EU COVID-19 Solidarity Programme: Reflections on advocacy and policy development

As part of the EU COVID-19 Solidarity Programme for Eastern Partnership, the Netherlands Helsinki Committee (NHC) joined forces with People in Need (PIN), and AFEW International(AFEW) to propose a set of interventions in Armenia, Georgia, Moldova and Ukraine to mitigate the impact of the COVID-19 pandemic in closed institutions, and contribute towards longer term socio-economic resilience of vulnerable groups.

During the first phase of the project, we aimed to ensure continued and enhanced monitoring and advisory work on COVID-19 measures in closed institutions (both in the penitentiary and in the mental sector) as well as assessment and provision of the immediate needs of people confined in these institutions. The NHC provided sub-grants to civil society organisations (CSOs) on the ground, to monitor implementation of COVID-19 measures in and provide equipment (PPE and IT) for the closed institutions. Find out more about the first phase of the project here.

In the second phase of the project, the NHC and the Global Initiative on Psychiatry are providing capacity development opportunities to CSOs and watchdog initiatives for advocacy and policy development in connection to longer-term pandemic resilience of people in the closed institutions.

As part of the second phase, three advocacy trainings have already taken place in Armenia (22 and 23 July), Georgia (25 and 26 July 2022) and Moldova (18 and 19 August 2022). Participants included sub-grantees who will carry out their own advocacy initiatives in the months following the training, and other organisations that were interested in improving their advocacy skills. The participants of the trainings will continue to develop their plans, and in the coming two months will work with the NHC to receive small-scale coaching and follow-up for their programmes.

The participants of the programme include:

• Helsinki Citizen’s Assembly Vanadzor (Armenia)
• PEF for Freedom (Armenia)
• Centre for Legal Initiatives (Armenia)
• New Generation NGO (Armenia)
• Helsinki Association for Human Rights (Armenia)
• Disability Rights Agenda (Armenia)
• Pink Armenia (Armenia)
• PER (Georgia)
• Georgian Association for Women in Business (Georgia)
• Penal Reform International Georgia (Georgia)
• Georgian Association of Professional Psychologists (Georgia)
• Prevention for Progress (Georgia)
• Alliance for Better Mental Health (Georgia)
• Georgian Network of (Ex-)Users and Survivors of Psychiatry (Georgia)
• Ombudsman’s Office of the Republic of Moldova (Moldova)
• IDOM Human Rights (Moldova)
• AFI (Moldova)
• National Preventative Mechanism Moldova (Moldova)
• Positive Initiative (Moldova)
• Public Association “PULS Comunitar” (Moldova)
• Association for Integrated Sustainable Development (Moldova)

Stories of success: Alliance For Better Mental Health Georgia

About the organisation

Among the organisations taking part in the training was Alliance for Better Mental Health (ABMH) in Georgia, which has been working alongside Society of Georgian Psychiatrists (SGP) to promote safe and continuous care for people with mental disorders in pandemic and post-pandemic times. The main aim of the ABMH is to foster the development of a high-quality mental health system in the country.

The Alliance for better Mental Health (ABMH) is a union of the six professional organizations working in mental health. These organizations joined the alliance in order to increase their influence on the ongoing reforms in mental health care in Georgia and empower them with a multidisciplinary approach. ABMH has coordinated essential processes such as piloting and implementing new mental health community services, as well as mapping and developing standards of mental health care in the country. ABMH successfully advocated for increasing the budget for the State Mental Health program. They led the working group for the 2022-2030 mental health strategic and action plan adopted by the Government on February 2022.

ABMH and SGP are enhancing human rights and continuity of care by developing national practice recommendations, protocols and training modules in evidence-based de-escalation and restraint practices, and telemedicine for health care providers working in mental health services. Within the EU COVID-19 Solidarity project, they aimed to monitor the state mental health inpatient psychiatric hospitals, including the Tbilisi, Rustavi, Surami, and Senaki mental health centers and analyze:

• Preparedness for the pandemic and COVID-19 management in the hospitals
• Human rights and safety of the patients during the pandemic and post-pandemic time

The data gathering through this monitoring revealed poor conditions in terms of human rights during the pandemic.

Reflections on training

In July of 2022, two persons from ABMH and two from SGP took part in a communication and advocacy training that helped them develop a de-escalation training module and national practice recommendations based on the results of their monitoring.

On the basis of this, ABMH and SGP organised roundtable discussions with managers, heads of psychiatric hospitals, ambulatories, and non-governmental organisations working in mental health, including organisations of service users and caregivers.

Using skills developed during the training, ABMH also organised a symposium on the needs of mental health institutions at the October 2022 International WPA Thematic Congress on the “Treatment And Management Of Mental Disorders In A Post-Pandemic Era”, with the participation of the World Psychiatric Association and EPA (European Psychiatric Association) representatives. The participation of international organisations is set to increase the impact on the decision-making bodies.

Looking ahead: Long-lasting impact & sustainable approach

Three meetings with key decision-makers (The Ministry of Health,The Parliament’s Health Committee and The Office of a Public Defender) have taken place to discuss the needs of mental health services and review the possible solutions. As a result, ABMH agreed with the Ministry of Health to start working on the standards of care in the institutions and most importantly, to increase funding for the infrastructure projects and trainings for staff in de-escalation and human rights. ABMH hopes the Ministry of Health will approve the developed protocols and guidelines, which would result in a shift from current coercive practices in mental health institutions to far more humane ones.