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State system of rehabilitation of veterans of war doesn’t meet needs – veterans, experts

Проблема психосоціальної реабілітації для учасників АТО. УКМЦ, 21.02.2017

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Specialists and veterans of war in the east of Ukraine shared their opinion about the role of NGOs and the State in adaptation of veterans who come back from the frontline, the urgent problems in this field and provided recommendations how rehabilitation system should be improved.

It is necessary to enhance quality and efficiency of work of state institutions and specialists responsible for psychological rehabilitation of veterans of war, because at present, the system is inefficient, said experts in healthcare and veterans at a press briefing at Ukraine Crisis Media Center. “There is no “window” which would help to build trust: a veteran is not sure that he can ask for support and there is someone to address to. The state authorities which should deal with this issue are very passive. When I came back and had to communicate with various state authorities I had a feeling that all they were hostile and that I had to fight for my rights with this system. […] During these two years, the work of ordinary staff changed for better, but these changes did not result from the efforts of the state. The support offered by unions of veterans and NGOs working in this field is very efficient, and practically all support that I received came from them, except for support from my family,” said Taras Kovalyk, АТО veteran, trainer of volunteer rehabilitation programs.

Where the problem lies?

One of the elements of the problem is the lack of understanding how and when rehabilitation should be offered. “Rehabilitation cannot be offered in a psychiatric care hospital, a resort facility or other “closed” facilities, where one’s freedom is in some way limited. Psychological rehabilitation is possible when a person lives inside the society and at the same time obtains comprehensive and professional help,” noted Vitaliy Klymchuk, executive director of the Institute of Mental Health of the Ukrainian Catholic University. According to him, preparation of a soldier to problems that he probably will face coming back from the frontline should start even before his mission in the conflict zone, it should continue at the frontline and after demobilization.

One more problem is the lack of competent professionals. According to Vitaliy Klymchuk, the best specialists are those who have been trained within NGOs programs, and their number is not sufficient. Moreover, nowadays management of rehabilitation programs for veterans is the responsibility of local authorities, and rather often they are not ready to do it. Another fact that complicates the matter is that in the Ukrainian society going to see a psychologist is not considered absolutely normal; it is necessary to change this biased attitude.

“The core of the problem is not the indifference of the society or indifference of the state. The core of the problem is that for 20 years we [Ukraine as a state] had no need in this system, and nowadays everyone who helps does it independently of a comprehensive state policy. We need a structured management, structured funding and distribution of money that would be allocated from the state budget, we need  trained professionals and a set of criteria to evaluate their competence, as well as standards and protocols,” noted Zoryana Chernenko, professor of the National University of “Kyiv-Mohyla Academy”, expert of healthcare reform group of the “Reanimation package of reforms”. She emphasized that the draft law on psychological and social rehabilitation is being discussed for already two years but is not yet finalized.

Recommendations

According to Taras Kovalyk, it is much easier for a veteran to communicate with the state authorities through persons who have the same experience. “There is a very good example in Lviv where the city authorities created a special service responsible for interaction between the veterans and the state system. The staff members there are veterans and wives and mothers of veterans. It is much easier for them to communicate with the veterans, as they had a similar experience,” he noted. The same approach of veterans helping other veterans turned out to be very efficient in rehabilitation programs.

The second recommendation is to provide more information to the society, especially staff members of social services, about changes happening to a person who had combat experience, and what is the right way to communicate with veterans, Kovalyk noted. For instance, veterans have a very strong sense of justice which can be manifested through very strong emotional reactions. If people are unaware of this, they may be frightened by this behavior. Secondly, it is necessary to root out the stereotype that a veteran is a “victim”, while in fact they are very strong and dignified people who “voluntarily chose to risk and come back with several problems, which in no way reduce their dignity”, stressed Kovalyk.

“We often say “veterans”, “IDPs” (internally displaced persons) and so on, and say it in terms “we” and “they”. Even on the level of narrative it lays down inequality, discrimination and stigma. Real changes will start on the day when we start saying “we”, added Vitaliy Klymchuk.

Zoryana Chernenko said that on Thursday, February 23, there will be a roundtable on this topic. “There will be presentations of analytics on the current state of things and current figures in the statistics, and after this we will discuss what should be done to improve the situation. There will be presentations of those specialists who already work in this field”, she elaborated.