The role of host national contact in the mental health of displaced Ukrainians in the Netherlands
Authors: Al-Saqaff Naome 
Published: September 2023

Purpose
The Russian invasion of Ukraine in February 2022 has led to the displacement of many Ukrainians. The purpose of this study is to investigate the relationship between their contact with Dutch society and their mental health. To this end, 136 adult, mostly female, displaced Ukrainians in the Netherlands participated in an online survey to investigate the relationship between quality of host national contact and mental health, as moderated by quantity of host national contact. The survey had a Ukrainian, Russian and English version, and it consisted of single questions assessing various variables, including quality of host national contact, quantity of host national contact, amount of discrimination/prejudice as well as five questions assessing mental health (Mental Health Inventory 5 [MHI-5]; Berwick et al., 1991). Contrary to the hypotheses, no interaction was found between quality of host national contact and quantity of host national contact, and quality of host national contact did not have a significant main effect on mental health. However, there is a significant, yet nonlinear main effect of quantity of host national contact on mental health. Moreover, there is a significant correlation between quality of host national contact and quantity of host national contact. Finally, and interestingly, there is a positive relationship between the amount of discrimination/prejudice and mental health among people who chose to fill out the Ukrainian version of the survey. These results provide a nuanced view of the relationship between the host environment and mental health, and governmental policies should take into account the complexity of this relationship.

Design/methodology/approach
A total of 161 displaced, mostly female (90.40%), Ukrainians in the Netherlands with the average age of 35 agreed to participate in this online survey. The main variables measured were mental health (dependent variable), quality of host national contact (independent variable 1) and quantity of host national contact (independent variable 2/moderator). Additional variables, such as the level of perceived discrimination/prejudice, have been included in the analyses. The survey was available in three different languages: Ukrainian, Russian and English.

Findings
In this study, the role of host national contact in the mental health of displaced Ukrainians in the Netherlands was investigated. The results showed that there was no interaction between quality of host national contact and quantity of host national contact in the prediction of mental health. Moreover, quality of host national contact did not predict mental health. Thus, both of the (preregistered) hypotheses of this study were refuted. However, the amount of perceived discrimination/prejudice turned out to be linked to mental health. Surprisingly, the amount of perceived discrimination/prejudice predicted higher mental health scores among participants who chose to fill out the survey in Ukrainian. Moreover, of the respondents included in the analysis, 94.85% gave reason for mental health concerns, as expressed by a converted MHI-5 score below 60.

Research limitations/implications
Even though this study does show a positive relationship between the level of discrimination/prejudice and mental health among displaced Ukrainians who filled out the Ukrainian version of the survey, it does not offer a definite explanation for why this seemingly unexpected result occurred. No causal conclusions can be drawn based on this study regarding the relationship between host national contact and mental health.

Practical implications
The results of this study show that certain occurrences in the contact with host society members relate to mental health in unexpected and seemingly complex ways. This might mean that this study has potential for nuancing the current scientific knowledge regarding the relationship between host national contact and mental health. Such nuances might be quite important, as scientific research often forms the basis for governmental policies aimed at improving the mental health of displaced people. Therefore, governmental policymakers should be aware of the fact that there is no easy, clear-cut answer yet to the complex host society factors that play a role in the mental health of various displaced groups. Moreover, an investigation of the role of host national contact might lead to valuable knowledge about factors that contribute to the mental health of refugees. As has been said, refugees are at risk of developing various mental health issues, so they might need help managing their mental health. To this end, policymakers might need evidence-based information to develop interventions targeted at specific refugee groups. By investigating the mental health of displaced Ukrainians in the Netherlands, new insights will be gained to optimize mental health care for this particular refugee group.

Social implications
This study yields important information regarding the degree of participation and inclusion of displaced Ukrainians in Dutch society, which can inform policies targeted at improving the experiences of this new displaced group. Because displaced Ukrainians have to deal with the mental health consequences of war and displacement, they might be particularly in need of a safe haven in which they feel included.

Originality/value
To the best of the author’s knowledge, this is the first study in which the role of the host society context in the mental health of displaced Ukrainians in the Netherlands is assessed. The results are quite unexpected and can nuance the current research on the link between discrimination and mental health. Moreover, this study can inspire future research to be conducted in the reasons behind this nuance, by researching the role of identity and uncertainty. Also, the author believes that this study is particularly suitable for this journal because it really looks at the link between social inclusion in the Dutch context and mental health outcomes.