Pictured above: CAMH's Dr. Yuliya Knyahnytska
By: Sean O'Malley, CAMH Senior Writer
CAMH psychiatrist Dr. Yuliya Knyahnytska's parents are two of the lucky ones. Two days before the first bombs dropped on Ukraine, they made a harrowing two-day journey by bus from their home in the small town of Chernivtsy to the safety of the Polish border.
There to greet them was Dr. Knyahnytska, who took an emergency leave from CAMH's Temerty Centre for Therapeutic Brain Stimulation and travelled through two countries to meet her parents among the large crowd of refugees escaping the war.
Her parents already had valid visas to come to Canada. They were about to come for an extended visit anyway to spend a few months with their daughter and grandchildren, the first since before the pandemic began.
But as the war was breaking out, they wanted to stay in Ukraine and help their fellow citizens.
“I said if you don't come, I'm going over there on a plane and I'm going to drag you home," said Dr. Knyahnytska. “And that's what I did."
While her parents are now safe and living with her in Toronto, they have struggled to access basic services since their arrival. Because they arrived with valid visas to Canada and not as refugees, they remain stuck in a bureaucratic limbo in regards to OHIP and have been unable to obtain any emergency healthcare coverage since their arrival.
Despite having a daughter who knows exactly how to navigate the Ontario healthcare system, Dr. Knyahnytska's parents have been rejected four times for temporary OHIP coverage.
Dr. Knyahnytska vividly recalls one elderly refugee she saw who had escaped some of the heaviest bombing in eastern Ukraine, and was pleading for help in broken English.
“She was crying, she was screaming. She was in so much distress," said Dr. Knyahnytska.
But this was not one of the refugees she saw in those chaotic scenes at the Polish border. This happened in a government services office in Toronto, where she, like Dr. Knyahnytska's parents, was told her documents were not in order.
“We need to remember that this is different from other refugee waves," said Dr. Knyahnytska. “They survive the war, then they come with different visas with different codes that don't get them access to OHIP. “ I'm a physician, I know the system. I speak fluent English. And I still can't get around the bureaucracy. I just wonder how other refugees are dealing with this."
Dr. Knyahnytska says many displaced Ukrainians in Canada try to ignore mental health trauma from the war by immediately immersing themselves in work.
“Many of them start working literally from the moment they get off the plane, working menial jobs as cleaners or anything they can find. They have a mindset that if they come to Canada, they need to do something useful right away and they work non-stop. There is no self-care. They conceptualize self-care as selfish."
Since bringing her parents safely to Canada, Dr. Knyahnytska has continued to work around the clock to assist Ukrainians displaced by the war, both in her formal duties at CAMH and through her extensive networks of Ukrainian expats in Canada and friends and colleagues still in Ukraine. Her garage is currently being used as an informal warehouse to store and distribute essential supplies to war refugees in Canada through a Ukrainian community Facebook group.
Dr. Knyahnytska also recently hosted a CAMH information session through ECHO, a virtual hub of CAMH mental health experts, to advise health care providers across Ontario on best practices for helping Ukrainians in Canada displaced by the war navigate the healthcare system. She warned them that because so many displaced Ukrainians are struggling to access basic services in a fragmented system, many are only seeking clinical help in the later stages of an illness or arriving at an emergency department out of desperation.
In addition to providing information on how to best help Ukrainian patients, Dr. Knyahnytska's ECHO session provided guidance and resources for self-care for frontline healthcare workers who are already struggling with burnout in the third year of the pandemic.
She has also seen the war having a negative impact on the mental health of her own patients, even those who have no direct connection to the suffering in Ukraine.
“There was already a high level of chronic stress when the war started and the emotional responses to the war and all of the graphic images create a physiological reaction that makes people feel irritable, snappy and just exhausted from everything," said Dr. Knyahnytska. “I always say I know how to deal with my own mental health, but even while we are talking about the war now I have goosebumps and I'm trying not to cry. I hear a lot of stories. It gets under your skin."
To help build coping skills and resiliency, the Ministry of Health and Ontario Health have partnered with five hospitals to provide mental health and addictions supports for frontline health care workers dealing with COVID-19 and any other stressors, including the war in Ukraine. Frontline health care workers can self-refer for this service here.
CAMH has also curated a list of public resources to help people cope with stress and anxiety related to the war in Ukraine. It is available here.
“Help is a community-based effort now," said Dr. Knyahnytska. “Random strangers coming together to help. I am invested, it's my nation. But I admire those who do it just because they are good human beings."