Ukrainian psychiatrists took home best practices from Yale in treating mental health and addiction disorders among war veterans after a recent month-long visit funded by the nonprofit Doctors United for Ukraine.
"We had this problem before the war, like everyone," said Dr. Oleksandra Hrushynska, a psychiatrist and head of the inpatient department at the Lviv Regional Clinical Psychiatric Hospital, describing common patient disorders. "But it really increased after the full-scale war started."
Hrushynska said veterans with post-traumatic stress disorder are turning to alcohol, opioids and cannabinoids to cope. Yale’s approach in treating addiction and mental health simultaneously is a template doctors from Ukraine can use, she said.
“[In] Ukraine we have the problem with that because we learned to treat first addiction and then mental health issues,” she said. “It was a great opportunity to see how it works together.”
Hrushynska also hopes to increase harm reduction programs for alcohol use disorder in Lviv, she said.
At the Ukrainian capital, psychiatrist Dr. Nataliia Petrenko works at the Kyiv City Clinical Hospital 4. She studied methodologies at Yale to integrate medicine, social work and family services to treat veterans with addiction and mental health disorders.
“We are trying to change the system,” she said. “My center must work in this multidisciplinary team. And for me, [it] was very important to see how it worked in Yale.”
Petrenko also plans to increase the use of transcranial magnetic stimulation among her patients — a procedure used routinely at Yale, but infrequently in Ukraine, she said.
Another takeaway is that medical teams plan for the patient's future after they're discharged while they're in the hospital, she said.
“In Ukraine we have [a] really good harm reduction program with opioid use disorders, but we have really [a] lack of alcohol use harm reduction programs," she said. "So it will be great to start doing something in this way.”
Yale has a long history of pioneering mental health treatments, including the use of medication like ketamine. Doctors also use therapeutic interventions using transcranial magnetic stimulation or electroconvulsive therapy to manage very ill patients.
“So one of the benefits of this program is the exposure that our Ukrainian colleagues who have great clinical experience are now having to these advanced therapies," said Dr. Andrey Zinchuk, an associate professor at the Yale School of Medicine and director of Doctors United for Ukraine.
“Another really important place for learning together is that they get to experience how a mental healthcare system at Yale or in the U.S. is organized,” he said. “So the communication between inpatient and outpatient services, the follow-up, the integration of family services, social workers, and assessment of home environment, by which patients are followed and enabled to be made better.”
