reaching and severe, and it is important that we, here and now, in 2022, ensure that awareness is raised about this at all levels of society.

By Leon de BeerDeputy Director, SA Federation for Mental Health

Subscribe to Our Newsletter


COVID-19 Corona Virus South African Resource Portal

Please visit the COVID-19 Corona Virus South African Resource Portal at www.sacoronavirus.co.za. Alternatively contact the Emergency Hotline: 0800 029 999 or the WhatsApp Support Line: 0600 123456