Warsaw, Poland, 15 July 2024 – A UNICEF report, developed in collaboration with SWPS University and the Foundation of the Institute of Mother and Child, sheds light on the barriers and enablers for seeking mental health and psychosocial support by adolescents from Ukraine in Poland. Titled "Understanding Ukrainian adolescents’ attitudes to Mental Health and Psychosocial Support in Poland," the report looks into the lives of these young individuals, uncovering the pervasive stigma surrounding mental health services and the barriers it creates.

Since the escalation of the war in Ukraine in February 2022, Poland has been on the frontline of the refugee crisis. Currently, around 950,000 refugees from Ukraine remain registered in the system, 38% of whom are children. The mental health and psychosocial toll of the conflict is immense. The experience as a refugee presents a host of challenges to a person’s wellbeing, and specifically to their mental health. Last year's study "It is cool here, no doubt about it... but home is home" revealed that many children and adolescents became apathetic and resorted to excessive sleeping and eating when overwhelmed by stress. More than half of the participants of that study expressed a desire to talk to a professional about their mental health. Recognizing the unique needs of adolescents from Ukraine, this research focuses on special requirements and behaviors.

The comprehensive study, involving over 700 participants, including adolescents from Ukraine (16-19 y.o.), their parents, and Mental Health and Psychosocial Support (MHPSS) professionals, utilized both qualitative and quantitative research methods. The findings reveal startling insights into the factors influencing their attitudes toward mental health and psychosocial support in Poland.
"The goal of the study was to examine how psychological, sociological, and environmental factors affect young people's willingness to mental health support. What surprised us the most was that although many young people from Ukraine recognize the benefits of mental health support, their intention to use these services varies”, said Nona Zicherman, Country Coordinator for the UNICEF Refugee Response Office in Poland. “This means that highlighting the benefits of available services is not always enough to get them to seek help. Peer influence appears much more effective in motivating young people to seek mental health support. We found that messages from other adolescents, highlighting that many young people from Ukraine are already benefiting from taking care of their mental health, worked best: when young people hear from someone their age that it's normal to seek help, they feel more comfortable doing it themselves."

Peer influence and sociocultural factors

The aim of the report was to identify barriers to using mental health support among young people from Ukraine and to explore ways to help them overcome these barriers. Peer influence emerged as a key factor in encouraging adolescents to seek psychological help. Adolescents with friends who engage in MHPSS are less likely to experience self-stigma (negative beliefs that one holds about themselves often stemming from societal stigma), underscoring the crucial role of supportive social networks. In the study, young participants were shown a number of short videos encouraging them to start taking care of their mental health. The most effective message came from a young person sharing their own experience and assuring that "Many young people from Ukraine are benefiting from taking care of their mental health."

Peer influence on the decision to seek mental health support is also confirmed by the study participants themselves. “I think that if information about available MHPSS is passed on, for example, by friends then probably they (adolescents) would take advantage of it (MHPSS),” said an adolescent from Ukraine living in Poland. This means that it is worthwhile to involve young people in various activities and campaigns that normalize seeking mental health support.

Additionally, the study highlights gender differences, with female adolescents reporting lower levels of self-stigma than males, suggesting the need for gender-sensitive mental health interventions.
At the same time, despite recognizing the need for mental health support, many Ukrainian parents and caregivers still view seeking help from psychologists as a sign of weakness, potentially limiting their children’s access to necessary resources. If adolescents believe that people who are important to them have a negative view of mental health services, they have weaker intentions to seek support.

Another key finding of the report is the impact of the duration of stay in Poland on self-stigma. Adolescents who have been in the country longer tend to report higher levels of self-stigma, possibly due to prolonged exposure to integration challenges and varying degrees of support over time.

Language proficiency is also among the limiting factors, with adolescents with lower Polish language proficiency facing greater challenges in accessing services and integrating into society.

A path forward

In response to these findings, the authors call on public institutions, policymakers, organizations, educators, community leaders and all stakeholders to collaborate on implementing comprehensive strategies aimed at reducing stigma and enhancing mental health services for Ukrainian adolescents in Poland.

This report not only calls attention to pressing mental health issues but also advocates for tangible steps towards ensuring the well-being and successful integration of youth from Ukraine in Polish society.

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The full text of the report “Understanding Ukrainian adolescents’ attitudes to Mental Health and Psychosocial Support in Poland” can be found here: https://www.unicef.org/eca/reports/understanding-ukrainian-adolescents-attitudes-mental-health-and-psychosocial-support-poland.

Key findings:
1. Close Circle - When adolescents believe that people, they care about have a negative view of mental health services, they are less likely to seek help themselves.
2. Social Norms - Adolescents who strongly agree that talking about mental health is a sign of weakness and who believe that people who use mental health services are seen as inferior by others tend to experience higher levels of self-stigma.
3. Perceived Benefits of MHPSS - A significant proportion of respondents (42%) strongly agreed with the statement "Integrating mental health and psychosocial support into my life would improve my wellbeing".
4. Peer Influence - Adolescents who have friends who are currently involved in MHPSS report less self-stigma.
5. Gender Differences - Female adolescents report less self-stigma compared to male adolescents. Gender differences in self-stigma may be influenced by different social expectations and norms.

Key recommendations:
1. Education and Awareness Campaigns: To foster positive attitudes towards mental health services.
2. Peer Support Networks: To leverage the influence of peer behavior in reducing stigma.
3. Gender-Sensitive Approaches: To address the specific needs and challenges faced by male and female adolescents.
4. Language Support Programs: To improve Polish language proficiency and facilitate better integration into the local community.