Feasibility of mental health and substance use research in conflict settings: Insights from Ukraine
K Hook, V Truong, N Gnatienko, P Smyrnov, MC Greene, J Kane, K Lunze, S BogdanovAbstract
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.