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

在许多较贫穷的国家，精神健康被忽视，患有精神分裂症和双相情感障碍等严重疾病的人遭受耻辱和人权侵犯。在过去的十年里，加纳和印度尼西亚等国家一直在努力改善获得精神卫生服务的机会，防止侵犯人权。有心理健康状况经历的人已经开始公开谈论他们的经历并倡导改变。不幸的是，全球COVID-19大流行有可能逆转这一进展。加纳和印度尼西亚的精神卫生服务仍然很少，在大流行期间，人们很难获得支持和护理。此外，许多有严重心理健康问题的人发现很难找到工作，这变得更加困难。家庭照顾者，往往是妇女，可能不得不独自奋斗，没有家人、朋友和社区的任何通常支持。这可能会使有精神健康问题的人的身心健康恶化，使他们更难行使融入社会的权利。该项目将在加纳和印度尼西亚培训有精神健康问题生活经验的人，与研究人员一起工作，以了解大流行病和政府的应对措施如何影响生活在贫困城市和农村社区的人们。这包括它如何影响工作，关系，身心健康以及获得医疗服务和支持。我们还将找出在大流行期间对精神健康状况有帮助的人，例如来自家人，朋友和宗教团体的支持。我们将利用这一研究成果，制定新冠肺炎疫情恢复计划的指导方针，指导如何将精神健康问题患者纳入其中，并保护他们的人权。目的和目标目的：了解新冠肺炎疫情对加纳和印度尼西亚严重精神健康问题患者的影响，并为将他们纳入恢复计划提供指导方针。目的：A）我们将利用我们的研究成果，提供以下方面的证据：i）2019冠状病毒病大流行和政府应对措施对低收入和中等收入国家严重精神健康状况患者的健康、人际关系、日常生活和生计的影响ii）大流行和政府应对措施对精神健康状况患者人权的后果，三）有精神健康问题的人及其家庭在大流行病期间使用的支助来源iv）最好的方法是将有心理健康状况生活经验的人纳入研究，宣传，和制定复苏政策B）利用两国的证据制定指导方针，将精神健康问题患者纳入保护其人权的康复计划。潜在应用和益处本研究将提供以下方面的证据：2019冠状病毒病大流行如何影响贫困国家的精神健康状况患者及其家人，以及是什么帮助他们适应和恢复。调查结果将用于编写一份报告，该报告将与政策制定者，慈善机构，精神卫生服务机构和其他相关人员分享，并可用于制定考虑到精神卫生状况患者及其家人需求的康复计划。培训材料将免费提供，以培训有心理健康状况生活经验的人作为研究人员。该项目将提供宝贵的信息，说明如何让生活在较贫穷国家的精神健康问题患者作为研究人员参与进来，并使他们能够为影响他们的计划做出贡献。这将有助于确保各项计划和政策与受其影响的人民的需要和优先事项相关。

ContextIn 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 objectivesAim: 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 countriesii) 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 restraintsiii) Sources of support used by people with mental health problems and their families during the pandemiciv) 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 rightsPotential applications and benefitsThis 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.