Marushchenko K. Justification of psychohygienic measures to preserve and strengthen the mental health of servicemen who participated in hostilities

The dissertation presents an original solution to an important scientific problem in the field of military health care concerning the improvement of psycho-hygienic measures to maintain and strengthen the mental health of servicemen who participated in hostilities during the deployment of troops (forces) and in the post-war period, based on the substantiation of an improved conceptual model of the system of psycho-hygienic measures to maintain and strengthen the mental health of military personnel in a special period and the technology of staged provision of medical and psychological assistance at different levels of medical care for military personnel. The study was conducted with the use of appropriate methodological tools, which allowed to collect information, create databases, process, analyze and visualize them, substantiate and develop psycho-hygienic measures to maintain and strengthen the mental health of military personnel participating in hostilities, and implement their individual elements into the educational activities of the UMMA and the practical activities of the medical institutions of the MoD of Ukraine. The scientific novelty of the obtained results is that: the features of the impact of various harmful factors of the combat environment on the mental health of servicemen in a modern armed conflict were identified, and a model of decision support was developed for the individual assessment of the adaptive potential of a serviceman according to the parameters of his sensitivity to the impact of factors of the combat environment; the features of the dynamics of changes in the main indicators of the mental health of servicemen participating in combat were established, which consist in the non-linearity of their changes since 2014 and are characterised by a peak of mental and behavioral disorders in 2015 and 2022 in the general nosological structure; the characteristics of maladaptive changes in military personnel after participation in armed conflicts of various intensity were identified, which form the phenomenological resilience of a certain part of combatants who did not require psychiatric care, to withstand combat stress and recover in difficult circumstances, the characteristics of the influence of the information factor on the characteristics of mental health in military personnel were established as the primary factor that forms negative changes in the psycho-emotional state of a person with minor mental disorders; qualitative and quantitative characteristics of mental disorders and the functional state of servicemen who participated in hostilities in 2023, who required the consultative help of a psychiatrist and had 30% of signs of PTSD, clinically pronounced anxiety and depression in 22% and 14% of people, respectively, were establish; the conceptual model of the system of psycho-hygienic measures to maintain and strengthen the mental health of military personnel in a special period was further developed, aimed at destigmatisation and integration of these measures at the primary, secondary and tertiary levels and including a technology of staged provision of medical and psychological care, which includes the use of patient-oriented psychosocial therapy, rehabilitation and expansion of a number of relevant psycho-hygienic measures at different levels of medical support, and its predicted medical and social effectiveness was also determined. The practical significance of the research is that it became the basis for the development of guidelines for maintaining the mental health of military personnel in the area of deployment of troops (forces) and during the restoration of combat readiness of military units (subunits), as well as for timely diagnostics and psychoprophylaxis of adjustment disorders in servicemen with combat wounds and injuries, the implementation of which will contribute to the full performance of combat tasks in the zone of armed conflict by reducing the incidence of mental and behavioral disorders, preventing suicidal and addictive behavior, and reducing the level of professional disqualification of servicemen, which will allow to preserve the personnel potential and professional longevity of servicemen of the Armed Forces of Ukraine. An improved conceptual model of the system of psycho-hygienic measures to preserve and strengthen mental health of military personnel in special periods was developed, aimed at destigmatisation and integration of these measures at the primary, secondary and tertiary levels and including a technology for staged provision of medical and psychological care, which includes the use of patient-oriented psychosocial therapy, rehabilitation and expansion of a number of relevant psycho-hygienic measures at different levels of medical support, using a decision-support model for individual assessment of a military personnel's adaptive potential according to the parameters of his sensitivity to the effects of combat environment factors.