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The impacts of COVID-19 on people with disabilities: a rapid review. Disability Inclusion Helpdesk Query No: 35

MEANIE-DAVIS, Jessie
LEE, Harri
CORBY, Nick
April 2020

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There is currently very limited data and evidence on the impacts of COVID-19 on people with disabilities and pre-existing health conditions, with no disability-disaggregated data on mortality rates available in the public sphere. However, reports from the media, disability advocates and disabled peoples’ organisations (DPOs) point to several emerging impacts, including primary and secondary impacts including on health, education, food security and livelihoods.  Most of the available data is from high income countries (HICs) though reports from low- and middle-income countries (LMICs) are likely to emerge. Evidence was gathered by a rapid desk based review. Gaps are identified. 

 

The section concerned with lessons drawn from similar epidemics draws heavily on lessons learned from the Ebola outbreak in West Africa in 2014-2016, and touches on lessons from the Zika outbreak in 2015-2016 and the SARS pandemic in the early 2000s.10 It also touches briefly on SARS, MERS and H1N1 (swine flu). 

 

Primary and secondary impacts of COVID-19 on people with disabilities are reviewed.


People with disabilities are disproportionately impacted by COVID-19 not only because it can exacerbate underlying medical conditions, but because of attitudinal, environmental and institutional barriers to their participation in and benefit from the pandemic response. For example, inaccessible public health messaging and healthcare facilities, and stigma and discrimination.

Missing millions: How older people with disabilities are excluded from humanitarian response

SHEPPARD, Phillip
POLACK, Sarah
McGIVERN, Madeleine
July 2018

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The aim of this study was to explore the experiences of older people with disabilities across a range of humanitarian settings, considering:

  • whether older people with disabilities have additional needs and challenges accessing humanitarian assistance and protection
  • what factors facilitate or limit access by older people with disabilities to humanitarian assistance and protection
  • to what extent is humanitarian response inclusive of older people with disabilities

A systematic literature review of published studies was conducted. Key online humanitarian guidelines were explored to review how far they explicitly address older people with disabilities. Data from six population-based disability surveys comparing the living situation of older people with and without disabilities were analysed. These included databases from two crises-affected populations in Haiti (post-earthquake) and Palestine. Data from four non-humanitarian settings was also reviewed to explore more broadly the situation for older people with disabilities – India, Guatemala, Cameroon and Nepal. Interviews were held with older people with disabilities, members of their families and local key informants in two conflict-affected populations in Ndutu and Mtendeli refugee camps in Western Tanzania, and Donetsk and Luhansk regions of Eastern Ukraine to find out about their experiences. Staff of five international agencies working in humanitarian response were also interviewed. 

 

Findings highlight particular issues facing older people with disabilities in humanitarian crises: more risk escaping from danger;  barriers to accessing social protection and work; barriers to accessing health and rehabilitation services; barriers to accessing food and other essentials; unsuitable housing and poor living conditions;  insecurity and discrimination; threats to dignity and independence; social isolation and loneliness; risks to mental health; and missing from humanitarian response.

 

A table brings together the findings from the different components of the research to show the needs, risks, barriers and enablers for older people with disabilities identified in the research. Recommendations are provided to humanitarian donors, policy makers and practitioners

Not forgetting severe mental disorders in humanitarian emergencies: a descriptive study from the Philippines

WEINTRAUB, Ana Cecilia Andrade de Moraes
et al
November 2016

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"In response to the Typhoon Haiyan in the Philippines, Médecins Sans Frontières-Operational Centre Brussels (MSF-OCB) decided to concentrate its efforts in the severely affected area of Guiuan and its four surrounding municipalities. The MSF-OCB intervention included a comprehensive approach to mental health, including care for people with pre-existing and post-disaster severe mental disorders. Based on this experience of providing MH care in the first five months after Typhoon Haiyan, we report on the monthly volume of MH activities and beneficiaries; sociodemographic and care seeking characteristics of beneficiaries receiving MH counselling/care, stratified by the severity of their condition; profile and outcomes of patients with severe mental disorders; prescribing practice of psychotropic medication; and main factors facilitating the identification and management of individuals with severe mental disorders"

International Health, Vol.8, No.5, pp. 336-344

Doi: 10.1093/inthealth/ihw032

Mental health problems in Juba, South Sudan: local perceptions, attitudes and patient care - A socio-anthropological study

LOHINIVA Anna-Leena
May 2016

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Mental health programming is important in post-conflict settings such as South Sudan. Handicap International is currently implementing a project entitled “Touching Mind, Raising Dignity; to stop the stigma toward people with mental health problems” which aims to improve the social and community involvement of people living with mental health problems. This qualitative research study was conducted to understand local concepts linked to mental health problems and health-seeking in order to develop effective mental health interventions in the context of Juba, South Sudan. The study was conducted in four locations in Juba among community members, people with mental health problems, their caregivers and service providers. Focus group discussions & in-depth interviews were conducted with a total of 130 study participants. The interviews were conducted in English or by translating from Juba Arabic. The data was analysed using thematic analysis. Respondents used two wide categories when discussing people with mental health problems: mad (majnun) and sad and tired (mariid= sick). Substance abuse related madness and maratsarra (epilepsy) were genuine community concerns. Mild signs and symptoms were not recognized as mental health problems, the causes of mental health problems were viewed as numerous and complex, and mental health problems were believed to be common in South Sudan. 

mhGAP Humanitarian Intervention Guide (mhGAP-HIG) Clinical Management of Mental, Neurological and Substance Use Conditions in Humanitarian Emergencies

WORLD HEALTH ORGANIZATION
2015

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"The mhGAP Humanitarian Intervention Guide contains first-line management recommendations for mental, neurological and substance use conditions for non-specialist health-care providers in humanitarian emergencies where access to specialists and treatment options is limited. It is a simple, practical tool that aims to support general health facilities in areas affected by humanitarian emergencies in assessing and managing acute stress, grief, depression, post-traumatic stress disorder, psychosis, epilepsy, intellectual disability, harmful substance use and risk of suicide....This new tool is an adaptation of WHO’s mhGAP Intervention Guide, a widely-used evidence-based manual for the management of these conditions in non-specialized health settings."

United Nations expert group meeting on mental well-being, disability and disaster risk reduction

UNITED NATIONS UNIVERSITY
et al
2014

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This report presents information from the Expert Group Meeting on Mental Well-being, Disability and Disaster Risk Reduction and highlights "to achieve sustainable human development that leaves no one behind, it is necessary to prioritise the mental health and psychosocial well-being of all people, including persons with physical, mental, intellectual or sensory impairments. It is also imperative to make DRR measures that are inclusive of disability and do not neglect persons with mental or intellectual disabilities. In this regard, the expert group adopted the recommendations indicated below for outcomes and follow-up with respect to (1) the Post-2015 Framework for Disaster Risk Reduction at the World Conference on Disaster Risk Reduction in 2015, (2) follow-up of the Third High-level Meeting on Disability and Development, (3) the Post-2015 Development Agenda/Sustainable Development Goals, which will be adopted in 2015, and other relevant international and national frameworks"

Expert Group Meeting on Mental Well-being, Disability and Disaster Reduction

Tokyo, Japan

November 2014

UNHCR mental health and psychosocial support for persons of concern

MEYER, Sarah
2013

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"This evaluation reports on how well the United Nations High Commission for Refugees considers and provides for the well-being and mental health of persons of concern to the agency. Through a survey of UNHCR field staff, extensive literature and policy review, and key informant interviews with MHPSS experts from academic institutions, international agencies and non-governmental organizations, this review provides insight into how UNHCR’s current activities contribute towards improved mental health and psychosocial well-being of displaced persons and how UNHCR’s current policy frameworks relate to established practices and frameworks in the MHPSS field"

Who is where, when, doing what (4Ws) in mental health and psychosocial support : manual with activity codes

IASC REFERENCE GROUP FOR MENTAL HEALTH AND PSYCHOSOCIAL SUPPORT IN EMERGENCY SETTINGS
2012

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"Humanitarian actors in emergencies often encounter challenges in knowing Who is Where, When, doing What (4Ws) with regard to mental health and psychosocial support (MHPSS). Such knowledge is essential to inform coordination. 4Ws tools are used in many areas of aid to map activities conducted across large geographical areas". This manual outlines the 4Ws with regard to mental health and psychosocial support for humanitarian actors with MHPSS coordinating responsibilities. The tool exists in two parts: a 4Ws data collection spreadsheets application (in excel online) and this manual which describes how to collect the data

Guiding principles for the domestic implementation of a comprehensive system of protection for children associated with armed forces or armed groups

INTERNATIONAL COMMITTEE OF THE RED CROSS (ICRC)
September 2011

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"These Guiding Principles are intended to serve the purpose of promoting and spreading knowledge of international humanitarian law and, in particular, of implementing the provisions protecting children affected by armed conflicts, especially children associated or previously associated with armed forces or armed groups. The Guiding Principles suggest a number of practical, regulatory and legal measures as means to encourage States to improve such protection. They are based mainly on binding international rules (taking into account the specific obligations of all relevant treaties and of customary law). They also refer to widely accepted instruments of a non-binding character ("soft law"). A checklist of the main obligations regarding children associated with armed forces and armed groups is provided in Annex IV"

Psychological first aid : guide for field workers

WORLD HEALTH ORGANIZATION (WHO)
WAR TRAUMA FOUNDATION (WTF)
WORLD VISION INTERNATIONAL
2011

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"This guide covers psychological first aid which involves humane, supportive and practical help to fellow human beings suffering serious crisis events. It is written for people in a position to help others who have experienced an extremely distressing event. It gives a framework for supporting people in ways that respect their dignity, culture and abilities. Despite its name, psychological first aid covers both social and psychological support"

The humanitarian emergency settings perceived needs scale (HESPER) : manual with scale

WORLD HEALTH ORGANIZATION (WHO)
KINGS COLLEGE LONDON
2011

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The HESPER Scale "aims to provide a method for assessing perceived needs in representative samples of populations affected by large-scale humanitarian emergencies in a valid and reliable manner. This manual includes the HESPER Scale (see Appendix 1), as well as a detailed explanation of how to use the HESPER Scale, how to train interviewers, and how to organise, analyze and report on a HESPER survey"

Mental health and psychosocial support in humanitarian emergencies : what should humanitarian health actors know

IASC REFERENCE GROUP FOR MENTAL HEALTH AND PSYCHOSOCIAL SUPPORT IN EMERGENCY SETTINGS
2010

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"This document is for humanitarian health actors working at national and sub-national level in countries facing emergencies and crises. It applies to Health Cluster partners, including governmental and non-governmental health service providers. Based on the IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings (IASC, 2007), this document gives an overview of essential knowledge that humanitarian health actors should have about mental health and psychosocial support (MHPSS) in humanitarian emergencies"

IASC guidelines for mental health and psychosocial support in emergency settings : checklist for field use

INTER-AGENCY STANDING COMMITTEE (IASC)
2008

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This resource provides a summary of the guidelines for mental health and psychosocial support in emergency settings. It details a general introduction, a matrix of minimum responses in the midst of emergencies, and eleven checklists for key actions of emergency response. The checklists cover the following areas: coordination; monitoring and evaluation; protection and human rights; community mobilization and support; health services; education; dissemination of information; food security and nutrition; shelter and site planning; water and sanitation. This resource is useful for humanitarian agencies and practitioners

IASC guidelines for mental health and psychosocial support in emergency settings

INTER-AGENCY STANDING COMMITTEE (IASC)
2007

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These guidelines provide information to organisations and individuals on how to respond during humanitarian emergencies by highlighting eleven specific action sheets that offer practical guidance on mental health and psychosocial support. The guidelines include a matrix of interventions with guidance for emergency planning, actions to be taken in the early stages of an emergency, and comprehensive responses needed in the recovery and rehabilitation phases. This resource is gives humanitarian actors useful inter-agency, inter-sectoral guidance and tools for responding effectively in the midst of emergencies

Protecting children from sexual exploitation and sexual violence in disaster and emergency situations

DELANEY, Stephanie
March 2006

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"This manual is about how to protect children from sexual violence and sexual exploitation, specifically in disaster and emergency situations. It is not intended to be an academic report but instead is a practical guide that we hope will be of use to people working directly in the field. The aim is to provide fundamental information to assist personnel working in emergency situations in responding to protect children, in terms of what can be done before disaster strikes (which might be called ‘mitigation’ efforts), in the immediate aftermath (the ‘response’) and in the longer term reconstruction phase (sometimes called the ‘recovery’). We have also included recommended actions and key considerations to be taken into account in the event of sexual violence or sexual exploitation"

Mental health of populations exposed to biological and chemical weapons

WORLD HEALTH ORGANIZATION (WHO)
2005

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"The mental and social health consequences of exposure to biological or chemical weapons require a public health strategy. Attacks with chemical and biological weapons are likely to be accompanied by acute fear, organic mental problems, psychological responses to somatic illnesses and injuries, and long-term development of medically unexplained symptoms. The paper outlines some early social interventions, followed by descriptions of early mental health interventions"

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