The study, carried out among 1,631 Ukrainian adults in seven European host countries and Ukraine, found that mental health outcomes differed significantly depending on where people were living after having fled their homes.
The research was conducted as part of Multi-CultiMed, an international project involving universities and institutions from Poland, Germany, Spain, Cyprus, Slovenia, Ukraine, Serbia and Portugal.
Its results were published in Frontiers in Public Health, a peer-reviewed public health journal.
Researchers surveyed Ukrainian refugees living in Poland, Germany, Spain, Cyprus, Slovenia, Portugal and Serbia, as well as internally displaced people in Ukraine.
Most respondents were women, and the average age was below 40. The survey was carried out in 2025 through refugee support organizations, nongovernmental organizations, Ukrainian community networks and social media.
“The country to which Ukrainian refugees went proved to be of great importance for their level of psychological functioning,” said Małgorzata Szkup, an author of the study and a researcher at Pomeranian Medical University in Szczecin, northwestern Poland.
“The highest distress was felt by internally displaced people, and the lowest by those staying in Cyprus and Poland.”
Researchers measured psychological distress, symptoms of anxiety and depression, the effects of traumatic experiences, coping strategies and resilience.
“Resilience is a measure of how quickly we are able to get back on our feet after a difficult event,” Szkup said. “Some people may be broken by such experiences for a very long time, while others are able to rise again and return to normal functioning.”
The study found significant differences between countries in nearly all the mental health indicators examined. These differences remained even after researchers took into account age, sex, marital status and employment status.
The highest level of psychological distress was found among internally displaced people in Ukraine.
Among refugees living abroad, the highest levels were recorded in Slovenia, Portugal, Spain, and Germany. The lowest levels were found in Cyprus and Poland.
Poland and Germany recorded the highest levels of resilience, while Spain recorded the lowest level. Portugal, Slovenia, and internally displaced people in Ukraine fell between those groups.
The study also found differences in how refugees coped with stress. Adaptive strategies, such as seeking work, joining a language course, looking for support, or trying to solve practical problems, were most common among refugees in Germany, Poland, and Slovenia.
They were least common among those in Cyprus and Serbia.
Szkup said maladaptive strategies, which can include avoiding social contact, putting off decisions, or waiting for problems to resolve themselves, may bring negative consequences later. Differences between countries in these behaviors were less pronounced.
The research did not attempt to identify the direct causes of the differences between countries. It did not assess the quality of support systems, social policy, healthcare access, integration, or other conditions in each country.
Szkup said the results still suggest that the environment in which refugees live may affect their mental health.
“Our results suggest that the mental health of refugees does not depend solely on their individual characteristics,” she said. “It may also be linked to conditions in the host country. Access to healthcare, public services, the labor market, and the possibility of integration may play an important role.”
She said support for refugees should include psychological help, but also conditions that allow people to function safely and steadily in a new place.
The next stage of the research will examine which factors most harm the mental health of Ukrainian refugees and which help them adapt.
Researchers plan to look at the role of raising minor children, maintaining contact with relatives in Ukraine, health, finances, employment, and individual wartime experiences.
(rt/gs)
Source: PAP