Addressing war trauma in Ukrainian refugees before it is too late

Russian invasion of Ukraine has led to one of the largest refugee crises in recent history. Many internally displaced Ukrainians and refugees will need care for PTSD, anxiety, and depression. Here I will suggest practical steps to reduce long-term impact of trauma and stress on refugees' mental and physical health, and functioning. These include mental health first aid in acute phase of arrival, education of mental health and navigating healthcare system in the host countries. As well, training of manualized trauma-focused therapy and intervention methods in the host countries, focused education for physicians on psychopharmacological interventions for common mental health issues among refugees (PTSD, depression, anxiety), and utilization of videoconferencing for treatment, and consultation and supervision for providers. Highlights: Many internally displaced Ukrainians and refugees will need care for PTSD, anxiety, and depression to prevent long-term disability and health consequences.There are challenges in receiving the needed care including stigma, lack of awareness by patients and providers, lack of resources, and lack of skills in trauma-focused treatments.In this article, suggestions are made on how to overcome these obstacles, that include mental health first aid upon arrival, education for refugees and those serving them, training providers at different layers, and remote treatment and counselling/supervision services.