Feasibility of mental health and substance use research in conflict settings: Insights from Ukraine
Abstract
Background: SHAWL and SUPRA are two Ukraine-based studies initiated in response to the ongoing full-scale invasion. These studies address prevention of mental health disorders and substance use disorders, as these conditions commonly occur in conflict-affected settings.
Methods: SHAWL, a pilot RCT (n = 120), aims to determine the potential effectiveness of a single-session group therapy intervention on decreasing mental health symptoms among displaced women. SUPRA has dual aims of measuring patterns of substance use among displaced persons via survey (n = 400), followed by a pilot RCT (n = 144) to deliver a substance use prevention intervention.
Results: SHAWL completed data collection in January 2026 and remained ahead of track throughout recruitment; 113 participants, 95.76% of those enrolled, completed 3-month primary outcome follow-up. SUPRA was significantly affected by changes in funding policies; while survey data collection time was reduced from six to two months, the overall aims of the project were still met. Outside of funding impacts, as these studies were conducted in-person, significant challenges related to maintaining participant and staff safety and were mitigated with the development of robust safety plans. Other challenges, such as enrolling younger people, those with childcare needs, or those who were treatment naïve, were addressed with a variety of strategies. The most critical facilitator to project success was the working alliance with on-the-ground teams.
Conclusions: Despite challenges, these studies demonstrate that conducting rigorous research in conflict-affected settings is feasible and can be successful when working closely with local partners. Adaptability to meet study aims while responding to complex environments and willingness to be responsive to participant needs are key factors to improve outcomes. The lessons learned through these processes have relevance for other public health interventions in similarly complex humanitarian zones.
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BibTeX
@article{hook2026feasibility,
title = {{Feasibility of mental health and substance use research in conflict settings: Insights from Ukraine}},
author = {K Hook and V Truong and N Gnatienko and P Smyrnov and MC Greene and J Kane and K Lunze and S Bogdanov},
journal = {The European Journal of Public Health},
year = {2026},
month = oct,
doi = {10.1093/eurpub/ckag169.468},
url = {https://doi.org/10.1093/eurpub/ckag169.468},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Feasibility of mental health and substance use research in conflict settings: Insights from Ukraine
AU - K Hook
AU - V Truong
AU - N Gnatienko
AU - P Smyrnov
AU - MC Greene
AU - J Kane
AU - K Lunze
AU - S Bogdanov
PY - 2026
DA - 2026/10/01
JO - The European Journal of Public Health
DO - 10.1093/eurpub/ckag169.468
UR - https://doi.org/10.1093/eurpub/ckag169.468
AB - Background: SHAWL and SUPRA are two Ukraine-based studies initiated in response to the ongoing full-scale invasion. These studies address prevention of mental health disorders and substance use disorders, as these conditions commonly occur in conflict-affected settings. Methods: SHAWL, a pilot RCT (n = 120), aims to determine the potential effectiveness of a single-session group therapy intervention on decreasing mental health symptoms among displaced women. SUPRA has dual aims of measuring patterns of substance use among displaced persons via survey (n = 400), followed by a pilot RCT (n = 144) to deliver a substance use prevention intervention. Results: SHAWL completed data collection in January 2026 and remained ahead of track throughout recruitment; 113 participants, 95.76% of those enrolled, completed 3-month primary outcome follow-up. SUPRA was significantly affected by changes in funding policies; while survey data collection time was reduced from six to two months, the overall aims of the project were still met. Outside of funding impacts, as these studies were conducted in-person, significant challenges related to maintaining participant and staff safety and were mitigated with the development of robust safety plans. Other challenges, such as enrolling younger people, those with childcare needs, or those who were treatment naïve, were addressed with a variety of strategies. The most critical facilitator to project success was the working alliance with on-the-ground teams. Conclusions: Despite challenges, these studies demonstrate that conducting rigorous research in conflict-affected settings is feasible and can be successful when working closely with local partners. Adaptability to meet study aims while responding to complex environments and willingness to be responsive to participant needs are key factors to improve outcomes. The lessons learned through these processes have relevance for other public health interventions in similarly complex humanitarian zones.
SN - 1101-1262
SN - 1464-360X
ER -