Depression, anxiety, suicidal ideation and social determinants of mental health of Romani in Ukraine
| Date | 24 July 2023 |
| Pages | 678-698 |
| DOI | https://doi.org/10.1108/MHSI-06-2023-0070 |
| Published date | 24 July 2023 |
| Subject Matter | Health & social care,Mental health,Social inclusion |
| Author | Viktoriia Gorbunova,Vitalii Klymchuk,Olha Savychenko,Valeriia Palii,Zemfira Kondur,Viola Popenko,John Oates |
Depression, anxiety, suicidal ideation and
social determinants of mental health of
Romani in Ukraine
Viktoriia Gorbunova, Vitalii Klymchuk, Olha Savychenko, Valeriia Palii, Zemfira Kondur,
Viola Popenko and John Oates
Abstract
Purpose –This paper aims to explore the prevalence of depression, anxiety symptoms and suicidal
ideation among the Romani population in Ukraine and their connections with various social health
determinants:age, gender, household characteristics,employment and livingconditions.
Design/methodology/approach –For measuring mental health conditions, GAD-7 and PHQ-9 were
used. Individual interviews were conducted by trained volunteers of the International Charitable
Organization‘‘Roma Women’s Foundation Chirikli’’.Data were gathered from January to March 2020.
Findings –The overall level of depression found in the sample was 8.08, while the mean for anxiety was 7.22.
In general, 32.7% of respondents scored positively for signs of depression and 29.6% for anxiety. The two-
week prevalence of suicidal ideations was 26.9%. Comp ared to the general population, the prevalence of
depression among the Romani research participants was twofold higher , and anxiety was 2.5-fold higher.
Signs of depression and anxiety in women were signi ficantly higher (36% vs 28.6% for depression and 33.9%
vs 24.2% for anxiety) than in men. Signs of depression and anxiety were high er for people without education
than for university students (9.32 vs 3.04 for depression and 8.26 vs 3. 00 for anxiety). The lowest levels of
depression, anxiety and suicidal ideation were among off icially married persons (6.61, 6.36 and 0.23,
respectively). Significant smallpositive correlations were found between all measurements and the number of
household members (0.149 for depression, 0.124 for sui cidal ideation and 0.175 for anxiety; p<0.001) and
the number of children (0.303 for depression, 0.224for suicidal ideation and 0.243 for anxiety; p<0.001). In
terms of employment, the highest scores for depression, anxie ty and suicidal ideation were found among
those who are employed seasonally (9.06, 8.25 and 0.61) or irregularly (9.09, 8.12 and 0.57) in contrast with
self-employed (4.88, 4.90 and 0.19) and full-time employees (5.86, 5.51 and 0.18). Living place (city, village or
camp) showed no relation with mental health, except for sui cidal ideation: those living in villages had higher
levels of suicidalideation than those living in cities (0.49 vs 0.31).
Research limitations/implications –The study has some limitations. Data were gathered from Jan uary to
March 2020, and since then, the situation in Ukraine has dra stically changed due to the full-scale Russian
invasion. While this study’s data and conclusions might serv e as a baseline for further research, they do not
represent the real-time situation. While many social factors were analysed, the effects found for them do
not necessarily represent causality, given the statistic al methods used. Interactions among factors were not
studied; therefore,no firm conclusions can be made about the effects of those interactions on mental health.
Originality/value –To the best of theauthors’ knowledge, this paperis original in terms of its topic, as the
first-ever in Ukraine quantitative study of mental health and social determinants of mental health of the
Romanipopulation.
Keywords Romani communities, Mental health, Social determinants of mental health, Depression,
Anxiety, Suicidal ideations
Paper type Research paper
Introduction
Collecting reliable quantitative data is necessary for further actions to improve the situation
in any country’s health and social care system. Unfortunately, we do not have any systemic
(Informationabout the
authorscan be found at the
end of this article.)
The article is based on the
results of the project “Ethnicity
and Mental Health: Exploring
Nonmedical Approaches to
Mental Health for Roma
Communities in Europe”,
fulfilled with the financial
support of the Foundation
Open Society Institute (FOSI),
Grant No. OR 2019-64315).
Project performers: Public
Association “National
Psychological Association” of
Ukraine, and International
Charitable Organization “Roma
Women’s Foundation Chirikli”.
The sponsor was not involved
in the study design, the
collection, analysis and
interpretation of data or the
preparation of the article.
Author contributions:Viktoriia
Gorbunova –research
management; writing
Introduction,Conclusion and
Discussion sections. Viktoriia
Gorbunova, VitaliiKlymchuk and
Olha Savychenko –creating
research design. Olha
Savychenko initialdata analysis,
Vitalii Klymchuk –overall project
management, in-depth data
analysis and writing the Result
and Discussion sections; Valeriia
Palii –drafting Discussion
section. ZemfiraKondur and
Viola Popenko –data collection
and research management,
article editing. John Oates –
methodologicalsupport and final
article editing.
Conflicts of interest: All authors
declare no conflict of interest.
PAGE 678 jMENTAL HEALTH AND SOCIAL INCLUSION jVOL. 28 NO. 5 2024, pp. 678-698, ©Emerald Publishing Limited, ISSN 2042-8308 DOI 10.1108/MHSI-06-2023-0070
procedures for mental health and well-being screening in Ukraine. The first and only study
with a large whole-country sample was conducted by the World Health Organization in
2002. The lifetime, 12-month and 1-month prevalenceof nine mental health and alcohol use
disorders were estimated within the World Mental Health research program (Bromet et al.,
2007).
The next wave of studies waslinked with the war events in the East of Ukraine, which started
in 2014. Their focus was primarily on military personnel directly exposed to combat
(Chaban and Bezsheiko, 2017), internally displaced people (Roberts et al.,2019;
Kuznetsova et al., 2019) and the population of Donetsk and Luhansk oblasts (KIIS, 2019).
However, no ethnic minority group had a specific analysis of their mental health and well-
being. Besides their suffering as refugees during the events, the Romani people did not
receive the necessary investigatory or medical attention. In addition, a lot of Romani from
Eastern Ukraine suffer from xenophobia, biased treatment and entrenched suspicion of
criminality and poverty (ADC Memorial, 2015). These problems are not unusual for Romani
communities from other parts of the country, with a long history of discrimination. These
issues continue today despite recent attempts to resolve the situation, mainly from Romani
NGOs (Bocheva, 2019).
Data collected in the European Region show that self-reported health and well-being are
extremely different between social groups with different incomes and life circumstances in
the same country (WHO, 2019). On the one hand, financial insecurity, the experience of
inequality and human rights violation, obstacles in obtaining proper education, etc.,
contribute to lower well-being and mental health (often as stress, anxiety and depression).
On the other hand, social inclusion and participation in society, as well as family support
and higher levels of trust, contribute to stronger individual and social resilience and higher
mental and social well-being.
Ukrainian Romani communities are subject to both groups of social factors, protective and
risk factors. Our previous research has explored these social determinants using a
qualitative approach. We have shown that positive social constructions of mental health,
family relationships and relations with the “outside” world are essential in empowering
community members towards better well-being (Gorbunova et al.,2021,2022). So, to
obtain a broader picture of the mental health of local Romani communities in Ukraine, we
carried out this study. The study aimed to explore the prevalence of depression and anxiety
symptoms and their links with various social health determinants: age, gender, household
characteristics and living environment.
Materials and methods
Methods and data collection
For measuring mental health conditions, GAD-7 and PHQ-9, validated in Ukraine for similar
research in different populations,were used (Roberts et al., 2019;Kuznetsova et al., 2019).
Data were collected from January to March 2020 through in dividual interviews conducted by
the International Charitable Organization “Roma Women’s Foundation Chirikli” volunteers, who
received detailed step-by-step instructionsand special training.
Data analysis
Data analysis was performed using IBM SPSS Statistics, version: 28.0.0.0 (190). Data
visualisation was performed withMS Excel and DataWrapper [1].
All the data were analysed by gender, age, region and place of residence, education,
employment, marital statusand the presence of children in the family.
VOL. 28 NO. 5 2024 jMENTAL HEALTH AND SOCIAL INCLUSION jPAGE 679
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