Implementation of WHO Self-Help Plus among Ukrainian university students during wartime: A multicenter longitudinal study

Prolonged war-related adversity places Ukrainian university students at heightened risk of psychological distress. Scalable, low-intensity interventions such as WHO Self-Help Plus (SH+) show promise, yet evidence of their implementation and short-term effectiveness during active conflict is limited.

A multicenter longitudinal study was conducted across five universities. Students with mild-to-moderate distress (PSS-10) joined a 5-week offline Acceptance and Commitment Therapy-based SH+ course led by trained non-specialist facilitators. Outcomes included psychological distress (PHQ-9, GAD-7, PCL-5), well-being (WHO-5), daily functioning (WHODAS 2.0), and resilience (CD-RISC-10), assessed at baseline (T1), post-intervention (T2), and 3-month follow-up (T3). Analyses used non-parametric longitudinal tests on 297 completers.

SH+ participation significantly reduced perceived stress, depression, anxiety, and post-traumatic stress from T1 to T2. Well-being and daily functioning improved, with all gains sustained at T3. Resilience remained stable. Implementation barriers included security threats, power outages, and exam overlaps, contributing to attrition.

WHO SH+ is an effective, scalable first-line psychosocial intervention for university students in wartime. It alleviates distress, enhances functioning, and maintains benefits over 3 months. SH+ can be rapidly deployed by non-specialists within stepped-care university frameworks during humanitarian crises. Flexible delivery and alignment with academic schedules are essential to overcome conflict-driven barriers.