mental health care

At first lady’s invitation, Israeli trauma expert presents at Kyiv summit

Danny Brom, founder of Jerusalem’s Metiv: The Israel Psychotrauma Center, stressed the need to take seriously psychological damages of war while not pathologizing normal reactions to stress

A leading Israeli psychotrauma expert presented at the third Summit of First Ladies and Gentlemen in Kyiv, Ukraine, having been invited to the annual event by its organizer, the first lady of Ukraine, Olena Zelenska.

This year’s event was held last Wednesday at St. Sophia of Kyiv National Reserve with the theme “Mental Health: Fragility and Resilience of the Future.”

In his presentation, Danny Brom, the founding director of Metiv: The Israel Psychotrauma Center, a nonprofit based out of Jerusalem’s Herzog Hospital, warned against pathologizing normal reactions to stressful situations, which he referred to as going “into survival mode.” At the same time, he stressed the severity of the psychological damage caused by war, taking issue with a comment made by U.S. Secretary of State Tony Blinken earlier in the evening, who said that some Ukrianians are suffering “in ways we cannot fully see.”

Brom disagreed with referring to the psychological effects of war as “invisible wounds.”

“They are totally visible and it’s our individual responsibility to see [that],” he said.

The seeds of Brom’s involvement in the summit were planted last summer during Metiv’s annual two-week international course on trauma and resilience, held at the Rothberg International School of the Hebrew University of Jerusalem. Over 20 mental health professionals from Ukraine were invited to attend, and Brom connected with Svitlana Katsuenko, a Ukrainian clinical psychologist, and together they created a program to make Ukrainian school staff more trauma informed. Expected to launch in a couple months, their program is planned to be implemented in 2,000 schools within two to three years.

The focus on trauma at this year’s summit was important, Brom told eJewishPhilanthropy. “It’s genius to get the spouses of heads of state there because it’s an interesting way to get to the heads of state… It’s critical that there is a recognition that this is a long-term issue. Once the war is over, people can start to recover. And then we’ll see what the damage is about. It’s very critical that the heads of state realize that this is not something that’s going away easily. We know that from the Holocaust. We know that from the Israeli War [of Independence]. You will always find between 5 and 10% of children who will really get stuck in their development.”

The summit, which was streamed on YouTube, was attended, either in person or virtually, by nearly 30 first ladies and gentlemen, representing countries including Turkey, Kenya, the United Kingdom, Spain, Pakistan and more. (Israeli First Lady Michal Herzog did not attend in person but sent a video message.) Blinken and Ukrainian President Volodymyr Zelensky both gave brief speeches. The event was hosted by Hanna Homonai, Ukrainian TV news anchor, and Stephen Fry, the British actor, television presenter, writer, journalist and screenwriter. Also in attendance were actor and film director Sean Penn (in person) and Richard Gere (virtually), both of whom have raised awareness and money for Ukraine.

Brom spoke on a panel titled, “Impact of the War on Mental Health,” which featured Zelenska herself, along with other first spouses from Lithuania, Czech Republic and Slovenia. The panel looked at how war affects civilians and those fighting, recognizing the long-term effects on future generations.

Ukraine has a lot it can learn from the experiences of Israelis and the programs that have helped them with their own trauma, said Katsuenko. “It’s not just [advice] from another country, but a country which has experience living with a pretty aggressive neighbor, and [they are] doing something to help their people in the environment which is not predictable because any attacks can happen any minute. Of course, the war in Israel and the war in Ukraine is totally different. But we can find some connections, dots, and learn from each other. Danny basically represented a country who has certain success stories to share on how to deal with war trauma, and not just with kids, but generally in the whole population.”

Brom was specifically chosen to speak at the conference because of his “understanding of the dynamics of a society constantly faced with an existential threat, and most importantly, ways of strengthening mental resilience at all levels,” Oksana Zbitneva, head of the Coordination Center for Mental Health under the Cabinet of Ministers of Ukraine, who helped plan the event, told eJP via WhatsApp.

Zbitneva hopes that the summit brought leaders together so they can implement joint action based on what they learned. “The U.S.A., Belgium, Sweden, Poland, Israel, Canada, Australia, Germany, Norway, Denmark, the Baltic countries, Great Britain — many friends of Ukraine, in addition to opening their homes to our citizens who sought refuge, also help with expertise in the topic of mental health. This is very important when you are breaking new ground — and this is exactly what our country is doing, building a system to support the mental health of Ukrainians.”

The summit was fully funded by partner organizations including USAID, the World Health Organization, United Nations Ukraine, UNICEF, The International Organization for Migration, as well as sponsors including Mastercard, the Kyiv School of Economics Charitable Foundation, UPG gas station network, and the Vitagro agricultural group.

“Of course, Ukraine was on top of the agenda. It’s a big elephant [in the room]. We can’t ignore it,” Katsuenko said, explaining that though it was held in Ukraine and the war was emphasized, it wasn’t their only concern — improving mental health across the world was. “Not surprisingly, the mental health is the issue for Ukraine right now since the full-scale invasion, but [the issue didn’t only begin with the war with Russia] because before that we had eight years of war in the eastern part of Ukraine, and it coincided with the COVID pandemic.”

In preparation for the summit, a survey was conducted by Alligator Digital, a U.K.-based research agency, which surveyed 11,000 people, ages 13 and above, from 11 countries including Argentina, Brazil, the United Kingdom, Israel, Germany, Poland, the United States, Turkey, Ukraine, Croatia and Japan. The survey found that 1 in 2 Ukrainians said that they feel worse emotionally than three years ago, yet only 1 in 50 were found to have a mental health diagnosis (compared to 1 in 10 people in Israel, and 1 in 4 in America).

During times of war, people often exhibit symptoms that may resemble post-traumatic stress disorder, but these behaviors are actually adaptive to keep themselves safe, said Brom. 

Brom said that if the audience all jumped up the moment they heard a siren, which they have been trained to associate with an incoming rocket attack, that would not be a post-traumatic stress symptom, but an “adaptive way of coping with stress.”

“That’s certainly not a mental health problem, it is mental health,” he said.

In countries experiencing war, it’s important to strengthen the infrastructure already in place, creating what he calls a “psychosocial defense policy,” so they are prepared, with mental health services in place for those who need them when the fighting ends.

“The people that stay with high symptoms over time when the situation has improved, then you can start thinking about mental health services,” he said. Meanwhile, “all services and also doctors need to become trauma informed” so they can recognize and care for those who need help.

This care means providing them with the skills to self-regulate.

“Once there was an idea that if you go through more trauma, you become stronger or more resilient,” Brom said. “That is simply not true. The more trauma you go through the more vulnerable you get to the next trauma. We know that trauma affects the self-regulation in the brain and in the nervous system, so you [should] have programs on how to teach emotion regulation, how to regulate your body when you’re under stress. The better people can regulate themselves, the better they’ll get out of survival mode.”