Psychological resilience in trench warfare: Leveraging mental health frameworks for Ukrainian soldiers

The ongoing Russia-Ukraine War has highlighted the profound psychological toll of asymmetrical and hybrid warfare on military personnel, underscoring the need for tailored mental health interventions. This opinion paper examines the psychological challenges faced by Ukrainian soldiers, including prolonged combat stress, moral injury, and exposure to traumatic events. It reviews the effectiveness and limitations of existing mental health frameworks, such as Combat and Operational Stress Control (COSC), and proposes adaptations for application in low- and middle-income contexts. Key innovations in mental health support are explored, including the integration of digital tools, personalized interventions, and culturally adapted protocols like iCOVER, which emphasize resilience, flexibility, and coping efficacy. The paper also identifies gaps in training, preparedness, and long-term care, particularly in addressing continuous stressors like drone warfare, prolonged deployments, and hybrid psychological operations. A revised framework is proposed to enhance psychological readiness, incorporating principles such as maintaining routines, fostering cohesion, and sustaining hope and purpose. These principles are vital for addressing the unique challenges of trench warfare and the psychological effects of protecting one's homeland. Insights from this study offer practical guidance for mental health professionals and policymakers, emphasizing the need for scalable, context-sensitive approaches to sustain the mental fitness and survivability of soldiers in protracted conflicts.