Introduction
The Russian-Ukrainian conflict, which began in February 2022, has triggered a catastrophic
and rapidly growing humanitarian emergency and displacement, threatening the stability
of geopolitical relations. At the time of writing, the number of border crossings
from Ukraine recorded since the beginning of the war stands at 19,729,989 and the
number of Ukrainian refugees registered in Europe stands at 8,157,230, most of whom
are women and children because men have been drafted into the armed forces since the
conflict began (1, 2). Regarding the experience of forced migration, the literature
highlights several traumatic factors that can compromise the mental health of these
people (3, 4). Traumatic factors can be classified in relation to the period of forced
migration. Before migration, people may experience violence, loss of family or community
members, and disruption of family and community life; difficult and strenuous conditions
may occur during the journey to move and, finally, reached host countries people can
experience social isolation, joblessness and unemployment, language difficulties,
different forms of persecution and acculturative stress (5, 6). These experiences
are associated with psychological distress and an increased risk of psychiatric disorders;
women are also more likely to develop internalizing symptoms (7). In addition, these
people are at high risk of developing anxiety and depressive disorders, post-traumatic
stress disorder (PTSD), and suicidal ideation/behavior (8–11). To reduce the risk
of psychopathology and mental suffering and to improve recovery it is therefore necessary
to promote different protective factors, not only at the individual level, but also
at the community level (12, 13). It is therefore important to carry out community
actions outside of psychiatric service delivery settings to facilitate prevention
(14).
Protective factors of community
To address these traumatic factors, from an ecological and multilevel perspective,
the community, with its resources, can become a protective factor (15). Among other
definitions, in the psychological context, community has been defined as a group of
people who share the same values and interests and have similar experiences and needs
(16). Concerning community protective factors in forced migration, it is possible
to refer to both the migrant community and the host community. On one hand, different
aspects of the migrant community can be relevant to cope with the difficulties of
forced migration. In fact, faith in the cause of the community, a sense of pride in
belonging to one's own ethnic community and the maintenance of one's own community
values are protective aspects that facilitate the process of forced migration (6,
17). On the other hand, the host community with its attitude of acculturation can
foster the process of hospitality of forced migrants by promoting multiculturalism
and not considering migrants as competitors for material and intangible resources
(18). In relation to these aspects the protective factor of resilience, understood
as the ability to deal with traumatic events by finding the available resources, can
also be analyzed at the community level and not only at individual level (19).
Community resilience and related factors
Community resilience understood as the ability to recover from traumatic environmental,
economic, or social events and to prepare for future adverse events is conceptualized
as a set of adaptive capabilities that can be categorized into community competence,
information and communications, economic aspects, and social capital and can be used
as a conceptual framework to promote refugee integration and wellbeing and prevent
the onset of psychiatric disorders (20–23). In order to reduce the risk of psychopathology
of these people, it was deemed necessary to implement mental health and psychosocial
support programs (24). Therefore, interventions to promote community resilience for
refugees were seen as necessary by linking the community dimension with individual-focused
interventions and treatment to promote mental and physical health (25). In line with
this, implementing programs in the host country that can foster the different dimensions
of community resilience is a relevant aspect (19). In fact, the literature highlights
the interventions that promote community competence, such as the sense of agency and
empowerment, a sense of cooperation and common vision by creating moments dedicated
to the sharing of one's own history or culture through the organization of multicultural
meetings, day trips, or celebrating holidays typical of the ethnic culture of belonging
(26). Furthermore, the host community can facilitate community resilience by promoting
the social support offered by the different formal and informal community services
such as the church or voluntary associations and by encouraging the creation of social
networks to reduce the risk of isolation (27). In addition, providing adequate information
about the host culture and political rights of refugees, promoting the dissemination
of positive narratives about migrants, and encouraging access to economic resources
through the implementation of job training or economic benefits deriving from the
assistance of local non-profit organizations, are key aspects of promoting community
resilience (17, 28). Finally, to promote community resilience by enhancing the various
factors that characterize the community, the host context might take action to strengthen
social support networks, create collaborations and partnerships among community organizations,
enhance community resources, and promote the building of a community identity based
on cohesion and agency (16, 29–31).
Promoting community resilience in Ukrainian refugees
The Inter-Agency Standing Committee (IASC) Guidelines (32) emphasize the importance
of involving community members in coping with emergencies. Bhugra et al. (33) highlight
in their recommendations to policymakers the importance of involving migrants in various
actions such as cultural competence training. Finally, it is necessary to host Ukrainians,
with their specificity of being predominantly refugee women and children who have
often found refuge in countries neighboring Ukraine, where there is greater cultural
proximity and possibility of return to their homeland, helping them to become citizens
and to contribute their resources and talents to a cultural exchange with the host
context (34, 35). In line with this to promote community resilience among forced migrants,
one useful approach is community-based participatory research (CBPR) (36). CBPR is
a research orientation that involves an equal partnership between communities and
researchers, incorporating community theories, participation and practices into research
efforts. This model fosters community health promotion through a participatory approach
in terms of intervention design and implementation (37). This mechanism creates a
process of empowerment through the sharing of information, resources, support and
decision-making power (38).
The use of CBPR, with constant involvement of the migrant community and its representatives
helps in tailoring services to the specific ethnic and cultural context of the community,
avoiding the implementation of general actions that may not be well-suited for the
population involved. This targeted approach is identified as key in the promotion
of mental health and the prevention of mental disorders in humanitarian emergencies
(39).
Promoting community resilience among Ukrainian migrants through a Community-Based
Participatory Research (CBPR) method can be highly effective in addressing their unique
needs and fostering empowerment as evidenced with refugees of other nationalities
(40). Table 1 shows how CBPR can be applied, along with practical examples with Ukrainian
community inspired by the key actions of the guidelines on mental health and on the
emergencies and literature on Ukrainian refugees and CBPR approach (22, 32, 33, 41).
Table 1
Practical examples proposal of CBPR method's steps with the Ukrainian refugees.
Identifying community needs and resources
Collaborative planning and decision-making
Capacity building and skill development
Action and evaluation
- Engage Ukrainian migrants and community members as active participants in the research
process to identify their specific needs and resources. - Gather information on the
key issues affecting the community, such as language barriers, employment opportunities,
or cultural adaptation challenges. But also, data related to the characteristics of
refugees (gender, average age, level of schooling etc.) to design specific actions
for in relation to these aspects. - Involving experts in Ukrainian culture, such as
representatives of Ukrainian associations in a host context, promotes a targeted knowledge
of culture and the possibility of planning actions aimed at Ukrainian ethnic cultural
identity.
- Establish partnerships between Ukrainian migrants, community organizations, researchers,
and relevant stakeholders to jointly develop strategies and interventions. - Collaborate
with educational institutions, NGOs, and vocational training centers to provide access
to education and training opportunities for Ukrainian refugee's children. - Hold community
meetings to ensure that the voices of Ukrainian migrants are heard and that their
priorities are reflected in the planning process.
- Provide training and capacity-building opportunities for Ukrainian migrants to enhance
their skills and knowledge about host countries and resources. - Offer workshops on
topics such as community competency, advocacy, or community organizing to empower
Ukrainian migrants to actively participate in decision-making processes and engage
with local institutions. - Create opportunities for cultural exchange between the
host community and Ukrainian refugees.
- Implement the planned interventions, monitoring their progress and evaluating their
effectiveness in collaboration with the Ukrainian refugee's community. - Continuously
engage community members in the evaluation process, gathering feedback.
Example: Collaborate with a refugee hosting association to conduct focus groups of
Ukrainian refugees, collecting data on their experiences in the host context and identifying
areas where community resilience-building efforts are most needed relation to their
ethnic cultural identity.
Example: Organize a community planning workshop where Ukrainian migrants, stakeholders,
and researchers come together to co-design programs that address the identified needs,
such as language classes, job placement initiatives, social support, and mental health
services. Promoting moments of cultural exchange and promotion of their ethnic culture
within the educational institutions where children may have been placed.
Example: Facilitate a series of workshops on community organizing and advocacy, equipping
Ukrainian migrants with the skills and knowledge needed to effectively advocate for
their rights and access resources within the host society. Furthermore, facilitating
cultural exchange between the host community and Ukrainian refugees through the promotion
of events highlighting Ukrainian culture related to, e.g., traditions, food or religion.
Example: Gathering feedback from refugees involved in the interventions on their experiences
and the benefits gained.
Discussion
In this opinion article, we presented the community resilience approach to promoting
refugees' integration and wellbeing and preventing the onset of psychiatric disorders,
which could also be applied to Ukrainian migrants. In our opinion hosting refugees
is a challenge also for the host community, which is called upon to deploy tangible
and intangible resources that can promote community resilience and reduce risk factors
for the development of mental health problems and psychiatric disorders among refugees,
with a consequent reduction of health care costs. At the same time, a resilient refugee
community can increase the resources of the host country. Indeed, in line with this
framework, it can be argued that the design and implementation of community-centered
interventions, with a focus on community resilience, are key aspects to protect the
traumatic factors to which these people are exposed.
Given the difficult situation of Ukrainian immigrants, host countries might take steps
to promote projects and actions that can foster the welfare of the individual at the
community level, in addition to the individual. Such projects should strength the
resilience of the refugee community who are facing the trauma of war and forced migration
and who may later face a possible return to their country with its attendant difficulties.
In order to do that, it is necessary to implement projects in which the community
is involved, in which it's possible to promote agency and empowerment, and in which
the different resilience factors of the community can be fostered, in a collaborative
approach between political institutions and various community actors, e.g., through
the CBPR methodology that involves community members in the whole process and promotes
the implementation of actions related to the ethnic, cultural and sociodemographic
specificity of Ukrainian refugees. Indeed, CBPR methodology can empowers Ukrainian
migrant communities to actively participate in research and intervention processes,
fostering community resilience. By leveraging their strengths and collaborating closely
with community members, researchers can create impactful initiatives tailored to the
specific needs of Ukrainian migrants.
In conclusion, further works are needed to clarify effective ways to implement projects
by host countries to empower the community resilience of Ukrainian refugees.
Author contributions
LM and DP developed the idea presented. PC and MO developed the theory and drafted
the manuscript. All authors critically reviewed the manuscript and gave their final
approval.