The challenges
The inception of our programme coincided with the emergence of the COVID-19
pandemic and we had concerns around the potentially disproportionate impact of
COVID-19 on people with disabilities and mental health conditions.
Misinformation was rife and accurate health information on how to protect and prevent
spread of the virus was not available in different formats. The restrictions imposed
increased mental health vulnerability as people became anxious and isolated. People
with disabilities and mental health conditions were likely to be more impacted by the
restrictions, finding it challenging to get access to self-help groups, medication, or
maintain their livelihoods. Health workers experienced additional burdens on the front
lines of the pandemic.
The solution
We needed to better understand the actual and potential impact of COVID-19 on
people with disabilities, including people with mental health conditions, in Ghana.
We needed to ensure that the people most affected by COVID-19 received increased
access to reliable wellbeing and psychosocial support. It was important to target
people with disabilities, people with mental health conditions, people infected with or
recovering from COVID-19, and healthcare workers.
Training was also critical on how to prevent spread of the disease, protect healthcare
workers and provide support for their own wellbeing. Training needed to consider any
adjustments in delivering healthcare services during the pandemic.
Enhancing the capacity of community volunteers was expected to support continuous
provision of mental health and psychosocial support to people with mental health
conditions and their primary caregivers during and after the COVID-19 pandemic.
What did the programme do?
We immediately commissioned a rapid assessment of the situation in Ghana and we
awarded seven fast-track COVID-19 psychosocial resilience grants.
We worked with civil society and grantees to deliver a range of activities to educate
and inform on how to protect self and others, how to maintain their livelihoods, and
develop resilience and how to access mental health and psychosocial support. Short
films were produced by the programme and grantees to demonstrate the impact and
lessons learned of COVID-19 projects.
These grants supported people with disabilities, including people with mental
health conditions, COVID-19 survivors and healthcare workers. These grants
allowed individuals to access healthcare through mental health nurses’ community
visits, mobile clinics, and other innovations. Under the grants, healthcare workers
were trained in supporting individuals with mental health conditions, implementing
safeguarding measures, and providing essential tools for their work including
psychosocial first aid. Some grantees established helplines (telehealth) services
allowing people to access mental health support without leaving their home.
The grantees also organised wellness clinics, radio programmes and community
talks to help people understand facts and dispel myths on the virus and later, on the
importance of vaccination.
Alongside the National Health Service, England, we provided training for healthcare
workers in Ghana on how to support and manage people with mental health
conditions and COVID-19. This training also supported healthcare workers to identify
ways to manage their own wellbeing.
We conducted training for the media on mental health and disability inclusion so they
could use appropriate language and consider how the pandemic and its restrictions
were impacting people with disabilities.
In 2021, we undertook a COVID-19 Readiness Assessment of the Ankaful, Pantang
and Accra psychiatric hospitals to help inform preparedness for future pandemics.
We produced Easy Read information on COVID-19 and when restrictions were lifted,
we helped 272 self-help groups to re-open safely. Consortium partner BasicNeedsGhana visited all the self-help groups to ensure they understood the government
COVID-19 protocols and requirements, using the Easy Read information on how to
protect and prevent spread. We provided basic materials for handwashing and masks,
meaning that all groups could safely resume their work.
How we made a difference
Increased knowledge
Assessment of healthcare workers after training showed significant increases in their
level of knowledge and confidence relating to COVID-19 management, risk management
and knowledge of symptoms. Healthcare workers were reportedly more engaged, and
less fearful. People with mental health conditions which got worse during the early days
of the pandemic were able to seek help using telehealth services.
Some health service providers told us they extended the training received to others
in their workforce as well as traditional and religious leaders, ensuring that there was
always someone in the community who had knowledge around mental health.
99% of 225 self-help group users surveyed found our Easy Read information useful
and 96.5% reported that the content of the materials was readily understandable.
Increased outreach
During the grantee work in this period, the proportion of people with mental health
conditions accessing mental health care rose from 20% to 35% across project districts in
northern Ghana.
The seven groups that received a COVID-19 response grant helped the wellbeing
of approximately 10,040 people with disabilities, including people with mental health
conditions. A further 8,100 members of self-help groups were provided with resilience
support.
Grantees specifically supported 457 COVID-19 infected people with psychosocial
support and recovery.
Resilience for the future
In Apam village, 14 young people from the community died in a tragic sea accident.
The training put in place through the pandemic meant that health services were poised
to recognise the mental health impact of the tragedy and attend to the bereaved and
survivors. Continued visits by health professionals to people impacted helped with
individual and community recovery. The hospital involved felt more resilient in the face of
this tragedy because of the pandemic training.
To prepare for future health emergencies, one grantee set out recommendations to
support inclusive pandemic responses in Ghana. And, following our assessment of the
three psychiatric hospitals, we provided six oxygen concentrators to the Mental Health
Authority for hospital use.
How we know we made a difference
With technical assistance that we provided, each grantee self-evaluated their project
and later, an external evaluator assessed their projects.
The short films demonstrating the impact of grantees’ COVID-19 projects, and the
accompanying report, captured challenges and learnings to inform activities and
approaches in the future. The films and reports also reflected hope and resilience and
uncovered numerous community stories of change.
Lessons learned
- People with disabilities and people with mental health conditions are at greater
potential risk of contracting COVID-19; at greater risk of adverse economic
and social impacts resulting from restrictions; face potential exacerbation
of pre-existing mental health conditions; face potential increased stigma,
discrimination, neglect, violence, and abuse. - Health crises shock health systems and communities and have a lasting
impact beyond the duration of the outbreak. Working with existing health
stakeholders who have extensive experience in coordinating response efforts
among governments, local and international partners can strengthen and
increase the resilience of health systems. - Gathering evidence allows the monitoring of situations and identifies gaps and
required actions to address these. - Providing information in a range of accessible formats such as Easy Read,
audio and sign language are critical and valued in an emergency. Without
diverse formats of information, large numbers of people are without the
necessary information to support themselves in a health emergency.
Resources produced on this topic
- Leave no one behind during the coronavirus outbreak in Ghana
- Rapid assessment: Impact of COVID-19 on people with disabilities, including
people with mental health disabilities, in Ghana - Assessment of preparedness of psychiatric hospitals in Ghana to manage
COVID-19: scorecard summary - An easy read guide to COVID-19
- Explore our grantees’ COVID-19 change story films
