The unknown number of Norwegian foreign fighters in Ukraine raises concerns for mental health treatment options

It is unclear how many Norwegians have traveled to Ukraine to enlist in the fight since Russia invaded its neighboring country in February 2022.

The Ukrainian embassy in Norway has given some statements that give a certain clue, but neither the Ministry of Foreign Affairs nor the PST keep track of this.

– We know that Norwegian citizens have enlisted in the Ukrainian military and some of them have been in contact with the Ministry of Foreign Affairs. Those who contact us about possible travel to Ukraine are advised against this, says senior adviser at the Ministry of Foreign Affairs, Lars Gjemble to Nettavisen.

Gjemble says that it is voluntary to register one’s trip to Ukraine with the Norwegian authorities, and that the Foreign Ministry therefore has no overview of how many are involved, where they are or what may have happened to them.

– The Ministry of Foreign Affairs has not confirmed information that enlisted Norwegian citizens have fallen or been injured as a result of the war in Ukraine, he says.

– Shouldn’t have been down here

Knut Flovik Thoresen is a former professional officer in the Norwegian armed forces and is now writing a book about Norwegian foreign fighters in Ukraine. In that context, he has been on several trips to Ukraine to talk to the Norwegian foreign fighters. When Nettavisen talks to him, Thoresen is in Ukraine.

– You have a very large range within those who are down here. After all, they have different backgrounds and different levels of experience with them. Some have a heavy military background and have been in Afghanistan or Iraq. Others have not even completed the initial service.

– You can’t get away from the fact that some of those who are down here shouldn’t have been down here, but the demands of the war naturally come first and then you don’t have time for the same selection as at the Norwegian officers’ school.

Thoresen says that he has spoken to experienced foreign soldiers, who themselves have said that they have a post-traumatic stress diagnosis with them when they arrive.

– Some say openly that they find a civilian life meaningless and that what they can do is fight.

News studio: The war in Ukraine

– Struggling to get the treatment they need

The former professional officer explains that it varies how long the Norwegian soldiers stay in Ukraine, but some have been here continuously since the war broke out.

– Some are tired, especially those who have been at the front for a long time. They try to rotate who is at the front a bit, but the overall rule is that you have to contribute where needed.

He adds that the vast majority of the Norwegian soldiers he has spoken to are doing well.

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Put the injuries up close

Sander Sørsveen Trelvik has been in Ukraine for five periods as an ambulance worker. He has been involved in transporting hundreds of wounded from the war to hospital and treatment.

– Many of our patients have stable physical injuries. For many of them, the only thing they need is a hand to hold and to know that they are safe, he says and continues:

– There are many people who are stressed. You can see that they are having flashbacks. We have also had patients with real PTSD, so if you drive over a bump in the road, you can see that they get really scared. They begin to tremble and cry.

In February, Trelvik himself was injured, when he and his ambulance colleagues were attacked while on duty. A Russian rocket hit them and Trelvik was severely injured. For two months he was in hospital.

– Didn’t understand what I had been through

trelvik says that the treatment he received in Norway was good.

– You were handled like a normal patient, but the difference was that I had injuries that are not exactly that common to see in Norway.

He says that he was also offered to speak to a psychologist, who visited the department a couple of times.

– They were ordinary psychologists. I chatted with them a bit, but I didn’t really feel the need for anything more then and there. Especially not considering that they didn’t seem to understand what I had been through at all, explains Trelvik and says he got little benefit from the conversations.

Furthermore, he explains that after he was discharged from hospital, he has not been offered any follow-up.

– If I need any follow-up now, I have to get it in the usual way.

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Fear of poor treatment options

Kjetil Bragstad is secretary general of the veterans’ organization SIOPS. He himself has served abroad for the Norwegian Armed Forces. He is concerned that the offer Norwegian veterans receive is too poor, including those who have fought voluntarily in Ukraine.

– I fear that they will be met by a treatment device that is not ready. You don’t have a good enough device that is good enough for those in the Armed Forces either. You run the risk of getting people who are not offered the treatment they need. They will very quickly be able to be left to themselves.

Bragstad says there are several veterans who do not realize that their ailments are due to psychological trauma from combat. You can go a very long time in denial, he explains.

– I can imagine that it is even more difficult for those who have been to Ukraine. Then it can be even more difficult to get the treatment you need.

The veteran knows what he’s talking about. In 2007, he himself was seriously injured on a mission for Norway in Afghanistan. He says that meeting an apparatus that has the veterans’ trust is important.

– When I was injured myself, I felt more secure when I saw someone in uniform, they understood me more than civilian therapists.

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Don’t know anything about those who have left

There is little, if any, knowledge about those who travel to Ukraine to contribute to the war. The fact is, however, that the chance of developing mental health problems after being in a conflict area skyrockets drastically.

In recent years, the Norwegian Armed Forces have contributed to a number of foreign operations in conflict areas under the auspices of NATO, including in Iraq and Afghanistan.

Over 40,000 Norwegians have experience from military operations abroad. Almost 10,000 of them served in Afghanistan. Following Norway’s contribution in Afghanistan, a number of investigations have been carried out into the mental health problems of the veterans after they returned.

Over 10 percent of Afghanistan veterans reported mental health problems an average of 10 years after their last trip abroad.

The Afghanistan survey from 2020 shows a very clear connection between exposure to serious incidents in war zones and mental health problems.

This is how they were distributed:

• Depression: 2.1 percent
• Anxiety: 3.1 percent
• Sleep problems: 5.2 percent
• Alcohol abuse: 1.3 percent
• Post-traumatic stress: 2.5 percent
• General stress reactions: 4 percent

“Degree of exposure to conflict and stress in the service area, duration of deployments, as well as the follow-up and care you receive after returning home. All these factors can affect mental health.”

According to The National Association for PTSD 1-2 percent of the population has the diagnosis. Among soldiers who have participated in war, the percentage is between 10 and 20 percent. People who stay in crisis situations also have an increased risk of developing PTSD.

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Thorough preparation and education

Those who have served for the Norwegian Armed Forces on assignments abroad have been through thorough preparations and screening.

The first selection process is already done before you are called up for initial service.

– Those who are called up for initial duty have already been carefully assessed both in terms of their records and character, and whether they can be security cleared. Furthermore, all soldiers on session must show that they have a certain robustness, both physically and mentally to serve in the Armed Forces, says Chief Sergeant in Brigade Nord, Jon Rune Rønneberg to Nettavisen.

After the end of initial service, the individual soldier can choose to apply for further service. Rønneberg says all applicants here are interviewed as part of the selection and that a new selection is made here of who will be included next.

– The most suitable are offered a contract. The content of the recording varies somewhat between the various departments, but common to all is the focus on attitudes and compliance with our values. In addition to this, one often looks at physical and mental robustness, as it turns out to help better cope with experiences on the battlefield.