Decade of war linked to widespread PTSD and suicidal behavior in Ukrainian children
For more than a decade, Ukrainian children have grown up with war as a constant backdrop. According to researchers, the psychological consequences are now becoming clear. A comprehensive scoping review of 37 studies finds that Ukrainian children and adolescents exposed to a decade of war face high levels of post-traumatic stress disorder (PTSD), internalising and externalising symptoms, suicidality, and self-harm.
An international research team led by the Research Centre for Child Psychiatry at the University of Turku, Finland, reviewed the available evidence on the mental health of Ukrainian children and adolescents. Their scoping review combined findings from 37 studies published between 2020 and 2024, covering research conducted from the early years of the conflict through the ongoing full-scale invasion.
Across studies, children and young people aged 0–19 were found to experience a broad range of mental health problems, including post-traumatic stress disorder (PTSD), depression, anxiety, conduct problems, suicidality, and self-harm. Although prevalence rates varied, the overall conclusion was consistent: prolonged exposure to war is taking a serious psychological toll on Ukraine’s youth.
“Most studies were cross-sectional and focused on children living in Ukraine, with fewer examining refugees or clinical populations. Differences in study design, assessment tools, and timing made direct comparisons difficult, but many relied on young people’s own reports, offering rare insight into their lived experiences”, says the study’s lead author, Postdoctoral Researcher Sanju Silwal from the University of Turku.
Silwal notes that several patterns emerged repeatedly.
“Girls were more likely than boys to report suicidal thoughts, suicide attempts, and self-harm, while boys showed higher levels of conduct disorders. Children living in regions most affected by fighting faced higher risks of moderate to severe mental health symptoms, including suicidality and self-harm. These risks were evident both during the early phase of the war and after the full-scale invasion, pointing to the cumulative impact of ongoing exposure.”
Displacement and family relationships shape children’s outcomes
Beyond general exposure to conflict, certain experiences sharply increased the risk of mental health problems. Children who had been forcibly displaced, exposed to violence, separated from parents, or who had lost loved ones were particularly vulnerable. Between one-quarter and one-half of young people reported direct or indirect exposure to war-related events. Around one-fifth had experienced displacement, either within Ukraine or abroad.
“Where children ended up mattered”, notes Silwal. “Forced relocation to another country was linked to higher risks of mental health problems, while internal displacement was associated with greater resilience, possibly because children remained within familiar cultural and social environments”.
Family dynamics also played a decisive role.
“Negative parenting practices or low parental involvement were linked to conduct problems and bullying, while supportive family environments appeared to offer some protection. Yet many children reported separation from parents or family members, disrupting vital sources of emotional security during a period of intense stress”, says Professor Andre Sourander from the University of Turku.
“We conducted a time-trend study during the early phase of war and the full-scale invasion of Ukraine, which revealed that adolescents exposed to both phases of war experience higher levels of psychological distress. More than 10 percent attempted suicide compared to 4 percent of non-exposed peers. This starkly illustrates the devastating, cumulative impact of prolonged war on young minds”, continues Sourander.
Many of the studies in the review were rated low to medium in quality, underscoring how difficult it is to conduct rigorous, long-term research in active war settings. Still, the inclusion of studies published in both English and Ukrainian provided important cultural and contextual insight.
“At a time when children worldwide are increasingly affected by armed conflict, understanding these experiences is urgently needed,” stresses Sourander.
Taken together, the findings portray a generation growing up under extraordinary strain and highlight an urgent need for sustained mental health support and stronger evidence to guide future interventions.
Journal
BMJ Global Health
Article Title
Mental health of Ukrainian children and youth during the Russian-Ukrainian war: a scoping review
Article Publication Date
19-Mar-2026
Kids who lose a parent to homicide, suicide or drug overdose are more likely to die as children
University of Michigan
Childhood deaths are significantly higher among children who lose a parent to drug overdose, homicide or suicide compared to the general child population, a new University of Michigan study found.
The research, published in JAMA Network Open, investigated the link between specific types of parental loss and the subsequent risk of mortality for children in Michigan, said study lead author Sean Esteban McCabe, professor at the U-M School of Nursing.
The study found that bereaved children who experienced a parental death from one of the three preventable causes accounted for 150 excess childhood deaths in the state over the 14-year study period.
"There are early preventive interventions and childhood bereavement services that have been shown to improve children's health following the death of a parent that need to be made more widely available so no Michigan child grieves alone," McCabe said. "Protecting vulnerable children with proven ways of helping must be a priority for all of us to save more lives because there is no greater failure as a community or state than failing to protect our children."
U.S. parental mortality has reached historic highs in recent years, increasingly associated with these three leading preventable causes of death. Previous research has shown that Michigan has higher parental mortality rates than the national average, said McCabe, who's also the director of the U-M Center for the Study of Drugs, Alcohol, Smoking and Health.
The U-M team wanted a more complete picture of how these kinds of parental deaths impacted childhood mortality, to help evaluate the need for preventive interventions for bereaved children. It's believed to be the first study of its kind.
Key findings:
Children bereaved by parental drug overdose face a mortality rate by age 17 or younger that was 700% higher than the average Michigan child. The mortality rates were even higher for children bereaved by parental suicide (1,200% higher) or homicide (2,000% higher).
The study found that the loss of a biological parent reduces a child's "level of protection against harm," increasing risk of early death. The metrics from the study can be used to evaluate bereavement services.
Children bereaved by a homicide death had the highest rate of childhood mortality (about 106 deaths per 10,000), followed by suicide (more than 66 per 10,000) and drug overdose (nearly 37 per 10,000). That's compared to the roughly 5 deaths per 10,000 for children in Michigan overall.
Researchers partnered with the Michigan Department of Health and Human Services to link birth and death records from parents and children from 1992-2023, to identify 32,262 children aged 17 or younger who had lost a biological parent to homicide, suicide or overdose. By comparing this group's mortality rate to the state average of 5.22 deaths per 10,000 children, the study calculated excess deaths attributed to those causes, to measure how these specific parental losses increased a child's own risk of mortality.
McCabe said that while the study provided critical insights, it's limited by a focus solely on biological parents and an underreporting of paternal deaths, which means the actual impact is likely much higher.
Next steps for statewide prevention strategies include creating a statewide bereavement collaborative and evaluating bereavement services, McCabe said.
"There is an urgent need to develop performance metrics and eliminate bereavement service deserts, mental health deserts, and addiction medicine and psychiatry treatment shortages in our state," he said. "A child's zip code should not dictate whether they receive evidence-based bereavement services and treatment."
McCabe has a deep personal and a professional interest in this research.
"I have had several close friends and loved ones die due to overdose, suicide and homicide leaving behind many children," he said. "I work as a volunteer children's bereavement group facilitator at a nonprofit in Southeast Michigan and I've worked with many children who've experienced parental death from overdose, suicide and homicide.
"Bereaved children often experience friends at school who have no clue what to say when they talk about their parent who died from a drug overdose, homicide or suicide."
McCabe said friends often change the subject, so grieving children don't want to discuss their deceased parent, and this isolation and lack of understanding speaks to the need for more awareness, education and support.
McCabe also co-leads the Michigan-based research collaborative HopeHQ, which offers technical assistance to help children bereaved by their parent or significant person's overdose death.
Co-authors include: Luisa Kcomt, Wayne State University; Rececca Evans-Polce, U-M School of Nursing; Glenn Radford, Michigan Department of Health and Human Services; Samuel Tennant, U-M School of Public Health; Eric Hulsey, Institute for Research, Education and Training in Addictions; and Vita McCabe, Michigan Medicine.
Study: Childhood mortality by parental cause of death (free full text of research letter available when embargo lifts)
Journal
JAMA Network Open
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