Association between household head displacement and accessibility to mental health services in Ukraine

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Statement of the Problem: The ongoing fighting for eight years in eastern Ukraine caused severe casualties and the destruction of critical infrastructure in the areas [1]. Displaced people, who lived in unstable places such as a house of relatives or acquaintances, communal camps, and temporary facilities, often became unemployed or had many restrictions on access to social support services [2, 3]. In addition, the outbreak of Coronavirus Disease 2019 (COVID-19) and restriction measures to control it have led to an increase in the economic downturn and unemployment, and the challenges could exacerbate the vulnerability of people in the Ukraine border areas [1]. A previous study showed that vulnerable groups in developing countries where disputes arise had experienced restrictions and difficulties accessing mental health services within the health care system [4]. Since socioeconomic constraints can act as risk factors for depression and anxiety, the need for mental health support for vulnerable Ukrainian people is growing [2, 3]. Therefore, the aim of the study is to explore factors associated with accessing mental health services for residents of the Ukrainian border areas, providing evidence base for establishing effective humanitarian support for vulnerable groups affected by the conflict. Methodology: This study used data from the 2020 Ukraine Multi-Sector Needs Assessment conducted by REACH to identify factors associated with the accessibility to mental health services for vulnerable groups in Ukraine[5]. Between 30 June and 15 August 2020, the data was collected through 1,617 household heads and household representatives in the Donbas living rural and urban regions between 0-5 km and 5-20 km from the contact line. The dependent variable was accessibility to mental health services, collected through the question of "If any household members needed mental health support, would they be able to access mental health services?" Independent variable was displaced status of household head. And demographic and sociological characteristics, characteristics related to householders' vulnerability, health-related characteristics were included in this analysis. A total of 876 were included in this analysis. The frequency, percentage analysis and binary logistic regression were performed to identify factors associated with accessibility to mental health services. All statistical analysis was performed using STATA/IC 15.1 and significance level was 5%

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