Urgent need for psychosocial support as child refugees bear ‘invisible’ scars of Ukraine conflict

Children who have fled the conflict in Ukraine are frequently showing signs of emotional distress, from struggling to speak to constant crying, according to testimonials gathered by Plan International.
30 March 2022


In north eastern Romania, a steady stream of refugees fleeing the conflict in Ukraine have been pouring through the Siret border crossing point for the past two weeks. As soon as they arrive, they are transferred to emergency shelters where they can rest, or taken to train stations so they can continue their journey.

Psychosocial support for refugee children and their caregivers must be scaled up urgently to prevent a long-term mental health crisis, the child rights and humanitarian NGO has warned.

As the number of children from Ukraine forced to flee their home surpasses 4.3 million, a growing proportion have witnessed death or widespread destruction and lived through bombings and missile strikes . Nearly all have had their lives uprooted, becoming separated from family, friends and classmates.

We must recognise the emotional needs of children and young people

Dr Unni Krishnan, global humanitarian director at Plan International, said: “In conflict and other humanitarian emergencies, emotional needs are often one of the least recognised and reported health issues. But the crisis in Ukraine will undoubtedly take a heavy toll on the mental health and psychological wellbeing of children and young people, with children bearing these invisible wounds long after they reach a place of safety.

“I have met mothers in Romania and Moldova who say their children have stopped speaking. Some talk only in their sleep, while others hug their mothers more often. Others have lost interest in normal childhood activities like playing and singing.

“These are natural reactions to an abnormal situation. But if left unattended, they can have severe long-term consequences, including depression, anxiety, unresolved grief and developmental delays, stopping children from rebuilding their lives and fulfilling their potential.

“It’s critical that we don’t neglect the emotional toll conflict takes on children and their families, and that they receive psychological first aid and referred for support from the very beginning.”

Children who have experienced traumatic events often show signs of feeling sad or distressed, and may withdraw from normal activities. These signs can include palpitations, recurring nightmares, regressive behaviours such as bed wetting or frequent crying, while others may become attached to their parents, for example hugging them more often.

Caregivers’ mental health issues can impact children

It is also important that parents and grandparents can access psychosocial support as children, especially those aged under five, take their cue from their caregivers and if left unattended, their mental health can negatively impact children.

“Survivors of conflict are unlikely to walk into a health centre and request emotional care and support. In many contexts and cultures, stigma related to mental health issues also inhibits survivors from asking for help.”

Dr Unni Krishnan

People with pre-existing health conditions, injuries, disabilities or those who have previously suffered extreme fear or stress are often at greater risk of further stress on their mental wellbeing.

Anna*, seven, who fled bombing in Odessa with her mother and grandmother, now only talks in her sleep.

Speaking at a temporary reception in Galati on the Ukraine-Romania border, Anna’s grandmother explains that she used to sing at a choir in Odessa Opera House, but has become withdrawn after living through explosions and seeing others die.

She was also devastated by having to leave her pet dog Sheyla behind, and now hugs her mother Sofia constantly.

Dr Krishnan continued: “The reasons why emotional needs go unnoticed and unacknowledged are many. Firstly, unlike a physical illness or disability that can be detected with visible symptoms, what is going on in the minds of survivors of war, conflict and disaster isn’t always easy to spot.

“Second, crisis often results in people withdrawing from normal activities. Survivors of conflict are unlikely to walk into a health centre and request emotional care and support. In many contexts and cultures, stigma related to mental health issues also inhibits survivors from asking for help”.

“Finally, there is very limited resources, both in terms of expertise and funding, available for psychosocial support services. Emotional care and support is all too often not a priority in relief settings.”

In the Romanian city of Suceava, 25 miles south of the Ukraine border, Angelina, six, is now physically safe from fighting but is still frightened by loud noises.

Air attacks take mental health toll

Describing the daily attacks on their city before they left, her mother Ina explains: “Air attacks were happening 10 times a day in our city, the siren was going all day. Rockets were flying over the city always. 10 times a day we would have to go down to the bunkers. We stayed with our relatives in the basement to save our lives from the bombs.”

“Angelina was very frightened and still talks about the noise of the sirens. They scared her. When she hears a loud noise, she thinks it’s the sirens and is scared. That will stay in her mind for a long time.”

In Moldova, Romania and Poland, Plan International has been working with local organisations to set up psychosocial support programmes and activities to provide refugee children from Ukraine with a safe environment and greater sense of normality.

These include mobile psychosocial support units and support getting back to school – a critical part of adjusting to life in a new country as a child – as well as referral services to specialised care and support.

*Name has been changed

For more information, case studies or interviews, please contact:

Anna MacSwan
Global Media Manager
Email: anna.macswan@plan-international.org

Mobile: +44 0790 822 5389