The prevalence of mental health disorders and stress coping strategies among forced migrants from Ukraine and Russia

Abstract

In research on the mental health of migrants and refugees, the framework of pre-migration and post-migration stressors is frequently applied. The present study sought to determine which of these stressors contribute to mental health disorders among forced migrants from Ukraine and Russia. In addition, the analyses aimed to compare the prevalence of mental health disorders between these two groups and to evaluate the effectiveness of coping strategies employed. The study also aimed to broaden the understanding of the predictors of mental health outcomes among different groups of forced migrants. A cross-sectional survey was conducted using the Computer-Assisted Web Interview (CAWI) technique. Participants were recruited through purposive sampling, with invitations disseminated via social media platforms (Telegram, Facebook) targeting Ukrainians residing in Russia. The sample comprised N = 200 Ukrainian and N = 164 Russian respondents. Data collection took place in the first quarter of 2025, which corresponds to the third year of Russia’s war against Ukraine. Depression, anxiety, and stress were assessed using the PHQ-9, GAD-7, and PSS-10 scales, respectively. Multivariate linear regression analyses were performed to identify predictors of mental health outcomes. Ukrainian migrants exhibited significantly higher rates of anxiety, depression, and stress (45%, 56%, 20.76 ± 5.9) compared with Russian migrants (37%, 39%, 18.79 ± 2.92). Notable differences in coping strategies were also observed: Ukrainian female migrants more frequently employed emotion-focused and resignation strategies, whereas Russian migrants tended to use problem-focused strategies. Among Ukrainians, significant predictors of poorer mental health included negative attitudes from the host population, relocation during the stay, higher educational attainment, and the use of emotion-focused or avoidance coping strategies. For Russian migrants, poorer mental health was associated with lower self-rated quality of life, underemployment, negative attitudes from the host population, and emotion-focused or avoidance coping strategies. In the context of prolonged residence in a host country, post-migration stressors and dysfunctional coping strategies appear to be the primary risk factors for mental health disorders among forced migrants. Given the cross-sectional design, the findings should be interpreted as associative rather than causal.

Introduction

Wars and armed conflicts have long been a major cause of forced migration worldwide. According to UNHCR, the UN Refugee Agency, at the end of April 2025, the global figure exceeded 122 million people forced to flee from persecution, conflict, violence and human rights violations (UNHCR, 2025). Wars are particularly dangerous as, beyond violence and the deaths of soldiers, they lead to mass emigration and cause fear, depression, and post-traumatic stress disorder (PTSD) among refugees^1–3. Following the Russian armed attack against Ukraine, several million people were forced to leave their country and seek refuge beyond its borders. According to UNHCR, as of April 2025, 6,357,600 Ukrainian war refugees were residing in European Union countries, whereas a further 560,200 were living outside the EU⁴. Furthermore, it was reported that over 3.6 million people became internally displaced persons (IDPs) within Ukraine (IOM Ukraine⁵. By March 2025, 4.26 million Ukrainians had obtained temporary protection status within the European Union (Eurostat⁶, with the largest host countries being Germany (1,184,890 or 28% of the EU total), Poland (997,120 or 23%), and the Czech Republic (365,055 or 9%). In the first months of the war, the largest number of Ukrainian war refugees arrived in Poland. The popularity of Poland as a refuge from the war was determined by well-established social networks, a well-developed network of rail and road connections, Poland’s membership in NATO, and cultural similarities between Poland and Ukraine^7,8. Yet another factor facilitating war-related migration to Poland was the welcoming atmosphere, support, and assistance offered to Ukrainian war refugees, most of whom were young women with children⁷.

In this study, the term “Ukrainian refugee women” refers to women who were forced to leave Ukraine due to the war. For brevity, this group is also referred to as “Ukrainian women” in the subsequent sections. The term “Russian migrants” refers to people who migrated from Russia in the context of political repression and the risk of mobilisation.

While the psychosocial effects of the ongoing war affecting Ukrainian society^9–11 and the mental health problems among women who are refugees from Ukraine^12–16; are well documented, research on the adverse consequences of the war for the Russian society is scarce.

Recent studies indicate that the prevalence of mental health disorders among Ukrainian populations affected by the war is substantial. Estimates suggest that depressive symptoms occur in approximately 19–55% of respondents, while anxiety disorders affect between 3% and 33%, depending on the population studied and the measurement instruments used¹⁷. In surveys conducted shortly after the outbreak of the full-scale invasion, anxiety symptoms were reported by over half of Ukrainian refugees, highlighting the severe psychological impact of war and displacement¹⁸. In contrast, systematic prevalence estimates for people who migrated from Russia remain limited, as this migration wave emerged only after the full-scale invasion in 2022. Existing studies therefore focus mainly on indicators of psychological distress, emotional burnout, and reduced subjective well-being among people who migrated from Russia leaving the country due to political repression and the threat of mobilisation. According to studies conducted among Russian political migrants, the proportion of respondents reporting feelings of happiness increased from 37% in 2022 to 53% in 2024, while the percentage reporting sadness declined from 51% to 34% during the same period¹⁹.

Following the outbreak of the war on 24 February 2022, groups of Russians took to the streets of major cities to protest against the war and the policies of President Vladimir Putin. The anti-war demonstrations were suppressed by state authorities^20,21. Protest participants were charged with criminal offences, including allegations of extremism, terrorism, or public disorder. In this context, increased emigration was observed among individuals opposing the war and seeking to avoid potential legal or political consequences.

To avoid repression and escape mobilisation and conscription, Russians were contributed to increased emigration. A scale arguably not seen since the Bolshevik Revolution of 1917. Some analysts interpret this movement as representing Russia’s most significant intellectual and professional exodus since the collapse of the Soviet Union²².

It is estimated that over 800,000 Russians have left Russia since the beginning of the war, relocating to diverse destinations including Kazakhstan, Georgia, Armenia, Serbia, Turkey and Germany²¹. Between 80,000 and 110,000 Russian war migrants were living in Serbia^23,24.

In the case of Russians migrating to Serbia, the country became one of the easiest European destinations for Russians to reach, free from the visa and logistic complications or strict border controls. This convenient access has led to a major influx of Russian nationals into Serbia, who now form one of the largest minority communities in the country²³. Russians who have emigrated after the year 2022 have to face repression both at home and abroad. They have been denied temporary protection, employers in Russia have been forced to dismiss them if they work remotely, and their assets have been confiscated. They have also been stigmatised and burdened with collective responsibility, as well as the uncertainty and instability associated with their migrant status and the consequences of international sanctions^21,25.

The accumulation of stressors may lead to a deterioration in mental health, even if appropriate living conditions have been secured. The psychosocial condition of people who migrated from Russia may be similar to that reported by Ukrainian war refugees.

The outbreak of the war between Russia and Ukraine resulted in the emergence of forced migrants in both countries. Ukrainians fled air raids and lived in shelters to save their lives, whereas Russians escaped the repression of the authoritarian state after participating in protests against the war in Ukraine. The surveyed groups once lived in one country and formed a single society. Until the dissolution of the Soviet Union in 1990, Ukraine was one of its republics. The two societies shared a common history, culture, and language.

At the same time, migrants from Russia and Ukraine share a broader cultural and institutional legacy shaped by the Soviet and post-Soviet context. Previous studies have shown that migrants originating from the former Soviet Union often exhibit similar patterns of cultural adaptation, social networks, and attitudes toward mental health services. However, contemporary political developments and the ongoing war may lead to important differences in migration motives, identity formation, and exposure to stressors between Ukrainian refugees and Russian emigrants.

Even before the collapse of the Soviet Union, research indicated that migrants from the Soviet Union experienced high levels of demoralisation, depression, anxiety, post-traumatic stress disorder, and somatic symptoms^26–28. More recent studies have confirmed elevated levels of psychological distress among migrants from the former Soviet Union in various host countries, including Israel, and have highlighted the role of acculturation in shaping mental health literacy and help-seeking behaviours^29–31. These studies provide important insights into the mental health challenges experienced by migrants from the post-Soviet region and offer a useful comparative framework for understanding the psychological well-being of contemporary migrants from Ukraine and Russia.

While the nature of pre-migration stressors differs substantially between the two groups, both can be conceptualised within the broader framework of forced migration. Ukrainian refugees were directly exposed to war-related trauma, including air raids, shelling, displacement, and threats to life. In contrast, Russian emigrants were primarily exposed to politically induced stressors such as the risk of forced mobilisation, criminal prosecution for anti-war activities, state surveillance, repression, loss of employment due to political stance, and the fear of arrest. Although these experiences differ in form and intensity, both involve coercive circumstances that significantly limit individual agency and compel migration.

Both groups may also face stressors connected with adaptation to a new place of residence. Acculturation problems can be burdensome and may intensify stress³². Similar post-migration stressors occur in both groups of refugees, such as a decline in social status, a decrease in living standards, economic uncertainty, labour market discrimination, and prejudice^33,34. An additional source of stress is the concern for the lives and health of family members left behind in the country at war¹⁶. Furthermore, among Russians, the problem of transnational repression arises. The rise in transnational repression – a multifaceted tool for political control employed by states to quash dissent beyond their jurisdiction – has been observed (Hassan at al.,2022; Sergeeva & Kamalov, 2022³⁵.

From a theoretical perspective, research on refugee and migrant mental health emphasises that psychological outcomes are shaped not only by the severity of pre-migration trauma but also by post-migration stressors such as discrimination, underemployment, legal insecurity, and social isolation^2,36,37. Therefore, comparing Ukrainian refugees and Russian political migrants does not imply equivalence of their traumatic experiences. Instead, the comparison allows for the examination of how different trajectories of forced migration interact with post-migration stressors and coping strategies in shaping mental health outcomes.

The research to date indicates that, as a result of the numerous traumas and stressors experienced by immigrants and refugees, they are exposed to a high risk of mental health problems^{38– 40}. Mental health problems can adversely affect the immigrants’ successful adaptation and their functioning after immigration^32,37. The present study seeks to address the existing gaps in literature by demonstrating the relationship between strategies for coping with stress and mental health status among war refugees and political emigrants from Eastern Europe.

Despite the growing body of research on the mental health of Ukrainian refugees, comparative studies examining mental health outcomes among Ukrainian refugees and Russian political migrants remain scarce. Moreover, relatively little attention has been paid to the role of coping strategies in shaping mental health outcomes among these groups of forced migrants. Understanding similarities and differences between these two groups may provide valuable insights into how different forms of forced migration influence both the prevalence of mental health disorders and the strategies used to cope with stress.

The present study addresses these gaps by examining mental health outcomes, coping strategies, and the role of post-migration stressors among Ukrainian refugees and Russian emigrants. Based on previous research on forced migration and mental health, the following hypotheses were formulated:

H1

Ukrainian refugees will report higher levels of mental health problems, particularly anxiety and perceived stress, compared to Russian emigrants.

H2

Ukrainian refugees and Russian emigrants will differ significantly in the coping strategies they use, with Ukrainian refugees using emotion-focused and resignation/avoidance strategies more frequently, and Russian emigrants using problem-focused strategies more often.

H3

Maladaptive coping strategies and post-migration stressors will be associated with poorer mental health outcomes among forced migrants.

Methods

Participants and procedure

Survey data were collected between February and April 2025 using the LimeSurvey online survey platform. A link to the online survey, hosted on a secure server at the University of the National Education Commission, was distributed via Facebook and Telegram. The questionnaire was available in Ukrainian and Russian.

The questionnaire was prepared in both languages to ensure linguistic accessibility for participants from Ukraine and Russia. Standardised psychological instruments (GAD-7, PHQ-9, and PSS-10) were administered using previously validated Russian and Ukrainian adaptations reported in the literature. The remaining survey items were translated and reviewed for linguistic clarity. The Ukrainian version of the questionnaire had also been used in previous waves of data collection, which allowed the wording of the items to be tested and refined prior to the present study.

At the beginning of the questionnaire, participants were asked screening questions regarding their country of origin and migration status to ensure that they belonged to the target population of migrants from Ukraine or Russia.

All Ukrainian respondents reported residing in Poland and were recruited through social media networks. The Ukrainian sample consisted exclusively of women, which reflects wartime mobility restrictions preventing most men aged 18–60 from leaving Ukraine during the period of the study and the resulting gender structure of refugee populations. Russian migrants reported residing in several European countries. Half of the respondents lived in Serbia, while others lived in France (8%), Montenegro (7%), Georgia (4%), Turkey (4%), Germany (4%), and other countries.

To minimise the risk of automated or non-human responses, the survey platform required CAPTCHA verification and allowed monitoring of potential duplicate submissions. The questionnaire also included several open-ended questions requiring written responses, which helped verify that responses were generated by human participants. After data collection, the dataset was screened for irregularities such as duplicate entries, inconsistent response patterns, and unusually short completion times. No responses indicating automated participation were identified.

Participants were eligible if they were adults (18 years or older) who had left their home country after the outbreak of the war and were residing outside their country of origin at the time of the survey. Questionnaires that were incomplete, duplicated, or contained inconsistent response patterns were excluded from the analysis.

The research sample was selected using non-probability sampling, that is, it constituted an opportunity sample⁴¹. As recruitment was conducted through social media networks, the sample may overrepresent migrants who are active online and connected to migrant communities. Participation was voluntary and anonymous, and respondents provided informed consent before completing the questionnaire. No financial or material incentives were provided for participation.

Web-based surveys offer several advantages, including efficiency and the ability to reach geographically dispersed populations⁴². However, as with other CAWI-based studies, participation is based on self-selection and the results cannot be fully generalised to the entire migrant population⁴³.

The survey was developed for the purposes of this project. Participants provided demographic information regarding their age, sex, education, place of residence prior to leaving their country, marital status, and living situation. Participants were also asked about the length of their stay in the host country, which allowed the estimation of the approximate timing of relocation. This variable is presented in Table 2 and was considered in the interpretation of the results.

Table 2.

Life situation in displacement.

		Ukrainian n = 200	Russian n = 164
		M(SD)/N(%)	M(SD)/N(%)
Length of stay in the host country		27.38 (11.31)	24.26(13.07)
Quality of life in the host country		3.33 (0.45)	3.50(0.50)
Arrival with others	Alone	34(17.1)	33(23.9)
	With children	87(43.7)	12(8.7)
	With husband and children	32 (16.2)	81 (58.7)
	With partents, children, partner	46 (23)	12 (8.7)
Previous visits to the host country	Yes	106(53)	59(41)
	No	94(47)	85(59)
Change of place of residence during stay	Yes	86(43)	71(45.8)
	No	114(57)	84(54.2)
Contact with home country	Yes	128 (65)	72(47.1)
	No	69(35)	81(52.9)
Residing in their own home/rented accommodation	Yes	147(74.2)	133 (84.7)
	No	51 (25.8)	24(15.3)
Employment	Yes	110(59.1)	115 (73.7)
	No	76(40.9)	41(26.3)
Employment matching qualifications	Yes	49 (26.8)	104(69.8)
	No	134 (73.2)	45(30.2)
Arrival with children under 18	Yes	110(67.5)	75(52.8)
	No	53 (32.5)	67(47.2)
Knowledge of the local language	Yes	129 (80.1)	50(37.9)
	No	32(19.9)	82(62.1)
Attitudes among the local population	Positive	52(31.5)	97 (68.3)
	Neutral	74(44.8)	43(30.3)
	Negative	39(23.6)	2(1.4)

The respondents were also asked about their situation after leaving their home country. They provided the information on the number of months spent in their new place of residence, with whom they had arrived, whether they had previously visited this country, whether they had changed their place of residence within the host country, and whether they had travelled back to their home country during their stay. Subsequently, they were asked about their living conditions: whether they lived in their own home or rented accommodation, whether they were employed, whether their employment matched their qualifications, and whether they had arrived with children under the age of 18. The respondents were also asked about their level of proficiency in the local language, use of the support provided by a psychologist, and the attitudes of the local population towards migrants. Furthermore, the quality of life in the new place of residence was assessed using a five-point Likert scale (1 - very dissatisfied, 2 - dissatisfied, 3 - neutral, 4 - satisfied, 5 - very satisfied). The following aspects were assessed using the scale: (1) family finances; (2) contact with compatriots in the host country; (3) contact with family in Russia/Ukraine; (4) housing conditions; (5) employment; (6) remuneration; (7) own education; (8) children’s education; (9) leisure activities; (10) safety in the place of residence; 11) healthcare; 12) local public transport.

The study was reviewed and approved by the Interdisciplinary Laboratory for Research on Wars and Disasters University of the National Education Commission, Krakow approval number JLRWD 2024/1 and conducted in accordance with the principles of the declaration of Helsinki.

Measures

The internal consistency of the scales was satisfactory, as indicated by Cronbach’s alpha coefficients reported for the Russian and Ukrainian adaptations of the instruments.

Current psychiatric symptoms were assessed using the validated Generalized Anxiety Disorder-7 (GAD-7⁴⁴, the Patient Health Questionnaire- 9 (PHQ-9⁴⁵; and the Perceived Stress Scale⁴⁶.

The Generalized Anxiety Disorder GAD-7⁴⁴ was used to assess participants’ levels of anxiety over the past two weeks. Items were rated on a four- point Likert scale and total scores were calculated by summing all items. In accordance with previous research, a cut-off score of ≥ 10 was used to indicate clinically significant anxiety symptoms⁴⁴. The Russian⁴⁷(Cronbach’s α = 0.88) and Ukrainian (Aleksina⁴⁸ et al., 2024) (Cronbach’s α = 0.90) adaptations of the scale were used.

Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9⁴⁵, a nine-item instrument widely used to screen for depressive symptoms in research and clinical settings. Items on the PHQ-9 are rated on a four-point Likert scale and summed to obtain total scores. In the present study, a cut-off score of ≥ 10 was used to indicate significant depression⁴⁹. The Russian⁵⁰) (Cronbach’s α = 0.87) and Ukrainian⁵¹ (Cronbach’s α = 0.86) adaptations of the scale were used.

Perceived stress was measured using the Perceived Stress Scale (PSS-10⁴⁶;. This ten-item instrument uses a five-point Likert scale to measure the extent to which situations in one’s life were appraised as stressful over the past month^46,52. Final scores were obtained by reverse-scoring positively phrased items and summing across all items. The Russian⁵³) (Cronbach’s α = 0.82) and Ukrainian^14,54 (Cronbach’s α = 0.83) adaptations of the scale were used.

Strategies for coping with stress are divided into problem-focused strategies and emotion-focused strategies^55,56. The first strategy focuses on a problem (problem-focused strategies), whereas the latter concentrates on emotions (emotion-focused strategies). In the scale used, two problem-focused strategies for coping with difficult life situations were distinguished: (1) “I ask others for advice and help”; (2) “I get mobilised and take action”. The emotion-focused strategy consisted of 5 specific coping methods: (3) “I resort to alcohol”; (4) “I comfort myself with the thought that it could have been worse, or that others are worse off”; (5) “I take sedatives”; (6) “I pray to God for help”; (7) “I focus on other things which divert my attention and improve my mood”. Respondents also had the option of selecting: (8) “I give up; and I don’t know what to do”⁵⁷. In the questionnaire, respondents indicated whether they used each coping strategy by marking “1” if the strategy was used and “0” if it was not used. These variables were treated as binary indicators in the statistical analyses. The reliability and validity of this scale were previously established in the Diagnoza Społeczna research⁵⁷.

Data analysis

Descriptive statistics were used to characterise the socio-economic status of refugees, their situation in the host country, and the prevalence of mental health disorders. Linear regression analysis with forward variable selection and correlation analysis were performed to explore potential predictors of high levels of anxiety, depression, and significant stress during emigration. Prior to regression analyses, assumptions of linear regression were examined, including multicollinearity and normality of residuals. Student’s t-tests were used where applicable. All analyses were conducted in SPSS (Version 29), with an alpha level of 0.05 used to denote statistical significance.

The primary analyses were conducted to test the study hypotheses regarding group differences in mental health outcomes and coping strategies, as well as associations between coping strategies and mental health indicators. Additional analyses examining specific contextual predictors were treated as exploratory.

Results

The analyses were conducted in line with the study hypotheses, focusing on group differences in mental health outcomes and coping strategies, as well as associations between coping strategies and mental health indicators.

Sample demographics

A total of 200 questionnaires completed by female respondents from Ukraine (100%) were qualified for the analysis. The surveyed respondents had a mean age of 39.08 ± 11.48 years (range: 16–72) and were highly educated (73%). Most of them were urban residents (96%), and rated their financial situation before departure as good (58%). The majority of the respondents were in a relationship (64%) (Table 1).

Table 1.

Characteristics of the sample.

		Ukrainian n = 200	Russian n = 164
		Mean (SD)	Mean (SD)
Age		39.08 (11.48)	44.30 (9.61)
		N (%)	N (%)
Sex	Female	200 (100)	71(53)
	Male	-	63(47)
Education	Vocational	22(13.4)	7(5.3)
	Secondary	16 (8.0)	9(6.8)
	Higher	106 (73.6)	117(88)
Place of residence	Village	6(4.1)	4(2.5)
	City	142 (95.9)	154(97.5)
Civil status	Single	28 (19.7)	14(10.4)
	In a relationship	91(64.1)	104(77.6)
	Divorced	21(14.8)	13(9.7)
	Widow	2(1.4)	3(2.2)
Financial standing	Bad	20(14.1)	10(7.5)
	Average	40(28.2)	47(35.1)
	Good	82(57.7)	77(57.4)

164 correctly completed questionnaires were obtained from Russian emigrants. The respondents had a mean age of 44.30 ± 9.61 years (range: 20–82), were female in 53% of cases, highly educated (88%), and predominantly from large cities (98%). They rated their financial situation before departure as good (57%), and in most cases were living in a relationship (78%).

Both groups of emigrants are young, originate from urban areas, are highly educated, and rated their financial situation before departure positively. Differences emerge with respect to gender. Among the Ukrainian migrants, all respondents were female, which stems from the ban on men aged 18–60 leaving the country. There were more single women among the Ukrainians, whereas a higher proportion of the Russian respondents were in a relationship, which results from their older age and the need to leave the country with their families, as they could also face repression. Both groups were predominantly highly educated and originated mainly from urban areas.

Life in displacement

Table 2 presents the characteristics of living conditions of forced migrants. Ukrainian female migrants fled the war-torn country with children (44%), including those under the age of 18 (68%). Before arriving in Poland, 53% of respondents had previous experience with the country, and over a half (57%) did not change their place of residence after arrival. During their stay in the host country, most respondents maintained contact with Ukraine (65%), and the majority lived in their own or rented accommodation (73%). 59% of respondents were employed, with 27% working in positions matching their qualifications. Knowledge of the Polish language was reported by 80% of participants, and 32% observed positive attitudes among the local population. The mean length of stay in Poland was 27 months, and the average quality of life score assessed across the 12 items on the 5-point scale was 3.33.

Russian emigrants mainly left with their spouses and children (59%), including children under the age of 18 (53%). 41% of Russian migrants had previously visited their current host country, and 54% did not change their place of residence after arrival. During their stay abroad, 47% maintained contact with Russia, and the majority lived in their own or rented accommodation (87%). 74% of respondents were employed, with 70% working in positions matching their qualifications. Knowledge of the local language was reported by 38% of participants, and 68% observed positive attitudes among the local population. The mean length of stay in displacement was 24 months, and the average quality of life score assessed across the 12 items on the five-point scale was 3.5.

A comparison of the two migrant groups revealed significant differences. Ukrainian women spent longer periods abroad, and left the country with children under 18. They maintained contact with family members who had remained in Ukraine. They knew the local language but the majority of them were underemployed. Russian migrants were more often accompanied by their families, more frequently lived in rented or owned accommodation, were employed in positions matching their qualifications, had lower proficiency in the local language, and encountered more favourable attitudes from the local population. The differences in living conditions were reflected in the quality of life scores. The analysis of the students’ t-tests confirmed that the Russian migrants rated their quality of life abroad slightly higher than Ukrainian women, t (327) = −3.07, p = 0.002, Cohen’s d = −0.34.

Strategies for coping with stress

Strategies for coping with stress used by migrants were examined (Table 3). In both groups, emotion-focused coping strategies were used most frequently, whereas problem-focused strategies were less common, and resignation strategies were reported only occasionally.

Table 3.

Strategies for coping with stress.

	Ukrainian n = 200	Russian n = 164
	N(%)	N(%)
I get mobilised and do my best to cope with my problems	93(59.2)	97(70.8)
I focus on other things which divert my attention and improve my mood	86(54.8)	90(65.7)
I comfort myself with the thought that it could have been be worse	67(42.7)	60(43.8)
I pray to God for help	33(21)	19(13.9)
I ask others for advice and help	59(37.6)	64(46.7)
I take sedatives	45(28.7)	27(19.7)
I resort to alcohol, tobacco or other stimulants	8(5.1)	41(29.9)
I give up, don’t know what to do, don’t know what is going to happen	23(14.6)	4(2.9)

Significant differences between the groups were observed. Ukrainian refugee women reported higher use of emotion-focused and resignation strategies, whereas Russian migrants more frequently used problem-focused coping strategies. These differences were statistically significant: emotion-focused strategies, t (363) = −2.01, p = 0.022, Cohen’s d = −0.21. People who migrated from Russia used problem-focused strategies more frequently than Ukrainian women, t (363) = −2.80, p = 0.005, Cohen’s d = −0.29. In comparison to Russian migrants, resignation strategies were employed significantly more often by Ukrainian refugee women, t (363) = 3.33, p = 0.001, Cohen’s d = 0.35.

To sum up, Ukrainian refugee women more frequently reported the use of emotion-focused and resignation strategies, which have been associated in previous research with less effective coping. Russian migrants focused more frequently on problem-solving approaches.

It is worth mentioning that both groups sought psychological support. 40% of Ukrainian refugees and 34% of Russian migrants consulted mental health professionals.

Mental health

In the group of Ukrainian female migrants, according to DSM-5 criteria (Table 4), severe anxiety disorders were observed among 45% of the respondents, severe depression among 56%, with almost all reporting high stress levels. Among Russian migrants, 37% had severe anxiety disorders and 39% depressive disorders, while the majority experienced high levels of stress. GAD-7 and PHQ-9 scores in both groups fell within the upper ranges, which indicates a high prevalence of mental health disorders^{44, 49}.

Table 4.

Current psychiatric symptom severity.

	Ukrainian	Russian
	Mean (SD)	Mean (SD)
Generalized Anxiety Disorder-7	9.38 (5.23)	7.70 (5.49)
Patient Health Questionnaire-9	11.15(5.88)	9.24(6.35)
Perceived Stress Scale	20.76(5.9)	18.79(2.92)
Probable DSM-5 Diagnosis by Cut-Off Score
	N (%)	N (%)
(GAD-7 ≥ 10)	68(44.7)	52(37.1)
(PHQ-9 ≥ 10)	80(55.6)	53(38.7)

A comparison of the results between the two groups indicated that differences in anxiety levels were statistically significant, t (290) = 2.66, p = 0.008, Cohen’s d = 0.31. Similar results were obtained for depressive symptoms,

t (279) = 2.61, p = 0.009, Cohen’s d = 0.31, and for perceived stress levels, t (275) = 8.91, p = 0.001, Cohen’s d = 0.32. Mental health problems were more common among Ukrainian refugee women than among Russian political migrants.

In order to determine the predictors of mental health disorders among the surveyed migrants, a correlation analysis was carried out.

Among Ukrainian migrants, anxiety disorders (GAD-7) were correlated with quality of life (r = −0.20, p = 0.010), attitudes of the local population towards refugees (r = −0.21, p = 0.008), resignation and passivity (r = 0.19, p = 0.016), and the use of sedatives (r = 0.25, p = 0.002).

Depressive symptoms (PHQ-9) among Ukrainians were correlated with quality of life (r = −0.27, p = 0.001), attitudes of the local population towards refugees (r = −0.30, p = 0.001), knowledge of the local language (r = −0.17, p = 0.038), employment (r = −0.27, p = 0.003), mobilisation and coping with threats (r = −0.20, p = 0.016), resignation and passivity (r = 0.29, p < 0.001), and the use of sedatives (r = 0.21, p = 0.010).

Stress disorders measured with the PSS-10 scale among Ukrainian migrants were correlated with the level of education (r = 0.20, p = 0.016), quality of life (r = −0.23, p = 0.005), knowledge of the local language (r = −0.16, p = 0.045), attitudes of the local population towards refugees (r = −0.28, p = 0.001), comforting oneself with the thought that “it could have been worse” (r = 0.17, p = 0.041), resignation and passivity (r = 0.25, p = 0.002), and the use of sedatives (r = 0.19, p = 0.021).

Among Russians, anxiety disorders were correlated with their financial situation before emigration (r = −0.19, p = 0.027), quality of life (r = −0.34, p < 0.001), employment matching qualifications (r = −0.26, p = 0.002), use of sedatives (r = 0.16, p = 0.049), and praying to God for help (r = 0.20, p = 0.015).

Depressive disorders were correlated with quality of life (r = −0.46, p < 0.001), employment matching qualifications (r = −0.34, p < 0.001), resignation and passivity (r = 0.17, p = 0.044), and the use of sedatives (r = 0.18, p = 0.034).

Stress disorders were correlated with gender (r = 0.24, p = 0.006), quality of life (r = −0.33, p < 0.001), employment matching qualifications (r = −0.24, p = 0.006), resignation and passivity (r = 0.20, p = 0.016), and comforting oneself with the thought that “it could have been worse” (r = 0.22, p = 0.008).

In order to identify predictors of mental health disorders among Ukrainian and Russian refugees, a linear regression analysis with forward selection was conducted. For anxiety disorders (GAD-7) among Ukrainian refugees, the regression model was well-fitted to the data, F(4,117) = 9.50, p = 0.001. The explained variance in the dependent variable was R² = 22%. The predictors were resignation and passivity β = 0.29, p = 0.001, use of sedatives β = 0.18, p = 0.030, attitudes among the local population β = −0.28, p = 0.001, change of the place of residence β = 0.20, p = 0.017.

With respect to the regression model fitted to data on depressive disorders (PHQ-9), the test brought significant results, F(2,111) = 23.82, p = 0.001. The independent variables explained 29% of the variance in the dependent variable. Statistically significant predictors were attitudes among the local population towards migrants (β = −0.39, p = 0.001) and giving in to one’s fate (β = 0.37, p = 0.001).

For stress disorders measured with the PSS-10 scale, the regression model was well-fitted to the data, F(4,112) = 10.52, p = 0.001. In this model, the independent variables explained 24% of the variance in the dependent variable. The predictors of stress were the strategy of resignation and passivity (β = 0.28, p = 0.001), comforting oneself with the thought that “it could have been worse” (β = 0.17, p = 0.028), attitudes among the local population (β = − 0.32, p < 0.001), and the level of education (β = 0.25, p = 0.002).

It is noteworthy that the correlation coefficients were as follows: GAD-7 and PHQ-9 (r = 0.76, p = 0.001), GAD-7 and PSS-10 (r = 0.61, p = 0.001), and PHQ-9 and PSS-10 (r = 0.58, p = 0.001).

In the Russian group, the model was well-fitted to the data, F(2,87) = 8.50, p = 0.005. The explained variance in the dependent variable was R² = 14%. Statistically significant predictors were: quality of life (β = −0.34, p = 0.001) and asking others for advice and help (β = 0.22, p = 0.023).

Depression measured with the PHQ-9 scale was well-fitted to the data, F(3,85) = 18.98, p = 0.001. The independent variables explained 38% of the variance in the dependent variable. Statistically significant predictors were: quality of life (β = −0.46, p = 0.001), asking others for advice and help (β = 0.20, p = 0.016), and underemployment (β = −0.22, p = 0.022).

The regression model explaining the level of stress disorders measured with the PSS-10 scale was well-fitted to the data, F(5,84) = 7.60, p = 0.001. The independent variables explained 27% of the variance in the dependent variable. Statistically significant predictors were: quality of life β = −0.36, p = 0.001, asking others for advice and help β = 0.19, p = 0.040, comforting oneself with the thought that “it could have been worse, but I feel safe” β = 0.21, p = 0.023, I give up and don’t know what to do β = 0.23, p = 0.016, attitudes among the local population towards migrants β = −0.21, p = 0.043.

It is noteworthy that the correlation coefficients were as follows: GAD-7 and PHQ-9 (r = 0.73, p = 0.001), GAD-7 and PSS-10 (r = 0.54, p = 0.001), and PHQ-9 and PSS-10 (r = 0.52, p = 0.001).

Discussion

The comparison between Ukrainian refugees and Russian political migrants should not be interpreted as suggesting equivalence of their pre-migration trauma. Rather, the study analyses two distinct forms of forced migration generated by the same geopolitical conflict.

In addition, differences between the groups in terms of gender composition, host-country context, and duration of stay should be taken into account when interpreting the findings, as these factors may influence both mental health outcomes and coping strategies.

The findings should be interpreted as associative rather than causal, given the cross-sectional design of the study and differences between the compared groups.

It should also be noted that mental health outcomes among forced migrants are shaped not only by post-migration stressors but also by experiences occurring prior to migration³². Ukrainian refugees were likely exposed to direct war-related trauma, including air raids, displacement, and threats to personal safety^12–14. In contrast, Russian emigrants may have experienced politically induced stressors before migration, such as repression, fear of mobilisation, and criminal prosecution for anti-war activities^25,58. According to the theoretical framework of refugee mental health, psychological outcomes among migrants are often the result of the cumulative effects of pre-migration trauma, migration-related stress, and post-migration adaptation challenges^59,60.

The findings suggest that mental health disorders are prevalent among forced migrants from Ukraine and Russia, which is consistent with theoretical considerations^32,37. Social mobility has long been associated with psychological strains and stress⁶¹. This suggests that forced migration may be associated with accumulated and persistent stress^62,63. In such cases, pre-migration, migration, and post-migration stressors may be involved^32,37. The level of diagnosed stress disorders among Russian forced migrants is comparable to that observed among Syrian refugees in Turkey⁶⁴. Among Ukrainian female migrants, stress levels are higher than among Russian migrants; nevertheless, they are lower than those observed among Ukrainian refugee women in the Czech Republic (PSS-10 score of 23.20)¹⁴.

A comparative analysis between the two groups of migrants indicates that Ukrainian refugee women have poorer mental health than Russian forced migrants. An important contributing factor may be that the majority of those arriving in Poland were women with children, and, as previous studies have shown, mental health disorders occur more frequently among women than among men^1,62,65. Women fleeing the war are often deprived of social support. Not only must they cope with their own problems but also with those of their children^16,14. Russian migrants more frequently relocated with their families, which was also observed in other studies^23,58. As a result, they could rely on stronger social support. Better mental health outcomes observed among people who migrated from Russia may also be explained by the fact that they resided in countries with generally positive attitudes towards them (e.g., Serbia – 50%). As demonstrated by numerous studies, discrimination and prejudice have a negative impact on the migrants’ mental health status^3,66,67.

Notably, the relatively high prevalence of mental health disorders among Russian migrants is somewhat surprising, and has also been observed in other studies Sergeeva & Kamalov, 2022³⁵. These disorders have been attributed to transnational repression from the Russian government, discrimination, collective guilt and responsibility, and conflicts with relatives remaining in Russia Sergeeva & Kamalov, 2022,³⁵.

The elevated levels of psychological distress observed among Russian migrants may also be interpreted through the lens of moral injury. This concept refers to psychological distress resulting from experiences that violate an individual’s moral or ethical beliefs. In the context of the war in Ukraine, some Russian migrants may experience internal conflict related to perceived responsibility, feelings of guilt, or disagreement with the actions of their home country. Such experiences may contribute to increased emotional burden and may partially explain the observed mental health outcomes in this group⁶⁸.

Both groups of migrants tended to employ emotion-focused strategies for coping with stress more frequently. Nevertheless, it is worth noting that the difference between problem-focused and emotion-focused strategies was slight, which has also been reported in studies conducted among Ukrainian refugee women in the Czech Republic¹⁴. Importantly, individuals may change their strategies for coping with stress depending on the context and often use multiple strategies⁵⁵. In this context, it should be noted that Ukrainian refugee women have now lived in Poland for three years; therefore, emotion-focused and avoidant coping strategies may be predominant. This may stem from their exhaustion from prolonged active coping with stress throughout their stay.

The results of the correlation and regression analyses allow for a more detailed examination of the situation of both groups of migrants and the identification of factors associated with the prevalence of mental health disorders.

Among Ukrainian forced migrants, the correlation analysis indicates that anxiety disorders are associated with low perceived quality of life, negative attitudes of the local population, and reliance on emotion-focused coping strategies. Apart from the aforementioned factors, depressive disorders were also correlated with insufficient language proficiency and unemployment, while being negatively correlated with mobilisation and active coping with threats. In the case of stress disorders, in addition to the aforementioned factors, the strategy of self-reassurance that “it could have been worse, but now it’s safe” also emerged.

Problems with adaptation and integration, combined with the use of emotion-focused strategies, may contribute to poorer mental health outcomes. Emotion-focused coping does not directly address external stressors such as language barriers, unemployment, or discrimination, which are central to the post-migration experience. As a result, reliance on such strategies may limit the individual’s ability to effectively manage ongoing stressors related to adaptation.

At the same time, the preference for emotion-focused coping may also be shaped by pre-migration cultural norms and gender-related factors. Previous research indicates that women are more likely to use emotion-focused coping strategies, particularly in situations characterised by limited control over external circumstances. In the context of forced migration, such patterns may be further reinforced by prolonged stress, caregiving responsibilities, and reduced access to instrumental resources.

In the case of Russian migrants, in addition to the factors mentioned above, underemployment, the assessment of pre-migration financial situation, and female gender were also significant.

The findings suggest that post-migration stressors and coping strategies may be important factors associated with mental health outcomes^32,55.

In order to identify the factors associated with mental health outcomes accurately, a regression analysis using the forward selection method was conducted. The results indicate that the attitudes of the local population towards migrants are associated with mental health outcomes among Ukrainian forced migrants. This suggests that positive integration into the host society may play an important role in psychological well-being. Discrimination and prejudice pose a threat to mental health^32,67. This has also been corroborated by studies conducted among Ukrainian female migrants in the Czech Republic¹⁴ and among Syrian refugees in Norway³. In addition to integration, acceptance by the host society provides migrants with social support that protects them against stress^15,69. Yet another significant factor increasing the level of mental health disorders among Ukrainian women is the use of emotion-focused strategies for coping with stress, which was also observed in numerous other studies^13,70. One more factor is a change in the place of residence, which may indicate that migrants relocated to environments where they experienced varying levels of discrimination and thus were forced to move to more welcoming settings. It was also found that individuals with higher education levels experience greater stress, as they may have a stronger sense of loss and relative deprivation^2,71.

Data collected in the third year of residence of Ukrainian women who fled the war confirm that the main risk factors for mental health disorders are emotion-focused strategies for coping with stress and the lack of acceptance or discrimination in the host society. The negative attitudes of the Polish society towards migrants from Ukraine may be influenced by perceived competition for employment and social or partnering opportunities, which may contribute to tensions related to access to resources⁷². It is worth noting that the problem of discrimination is also reported by internally displaced persons (IDPs)^73,74.

In the case of Russian forced migrants, low quality of life is the main risk factor for mental health disorders. This may be explained by the phenomenon of relative deprivation, that is, the perceived loss of social status, as well as social and occupational downward mobility in the host country^2,25,71. The arrival of the affluent middle class from large Russian cities to less affluent countries is associated with a perceived decline in living conditions. This is further explained by another variable – underemployment. Yet another important risk factor for mental health disorders is the use of emotion-focused strategies as well as resignation and passivity. Seeking social support was also associated with mental health outcomes. Originally, this strategy was considered an indicator of instrumental coping strategy by Lazarus and Folkman⁵⁵ and Czapiński⁵⁷. Nonetheless, in the studies conducted among Russian migrants, it was found to be maladaptive, which contradicts theoretical assumptions that active coping strategies should counteract negative emotions. In this case, it may be that the experience of stress prompts respondents to seek support primarily from compatriots in order to obtain emotional comfort, sympathy, understanding, and moral support. According to Carver’s concept⁷⁵, seeking support can be both instrumental and emotional. Moreover, research has shown that seeking support is sometimes associated with engaging in social contacts in order to avoid solving the problem⁷⁶. The remaining findings confirm earlier evidence indicating that self-reassurance as an emotion-focused strategy, as well as withdrawal and resignation, are associated with higher levels of mental health disorders^12,55,57.

In summary, the comparative analysis of both groups of forced migrants indicates that the main factors contributing to mental health disorders are post-migration stressors. This is also consistent with findings from studies conducted among refugees in Europe¹, Australia³⁶, and Africa⁶⁶. The results have also shown that the use of emotion-focused strategies for coping with stress, as well as strategies involving resignation and passivity, may exacerbate mental health disorders among migrants. This finding was confirmed in studies conducted among Ukrainian female migrants in the Czech Republic¹⁴.

The findings highlight the importance of addressing post-migration stressors and promoting effective coping strategies in order to improve mental health outcomes among forced migrants. Both clinical interventions and social policies aimed at reducing discrimination, improving access to resources, and supporting integration may play a crucial role in mitigating psychological distress.

Limitations

Several limitations of this study should be acknowledged. First, the sample was recruited using non-probability sampling through social media networks, which may limit the generalisability of the findings and lead to an overrepresentation of individuals who are more active online or more engaged in migrant communities. In addition, the use of an online survey distributed via platforms such as Facebook and Telegram may have excluded individuals with limited access to digital technologies or social media, thereby introducing potential sampling bias.

Another limitation concerns the gender composition of the sample. The Ukrainian group consisted exclusively of women due to wartime mobility restrictions preventing most men aged 18–60 from leaving the country, while the Russian migrant group included both men and women. This gender imbalance may affect the comparability of the two groups, as gender differences are known to influence mental health outcomes. Consequently, the findings for the Ukrainian group primarily reflect the experiences of female refugees, and the generalizability of the results to the broader population of Ukrainian migrants is limited. The study also relied on self-report measures, which may be subject to response biases, including social desirability and recall bias. Finally, some of the analyses were exploratory in nature and should be interpreted with caution.

Future research could benefit from conducting gender-specific analyses within migrant groups, particularly among Russian migrants, to better understand potential gender differences in mental health outcomes and coping strategies.

In addition, the cross-sectional design of the study limits the ability to draw conclusions about causal relationships between variables. Future studies should consider using complementary sampling strategies, such as offline recruitment or mixed-method approaches, to reduce potential selection bias and improve the representativeness of migrant populations.

Author contributions

Conceptualization P.D\&L.Y; methodology P.D\&L.Y, investigation P.D\&L.Y, writing P.D\&LY, review and editing P.D\&L.Y.

Data availability

Data available on request from the corresponding author.

Declarations

Competing interests

The authors declare no competing interests.

Ethics approval and consent to participate

The study was reviewed and approved by the Interdisciplinary Laboratory for Research on Wars and Disasters, University of the National Education Commission, Krakow (approval no. JLRWD 2024/1). The study was conducted in accordance with the principles of the Declaration of Helsinki, and all participants provided informed consent prior to participation.