The impact of COVID-19 on people living with psychosocial disabilities in Ghana and Indonesia and priorities for inclusive recovery

Context In many poorer countries mental health is neglected and people with serious conditions like schizophrenia and bipolar disorder experience stigma and human rights abuses. In the last ten years countries like Ghana and Indonesia have worked hard to improve access to mental health services and prevent human rights abuses. People with lived experience of mental health conditions have started to talk openly about their experiences and advocate for change. Sadly, the global COVID-19 pandemic threatens to reverse this progress. Ghana and Indonesia still have few mental health services and during the pandemic it has become difficult for people to access support and care. In addition, many people with serious mental health conditions find it hard to get work and this has become even more difficult. Family caregivers, often women, may have to struggle alone without any of the usual supports from family, friends and the community. This is likely to worsen the physical and mental health of people with mental health conditions and make it harder for them to exercise their right to be included in society. This project will train people with lived experience of mental health problems in Ghana and Indonesia to work alongside the researchers to find out how the pandemic and government responses have affected people living in poor urban and rural communities. This includes how it has impacted on work, relationships, mental and physical health and access to health services and support. We will also find out what has helped people with mental health conditions during the pandemic, such as support from family, friends and religious groups. We will use this to develop guidelines on how plans for recovery from the COVID-19 pandemic can include people with mental health conditions and protect their human rights. Aims and objectives Aim: To understand the impact of COVID-19 on people with serious mental health conditions in Ghana and Indonesia and inform guidelines to include them in recovery plans. Objectives: A) We will use our research to provide evidence on the following: i) The impact of the COVID-19 pandemic and government responses on the health, relationships, daily life and livelihoods of people with severe mental health conditions in low- and middle-income countries ii) The consequences of the pandemic and government responses for the human rights of people with mental health conditions, including forced treatment and use of physical restraints iii) Sources of support used by people with mental health problems and their families during the pandemic iv) The best ways to include people with lived experience of mental health conditions in research, advocacy, and developing policies for recovery B) To use evidence from the two countries to develop guidelines to include people with mental health conditions in plans for recovery which protect their human rights Potential applications and benefits This research will provide evidence on how the COVID-19 pandemic has affected people with mental health conditions and their families in poorer countries and what has helped them to adapt and recover. The findings will be used to develop a report which will be shared with policy makers, charities, mental health services and other relevant people and can be used to develop plans for recovery which take into account the needs of people with mental health conditions and their families. The training materials will be made freely available to train people with lived experience of mental health conditions as researchers. This project will provide valuable information on how to involve people with mental health conditions living in poorer countries as researchers and enable them to contribute to plans which affect them. This will help to make sure that plans and policies are relevant to the needs and priorities of the people they affect.