Journal Health of Woman. 2026. 2(183): 76-80. doi: 10.15574/HW.2026.2(183).7680
Bozhuk B. S.¹, Kropatnytska Ya. V.¹, Herasym L. M.^2
1SI ‘Institute of Occupational Medicine named after Yu.I. Kundiyev NAMS of Ukraine’, Kyiv
²Bukovinian State Medical University, Chernivtsi, Ukraine

For citation: Bozhuk BS, Kropatnytska YaV, Herasym LM. (2026). Organizational resilience of the mental health system in wartime: ensuring accessibility and continuity of care for the female population. Ukrainian Journal Health of Woman. 2(183): 76-80. doi: 10.15574/HW.2026.2(183).7680
Article received: Jan 07, 2026. Accepted for publication: Mar 22, 2026.

The organizational stability of the mental health system in wartime is one of the key factors in ensuring the availability and continuity of medical care for the population. Special attention is needed for the female population, who belong to the most vulnerable groups in the conditions of military conflicts due to the increased risk of developing anxiety, depressive, and post-traumatic stress disorders, forced displacement, loss of social support and the growth of gender-based violence.
Aim – to systematize modern scientific data on the organizational stability of mental health systems in war conditions and to determine the mechanisms for ensuring the availability and continuity of assistance to the female population, taking into account the Ukrainian experience.
The analysis of literary sources proved that the most effective mechanisms for ensuring the sustainability of the mental health system are the integration of psychiatric care into the primary medical link, the development of interdisciplinary teams, the introduction of telemedicine technologies and the expansion of public support services. It was established that continuity of the patient's route, territorial availability of services, psychological support during displacement and specialized programs for internally displaced persons, mothers, wives of servicemen, and female veterans are of particular importance for women in war conditions. The Ukrainian experience demonstrates an active transformation of the mental health system, but staffing problems, uneven access to services and the need for further development of gender-oriented approaches remain.
Conclusions. The organizational resilience of the mental health system in the context of war is determined by the ability to ensure the availability of care for the most vulnerable population groups, in particular, women. The integration of mental health services into all levels of medical care, the expansion of digital services, the strengthening of intersectoral interaction, and the introduction of gender-sensitive models of care organization are promising areas of development.
The authors declare no conflict of interest.
Keywords: mental health, organizational sustainability, war, female population, availability of care, continuity of medical care, Ukraine.

REFERENCES

1. Adedeji A, Kaltenbach S, Metzner F, Kovach V, Rudschinat S et al. (2025, Jan 28). Mental Health Outcomes Among Female Ukrainian Refugees in Germany-A Mixed Method Approach Exploring Resources and Stressors. Healthcare (Basel). 13(3): 259. https://doi.org/10.3390/healthcare13030259; PMid:39942449 PMCid:PMC11816652

2. Badanta B, Márquez De la Plata-Blasco M, Lucchetti G, González-Cano-Caballero M. (2024, Jan). The social and health consequences of the war for Ukrainian children and adolescents: a rapid systematic review. Public Health. 226: 74-79. https://doi.org/10.1016/j.puhe.2023.10.044; PMid:38007844

3. Beech EH, Young S, Anderson JK et al. (2022, Oct). Evidence Brief: Safety and Effectiveness of Telehealth-delivered Mental Health Care. Washington (DC): Department of Veterans Affairs (US). URL: https://www.ncbi.nlm.nih.gov/books/NBK586283/.

4. Bilewicz M, Babińska M, Gromova A. (2024). High rates of probable PTSD among Ukrainian war refugees: the role of intolerance of uncertainty, loss of control and subsequent discrimination. Eur J Psychotraumatol. 15(1): 2394296. https://doi.org/10.1080/20008066.2024.2394296; PMid:39355973 PMCid:PMC11448335

5. Greene EA, Serpico EJ, Legault GL, Williams SG. (2025, Dec 29). Staying Relevant in the Digital Age: Exploring the Evolving Frontier of Telehealth for Mental Health in the Military Health System and Veterans Health Administration. Curr Psychiatry Rep. 28(1): 8. https://doi.org/10.1007/s11920-025-01651-3; PMid:41460423 PMCid:PMC12748128

6. Griban GP, Trufanova VP, Lyukianchenko MI, Dovhan NY, Dikhtiarenko ZM et al. (2024). Causes of stress and its impact on women's mental and physical health. Wiad Lek. 77(12): 2493-2500. https://doi.org/10.36740/WLek/197113; PMid:39874335

7. Khailenko O, Bacon AM. (2024, Sep). Resilience, avoidant coping and post-traumatic stress symptoms among female Ukrainian refugees and internally displaced people. Int J Soc Psychiatry. 70(6): 1164-1174. https://doi.org/10.1177/00207640241264662; PMid:39049605 PMCid:PMC11408952

8. Krupelnytska L, Vavilova A, Yatsenko N, Chrzan-Dętkoś M, Morozova-Larina O et al. (2025, Mar 8). War in Ukraine vs. Motherhood: Mental health self-perceptions of relocated pregnant women and new mothers. BMC Pregnancy Childbirth. 25(1): 253. https://doi.org/10.1186/s12884-025-07346-0; PMid:40057739 PMCid:PMC11889800

9. Ladyk-Bryzghalova A, Zemp C, Rivest-Beauregard M, Kostiuchenkov O, Schafer A, Adams B et al. (2025, Sep 3). Clinical and functioning outcomes during the establishment phase of Ukraine's community mental health teams: a descriptive analysis. Lancet Reg Health Eur. 58: 101446. https://doi.org/10.1016/j.lanepe.2025.101446; PMid:40980815 PMCid:PMC12446188

10. Limone P, Toto GA, Messina G. (2022, Nov 25). Impact of the COVID-19 pandemic and the Russia-Ukraine war on stress and anxiety in students: A systematic review. Front Psychiatry. 13: 1081013. https://doi.org/10.3389/fpsyt.2022.1081013; PMid:36506419 PMCid:PMC9732235

11. Li X, Li KK. Mental Health Help-Seeking Among Young Internal Migrants in China: Shame as a Double-Edged Sword. Psychiatr Q. 2025 Dec;96(4):829-845. https://doi.org/10.1007/s11126-025-10127-9; PMid:40232536 PMCid:PMC12647222

12. Martsenkovskyi D, Shevlin M, Ben-Ezra M, Bondjers K, Fox R, Karatzias T et al. (2024, Mar 27). Mental health in Ukraine in 2023. Eur Psychiatry. 67(1): e27. https://doi.org/10.1192/j.eurpsy.2024.12; PMid:38533632 PMCid:PMC10988158

13. Mazhnaya A, Meteliuk A, Bogdanov S, McGinty EE. (2025, Dec 8). Bridging factors within Ukraine's mental health system during wartime: a qualitative study of stakeholders' perspectives. Implement Sci Commun. 7(1): 22. https://doi.org/10.1186/s43058-025-00825-7; PMid:41361279 PMCid:PMC12882479

14. Mazziotti R, Rutigliano G. (2021, Jul 29). Tele-Mental Health for Reaching Out to Patients in a Time of Pandemic: Provider Survey and Meta-analysis of Patient Satisfaction. JMIR Ment Health. 8(7): e26187. https://doi.org/10.2196/26187; PMid:34114956 PMCid:PMC8323764

15. Missler M, Karaban I, Cheliuskina K, Frankova I, Dobrova-Krol N, Sijbrandij M et al. (2025, Apr 2). Risk and protective factors for the mental health of displaced Ukrainian families in the Netherlands: study protocol of a 4-year longitudinal study. BMJ Open. 15(4): e089849. https://doi.org/10.1136/bmjopen-2024-089849; PMid:40180395 PMCid:PMC11966996

16. Naslund JA, Mitchell LM, Joshi U, Nagda D, Lu C. (2022, Jun). Economic evaluation and costs of telepsychiatry programmes: A systematic review. J Telemed Telecare. 28(5): 311-330. https://doi.org/10.1177/1357633X20938919; PMid:32746762 PMCid:PMC11694481

17. Pinchuk I, Yachnik Y, Goto R, Skokauskas N. (2025, Mar 28). Mental health services during the war in Ukraine: 2-years follow up study. Int J Ment Health Syst. 19(1): 11. https://doi.org/10.1186/s13033-025-00667-9; PMid:40148922 PMCid:PMC11951524

18. Piotrowski A, Boe O, Sygit-Kowalkowska E, Petrovska I, Predoiu A, Predoiu R et al. (2023, Jul 19). Women during the war – stress, resilience and self-efficacy during the Russian-Ukrainian war (May 2022) among women from Ukraine, Poland, Slovakia and Romania. Eur Psychiatry. 66; Suppl 1: S649. https://doi.org/10.1192/j.eurpsy.2023.1350; PMCid:PMC10661404

19. Preiss M, Fňašková M, Berezka S, Yevmenova T, Heissler R, Sanders E et al. (2024, Apr 8). War and women: An analysis of Ukrainian refugee women staying in the Czech Republic. Glob Ment Health (Camb). 11: e47. https://doi.org/10.1017/gmh.2024.7; PMid:38690571 PMCid:PMC11058516

20. Reznik A, Pavlova I, Pavlenko V, Kurapov A, Drozdov A, Korchakova N et al. (2025, Dec 10). Mental health and well-being among Ukrainian female university students: The impact of war over 3 years. Glob Ment Health (Camb). 12: e149. https://doi.org/10.1017/gmh.2025.10112; PMid:41438265 PMCid:PMC12720378

21. Reznik A, Pavlenko V, Kurapov A, Zavatska L, Korchakova N, Pavlova I et al. (2025, Apr 3). War impact on mental health and well-being among Ukrainian and Israeli women: A cross-national comparison. Glob Ment Health (Camb). 12:e46. https://doi.org/10.1017/gmh.2025.30; PMid:40303961 PMCid:PMC12037348

22. Shaker AA, Austin SF, Storebø OJ, Schaug JP, Ayad A, Sørensen JA et al. (2023, Jul 5). Psychiatric Treatment Conducted via Telemedicine Versus In-Person Modality in Posttraumatic Stress Disorder, Mood Disorders, and Anxiety Disorders: Systematic Review and Meta-Analysis. JMIR Ment Health. 10: e44790. doi: 10.2196/44790. Erratum in: JMIR Ment Health. 2023 Sep 18; 10: e52269. https://doi.org/10.2196/52269; PMid:37722110 PMCid:PMC10546272