“They are dangerous people”: the thousands of Russian soldiers who return from the front with post -traumatic stress and do not receive help

As Tatyana explains, the transition back to the relative calm of civil life can trigger uncontrollable aggressiveness in some ex -combatants.

“My colleague had a patient who entered a cafeteria and started hitting customers because they were sitting there,” he says.

And he points out that “there is that internal conflict: 'Here I am a good person, kind, and there I was killing people'”.

He also remembers working with a commander who forced his subordinates to remain in a hole without food or water, a method he considered necessary to impose discipline.

“When he returned home with his family, he wondered: 'My God, how could I treat these boys?'” He says.

In the course of a whole year, says Tatyana, only eight soldiers went to her in search of psychological support, and several of them ended up withdrawing and resorting to alcohol.

Moscow has not revealed how many soldiers are currently participating in fighting.

However, in December 2023, the president of Russia, Vladimir Putin, declared that there were 617,000 soldiers in the front. Another 490,000 were deployed the following year.

According to the Bekhterev psychiatry center in Russia, between 3% and 11% of the soldiers who pass through the front could suffer posttraumatic stress disorder (PTSP).

In the case of a serious injury, the probability of developing a disorder increases to 14-17%, according to the same body.

Since the beginning of the large-scale invasion of Ukraine, the Russian Ministry of Health has established some 2,700 medical-psychological guidance offices throughout the country to protect the mental health of veterans and their families.

There is also a program funded by the State that offers support, in addition to some volunteer networks.

But all these efforts are insufficient and the centers that provide psychological assistance are too small or lack personnel, says Yana (fictional name), a psychologist who works in one of these support offices.

Yana opposes the invasion of Ukraine and at first thought it would be difficult to work with men who had participated in the fighting; But in the end he felt his help could make a difference.

“They are dangerous people and I can make them less dangerous,” he tells the Russian service of the BBC.

But there is another challenge, he says: operating in an increasingly repressive environment in which any criticism of what Kremlin calls “special military operation” is illegal.

Both therapists and patients are usually afraid to speak frankly.

“We are all afraid to speak,” says Yana. “If you talk to someone who does not share your ideas, there may be consequences. Someone could give you away and your life was ruined,” he says.

Remember how some patients put it to the test during the sessions, making casual comments about the war while carefully observing their reaction.

Very few of his civil patients openly support war, he says. Most simply want me to end.

When Russia launched its large -scale invasion of Ukraine in 2022, not only sent professional soldiers in front; Among their ranks were also convicted criminals who agreed to fight in exchange for condemnation reductions.

Many were recruited by the Mercenary Grupo Wagner, founded by the late Yevgeny Prigozhin. The prisoners were promised clemency and a total pardon in exchange for six months of combat service. According to Prigozhin himself, around 50,000 inmates were enlisted.

However, in January 2024, Wagner's role in recruitment had decreased, and the Russian Defense Ministry assumed control.

The conditions changed significantly: the prisoners that were offered as volunteers now had to serve during everything that would prolong the war.

In fact, they are convicted or not, most soldiers are now subject to contracts without completion date.

Since the mass mobilization was declared in September 2022, military service has become, in practice, indefinite. The decline is only granted in cases of serious injuries, old age or new criminal convictions.

And these convictions are increasingly frequent.

According to an independent environment Verstkaat least 242 people have died and another 227 have been injured in crimes committed by war veterans between February 2022 and August 2024 in Russia. Cases range from murders to sexual aggressions and possesses.

In early 2025, the Legal Institute of the Urals – dependent on the Ministry of Interior – published a study on the “impact of the special military operation on crime in Russia.”

He concluded that, since war began, serious and violent crimes have increased significantly throughout the country.

Matvey (fictional name), a psychologist in a clinic of addiction treatment in a Russian region, says that he and his companions were waiting for an increase in cases of alcohol abuse related to the PTSD among the soldiers who returned.

According to the clinical guidelines of the Bekhterev Center, people exposed to extreme traumas – such as combat – have a high risk of developing addiction problems.

In 2024, military personnel represented 10 % of all cases treated by addiction at the Serbsky Center, the main psychiatric hospital in Russia.

Despite the clear link between trauma and addiction, effective treatment options remain scarce.

Matvey explains that patients usually remain in their center at most two weeks, a period of “palliative care” rather than effective treatment.

Methods such as cognitive processing therapy, which requires at least 12 sessions, are practically non -existent.

“For most, therapy is too painful or too abstract to commit to it,” says Matvey.

“Our patients can realize that something is not right, but the problem is so terrible, so traumatic and painful, that they do not want to touch it,” he says.

And he adds: “I think that PTSD treatment should be more or less mandatory.”

President Putin raised at the beginning of 2024 the idea of making the therapy for soldiers returning, but so far no policy has been implemented in that regard.

Even if there is political will, the country faces a serious shortage of qualified specialists.

Estimates on the number of exercise psychologists in Russia vary widely, between 57,000 and more than 100,000.

According to the World Health Organization, that equals just between 4 and 5 psychologists per 100,000 inhabitants, well below international standards.

Despite all systemic obstacles, some psychologists say their work has not been in vain.

Yana continues to attend civilians, refugees and relatives of soldiers, of whom quite deal with PTSD and acute anxiety.

In just 10 to 12 sessions, he says, many patients begin to feel safe again.

“It is positive, because most could not afford psychological help in another way,” he says.

Tatyana believes that much more is needed to help combat veterans.

“We don't have a unified organization throughout the country,” he says.

And sentence: “People are left alone, looking for volunteers or trying to fix them on their own if they want to work with a psychologist.”

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