Executive Summary
The ongoing Russian invasion of Ukraine has resulted in massive physical devastation and deep psychological trauma among civilians. Forced displacement, torture, and deliberate targeting of noncombatants have led to a sharp increase in interpersonal and community violence within Ukrainian society. Research highlights that the war has severely destabilized social and familial structures, fueling this rise in violence. Public health frameworks and recent empirical evidence can help outline data-driven strategies for preventing and reducing violence among civilians in Ukraine. Drawing on global best practices and local empirical evidence, this policy report recommends five integrated strategies that address both the immediate and long-term consequences of violence, help mitigate risks associated with PTSD and moral injury, and strengthen societal resilience. Effective implementation requires coordination across multiple sectors and levels, including individual, family, community, and national systems, as well as investment in mobile and community-based services. By adopting a public health approach, Ukraine can proactively prevent violence, protect civilians, and establish the foundation for long-term recovery, social cohesion, and stability.
Introduction
The ongoing Russian invasion of Ukraine has caused extensive physical destruction and profound psychological harm to civilians. Forced displacement, torture, and deliberate targeting of noncombatants have led to a sharp increase in interpersonal and community violence within Ukrainian society.
The Ukrainian government ratified the Council of Europe Convention on Preventing and Combating Violence against Women and Domestic Violence in June 2022 to strengthen national laws and enforcement, but violence continues to escalate. In 2023, over 291,000 domestic violence cases were reported, a 20% rise from 2022, while registered criminal offenses increased by 80%. Apart from domestic violence, community-level violence, including attacks on Territorial Recruitment and Social Support Centers responsible for conscription, mobilization, and military record-keeping, and armed aggression by poorly reintegrated veterans, is increasingly observed, though not always fully reflected in official reports.
Research highlights that the war has severely destabilized social and familial structures, fueling this rise in violence. Public health frameworks and recent empirical evidence can help outline data-driven strategies for preventing and reducing violence among civilians in Ukraine. Within this framework, psychological mechanisms play a critical role: Post-traumatic stress disorder (PTSD) and moral injury are key drivers. PTSD manifests as intrusive memories, hyperarousal, emotional numbing, and impaired regulation of fear and anger, often resulting in irritability and aggression, especially in high-stress environments. Moral injury arises from actions or experiences that violate deeply held moral beliefs, causing feelings of guilt, shame, anger, and a sense of betrayal, which can be externalized through violence.
The authors’ large-scale study of 1,249 Ukrainian civilians during the first year of active conflict found that 76% met PTSD symptoms diagnostic criteria based on PCL-5, while 66% exhibited significant moral injury symptoms. Risk factors for PTSD include female gender, displacement, residence in occupied territories, older age, and lower education levels, whereas younger age strongly correlates with moral injury.
Policy Recommendations
- Given the association of PTSD and moral injury as key risk factors for violent behavior within the public health framework, systematic data collection is vital for anticipating increases in interpersonal aggression and for the efficient allocation of mental health and psychosocial resources. This underscores the importance of employing validated and culturally sensitive diagnostic assessment tools, as well as considering contextual factors when interpreting prevalence rates of PTSD and moral injury.
- To ensure effective emergency and psychosocial support amid widespread damage to Ukraine’s health care system, front-line and emergency services must prioritize timely treatment and brief interventions. Mobile medical units, telemedicine platforms, and community health workers should be deployed to reach displaced and underserved populations, including females, people in occupied territories, and individuals with lower education level. A stepped-care approach, ranging from self-help and group therapy to specialized psychological treatment, should guide service delivery. These measures, supported by the World Health Organization’s 2023 evidence on mobile health interventions, will help maintain continuity of critical care and psychosocial support despite severe infrastructural challenges.
- Community-based prevention programs should be implemented, including parenting support, youth mentoring, and trauma-informed psychosocial care, to protect children and adolescents from war-related violence. Mobile brigades and safe spaces should be expanded, coordination should be strengthened among government, NGOs, and local communities, and evidence-based, culturally sensitive interventions should be integrated to address domestic and gender-based violence effectively. Continuous training and collaboration with health care providers, law enforcement, and community leaders will enhance program reach and sustainability.
- Modifiable risk factors including alcohol misuse, untreated mental health conditions, and limited access to services should be targeted through brief counseling, mobile mental health teams, and harm-reduction initiatives. Interventions must be co-designed with people with lived experience, researchers, and clinicians to guarantee cultural relevance, feasibility, and effectiveness, particularly in conflict-affected and displaced communities.
- An ecological, multi-level approach should be promoted to address violence prevention at individual, family, community, institutional, national, and international levels and create safe environments, including shelters, child-friendly spaces, and accessible psychosocial services.
Acknowledgements
The policy report is based on the results of The Language of Trauma in Testimonies of the Russia-Ukraine War project (NFRFE-2022-00802)
The views expressed in this article are those of the author and not an official policy or position of New Lines Institute.