{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T12:11:07Z","timestamp":1780920667794,"version":"3.54.1"},"reference-count":53,"publisher":"BMJ","issue":"6","license":[{"start":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T00:00:00Z","timestamp":1780876800000},"content-version":"unspecified","delay-in-days":7,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,5,13]]},"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      The\n                      <jats:italic>Mental health care: Adverse Sequelae of COVID-19<\/jats:italic>\n                      study aimed to (1) compare the consequences of the COVID-19 pandemic for mental health services and people with pre-existing mental health conditions (MHCs) in six low- and middle-income countries and (2) identify good practice to mitigate these impacts.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>An observational study, using a mixed-methods convergent design triangulating data from (1) semistructured interviews or focus groups and\/or a self-completed survey, (2) routine service utilisation data, (3) local grey literature and (4) expert consultation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>The study was conducted in Chile, Ethiopia, Georgia, Nigeria, South Africa and Sri Lanka.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>121 key informants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We found clear evidence in all sites that the pandemic exacerbated pre-existing disadvantages experienced by people with MHCs and led to a deterioration in the availability and quality of care, especially psychosocial care. Alongside increased vulnerability to COVID-19, people with MHCs faced additional barriers to accessing prevention and treatment interventions compared with the general population. To varying extents, sites showed accelerated implementation of digital technologies, but with evidence of worsening inequities in access. In sites where primary care-based mental healthcare was more developed or prioritised, systems seemed more resilient and adaptive.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our findings have the following implications. First, these mental health service reductions are clear examples of \u2018structural stigma\u2019, namely policy level decisions in healthcare which place a low priority upon services for people with MHCs. Second, integration of mental healthcare into all general healthcare settings is key to ensuring accessibility and parity of physical and mental healthcare. Third, digital innovations should be designed to strengthen and not fragment health systems. We discuss these findings in terms of anticipating such challenges for future pandemics and preparing layers of resilience.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-103813","type":"journal-article","created":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T11:45:18Z","timestamp":1780919118000},"page":"e103813","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Adverse sequelae of the COVID-19 pandemic on mental healthcare in six low- and middle-income countries (MASC): a mixed-methods study with lessons for the future"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7937-3226","authenticated-orcid":false,"given":"Charlotte","family":"Hanlon","sequence":"first","affiliation":[{"name":"Division of Psychiatry, Institute for Neuroscience and Cardiovascular Research, University of Edinburgh, Edinburgh, UK"},{"name":"Department of Psychiatry, WHO Collaborating Centre for Mental Health Research and Capacity Strengthening, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidi","family":"Lempp","sequence":"additional","affiliation":[{"name":"Inflammation Biology, King\u2019s College London, London, England, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atalay","family":"Alem","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, WHO Collaborating Centre for Mental Health Research and Capacity Strengthening, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2898-713X","authenticated-orcid":false,"given":"Azeb Asaminew","family":"Alemu","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, WHO Collaborating Centre for Mental Health Research and Capacity Strengthening, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rub\u00e9n","family":"Alvarado","sequence":"additional","affiliation":[{"name":"Universidad de Valparaiso, Valpara\u00edso, Valparaiso Region, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3896-226X","authenticated-orcid":false,"given":"Olatunde Olayinka","family":"Ayinde","sequence":"additional","affiliation":[{"name":"University College Hospital Ibadan, Ibadan, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1805-1191","authenticated-orcid":false,"given":"Adekunle","family":"Adesola","sequence":"additional","affiliation":[{"name":"Northamptonshire Healthcare NHS Foundation Trust, Kettering, England, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elaine","family":"Brohan","sequence":"additional","affiliation":[{"name":"Health Service and Population Research Department, King\u2019s College London, London, England, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thandi","family":"Davies","sequence":"additional","affiliation":[{"name":"University of Cape Town, Rondebosch, WC, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7418-4955","authenticated-orcid":false,"given":"Wubalem","family":"Fekadu","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, WHO Collaborating Centre for Mental Health Research and Capacity Strengthening, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oye","family":"Gureje","sequence":"additional","affiliation":[{"name":"Psychiatry, University of Ibadan College of Medicine, Ibadan, Oyo, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucy","family":"Jalagania","sequence":"additional","affiliation":[{"name":"Ilia State University, Tbilisi, Tbilisi, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nino","family":"Makhashvili","sequence":"additional","affiliation":[{"name":"Ilia State University, Tbilisi, Tbilisi, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5956-114X","authenticated-orcid":false,"given":"Awoke","family":"Mihretu","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, WHO Collaborating Centre for Mental Health Research and Capacity Strengthening, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3912-3409","authenticated-orcid":false,"given":"Eleni","family":"Misganaw","sequence":"additional","affiliation":[{"name":"Mental Health Service User Association, Addis Ababa, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6798-8178","authenticated-orcid":false,"given":"Maria","family":"Milenova","sequence":"additional","affiliation":[{"name":"Institute of Psychiatry, Psychology and Neuroscience, King\u2019s College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamar","family":"Mujirishvili","sequence":"additional","affiliation":[{"name":"University of Alicante, Sant Vicent del Raspeig, Valencian Community, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olha","family":"Myshakivska","sequence":"additional","affiliation":[{"name":"Taras Shevchenko National University of Kyiv, Kyiv, Kyiv City, Ukraine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irina","family":"Pinchuk","sequence":"additional","affiliation":[{"name":"Taras Shevchenko National University of Kyiv, Kyiv, Kyiv City, Ukraine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camila","family":"Solis-Araya","sequence":"additional","affiliation":[{"name":"University of Chile, Santiago, Santiago Metropolitan Region, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Sorsdahl","sequence":"additional","affiliation":[{"name":"University of Cape Town Faculty of Health Sciences, Observatory, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gonzalo","family":"Soto-Brandt","sequence":"additional","affiliation":[{"name":"University of Chile, Santiago, Santiago Metropolitan Region, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ezra","family":"Susser","sequence":"additional","affiliation":[{"name":"Columbia University, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga","family":"Toro-Devia","sequence":"additional","affiliation":[{"name":"University of Chile, Santiago, Santiago Metropolitan Region, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Votruba","sequence":"additional","affiliation":[{"name":"University of Oxford, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anuprabha","family":"Wickramasinghe","sequence":"additional","affiliation":[{"name":"University of Colombo, Colombo, WP, Sri Lanka"},{"name":"Rajarata University of Sri Lanka, Mihintale, Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shehan","family":"Williams","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Kelaniya, Kelaniya, WP, Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graham","family":"Thornicroft","sequence":"additional","affiliation":[{"name":"Health Service and Population Research, King\u2019s College London, London, England, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,6,8]]},"reference":[{"key":"2026060804451175000_16.6.e103813.1","unstructured":"World Health Organisation . World Mental Health Report. Geneva: WHO, 2022."},{"key":"2026060804451175000_16.6.e103813.2","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.116.188078"},{"key":"2026060804451175000_16.6.e103813.3","doi-asserted-by":"publisher","DOI":"10.1177\/0706743720926676"},{"key":"2026060804451175000_16.6.e103813.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2020.11.117"},{"key":"2026060804451175000_16.6.e103813.5","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1002\/wps.20806","article-title":"Increased risk of COVID-19 infection and mortality in people with mental disorders: analysis from electronic health records in the United States","volume":"20","author":"Wang","year":"2021","journal-title":"World Psychiatry"},{"key":"2026060804451175000_16.6.e103813.6","unstructured":"World Health Organization . The Impact of COVID-19 on Mental, Neurological and Substance Use Services: Results of a Rapid Assessment. Geneva: World Health Organization, 2020."},{"key":"2026060804451175000_16.6.e103813.7","unstructured":"United Nations . The 2030 Agenda for Global Action and the Sustainable Development Goals. NY, 2015."},{"key":"2026060804451175000_16.6.e103813.8","doi-asserted-by":"crossref","first-page":"s47","DOI":"10.1192\/bjp.bp.114.153767","article-title":"District mental healthcare plans for five low- and middle-income countries: commonalities, variations and evidence gaps","volume":"208 Suppl 56","author":"Hanlon","year":"2016","journal-title":"Br J Psychiatry"},{"key":"2026060804451175000_16.6.e103813.9","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61414-7"},{"key":"2026060804451175000_16.6.e103813.10","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(22)01470-2"},{"key":"2026060804451175000_16.6.e103813.11","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.114.149112"},{"key":"2026060804451175000_16.6.e103813.12","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20384"},{"key":"2026060804451175000_16.6.e103813.13","doi-asserted-by":"crossref","first-page":"878","DOI":"10.1016\/S0140-6736(07)61239-2","article-title":"Resources for mental health: scarcity, inequity, and inefficiency","volume":"370","author":"Saxena","year":"2007","journal-title":"The Lancet"},{"key":"2026060804451175000_16.6.e103813.14","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0116820","article-title":"The global burden of mental, neurological and substance use disorders: an analysis from the Global Burden of Disease Study 2010","volume":"10","author":"Whiteford","year":"2015","journal-title":"PLoS One"},{"key":"2026060804451175000_16.6.e103813.15","doi-asserted-by":"crossref","DOI":"10.1192\/bjo.2018.90","article-title":"Strengthening mental health systems in low- and middle-income countries: recommendations from the Emerald programme","volume":"5","author":"Semrau","year":"2019","journal-title":"BJPsych Open"},{"key":"2026060804451175000_16.6.e103813.16","unstructured":"World Health Organization . Everybody\u2019s Business: Strengthening Health Systems to Improve Health Outcomes \u2013 WHO\u2019s Framework for Action. Geneva: WHO, 2007."},{"key":"2026060804451175000_16.6.e103813.17","unstructured":"World Health Organization . Guidance on Community Mental Health Services: Promoting Person-Centred and Rights-Based Approaches. Geneva: WHO, 2021."},{"key":"2026060804451175000_16.6.e103813.18","doi-asserted-by":"publisher","DOI":"10.1037\/amp0000068"},{"key":"2026060804451175000_16.6.e103813.19","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1004224","article-title":"Reimagining the journey to recovery: The COVID-19 pandemic and global mental health","volume":"20","author":"Patel","year":"2023","journal-title":"PLoS Med"},{"key":"2026060804451175000_16.6.e103813.20","doi-asserted-by":"publisher","DOI":"10.1080\/09540261.2022.2145183"},{"key":"2026060804451175000_16.6.e103813.21","doi-asserted-by":"crossref","DOI":"10.1186\/s12889-022-12625-y","article-title":"Locked out during COVID-19 lockdown\u2014an online survey of relatives of people with psychotic and bipolar disorders in Norway","volume":"22","author":"Aminoff","year":"2022","journal-title":"BMC Public Health"},{"key":"2026060804451175000_16.6.e103813.22","doi-asserted-by":"crossref","DOI":"10.3389\/fpsyt.2021.697058","article-title":"Emergency Psychiatric Consultations During and After the COVID-19 Lockdown in Italy. A Multicentre Study","volume":"12","author":"Balestrieri","year":"2021","journal-title":"Front Psychiatry"},{"key":"2026060804451175000_16.6.e103813.23","doi-asserted-by":"crossref","first-page":"114136","DOI":"10.1016\/j.psychres.2021.114136","article-title":"Impact of the COVID-19 pandemic on acute inpatient psychiatric units in Spain","volume":"304","author":"Montes","year":"2021","journal-title":"Psychiatry Res"},{"key":"2026060804451175000_16.6.e103813.24","doi-asserted-by":"publisher","DOI":"10.1097\/NMD.0000000000001389"},{"key":"2026060804451175000_16.6.e103813.25","doi-asserted-by":"crossref","DOI":"10.3389\/fpsyt.2022.933858","article-title":"Mental health in individuals with self-reported psychiatric symptoms during the COVID-19 pandemic: Baseline data from a swedish longitudinal cohort study","volume":"13","author":"Rozental","year":"2022","journal-title":"Front Psychiatry"},{"key":"2026060804451175000_16.6.e103813.26","doi-asserted-by":"crossref","first-page":"114451","DOI":"10.1016\/j.psychres.2022.114451","article-title":"Psychological and behavioral response on the COVID-19 pandemic in individuals with bipolar disorder: A multicenter study","volume":"310","author":"Dalkner","year":"2022","journal-title":"Psychiatry Res"},{"key":"2026060804451175000_16.6.e103813.27","doi-asserted-by":"publisher","DOI":"10.1038\/s41380-021-01344-2"},{"key":"2026060804451175000_16.6.e103813.28","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1001\/jamapsychiatry.2020.4442","article-title":"Association of Psychiatric Disorders With Mortality Among Patients With COVID-19","volume":"78","author":"Nemani","year":"2021","journal-title":"JAMA Psychiatry"},{"key":"2026060804451175000_16.6.e103813.29","doi-asserted-by":"crossref","first-page":"945","DOI":"10.1001\/jamapsychiatry.2021.1416","article-title":"Implications of Global and Local Inequalities in COVID-19 Vaccine Distribution for People With Severe Mental Disorders in Latin America","volume":"78","author":"Mascayano","year":"2021","journal-title":"JAMA Psychiatry"},{"key":"2026060804451175000_16.6.e103813.30","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1016\/S2215-0366(21)00236-4","article-title":"COVID-19 vaccine prioritisation for individuals with psychoses","volume":"8","author":"Kumar","year":"2021","journal-title":"Lancet Psychiatry"},{"key":"2026060804451175000_16.6.e103813.31","doi-asserted-by":"crossref","first-page":"440","DOI":"10.37506\/ijfmt.v16i2.18022","article-title":"The Legal Responsibility to the Family for Shackling People with Mental Illness During the Covid-19 Pandemic","volume":"16","author":"Ariawan","year":"2022","journal-title":"Indian Journal of Forensic Medicine & Toxicology"},{"key":"2026060804451175000_16.6.e103813.32","doi-asserted-by":"crossref","DOI":"10.1186\/s12888-022-03790-w","article-title":"Prevalence of post-traumatic stress disorder symptoms among patients with mental disorder during the COVID-19 pandemic","volume":"22","author":"Tang","year":"2022","journal-title":"BMC Psychiatry"},{"key":"2026060804451175000_16.6.e103813.33","article-title":"Psychological Impact of the COVID-19 Pandemic and Associated Lockdown on Outpatients With Psychiatric Illness: A Cross-Sectional Study","volume":"24","author":"Gupta","year":"2022","journal-title":"Prim Care Companion CNS Disord"},{"key":"2026060804451175000_16.6.e103813.34","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1016\/S2215-0366(21)00025-0","article-title":"COVID-19 mental health impact and responses in low-income and middle-income countries: reimagining global mental health","volume":"8","author":"Kola","year":"2021","journal-title":"Lancet Psychiatry"},{"key":"2026060804451175000_16.6.e103813.35","doi-asserted-by":"crossref","DOI":"10.26633\/RPSP.2023.87","article-title":"Adverse sequelae of the COVID -19 pandemic on mental health services in Chile","volume":"47","author":"Toro-Devia","year":"2023","journal-title":"Rev Panam Salud Publica"},{"key":"2026060804451175000_16.6.e103813.36","doi-asserted-by":"crossref","DOI":"10.1186\/s13033-023-00612-8","article-title":"Impact of the COVID-19 pandemic on mental health care and people with mental health conditions in Ethiopia: the MASC mixed-methods study","volume":"17","author":"Mihretu","year":"2023","journal-title":"Int J Ment Health Syst"},{"key":"2026060804451175000_16.6.e103813.37","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0290712","article-title":"Impacts of Covid-19 on mental health service provision in the Western Cape, South Africa: The MASC study","volume":"18","author":"Davies","year":"2023","journal-title":"PLoS One"},{"key":"2026060804451175000_16.6.e103813.38","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1080\/14780887.2014.955224","article-title":"The Utility of Template Analysis in Qualitative Psychology Research","volume":"12","author":"Brooks","year":"2015","journal-title":"Qual Res Psychol"},{"key":"2026060804451175000_16.6.e103813.39","doi-asserted-by":"crossref","unstructured":"Symon G , Cassell C . Qualitative organizational research: core methods and current challenges . In: Symon G , Cassell C , eds. Doing Template Analysis. 1 Oliver\u2019s Yard, 55 City Road London EC1Y 1SP: SAGE Publications, 2012. Available: https:\/\/sk.sagepub.com\/books\/qualitative-organizational-research-core-methods-and-current-challenges","DOI":"10.4135\/9781526435620.n1"},{"key":"2026060804451175000_16.6.e103813.40","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.c4587","article-title":"Three techniques for integrating data in mixed methods studies","volume":"341","author":"O\u2019Cathain","year":"2010","journal-title":"BMJ"},{"key":"2026060804451175000_16.6.e103813.41","unstructured":"Creswell JW , Plano Clark VL . Designing and Conducting Mixed Methods Research. Thousand Oaks, CA: Sage Publications, Inc, 2011."},{"key":"2026060804451175000_16.6.e103813.42","doi-asserted-by":"publisher","DOI":"10.1111\/1475-6773.12117"},{"key":"2026060804451175000_16.6.e103813.43","doi-asserted-by":"crossref","DOI":"10.1017\/S2045796020000797","article-title":"Core components of mental health stigma reduction interventions in low- and middle-income countries: a systematic review","volume":"29","author":"Clay","year":"2020","journal-title":"Epidemiol Psychiatr Sci"},{"key":"2026060804451175000_16.6.e103813.44","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1017\/S2045796017000634","article-title":"Service user and caregiver involvement in mental health system strengthening in low- and middle-income countries: a cross-country qualitative study","volume":"27","author":"Lempp","year":"2018","journal-title":"Epidemiol Psychiatr Sci"},{"key":"2026060804451175000_16.6.e103813.45","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2021.31475","article-title":"Collaboration With People With Lived Experience of Mental Illness to Reduce Stigma and Improve Primary Care Services: A Pilot Cluster Randomized Clinical Trial","volume":"4","author":"Kohrt","year":"2021","journal-title":"JAMA Netw Open"},{"key":"2026060804451175000_16.6.e103813.46","unstructured":"World Health Organization Euro . WHO Mosaic Toolkit on Ending Stigma and Discrimination in Mental Health. Copenhagen: WHO Euro, 2024."},{"key":"2026060804451175000_16.6.e103813.47","doi-asserted-by":"crossref","DOI":"10.1016\/j.eclinm.2021.101111","article-title":"Mental and neurological disorders and risk of COVID-19 susceptibility, illness severity and mortality: A systematic review, meta-analysis and call for action","volume":"40","author":"Liu","year":"2021","journal-title":"EClinicalMedicine"},{"key":"2026060804451175000_16.6.e103813.48","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1136\/ebmental-2021-300254","article-title":"WHO mental health gap action programme (mhGAP) intervention guide: updated systematic review on evidence and impact","volume":"24","author":"Keynejad","year":"2021","journal-title":"Evid Based Ment Health"},{"key":"2026060804451175000_16.6.e103813.49","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/S2215-0366(21)00384-9","article-title":"Efficacy and cost-effectiveness of task-shared care for people with severe mental disorders in Ethiopia (TaSCS): a single-blind, randomised, controlled, phase 3 non-inferiority trial","volume":"9","author":"Hanlon","year":"2022","journal-title":"Lancet Psychiatry"},{"key":"2026060804451175000_16.6.e103813.50","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1016\/S2215-0366(20)30526-5","article-title":"Perspectives of lived experience across continents: our reality and call for universal health coverage","volume":"8","author":"Stewart","year":"2021","journal-title":"Lancet Psychiatry"},{"key":"2026060804451175000_16.6.e103813.51","unstructured":"World Health Organization . World Mental Health Report: Transforming Mental Health for All. Geneva: WHO, 2022."},{"key":"2026060804451175000_16.6.e103813.52","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(21)02233-9"},{"key":"2026060804451175000_16.6.e103813.53","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2020.12.016"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2025-103813","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T11:45:37Z","timestamp":1780919137000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2025-103813"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6]]},"references-count":53,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,6,8]]},"published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1136\/bmjopen-2025-103813"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2025-103813","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6]]}}}