Ladyk-Bryzghalova, Alisa, Zemp, Charles, Rivest-Beauregard, Marjolaine, Kostiuchenkov, Oleksii, Schafer, Alison, Adams, Ben, Chisholm, Dan, Hyland, Philip, Súird, Mel Ó, Drakos, Katerina, Mykychak, Iryna, Habicht, Jarno and Vallières, Frédérique (2025) Clinical and functioning outcomes during the establishment phase of Ukraine's community mental health teams: a descriptive analysis. The Lancet Regional Health - Europe, 58. p. 101446. ISSN 2666-7762
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Abstract
Background Ukraine’s nationwide Community Mental Health Teams (CMHTs) programme is key to Ukraine’s
ongoing mental healthcare reform. No studies to date, however, have reported on the impact of Ukrainian CMHTs
on service user clinical recovery. This study has two aims: (i) describe who the Ukrainian CMHTs are enrolling,
which services they most provide, and where 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 Most service users were male, unemployed, and diagnosed with schizophrenia spectrum disorders. Among
service users with available outcome data at both CMHT intake and the fifth (or fourth) follow-up visit, a significant
decrease in disability scores was observed (Median intake = 62⋅50, Median follow-up = 58⋅33, z = −6⋅27, p < 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.
| Item Type: | Article |
|---|---|
| Keywords: | Ukraine; Community mental health teams; Mental healthcare reform; Severe mental illness; Clinical recovery; |
| Academic Unit: | Faculty of Science and Engineering > Psychology |
| Item ID: | 21378 |
| Identification Number: | 10.1016/j.lanepe.2025.101446 |
| Depositing User: | Philip Hyland |
| Date Deposited: | 31 Mar 2026 14:07 |
| Journal or Publication Title: | The Lancet Regional Health - Europe |
| Publisher: | Elsevier |
| Refereed: | Yes |
| Funders: | Funded as part of the World Health Organization’s Special Initiative for Mental Health. |
| Related URLs: | |
| Use Licence: | This item is available under a Creative Commons Attribution Non Commercial Share Alike Licence (CC BY-NC-SA). Details of this licence are available here |
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