Clinical and functioning outcomes during the establishment phase of Ukraine's community mental health teams: a descriptive analysis

Background: they are provided and (ii) identify whether any clinical and/or functional improvements were detectable among service users after six CMHT visits (intake + five follow-up visits) and, if so, identify principal predictors of such improvements. Methods: 947 CMHT service users enrolled between April-December 2021 were assessed on clinical outcomes using the Clinical Global Improvement scale (CGI) and functional outcomes using WHO's Disability Assessment Schedule (WHODAS 2·0). Chi-square and Wilcoxon signed-rank tests were used to assess changes in CGI and WHODAS scores, respectively, at the fifth (or fourth) follow-up CMHT visit. Hierarchical multinomial logistic regression and hierarchical multiple linear regression identified predictors of clinical and functional improvement, respectively. Findings: < 0·001) and most service users' illness severity stabilised (n = 451/742, 60·8%) or improved (n = 243/742, 32·6%). Clinical stabilisation (compared to worsening) was predicted by being male and living <20 km from the CMHT office, while improvement was predicted by frequent receipt of pharmacological support and receiving CMHT care in non-conflict-exposed regions. Functional improvement was predicted by living between 20 and 100 km from the CMHT office, having a somatic comorbidity, more frequent receipt of psychosocial services for the service user's family, and more support for community integration. Interpretation: We found positive results associated with enrolment in Ukraine's CMHTs. Recommendations for future research and improvements to the CMHT programming are provided.