When missiles hit Kiev, these psychologists rush to help

Hands shaking as she covered her mouth, a woman looked at a gaping hole in the side of an apartment building, where the contents of apartments poured out the side.

Standing next to her was 29-year-old Ivanka Davydenko, dressed in a blue uniform with yellow “Psychologist” printed on both sides, her arm placed gently across the woman’s back.

She handed her a paper cup of water and asked how she could help. The woman’s son lived on the 18th floor of the building, she explained, and he wasn’t answering his phone. Most of that floor was gone.

“We help people because they are in a state of shock and don’t always understand what they need at the moment,” Ms Davydenko said. “We offer banal things: water, coffee, a blanket.”

Ms. Davydenko is part of a small team within the Ukrainian state emergency services, which provides psychological first aid in times of crisis in the capital Kiev. She arrived minutes after a Russian attack, early in the morning of June 24, in which Ukrainian air defenses destroyed incoming missiles, sending fragments into apartments.

Russia’s attacks on Ukraine have forced rescue crews to deal not only with fire, smoke and blood, but the rippling psychological effects felt by people who experience war. Public health experts warn that millions of Ukrainians are likely to develop mental illness as a result of the invasion, and that this number will only increase as the days of bombing, violence and grief continue.

Thus, Ukraine’s emergency services not only consist of firefighters, paramedics and police officers, but also psychologists, including Ms. Davydenko, to help people dealing with the immediate effects of shock or other acute mental health needs.

There are similar efforts in other cities, but with Russian missiles continuing to rain horror on the capital, the Kiev team may be the busiest.

“We used to respond to serious and large-scale emergencies, such as a gas explosion where many people had to be evacuated,” says Liubov Kirnos, the manager of the Kiev unit. “When the war started, we were on duty all the time, we didn’t leave the city.”

Like other care providers, the psychologists are on call. When an attack occurs, a coordination center sends a team to the location.

There, psychologists often find people crying, frozen in shock, or collapsing.

“When we meet someone for the first time, we ask, ‘What do you need now? How are you feeling now?’” Mrs. Kirnos said. Some people just ask the psychologists to stay around for a while. “They may be expecting their loved ones to be pulled out of the rubble,” she said.

Such was the case on June 24 with the mother who supported Mrs. Davydenko. The psychologist walked with her as she consulted a list of people who had been taken to hospital or were missing.

But as they walked away, a firefighter said in a low voice that there was nothing left on the 18th floor, where her son had lived.

Residents were asleep when the strike ripped open their building before dawn. The bodies of at least two victims had been thrown from the building, along with twisted metal, insulation and pieces of furniture, scattered in the parking lot below.

Dozens of people were in shock, Ms Davydenko said, including some who had seen dead bodies and others who were injured but did not fully understand that they were bleeding.

Ms. Davydenko and another colleague at the site would help about 45 people in about 12 hours.

Iryna Kuts, 62, went to Mrs. Davydenko with her daughter, still trembling with fright, asking for some water and a moment to talk.

Ms. Kuts described being shaken from her sleep in her 19th floor apartment, after which her room filled with smoke.

“We were just hugging, thinking we were going to suffocate,” she said. They eventually made their way down the stairs, aided by police officers, but stared at the ruins of their apartment building in a daze.

“We provide psychological first aid to people with anxiety, stress, crying, aggression,” explains Ms. Davydenko. “Then we work with people who stay on the benches, in the garden, because it’s like a second emotional wave hits.”

A young woman in a white top who had wandered around the parking lot sobbing was knocked over. The woman’s father, a resident, had survived the strike but refused to come out.

“Don’t worry, everything will be fine,” Mrs. Davydenko told her, holding her arm and adding that the fire department would help her father. “But you can’t go in – no one can.”

She waited for the father to finally emerge and the young woman to wrap her arms around his neck, crying.

Not everyone would have such a happy reunion. Later in the day, Ms. Davydenko accompanied the mother and her husband, who were looking for their son, to examine the badly mutilated remains of a body.

They were still waiting for official DNA confirmation, but the remains most likely belonged to her son, the psychologist explained.

The next day, city officials confirmed that five people had been killed in the strike.

Public health experts like Dr. Jarno Habicht, the head of the World Health Organization office in Ukraine, have warned of the war’s long-lasting and widespread effects on mental health. In an interview, he said an estimated 10 million people would most likely develop some form of mental health problem as a result of the Russian invasion.

The WHO estimate, based on an analysis of how other conflicts had affected mental health, is likely to increase as the war continues, he added. Stress-induced disorders, including anxiety and depression, are among experts’ top concerns.

The key to tackling mental health problems in Ukraine, Dr Habicht said, “is not waiting for the war to end.”

A handful of programs have sought to help Ukrainians, including one led by Olena Zelenska, the first lady, which aims to make high-quality, affordable mental health care available to people across the country.

The Ukrainian Ministry of Health, WHO and more than a dozen other partners have also started a program to train general practitioners in treating patients with depression, anxiety, post-traumatic stress disorder, suicidal behavior and substance abuse.

But programs like the emergency team of psychologists try to intervene early in moments of crisis.

“If you don’t deal with stress right away, it can turn into long-term stress, which can turn into PTSD,” says Ms Kirnos. “It’s meant to help people drive home the idea, ‘You were in danger, but now you’re safe.’ If we don’t do this right away, people could be trapped in this state.”

However, the burden can also be heavy for the person providing psychological care. Days after the missile strike on Kiev, Ms Davydenko said team members worked with their own therapists to process what they had seen.

“Of course,” she said, “I’m human too.”

Oleksandr Chubko And Oleksandra Mykolyshyn reporting contributed.