Supporting Behavioral Health for Ukrainian Refugees

In early April, Dr. Kira Mauseth, Senior Instructor, Psychology and co-lead of the Behavioral Health Strike Team for the WA State Department of Health, returned from nine days in Poland, where she and a team of four psychologists and one graduate student assisted in the behavioral health response for refugees in Poland who left Ukraine due to impacts of the war. Dr. Robert Porzak, Head of the Experimental Psychology Lab and member of the Faculty of Human Science, Economics and Innovation University in Lublin, Poland extended the invitation to the team. Dr. Mauseth was joined by Dr. Tona McGuire, her co-lead for the Behavioral Strike Team, Dr. Eric J. Bruns, UW SMART Center, Dr. Sharon Hoover, Co-Director, National Center for School Mental Health, Director, NCTSN Center for Safe Supportive Schools, and Robin Smith, a grad student and Mental Health Therapist.

The Health Support Team (HST) training they provided is designed to help community volunteers understand the typical behavioral health impact of disasters on adults and children. In addition, the curriculum covers how to help community members with communication, de-escalation, building resilience, understanding behavioral health emergencies and when to refer, managing acute stress responses, and self-care for volunteers. Training was also offered on PsySTART Mental Health Triage, which can quickly help identify children and adults most at risk for psychological disorders and prioritize them for care.

They also provided a “Train the Trainer” version of the curriculum to identify individuals with behavioral health training or background. The newly minted HST trainers are then able to continue to train HST to volunteers from impacted communities going forward, making this intervention culturally and linguistically appropriate as well as sustainable and not reliant on outside support.

During their first two days, the team completed some training for the volunteers at Caritas in Lublin, the Catholic equivalent of the Red Cross in Poland, and the largest non-profit in the area doing refugee support. One trainee was recalling a recent refugee who just didn’t stop shaking. They were unsure of how to help her and thought maybe it was best to “just let her shake”. The team gave the aid worker some tips on how to help the refugee become grounded and engage her parasympathetic nervous system in order to regulate a bit more.

Next came a day to “train the trainer” where they trained Ukrainian and Polish volunteers who are already in leadership positions with the agency on how to provide evidence-based disaster behavioral health support for adults. One of the biggest challenges with this group occurred when they got to the part of the training about volunteers establishing healthy boundaries in order to take care of themselves. “Some of the people in the room literally laughed out loud,” Dr. Mauseth remembers, “‘There is too much need, too much work. We can’t rest,’ was what they told us. We worked with them on the idea that the support they provide will go much further if they are able to replenish their own energy along the way, but it was a challenging interaction.”

They travelled to another Caritas location outside Lublin to provide training for parents and caregivers of children. “This is the youth-oriented version of our training that provides information about what’s typical for kids in crisis and how adults can recognize and provide appropriate supports,” says Dr. Mauseth. “We worked directly with Ukrainian mothers and their children as well as the relief staff at Caritas to provide training. This was a really hard day for me as a mother with two young boys of my own, to see families separated, and parents doing their best when they too have been traumatized."

The team also conducted trainings sponsored by the mayor's office and cultural center in Lublin for the equivalent of the staff of the city crisis center, as well as a second group of librarians, caregivers, coaches and other mentors for kids.

“There is no official refugee camp here so all of the refugees coming across the border nearby are being taken in directly by Polish families; staying in extra rooms, wherever they can find space,” she explains.  Many are wondering ‘for how long’? And there is not yet a plan to address this. Children and adults who have been taken in are often experiencing very distressing symptoms (like waking up screaming in the middle of the night) and the host families don’t understand what to do to help them. We held two webinars for host families, live translated into Polish and Ukrainian, that provided information on how to manage those crises.”

While in Poland, Dr. Mauseth taught her first two classes of the quarter virtually, at 1 and 3 a.m. her time. “We met via Zoom with my classes that were scheduled to meet in person. It was a great, although strange, start to my two sections of Senior Seminar despite the exhaustion. The theme for my senior seminar courses is ‘Turning Points’ major life events that shape how you come to be who and where you are at the present time. I thought it was apropos to be sharing one of my professional turning points in this type of relief work, with them in real time. We oriented to the start of the quarter, and I was also able to share some examples with them of the work and encounters I had had in Poland thus far."

The Seattle Times recently published an op-ed by the team, "We’ve seen firsthand Ukraine’s tragic behavioral-health crisis."

On a related note, a team of Psychology students, including Isabel Gilbertson, Sydney Lindell, Joanna Corpuz, and Sarah Ziegler, are lead authors of  SAFE Summer: Tip sheet for Teens & Young Adults, developed with Washington State Department of Health’s Behavioral Health Strike Team for the COVID-19 response in partnership with the Behavioral Health Research Group at Seattle University. 

Photos courtesy of Dr. Kira Mauseth