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abstract: 'Background A recent editorial urged those working in global mental
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health to ``change the conversation{''''} on coronavirus disease
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(Covid-19) by putting more focus on the needs of people with severe
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mental health conditions. UPSIDES (Using Peer Support In Developing
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Empowering mental health Services) is a six-country consortium carrying
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out implementation research on peer support for people with severe
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mental health conditions in high- (Germany, Israel), lower middle-
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(India) and low-income (Tanzania, Uganda) settings. This commentary
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briefly outlines some of the key challenges faced by UPSIDES sites in
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low- and middle-income countries as a result of Covid-19, sharing early
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lessons that may also apply to other services seeking to address the
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needs of people with severe mental health conditions in similar
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contexts. Challenges and lessons learned The key take-away from
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experiences in India, Tanzania and Uganda is that inequalities in terms
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of access to mobile technologies, as well as to secure employment and
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benefits, put peer support workers in particularly vulnerable situations
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precisely when they and their peers are also at their most isolated.
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Establishing more resilient peer support services requires attention to
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the already precarious situation of people with severe mental health
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conditions in low-resource settings, even before a crisis like Covid-19
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occurs. While it is essential to maintain contact with peer support
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workers and peers to whatever extent is possible remotely, alternatives
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to face-to-face delivery of psychosocial interventions are not always
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straightforward to implement and can make it more difficult to observe
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individuals'' reactions, talk about emotional issues and offer
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appropriate support. Conclusions In environments where mental health
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care was already heavily medicalized and mostly limited to medications
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issued by psychiatric institutions, Covid-19 threatens burgeoning
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efforts to pursue a more holistic and person-centered model of care for
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people with severe mental health conditions. As countries emerge from
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lockdown, those working in global mental health will need to redouble
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their efforts not only to make up for lost time and help individuals
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cope with the added stressors of Covid-19 in their communities, but also
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to regain lost ground in mental health care reform and in broader
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conversations about mental health in low-resource settings.'
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affiliation: 'Ryan, GK (Corresponding Author), London Sch Hyg \& Trop Med, Fac Epidemiol
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\& Populat Hlth, Dept Populat Hlth, London, England.
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Mpango, Richard, Butabika Natl Referral Hosp, Res \& Training Sect, Kampala, Uganda.
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Mpango, Richard, MRC UVRI \& LSHTM Uganda Res Unit, Mental Hlth Sect, Entebbe, Uganda.
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Mpango, Richard, Soroti Univ, Sch Hlth Sci, Dept Mental Hlth, Arapai, Uganda.
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Kalha, Jasmine; Kulkarni, Arti; Korde, Palak, Ctr Mental Hlth Law \& Policy, Pune,
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Maharashtra, India.
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Shamba, Donat; Ramesh, Mary; Ngakongwa, Fileuka, Ifakara Hlth Inst, Dept Hlth Syst
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Impact Evaluat \& Policy, Dar Es Salaam, Tanzania.
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Ngakongwa, Fileuka, Muhimbili Univ Hlth \& Allied Sci, Dept Psychiat \& Mental Hlth,
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Dar Es Salaam, Tanzania.
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Nakku, Juliet, Butabika Natl Referral Hosp, Psychiat, Kampala, Uganda.
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Ryan, Grace K., London Sch Hyg \& Trop Med, Fac Epidemiol \& Populat Hlth, Dept
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Populat Hlth, London, England.'
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article-number: '90'
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author: Mpango, Richard and Kalha, Jasmine and Shamba, Donat and Ramesh, Mary and
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Ngakongwa, Fileuka and Kulkarni, Arti and Korde, Palak and Nakku, Juliet and Ryan,
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Grace K.
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author-email: grace.ryan@lshtm.ac.uk
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author_list:
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- family: Mpango
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given: Richard
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- family: Kalha
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given: Jasmine
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- family: Shamba
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given: Donat
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- family: Ramesh
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given: Mary
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- family: Ngakongwa
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given: Fileuka
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- family: Kulkarni
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given: Arti
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- family: Korde
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given: Palak
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- family: Nakku
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given: Juliet
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- family: Ryan
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given: Grace K.
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da: '2023-09-28'
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doi: 10.1186/s12992-020-00622-y
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eissn: 1744-8603
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files: []
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journal: GLOBALIZATION AND HEALTH
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keywords: Peer support; Global mental health; Covid-19
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keywords-plus: HEALTH
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language: English
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month: SEP 25
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number: '1'
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number-of-cited-references: '14'
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orcid-numbers: Kalha, Jasmine/0000-0001-7357-2366
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papis_id: 01fd3c52b55d34a93c7d8b64e591c94a
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ref: Mpango2020challengespeer
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researcherid-numbers: 'Wheatley, Dorothy/HGC-9224-2022
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'
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times-cited: '11'
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title: Challenges to peer support in low- and middle-income countries during COVID-19
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type: Article
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unique-id: WOS:000576290700001
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usage-count-last-180-days: '0'
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usage-count-since-2013: '1'
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volume: '16'
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web-of-science-categories: Public, Environmental \& Occupational Health
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year: '2020'
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