Effectiveness of Self-Help Plus and Problem Management Plus interventions

Between April and October 2023, a pilot project was implemented to address the mental health needs of individuals with opioid use disorder (OUD) in Ukraine, particularly in the context of the ongoing war (by Public Health Center of Ministry of Health of Ukraine). The initiative focused on integrating two World Health Organization (WHO) scalable psychological interventions—Self-Help Plus (SH+) and Problem Management Plus (PM+)—into existing opioid agonist treatment (OAT) programmes across three regions: Lviv, Vinnytsia, and Sumy. The interventions aimed to support clients experiencing depression, anxiety, and emotional distress by offering either a group-based (SH+) or individual (PM+) format. Both interventions were delivered by trained non-specialist staff within the OAT centres.

The project consisted of a pragmatic trial assessing the effectiveness and acceptability of the interventions, combining quantitative and qualitative components. The results showed that SH+ helped create a supportive environment conducive to peer learning and emotional relief, while PM+ provided a more personalised and flexible approach, facilitating trust and open communication. Both clients and staff perceived the interventions as acceptable and beneficial, noting improvements in emotional regulation, sleep, interpersonal relationships, and overall well-being.

The project demonstrated that scalable mental health interventions could be feasibly integrated into harm reduction services in a conflict-affected setting. Key lessons included the importance of flexible implementation, ongoing supervision, and adapting strategies to local needs. The findings provided valuable insights for future scale-up efforts and contributed to bridging the mental health treatment gap among vulnerable populations in Ukraine.