Why Medication Matters: Mental Health, War, and Ukraine
In Ukraine and beyond, resilience requires more than courage. Robert Schuett and Georg Psota argue that it rests on combining people and pills, not pitting them against each other.
Global mental health is at a crossroads. Wars, conflict, social disruption, and economic inequality have displaced millions, fractured communities, and left invisible wounds that threaten individual and collective resilience. Across all age groups, mental health needs have escalated, and vulnerable populations face particularly urgent challenges.
Addressing this crisis requires a psycho-social approach—one that integrates medical (psychopharmacological), behavioural (psychotherapeutic and psychological), and social interventions (housing, employment, education, day structure, caregiver support). Large-scale recovery, resilience, and reform cannot be achieved if any of these pillars are neglected.
Medication is often misunderstood and stigmatised, yet it is an essential enabler of mental healthcare, especially for people with severe mental illness. Psychopharmacological treatment stabilises individuals, creating the prerequisites for outpatient care, community reintegration, and the effective deployment of other psychosocial interventions. History shows that no mental healthcare reform—from inpatient institutions to community-based care—has been possible without the stabilising role of medication.
In practice, pills are not replacements for people; they are enablers. By “people”, we mean families, caregivers, teachers, and multiprofessional healthcare personnel (including doctors, nurses, psychologists, psychotherapists, and social workers), whose engagement is essential for recovery, resilience, and social integration. Pills allow outpatient treatment to replace lifelong hospitalisation. They make it possible for behavioral therapies, family support, and community reintegration to succeed. Put simply: psychosocial care, in its fullest sense, includes both people and pills.
Medication should also be seen as a tool for prevention and resilience-building. People lacking access to care often self-medicate with alcohol, illicit drugs, or unsafe substances. Safe, evidence-based medications—ranging from standard pharmacological treatments to approved herbal remedies—can reduce harmful coping, prevent illness escalation, and build community resilience. In this sense, “good pills” can prevent “bad pills” by offering healthier pathways to manage distress and healthier coping.
Prevention also means ensuring equitable access. Denying vulnerable groups access to safe pharmacological options—whether in low-income settings or conflict zones—pushes people toward unsafe coping mechanisms. As with vaccines in infectious disease, prevention in mental health must include pharmacological as well as behavioral and social tools.
Stigma remains a major barrier to scaling medication. Pills are often perceived as tools of repression or symbols of weakness. This narrative must be challenged: medication is a public good, enabling recovery, resilience, and reform. Risks and side effects must be managed through informed consent, patient education, monitoring, and adjustment, while ensuring equitable access. A balanced approach recognises both the benefits and limitations of pharmacological interventions, integrating them with behavioural and social support.
Ukraine illustrates both the urgency and practical application of “people and pills”. Since the full-scale Russian invasion in 2022, millions have faced collective trauma layered on a history of suffering. Psychosocial interventions—medical, behavioural, and social—must scale rapidly to support recovery, resilience, and reintegration. What holds for Ukraine holds globally. Wars fracture communities and overwhelm health systems. But whether in conflict or peacetime, the principle is the same: true resilience comes from combining medical and social care, not pitting them against each other.
The global mental health crisis cannot be solved by medication alone. Nor can it be solved without it. Pills and people are not opposing forces but complementary pillars. Together, they create the conditions for healing, resilience, and reform. Mental healthcare reform, whether moving from institutional to community-based care or expanding preventive and resilience-focused programs, relies on a balanced deployment of people and pills.
This requires investment, stigma reduction, and a reframing of public discourse. Pills should not be feared as tools of control, but recognized as enablers of freedom—allowing people to leave institutions, engage in therapy, rebuild social lives, and contribute to their communities. People—families, caregivers, teachers, and healthcare professionals—are the irreplaceable partners who translate medical stability into social recovery.
The lessons are universal. In war, post-conflict recovery, and peacetime, global mental health depends on coordinated, scalable psychosocial strategies in which medication and human-centered care operate in tandem. People and pills enable societies to build resilience, restore dignity, and promote long-term mental health.
The world must stop asking whether it’s people or pills. Survival demands both.
A companion piece to this post can be read here.
Dr. Robert Schuett is co-founder and managing partner at STK Powerhouse, a global risk advisory firm. A former Defence civil servant, he also serves as Chairman of the Austrian Political Science Association and is a long-standing Honorary Fellow at Durham University.
Dr. Georg Psota was Medical Director of Vienna’s Psychosocial Services (PSD) from 2010 to 2025. A renowned psychiatrist, he now serves on the advisory board of STK Powerhouse to help drive mental health strategy.
Photo by Pixabay
