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An air raid alert has just started when Victoria Itskovych joins a Zoom call from Kyiv. “It’s, like, a usual situation,” she says. “But really, it’s not usual.” February 24 will mark the second anniversary of Russia’s full-scale invasion of Ukraine. For nearly two years now, Kyiv has been under bombardment. Some weeks, people have to trudge to their shelters night after night, checking text alerts and Telegram channels to figure out where the missiles are falling and when it’s safe to come out—although, it’s never really safe.
That relentless stress, and the trauma of losing family, friends, and colleagues on the front, has taken its toll. A poll by the city government last year found that 80 percent of residents reported symptoms of post-traumatic stress disorder. Russia’s full-scale invasion of Ukraine has exposed the whole of Ukrainian society to battle shock. “We’ve all suffered from this,” says Itskovych, who is director of the Kyiv City Council’s IT department. “Almost every person has somebody who was injured or died during the war, or lost their home or lost their health.”
In the face of such widespread injury, the Kyiv government has turned to Ukraine’s now-famous civic tech infrastructure for help. As the war enters its third year, the municipal government is starting to build a citywide system for providing mental health support to citizens. It’s a vast challenge, but also a unique opportunity—the first time that such a mass-trauma event has happened to a society that has already built the tools of digital government. Dealing with the mental health impacts of the invasion will be absolutely vital to keep society resilient, functioning, and committed enough to repel the invaders. It’s also the key to Ukraine’s postwar recovery, laying the groundwork now for a society that can rebuild itself physically and psychologically from the horrors of war. “This is the future of our society,” Itskovych says. “We are building the basis for the resilience of the community itself.”
At the heart of the plan is the Kyiv government’s digital platform, Kyiv Digital, which it launched in 2017. Before the invasion, it was largely used to manage parking and public transport, and to notify residents of disruptions to services such as road closures or power outages. When the war began, those notifications became more urgent: incoming attacks, the locations of bomb shelters, and the safest routes to reach them. Like other parts of Ukraine’s civilian technology, the city pivoted its tools to keep people safe and support the war effort, bootstrapping and rewiring the systems at pace.
“The first changes to the notifications we did in hours,” says Oleg Polovynko, adviser on digitalization to Kyiv’s mayor. Since then, the digital teams have been engaged in a constant cycle of innovation, trying to figure out what services they can bring online. The war has pushed them to act more quickly, to adapt tools they have and invent things that don’t exist.
They’ve expanded tools for civic participation, letting citizens vote on petitions, send feedback to the city government, and ask for help, such as financial support to repair bomb-damaged homes. And they’ve collected a lot of data, which is how the Kyiv government has been able to measure the scale of the city’s distress—and people’s reluctance to seek help. Of the 80 percent of residents who show signs of trauma, “40 to 45 percent are afraid to have contact with doctors who can help,” Polovynko says.
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But this is only half of the problem that needs solving. For those who do want to seek treatment, there simply aren’t enough resources to help them. Clinical psychologists are supposed to limit the number of patient consultations they do in a day, so they don’t burn out. Before the full-scale invasion, Inna Davydenko saw a maximum of four patients daily. Today, Davydenko, a mental health specialist at the City Center of Neurorehabilitation in Kyiv, sees twice that number. When we speak, she’s just finished a video call with a soldier stationed near the front, whom she’s helping cope with stress and anxiety.
Even before the war massively increased the number of people dealing with trauma, depression, and anxiety, Ukraine’s medical system suffered from an underinvestment in mental health provision. “In most hospitals, you have maybe one psychologist. In good hospitals, it’s maybe two,” Davydenko says. “A lot of people need psychological help, but we can’t cover everything.” There is simply no way that the current system can grow to match the enormous jump in demand. But, Davydenko says, “almost every Ukrainian person has a smartphone.”
This is exactly what Polovynko and Itskovych want to exploit, using Kyiv Digital’s platforms and data to digitize mental health support for the city, and so close the gap between need and resources. Their project will focus first on those they’ve identified as being most vulnerable—war veterans and children—and those most able to help others: teachers and parents. The next six months of the project will be a “discovery stage,” Polovynko says. “We need to understand the real life of our veterans now, of the children, of the parents, what’s their context, how they survive, what services they use.”
The project will track people through the process of recovering from trauma, monitoring the treatments they ask for and the ones they receive, their concerns as they move through the mental health system, and their outcomes. Once the team has a detailed map of services and bottlenecks, and data on what’s working and what’s not, they can match individual needs with treatments. A full roll-out is scheduled for early 2025.
“It doesn't mean that the whole chain of the service will be absolutely digital,” Itskovych says. Some patients may be directed to group therapy or one-on-one meetings with psychologists, others will be given access to online tools. The aim, she says, is to create efficiency, to close the service gap, but also to provide comfort, meeting people where they are. “For a big part of our clients, there is more comfort with getting the service online, in different ways. Some people are not comfortable meeting a specialist one-on-one; they prefer a digital way to get the service.”
The project is being supported financially and operationally by Bloomberg Philanthropies, a charitable organization created by former New York mayor and Bloomberg founder Michael Bloomberg. James Anderson, head of government innovation at the organization, says that the project comes at a critical time for Kyiv, where people continue to suffer even though global attention has shifted away to other crises.
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“There's always a tremendous amount of attention when the immediate crisis hits,” Anderson says. “But mayors continue to have to deal with the human costs of crises, long after the newspapers have turned to new subjects. That’s certainly what we sense and see in Kyiv.”
The size of the challenge in Kyiv is clearly daunting. But, Anderson says, there are reasons for optimism. Cities have got better over the past two decades at responding to common crises, such as Covid-19, which also required rapid, mass digitization of services. “Every crisis is distinct and different, and awful, in its own way,” Anderson says, “but there are lessons learned.” The Kyiv government, and Ukrainian society more widely, have demonstrated a capacity for rapid innovation to meet urgent needs, and Anderson hopes that success in this project could see it replicated internationally. “This is not the last war. This is not the last crisis,” he says. “I think Kyiv has lessons that they can share with cities around the globe.”
For Kyiv, and Ukraine, the crisis won’t end when the war does. “Psychological health is the number one problem for Ukraine,” Davydenko says, before correcting herself. “Number one is Russia, number two is our psychological health,” she says. “PTSD is our future.”
Updated 2-16-2024 3:30 pm GMT: The piece was corrected to indicate that Michael Bloomberg was the founder of Bloomberg, not its cofounder.
