Health official: No set plan for handling refugees' mental health needs

Ukrainian war refugees arriving in Tallinn in March 2022.
Ukrainian war refugees arriving in Tallinn in March 2022. Source: Ken Mürk/ERR

One of the biggest issues facing Estonia in accepting and integrating Ukrainian refugees is finding solutions for addressing their mental health needs — and as of yet, there is no good plan for doing so, said Ragnar Vaiknemets, head of the Department of Health Management and Continuity at Estonia's Health Board.

According to Vaiknemets, thus far, most refugees who have arrived in Estonia from Ukraine have sought help from the healthcare system with general medical concerns — fevers, chronic health issues, treatment that was left off in Ukraine. An estimated just over one third of them are vaccinated against the COVID-19 virus, he added.

One of the primary challenges to be faced by Estonia's healthcare system, however, will be the handling of refugees' mental health issues.

"When you escape a war zone — the children have heard bombings, fathers have been left behind on the front — this causes an incredible amount of distress, and this needs a different approach than just that which a family doctor or emergency medicine is capable of providing," Vaiknemets said.

According to the Health Board official, general medical issues and physical traumas are easier to treat. Experiences and insight gained from the COVID pandemic regarding the reorganization of hospital care, for example, may prove beneficial when it comes to this aspect as well. Finding solutions for mental health issues, however, isn't so simple.

"This was an area of concern for Estonian residents before already — when can I get an appointment with a psychologist or psychiatrist, or where can I access pastoral care services?" he highlighted.

While initial psychosocial crisis aid is currently being organized by the Social Insurance Boad (SKA), mental healthcare for issues such as post-traumatic stress disorder (PTSD), which may not be immediately apparent, needs a long-term approach, meaning support from a psychologist or psychiatrist. According to Vaiknemets, there is currently no definite plan in place for providing this, and it isn't possible to simply pull additional mental healthcare providers from out of nowhere.

"This is healthcare's primary concern in the COVID crisis as well — that healthcare resources are limited above all to their own staff," he highlighted.

There are, however, specific activities which could help alleviate the situation. "One measure would be if we managed to map out who should belong to what stage," Vaiknemets said.

Many people also simply need to be listened to, he added, and as many people are religious, it may be possible to cooperate with chaplains as well.

As of March 22, a total of 22,185 refugees have arrived in Estonia since February 27, according to Police and Border Guard Board (PPA) figures. This total includes thousands of children and youth.


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Editor: Aili Vahtla

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