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"Psychological ambulance" in quarantine - how mobile teams help in new conditions

2 June 2020

How often do situations arise when help is essential here and now, and yet there is no way to get it? How many people could have been saved if help had been faster?

Often time is crucial, and being in the right place at the right time is the key to effective help. In such cases, mobile teams become extremely relevant.

We are used to thinking that first aid is about physical health. However, mental health is no less important, and it also has its own "ambulances" - mobile teams of social and psychological assistance.

How the work and role of teams have changed during quarantine, whether the number of calls increased, and whether it is possible to help online - discussed in this article.

Domestic violence is a flagrant yet "quiet" problem

Domestic violence has been an extremely complex and dangerous phenomenon from which women continue to suffer disproportionately. With its various manifestations, it has a negative impact not only on the victims themselves but also on children, who often witness violence.

Until recently, Ukraine did not have any relevant legislation on this issue - the Council of Europe Convention on Preventing and Combating Violence against Women and Domestic Violence, better known as the Istanbul Convention, has not been ratified, and the Law on Prevention and Counteraction to domestic violence came into force only in early 2019.

This topic is considered "family-related" and taboo, victims often do not fully realize that their partner's behavior is violence indeed. The problem remains silent, but statistics show that one in four Ukrainian women between the ages of 15 and 49 has been sexually or physically abused at least once in their lives (UNFPA).

The role of mental health in domestic and gender-based violence should not be underestimated. In addition to the fact that psychological violence is more difficult to detect, it is more common and often affects how victims perceive the situation.

In such cases, mobile teams can be very effective. Often the emotional state of the victims is left out of the attention of doctors and law enforcement agencies, but this issue should also be taken seriously. And the state, activists, and non-governmental organizations have begun to pay more attention to the psychological health of victims, putting their coma in the phrase "to help impossible to ignore."

History of mobile teams in Ukraine

Mobile social and psychological assistance teams were launched in 2015 as part of the UN Population Fund's program "Integrated Approach to Addressing Violence against Women and Girls in Ukraine." Mobile teams provided urgent and planned assistance. 46 such teams existed in 12 regions of Ukraine and worked during 2015-2019 with the support of UK Government. Their task was to inform the victims about where they can get social services, appropriate assistance, and protection, as well as educate the communities. 

While existing, these brigades assisted in more than 67,000 cases of domestic violence but were later replaced by state-run ones, of which there are now more than 300. They work under the leadership of the Ministry of Social Policy and are guided in their work by the Regulation, which in 2018 was developed and adopted by the Cabinet of Ministers of Ukraine.

However, the mobile teams of social and psychological assistance working under the auspices of the United Nations Population Fund have not disappeared completely. They are now assisting ATO/JFO combatants and their families.

Last November, the United Nations Population Fund launched six mobile units that seek to prevent domestic and gender-based violence in the families of ex-combatants, as well as to minimize possible aggressive behavior and support families.

Quarantine assistance: how new challenges lead to new formats

Despite the quarantine, the work of mobile teams has not stopped. Under the current circumstances, six units continue to operate in Kyiv and Mykolaiv oblasts.

However, the new conditions require new means of assistance. For example, the teams use phones, Zoom, Facebook, Skype, and Viber in their work, and also have "invented" a kind of "quiet" means of help - by texting. This can be important for many victims, as abusers often try to control and restrict victims in communication and are aggressive in an attempt to report any issues or violence.

“Since the beginning of the quarantine, the number of complaints about psychological violence has increased. Our clients began to talk more about it. There are many factors, such as job loss, for example. The violence we have faced includes threats and blackmail. There is a trend I'm personally witnessing: more depressing thoughts occur, there is a decrease in activity, the mood is low. There is confusion about what will happen next. We can see growing anxiety among veterans because of long-term self-isolation," - Anastasia Chernyavskaya, the psychologist of a mobile team from Mykolaiv, tells.

The units advise the wives of combatants and the whole families on the issues of establishing relationships during the quarantine, as it is the first time many families have been staying together for such a long period. Also, planned psychological consultations continue to be conducted, and online support groups for ATO/JFO participants are functioning.

“We were approached by a family that was going through a cycle of violence: increased tension, explosion, remorse. The violence had started before the quarantine, we worked with them before. However, a new incident occurred during the quarantine. It was psychological violence,” Anastasia shared.

The number of requests to teams has increased significantly during the quarantine - the number of clients has increased by 192%. In some teams, the rates of appeals increased 3.5 times.

More than half of the quarantine consultations are conducted by phone. And although the lockdown simultaneously increases the number of appeals and is an obstacle for personal communication, experts note that the online format has its advantages: for example, the teams manage to reach more people and save resources on educational activities.

Attention to the participants in hostilities - why it is important

According to data in the OSCE-led survey, conducted in 2019, the families of former ATO/JFO participants are almost twice as likely to suffer sexual or physical violence: 31% versus 15% of cases where a partner has not participated in hostilities. These statistics make helping veterans and their families even more relevant, especially given that self-isolation and quarantine restrictions only increase overall stress and post-traumatic stress disorder.

Not only the wives or relatives of veterans but also the husbands themselves ask for psychological assistance. Realizing that they need help, they take the first step towards change approaching the psychologists of mobile teams.

Teams also work with people with disabilities. Psychologist Anastasia Chernyavska notes that often team members may not even know about the disability, if it is not physical, but notes that there are no obstacles for such people to receive help from the team.

The peculiarity of the units operating within the framework of the UN Population Fund is that, in addition to the social worker, psychologist, and coordinator, the team includes a “fellow” member of the ATO/JFO. "Fellows" listen to the client first, and it gets easier for men to ask for help since it is much more comfortable to open up to someone with whom you have a lot in common.

According to new research on post-traumatic stress disorder and its therapy, which was conducted in April 2020, 41% of veterans seek psychological help after returning to their family and community. And the model of communication with a "fellow", with whom a certain emotional bond is formed, proves its effectiveness.

Where do the teams operate?

Six mobile teams work in Kyiv and Mykolayiv oblasts. In particular, they operate in Bila Tserkva, Vyshneve, Borodyanka, Mykolayiv, Pervomaisk, and Mykolaiv oblast. Separate contacts and consultants exist for each team.

You can get a consultation from Monday to Friday from 9 am to 6 pm by phone, and also via Viber, Skype, Zoom or Facebook messenger. In addition to psychological support, the teams provide social help, but the client will need to call another number.

If you do not dwell in the above communities, but live nearby, you should also contact the team, if necessary. For example, the unit from Vyshneve also serves Boyarka and 30 surrounding villages and during the quarantine period advises online all those who need help, regardless of their place of residence.

What should I do if these teams do not function in my locality?

If you do not live in these towns or are not a member of the family of ATO/JFO participants, but suffer from violence, be sure to contact the hotline. 15 47 - a short number for victims of domestic violence, which you can call for free and around the clock. You can also contact the police directly at 102.

All-Ukrainian hotline numbers for the prevention of domestic violence - 116 123 and 0 800 500 335. More detailed information on shelters, emergency, and psychological assistance can be found on the "Break the Circle" website.

Domestic violence and emotional problems, both individual and family, have not disappeared behind closed doors of self-isolation. Violence is not paused and quarantined. Moreover, the perpetrators have gained even more control over their victims.

That is why it is important to know that the work of anti-violence services, although changed, has not stopped. Despite the need to go online and the increased number of appeals, teams, as well as other organizations - shelters, day centers - are doing everything possible for psychological and social help.