SUCCEED Africa: We are launching this World Human Rights Day!
By Julian Eaton [London School of Hygiene & Tropical Medicine] and Ms. Bisola Fasoranti [Peer Researcher]
“SUCCEED Africa builds on principles of co-production and South-South partnership to enable African countries to become regional leaders in research and policy on psychosocial disabilities, focusing on the people who are most severely disabled and excluded in the poorest communities”
Common mental conditions like depression and anxiety have tended to be the focus of health services research in low and middle income countries, because they are so common and are associated with significant proportion of total global disability. However, there is a lack of research into how best to support people with the most severely disabling conditions; psychotic conditions like schizophrenia and bipolar disorder. Although psychosis typically affect only around 1% of the population, people with psychosis and their families are among the most marginalised groups in society, and have a high risk of experiencing violence, poverty, homelessness, incarceration and unemployment. In Nigeria, for example, people with severe mental health conditions live under worst conditions such as in dilapidated buildings, under bridges and on the streets and it thus appear that they are at risk of being left behind in global mental health. With these kinds of living conditions, people with psychosis are at more risk of being exposed to infectious diseases and other social barriers such as stigma; structural barriers such as high rate of incarceration and poor physical health conditions which tend to lead to increase in mortality rate. Consequently there is a tendency for people with psychosis to be subjected to abusive practices such as chaining and beatings in traditional healing houses which tends to worsen their conditions rather than making it get better.
Families do render care but prolonged illness could lead to breakdown of family support network. This may result in shackling them in family compounds. Families pay out of their pockets for mental health care. The extreme poverty faced by people with psychosis in Nigeria and their families can threaten their survival.
Support, Comprehensive Care and EmpowErment for people with psychosocial Disabilities in sub-Saharan Africa (SUCCEED Africa) is a new research programme, launched in December 2020, and funded by the UK Foreign, Commonwealth and Development Office (FCDO). The programme seeks to work with people disabled by mental illness and their families to identify what their priorities are, and understand how we can find solutions to address the barriers that have held them back from participating in their local communities. This consortium of researchers from Universities in Malawi, Nigeria, Sierra Leone, Zimbabwe and London, will develop a package of care based on careful assessment of identified needs, and local resources. We will then evaluate the packages using a variety of methods, including rigorous randomized controlled trials, so that we generate high quality evidence that can be used to improve support for people with severe mental illnesses.
The SUCCEED Africa project is designed to help people living with psychosocial disabilities to lend their voices in the community through an improve health package using a community based rehabilitation intervention and also making use of vital health information from mental health workers and people with lived-in experience.
We take the view that people affected themselves are best placed to understand their needs. Research has historically been carried out in a top-down way, and we plan to engage with local communities, as well as a set of Peer Researchers, who have experience of mental illness themselves, to collaborate on this research, from beginning to end. Through formal structures like a Lived Experience Advisory Panel, and Local Advisory Groups, and building research skills of Peer Researchers, the research will follow a process of co-production. This research tradition has not been extensively used in this context, and we hope to build experience and evidence to inform others working in Global Mental Health.
Health, and social inclusion
Access to health services, or ‘closing the treatment gap’ is an important focus of research in Global Mental Health, but we will also draw on disability research and practice, which emphasizes the many other aspects of people’s lives to ensure that we consider barriers and supports in all aspects of community engagement. The concept of “psychosocial disabilities”, as defined by the United Nations (UN) Convention on the Rights of Persons with Disabilities, requires a holistic response to the “interaction between the impairments” caused by a mental conditions and the “various barriers [that] may hinder their full and effective participation in society on an equal basis with others”. SUCCEED is about working with people to find ways of promoting meaningful participation in communities, to break out of patterns of neglect and abuse, and enabling people to flourish, attain their full potential and contribute to their communities.
SUCCEED officially launched on December 10th 2020 – World Human Rights Day – and work over the course of 6 years to learn more about the real lives of people with psychosocial disabilities in sub-Saharan Africa, develop and test a package of support, and better understand how to work in co-production of research. There will be lots of opportunities to follow the work, and to get involved, through MHIN Africa.
Meet the Principal Investiagators and CEO