Frontline SHEROs: Women, War, and Mental Health in, and for, all Policies

As women face the greatest mental health burdens of war while driving recovery, Viktoriya Teliha and Susanne Schuett argue that mental health must be treated as a shared social and global responsibility across all sectors of public policy.

“It has probably become more dangerous to be a woman than a soldier in an armed conflict.” These stark words from former UN peacekeeping commander Major General Patrick Cammaert at the UN Security Council’s first-ever meeting devoted exclusively to sexual violence in 2008 remain painfully true today. The number of women and girls, who are disproportionately affected by conflict and war, is rising rapidly.

Globally, over 600 million women and girls live in conflict-affected areas – a 50% increase in just a decade – and the proportion of women killed in armed conflict doubled in 2023 compared to the previous year. Despite international conventions designed to protect their rights, from the “Fourth Geneva Convention” in 1949 to the “UN Security Council Resolution 1325” in 2000, the atrocities faced by women remain widespread and insufficiently confronted.

Gender-based violence has been a pervasive feature of conflict throughout history – and remains so today. As Christina Lamb documents in Our Bodies, their Battlefield: What War does to Women, rape is the “unspoken weapon” used systematically in war. Women’s bodies become the “extension of the battlefield”. Today, over 70% of women in humanitarian crises have experienced gender-based violence. In Ukraine, cases have surged by 36% since 2022. Even in places once considered safe, women and girls have become victims – in their own homes and in public spaces.

Gender-based violence does not stop at pregnant or breastfeeding mothers, who already suffer heightened vulnerabilities in peace-time – from food insecurity to elevated risks of perinatal mental health disorders, which can have lifelong effects on both mother and child. And many women still die during pregnancy or childbirth – half of them in conflict zones. Particularly vulnerable to violence are also all women and children among the more than 123 million forcibly displaced people worldwide (including 43 million refugees), who make up the majority. In Ukraine, 76% of refugees are women and children, many at heightened risk of violence, trafficking, and exploitation.

Economic collapse deepens women’s vulnerability. In conflict zones, women lose up to half their income sources, and Ukraine’s war has widened the gender employment gap and pay disparities to alarming levels. At the same time, women provide vital unpaid care – spending up to 56 hours weekly on childcare in Ukraine alone – often as sole breadwinners.

The disproportionate impact of war on women also manifests as a disproportionate mental health burden. The World Health Organization (WHO) estimates that in conflict-affected areas, 1 in 5 people will develop a long-term mental health condition such as depression, anxiety, or post-traumatic stress disorder (PTSD) – especially women. The female gender is also associated with greater severity of new-onset mental illness. High risk and high rates of mental illness are found among refugees, internally displaced people, and healthcare workers (most of whom are women) – as well as among veterans, active military personnel, children, the elderly, and people with disabilitites (many of whom are cared for by women). As a result, women more often than men, show increased levels of fear, depression, loneliness, suicidal ideation, PTSD and substance misuse.

It is important to note that this blog does not suggest that men are less affected by war’s mental health toll. Their experience is different. Addressing the invisible wounds, especially among boys and young men, caused by combat exposure, displacement, and rigid gender norms, is equally essential. At the same time, the mental health toll on women – shaped by overlapping roles and disproportionate burdens – demands focused attention. Focusing on women’s mental health is not only about protecting them – it strengthens the entire social fabric. When mothers and caregivers are supported, especially vulnerable boys and young men are more likely to grow up in environments where care and healing is possible.

Women are on the frontlines of a mental health crisis. But they are not only victims. Women are also essential agents of first response, recovery and resilience – the true SHEROs of war.

Women are the backbone of caregiving at home and across society – in peacetime, and even more so in wartime. In addition to caring for their children – who carry the future of the nation – women care for elderly parents, who embody the nation’s past, as well as for their returning veteran husbands – unless they must, heartbreakingly, mourn their loss in combat. Women also make up the vast majority of the system-relevant workforce: they are nurses, doctors, social workers, educators in kindergartens and schools, supermarket staff, sanitation workers, transport employees, and volunteers. Women provide shelter and meals to displaced people, teach in bunkers, rebuild communities, and lead civil society initiatives. Thus, even amid war, women preserve family cohesion and societal functioning.

Ukraine offers a powerful example of women-led mental health policy action amid war through the All-Ukrainian Mental Health Programme “How Are You?”, launched by First Lady Olena Zelenska and coordinated by the Ministry of Health, with support from the WHO. This programme operationalises the Mental Health in All Policies (MhiAP) approach, as recently endorsed by WHO’s Paris Statement, even during active warfare. It embeds mental health not only in healthcare, but across sectors – placing it at the centre of society: where mental illness develops, where it should be treated, and where it must be prevented in the first place.

But the programme also reflects an equally important and emerging shift: the need to treat mental health not only as something that benefits from other policy domains, but something that actively benefits them in return. This is the essence of the Mental Health for All Policies (MHfAP) approach, recently articulated in the OECD’s Win-Win Solutions for Well-Being and Mental Health report. Together, these two approaches — MHiAP and MHfAP — are mutually reinforcing. The former ensures accountability across sectors; the latter highlights the societal and economic payoff of investing in mental health as a foundation for better outcomes in education, employment, justice, and beyond.

This dual framing reflects a broader paradigm shift: mental health is not simply a health issue, nor is it a post-conflict add-on. It is a whole-of-society imperative, and a strategic resource to be cultivated — not only to protect individuals, but to build the very conditions for national resilience and recovery. Ukraine’s “How Are You?” initiative is a globally significant example of this thinking in action: a wartime innovation that demonstrates that mental health recovery must begin during conflict, not after it ends.

From this perspective, several policy shifts become essential:

• Embed mental health in all public policy domains, including health, education, employment, justice, and finance, from wartime onward.
• Invest in and empower women as leaders in the design and delivery of mental healthcare and recovery systems.
• Address gender-specific risks and barriers, particularly for displaced people, pregnant women, survivors of violence, and frontline care workers.
• Recognise and support unpaid care work through economic, legal, and social protections.
• Close gender gaps in education and employment, to strenghten women’s agency and wellbeing.
• Secure sustained mental health funding – not as crisis response, but as long-term, cross-sector investment.

This year marks 30 years since the “Beijing Declaration and Platform for Action” – a global commitment to uphold women’s rights as fundamental to sustainable development, peace, and security. Yet, three decades on, gender inequality remains deeply entrenched. At current rates, it will take nearly 300 years to close the global gender gap. We must not let that happen. Evidence shows that when women are empowered and included, recovery is faster, more inclusive, and more sustainable.

Women are not just victims of war and its mental health toll. They are frontline SHEROs. A Mental Health in All Policies – and for All Policies – approach is essential: not only to protect women, but to empower them as architects of resilience and recovery. This requires recognising mental health as a shared responsibility – embedded in how we care, educate, employ, and live together as a society, locally and globally, in peace and in war.

A companion piece to this post can be read here (https://www.globalpolicyjournal.com/blog/28/04/2025/silent-frontline).

Viktoriya Teliha is co-founder at STK Powerhouse, a global risk advisory firm. She holds degrees in Politics from the University of Vienna and the Diplomatic Academy of Vienna, and has previously served in the Ukrainian diplomatic service in Paris and Vienna.

Susanne Schuett is a senior executive at a Viennese outpatient mental health clinic. A psychologist by training, she holds the habilitation (venia docendi) in psychiatry from the Medical University of Vienna and serves on the advisory board of STK Powerhouse.

Photo by Luis Dalvan