戦時下のウクライナにおける学童の心理社会的支援：地域に基づくアクセスと保護者が報告する有用性

Since the onset of the full-scale war in Ukraine in 2022, numerous initiatives have been launched to strengthen mental health and psychosocial support (MHPSS), particularly for children and adolescents. Community-based psychosocial support has been declared a national priority; however, the availability, accessibility, and perceived helpfulness of such support remain insufficiently documented at the population level under conditions of ongoing conflict.

This study aimed to characterize access to psychosocial support among Ukrainian schoolchildren during wartime and to assess parent-reported perceived helpfulness of received support, with particular attention to social and community factors shaping help-seeking and perceived benefit.

Between 2022 and 2025, a nationwide survey was conducted among parents and caregivers of school-aged children (N = 7,551). Indicators were introduced iteratively across survey waves in response to evolving wartime conditions; analyses for each outcome were restricted to the years in which the respective item was measured. Binary logistic regression models were used to examine associations between sociodemographic, psychosocial, and contextual factors and (2022-2025) help-seeking and (2023-2025) perceived helpfulness.

Overall, 12.0% of parents reported that their children needed psychological support, while 9.9% reported contacting a psychologist. Among those who accessed services, 68.1% rated the received support as helpful. Perceived helpfulness was lower among children with anxiety and depressive symptoms (53.9%). The presence of potential anxiety and depressive symptoms in children was the strongest predictor of help-seeking (OR = 3.31; 95% CI: 2.69-4.09) and was also associated with lower perceived helpfulness (OR = 0.55; 95% CI: 0.37-0.81). In contrast, parental anxiety was independently associated with increased help-seeking (OR = 1.24; 95% CI: 1.01-1.53), but not with perceived helpfulness. Urban residence and displacement were positively associated with service use, whereas rural residence and lack of migration experience were associated with lower access. While parental education and general social support were not significant predictors of help-seeking, higher levels of social support were associated with greater perceived helpfulness, highlighting the role of interpersonal and community resources. Parent-reported perceived helpfulness appears to be shaped not only by children's mental health needs but also by parental well-being and broader social context. Based on these findings, a multisectoral model was developed to improve identification, referral, and support pathways for children in crisis.

Substantial gaps persist between perceived need and access to psychosocial support for Ukrainian schoolchildren during wartime, particularly in rural settings. Strengthening community-based psychosocial services, improving outreach, and supporting families with limited resources may help reduce inequalities in access to and perceived benefits of MHPSS during prolonged conflict.