The mental health and wellbeing of Ukrainian adolescent girls and young women living in the United Kingdom since the onset of the Russia-Ukraine war

The Russia-Ukraine war has displaced 6.2 million Ukrainians across Europe, with 247,000 seeking refuge in the United Kingdom (UK). Among them, adolescent girls and young women (AGYW, 15-to-24-years-old) face particular challenges to their mental health. War and displacement have occurred during crucial developmental stages. Missed education due to the Covid-19 pandemic, and ongoing displacement, have resulted in isolation from peers. In 2021, Ukrainian AGYW were among the most sexually exploited individuals in Europe, the scale of which has worsened significantly in war. In the UK, cost-of-living pressures and housing shortages put many at risk of homelessness. Visa uncertainty and language barriers affect ability to secure housing, jobs and higher education.

According to the Inter-Agency Standing Committee, all those affected by conflict should have access to mental health and psychosocial support which helps to develop healthy coping strategies and improve wellbeing. However, refugee populations face many barriers to accessing appropriate services in many high-income countries (HICs). In the UK, service providers identify communication difficulties, mistrust, stigma, lack of political will and the hostile environment as key challenges.

For Ukrainian AGYW in the UK, healthcare professionals are encouraged to refer to NHS Talking Therapies or Child and Adolescent Mental Health Services, but eligibility is unclear, waitlists are long, and providers lack cultural training. Non-governmental organisations and charities provide informal services however their resources are significantly overstretched, and service providers operate largely in silos. Barriers to access of appropriate services exist alongside widespread mental health stigma in the Ukrainian population.

This study will use a convergent parallel mixed methods study to examine the prevalence of symptoms of mental ill-health among Ukrainian AGYW in the UK, as well as their coping strategies and help-seeking behaviour. I will 1) undertake a cross-sectional survey to examine the prevalence of traumatic stress, depression and anxiety, main coping strategies and help-seeking behaviours of Ukrainian AGYW living in the UK, and 2) use creative photovoice methods to explore coping strategies and help-seeking behaviour in more detail within a community of Ukrainian AGYW. Quantitative and qualitative findings will be analysed separately and then integrated using a triangulation protocol. I will also 3) conduct a systematic review of coping strategies and help-seeking behaviour among displaced AGYW living in HICs, to situate findings from Objectives 1 and 2 within the broader literature.

Use of multiple and innovative research methods aims to encourage discussions about Ukrainian AGYW's coping strategies and help seeking behaviour, providing insights into both formal and informal support mechanisms amidst mental health stigma in the population. Methods will involve co-production with Ukrainian AGYW to empower the voices of young, female refugees, who are seldom heard. Additionally, the project will collaborate with a small group of Ukrainian AGYW living in the UK as youth advisors and peer researchers, to ensure cultural relevance and sensitivity of the study design, methods, analysis, interpretation and dissemination.

Findings will inform the development of targeted, culturally appropriate interventions for young female Ukrainian refugees, and other displaced AGYW, in the UK. This research fits with the ESRC's remit of widening cross-disciplinary research to understand the mental health needs of underserved populations, develop effective interventions and collaborate with people with lived experience of mental illness. I will develop skills in participatory and creative research methods, co-production and mixed methods analysis.