Understanding mental health needs in Ukraine: protocol for a longitudinal survey of mental health in children and caregivers during the war in Ukraine.

Background: The full invasion of Ukraine by Russia in 2022 has created a situation of sustained stress for the Ukrainian population. Initial surveys indicate that Ukrainians have experienced elevated rates of anxiety, depression, and posttraumatic stress disorder (PTSD) since the onset of the war. Most research has focused on adults and there is relatively less study on children and adolescent mental health. Research that has been conducted is limited by (a) predominant reliance on parent reports of children's mental health, (b) biased sampling, (c) lack of integrated child and caregiver reports, and (d) cross-sectional designs.Method: The Ukrainian Families Navigating Insecurity, Trauma, and Yielding Strength (UNITY) initiative is a nationally-representative longitudinal cohort study of mental health in Ukrainian children aged 8-16 years. Children (N = 3,000) will be recruited via schools from 22 oblasts across Ukraine. Sampling will be stratified from regions with high, medium, and low exposure to Russian attacks during the war. Recruitment will be stratified according to 8-12 and 13-16 years of age (on a 1:1 basis), gender of children (1:1), and urban vs. rural region (1:1). One caregiver of the child participant will also be assessed. Children will be assessed for anxiety, depression, PTSD, prolonged grief, externalizing problems, suicidality, positive affect, social and family support, posttraumatic cognitions, somatic symptoms, functioning, and posttraumatic growth. Caregivers will be assessed for family exposure to traumatic events, psychological distress, prolonged grief, psychological wellbeing, parenting practices, hope, and positive affect. The UNITY study will initially be conducted over three waves, with the expectation of ongoing collection following the war. The protocol was pre-registered at https://archive.org/details/osf-registrations-n62gy-v1.Discussion: The UNITY study will provide much-needed evidence regarding the mental health needs of young Ukrainians and their families, and the factors that moderate psychological adjustment during and after the war.