With trembling hands covering her mouth, the woman turned her eyes to a gaping hole in the side of the skyscraper, the contents of her apartment spilling out the side.
Standing next to her was Ivanka Davidenko, 29, in a blue uniform with the word “Psychologist” written in yellow on each side, gently placing her arm on her back.
She gave her a paper cup of water and asked how she could help. The woman’s son lives on the 18th floor of the building, she explained, and he missed the call. Most of that floor was gone.
“We help people because they are in shock and don’t necessarily understand what they need at the moment,” said Davidenko. “We provide the mundane things like water, coffee and blankets.”
Davidenko is a member of a small team within the Ukrainian State Emergency Service, providing psychological first aid in moments of crisis in the capital, Kiev. She arrived in the early hours of June 24, minutes after the Russian attack. In the attack, Ukrainian air defenses destroyed an incoming missile, whose fragments flew into an apartment building.
The Russian attack on Ukraine has left ambulance workers facing not only fire, smoke and bloodshed, but also the rippling psychological effects felt by those experiencing the war. Public health experts warn that millions of Ukrainians will likely develop mental illness from the invasion, and that number will only rise as days of shelling, violence and grief continue.
As such, the Ukrainian ambulance service includes not only firefighters, paramedics and police officers, but also psychologists, including Davidenko, to help those dealing with shock and other urgent mental health care needs. is
Similar efforts are underway in other cities, but the Kiev team is perhaps the busiest, as Russian missiles continue to rain terror over the capital.
“Previously, we were dealing with serious and large-scale emergencies like gas explosions and the need to evacuate many people,” said Kiev force manager Lyubov Kirnos. “When the war started, we were always on duty and never left the city.”
A psychologist is on standby, as are other paramedics. When an attack occurs, the Coordination Center rushes the team to the scene.
So psychologists often see people crying, frozen in shock, and broken down in tears.
“When we meet people for the first time, we ask them, ‘What do you need now?’ How are you feeling now?” Some just ask a psychologist to stay close for a while. “They may be waiting for their loved ones to be rescued from the rubble,” she said.
The same was true for the mother whom Davidenko was supporting on June 24. Her psychologist walked with her, going through lists of people who had been rushed to the hospital and those who were missing.
But as they left, the firefighter said in a low voice that there was nothing left on the 18th floor where her son lived.
Residents were sleeping when a strike destroyed the building before dawn. The bodies of at least two victims were thrown from the building, along with pieces of twisted metal, insulation and furniture, and scattered in the parking lot below.
Davydenko said dozens of people stood in shock. Among them were those who had seen the bodies, and those who had been injured but did not fully understand that they were bleeding.
Davidenko and another colleague on the ground helped about 45 people over the course of about 12 hours.
Irina Kuts, 62, went to Davydenko with her daughter, still shivering from shock, and asked for water and a little time to talk.
Katz said she was shaken from sleep in her 19th-floor apartment, filling the room with smoke.
“We were just hugging each other, thinking we were going to choke,” she said. They eventually made it down the stairs with the help of the police, but were stunned as they surveyed the ruins of the apartment building.
“We provide psychological first aid for people with anxiety, stress, crying and aggression,” explained Davydenko. “Then we work with people who stay on benches and in the garden because it’s like a second wave of emotion is coming.”
A young woman wearing a white tank top who was wandering around the parking lot crying was taken away. A resident woman’s father survived the strike, but she refused to come out.
“Don’t worry, everything will be fine,” Davydenko said as he held his arm, adding that firefighters would help his father. “But you can’t go in. No one can go in.”
She waited until her father finally showed up, and the young woman put her arms around her father’s neck and cried.
Not everyone can experience such a happy reunion. Later that day, Mr. Davidenko accompanied his mother and her husband, who were looking for his son, to inspect the badly mutilated body.
They are still awaiting official DNA confirmation, but the psychologist explained that the remains most likely belonged to her son.
The next day, city officials confirmed that five people had been killed in the strike.
Public health experts such as Dr. Jarno Habicht, Director of the World Health Organization Ukraine Office, have warned of the long-term and far-reaching effects of war on mental health. In an interview, he said an estimated 10 million people would likely develop some form of mental health condition due to the Russian invasion.
He added that the WHO’s estimates are based on an analysis of how other conflicts have affected mental health, and are likely to increase the longer the war lasts. Stress-induced disorders such as anxiety and depression are among the major concerns of professionals.
Habicht said the key to addressing mental health concerns in Ukraine “is not to wait until the war is over.”
Several programs are trying to help the Ukrainian people, including one led by First Lady Olena Zelenska, to make high-quality, affordable mental health services available to people across the country. It is intended to be
The Ministry of Health of Ukraine, WHO and a dozen other partners have also initiated programs to train primary care physicians on how to treat patients with depression, anxiety, post-traumatic stress disorder, suicidal behavior and substance abuse.
But programs like the Emergency Team of Psychologists are trying to provide early intervention in moments of crisis.
“If you don’t deal with stress right away, it can turn into long-term stress and lead to PTSD,” says Kirnos. “It’s meant to get people to understand the idea of ’we were in danger, but now we’re safe.’ If we don’t do this soon, people could end up in this state.”
Nonetheless, it is a heavy burden for those who provide mental health care. Days after the missile attack on Kiev, Davidenko said team members were working with their therapists to process what they saw.
“Of course I’m human too,” she said.
Oleksandr Chubko and Oleksandra Mycolysin Contributed to the report.