Editorial: The Reach of War in Childhood: Ukrainian Children Beyond the Frontlines and the Imperative to Scale and Strengthen Mental Health Services for All.

In 2024, UNICEF (United Nations Children's Fund) estimated that more than 473 million children, approximately 1 in 6 globally, lived in areas affected by armed conflict, setting new records.1 Rightfully so, a great deal of the international response has focused on the mental health needs of children closest to active combat. However, the study by Lestarevic Stojkov and Lero et al. 2 in this issue of JAACAP Open contributes to a growing body of evidence showing that we need to look far beyond the front lines when it comes to understanding and responding to the mental health needs of children affected by war. In a school-based sample of 4,753 children aged 7 to 17 in Ternopil, a western Ukrainian city distant from the front lines, 40.3% screened positive for significant posttraumatic stress symptoms on the 8-item Child Revised Impact of Events Scale (CRIES-8). Whereas children near active conflict zones undoubtedly face the greatest risks, the Ternopil findings remind us that mental health impacts of war extend beyond what humanitarian frameworks typically address, and effective responses should focus on strengthening mental health supports for all children affected by war.