Volunteer US and UK fighters in Ukraine face hidden health crises – new study
Volunteer soldiers who have served in Ukraine experience high levels of mental and physical health difficulties yet rarely receive the healthcare they need.
Key points
- Study offers insight into the experiences of foreign volunteer fighters in Ukraine for the first time.
- US and UK veterans who have volunteered in Ukraine report extremely intense combat exposure and limited training or preparation.
- Many experience significant combat trauma-related distress, alcohol misuse and untreated physical injuries, yet struggle to access appropriate healthcare in Ukraine or on returning home.
- Existing military and civilian support systems appear to be ill-equipped to recognise and meet the needs of these veterans. This highlights the importance of coordinated care pathways and prioritised clinical support.
- The findings come as new conflicts – including the escalating US/Israel/Iran war – highlight the wider mental‑health impact of modern high‑intensity warfare.
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Former soldiers who have served as volunteer fighters in Ukraine experience high levels of mental and physical health difficulties yet are rarely able to access the healthcare they need, either during or after deployment, a new UK study finds.
The research, which was led by Dr Victoria Williamson from the Department of Psychology at the University of Bath, investigates the operational experiences and wellbeing of US and UK military veterans who have volunteered in Ukraine following the escalation of conflict in 2022.
The research, which is published today in the European Journal of Psychotraumatology, reveals extremely intense combat exposure, including drone warfare, trench fighting and frequent physical injury.
Many volunteer veterans report having received little formal training or preparation by the Ukrainian armed forces before being embedded into frontline units and describe medical care in Ukraine as poor or unavailable. On returning home, some continue to struggle with untreated physical injuries and poor mental health.
Psychological distress is common. High levels of probable post-traumatic stress disorder (PTSD), common mental disorders, alcohol misuse, low quality of life and moral injury-related distress are also identified by the study’s authors.
Moral injury is the intense psychological distress that occurs when a person witnesses or takes part in events that violate their core moral beliefs. People who are morally injured often report persistent feelings of shame, guilt, disgust or anger.
Help is not forthcoming
The study’s veterans describe repeatedly seeking mental health care in Ukraine and again after returning to the US or UK. Many report being turned away or placed on long waiting lists.
As a result, these volunteer soldiers mostly turn to fellow volunteers rather than professional services or the Ukrainian chain of command for emotional support, both during and after service in Ukraine.
Since the conflict in Ukraine escalated in 2022, military veterans have travelled in significant numbers to support the Ukrainian Armed Forces. Reports suggest nearly 20,000 foreign nationals applied to join Ukraine’s forces following the outbreak of the conflict following Russia’s unprovoked invasion. Many are motivated by political beliefs or personal conviction.
Among these volunteers are a substantial number of veterans from the UK and US, with an estimated 3,000 Americans applying to join the International Legion. These fighters fall outside established military care systems, meaning their needs may go unrecognised within traditional support structures.
The new study involved 31 participants, all of whom completed psychological assessments, with 21 also providing in depth interview accounts of their time in the conflict zone.
The study’s authors warn that without coordinated and targeted support, these veterans risk becoming an invisible group whose significant mental and physical health needs remain unmet. They call for urgent improvements to clinical pathways that reflect the unique pressures faced by those who travel abroad to fight voluntarily.
Dr Williamson, who is also president of the UK Psychological Trauma Society said: “This is the first study to examine the experiences and health of UK and US veterans who have volunteered to fight in Ukraine. Many have described extremely intense combat, including sustained frontline exposure and persistent drone-related threat, often with limited preparation or support. Their psychological distress should not be surprising.
“The nature of combat in Ukraine is fundamentally different from other recent conflicts such as Iraq and Afghanistan. In those wars, Western personnel operated within formal military systems, with clear rules of engagement, structured command chains, and established legal and welfare protections. They received preparation before deployment and support on return.
“In contrast, many foreign volunteers in Ukraine are effectively self-deployed into a far less predictable environment. Levels of training, leadership, equipment, and medical support can vary considerably.
“Our study showed significant gaps in understanding of the clinical and welfare support needed by people subjected to these conditions. Without coordinated and informed care pathways, there is a real risk this group will fall through the cracks and remain unsupported.”
The authors also stress that the psychological impact of conflict is not confined to volunteer fighters or formal militaries. In current conflicts, such as the US/Israel/Iran war – which has involved large scale missile and drone strikes on urban areas, schools, airports and other civilian infrastructure, along with mass displacement – significant psychological strain is being placed on both military personnel and civilians.
All these factors are recognised drivers of trauma-related mental health needs. The researchers argue that ensuring timely, accessible psychological support for all groups affected by modern conflict is an urgent global priority.
This study also involved King’s College London, Combat Stress and Compass Pathways.
ENDS.
Journal
European Journal of Psychotraumatology
Method of Research
Survey
Subject of Research
People
Article Title
Volunteering for Ukraine: Scoping the Operational Experiences and Impacts Among UK and US Veterans
Article Publication Date
23-Mar-2026
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