The Impact Of The Covid-19 Pandemic And Its Response On The Mental Health Of People With Pre-Existing Mental Conditions In Uganda.

Background: Covid-19 is a worldwide highly infectious respiratory pandemic that causes much anxiety and stress leading to mass panic in populations worldwide People with Severe mental illness (SMI) are likely to be highly vulnerable to Covid-19 infection spread. They have difficulties understanding messages, are often neglected by family, have few or no support networks. The fear, anxiety and stress brought on by the Covid-19 pandemic may exacerbate their conditions e.g., post-traumatic stress disorder, panic anxiety, depression on top of their SMI. Objectives: This research proposal will seek to investigate the difficulties individuals and their caretaking families face during this Covid-19 epidemic and to find ways to mitigate them. The specific research objectives of this proposal will be to investigate the following: 1. The effect of Covid-19 and its response on the mental health of people with SMI 2. The effect of Covid-19 and its response on access to care for people with SMI 3. The effect of Covid-19 and its response on families & caretakers of individuals with SMI 4. The current health and information messaging and knowledge regarding Covid-19 and its response for people with SMI 5. The effectiveness of an outreach mobile mental health clinic (MMHC)7 initiative to mitigate the care and messaging gap for people with SMI during the Covid-19 pandemic and its response. Methods: This is a mixed methods study employing both qualitative and quantitative methodologies. The study will take place in Uganda at three sites: Butabika National Referral Mental Hospital, Masaka Regional Referral Hospital and Mityana District Hospital. The planned sample size for each site will be 30 outpatients, 60 family members (2 per patient) and 6 mental health professionals (one per 5 patients). Sample sizes of qualitative methodologies using Focus Group Discussions (FGD) and/or Indepth Interviews (II) of 8-10 participants. Analysis: For quantitative data, descriptive statistics will be used for socio-demographic data for all participants. To assess for effectiveness of the mobile outreach intervention, mean and standard deviations over the time points (baseline, 6 and 12 months) will be calculated, and the analysis tested using the significance of the differences between the means of the measured outcomes. Qualitative data will be analyzed using thematic analysis using NVivo qualitative analysis software. Expected Outputs Currently in Uganda, there is limited consideration of mental health matters as shown by the first consideration of the Ministry of Health response to this pandemic being the conversion of mental health units in the country Covid-19 isolation centers. With this research we hope to raise awareness that will influence Policy in the increased training of psychosocial responders and mental health supervision in all hospitals countrywide and setting up a national psychosocial response. In addition, this research will demonstrate the need to lobby for setting up family services divisions/secretariat from LCI to LCV to cater for psychosocial and domestic dimensions of the pandemic including caretaking of people with SMI, poverty issues and domestic problems, including Sexual and Gender Based Violence, all of which have increased in this pandemic