RFP АEXTENDED UNTIL JULY 6! EHRA is looking for the consultancy to develop approaches of ensuring optimal access to Mental Health care services by key populations in emergency situations related to COVID and war crisis 

Background  

Eurasian Harm Reduction Association (EHRA) is a non-for-profit public membership-based organization uniting harm reduction activists and organisations from Central and Eastern Europe and Central Asia (CEECA) with its mission to actively unite and support communities and civil societies to ensure the rights and freedoms, health, and well-being of people who use psychoactive substances in the CEECA region. 

EHRA is looking for a consultant to conduct a mapping of existing systems of the mental health care and an assessment of existing and potential barriers hampering the access to mental health services available to people using drugs involving war refugees from Ukraine, in emergency situations connected to COVID and war crisis. 

Living a healthy and positive life is not possible without adequate mental health; mental health problems may have a significant impact on daily life and its quality without being treated effectively.  

People who use drugs, like all people, should have an appropriate access to mental health support. Mental health issues and drug dependency can be brought in by the same factors, like poverty, lack of access to healthcare and other services, homelessness, stigma and discrimination; people may also start or continue using drugs to deal with mental health issues. Providing adequate access to mental health services for people who use drugs “without framing drug use and/or dependence as mental health issues in absolute terms” should be considered a priority. People who use drugs should be able to exercise their right to have a choice regarding their physical/mental health and relevant ways to encourage better access to mental health or barriers hampering such access should be identified and properly analysed. 

For the past several years certain factors have influenced the optimal access to mental health services:  

• influence of COVID-19 pandemic on mental health issues was obvious due to increased stress situations, lockdowns and growing waves of home and gender-based violence as well as extra strain on health care systems all over the world.  
• the most recent war in Ukraine caused nearly one third of its population (over 14 million) to flee the violence and abandon their homes in search of safe haven inside the country or abroad, with over 6 million Ukrainians having crossed the borders and living as refugees abroad, while over 8 millions are internally displaced within the country. Many of these people are or will be in the nearest future in dire need of essential mental health support, also to mention the more specialized services needed for key populations, including people who use drugs, OST clients and NPS users including war refugees from Ukraine.  
• some specific mental health challenges are encountered by a more specific group of people using NPS (new psychoactive substances). Services for NPS users are usually not available in existing harm reduction packages of services (syringe exchange, distribution of condoms and disinfectants, overdose prevention, testing for HIV and other infections, psycho-social assistance, etc.) and, therefore, opportunities to receive help with mental health or behavioral disorders due to the use of NPS is limited. Only a few countries in the region have established clinical protocols for the diagnosis and treatment of mental health and behavioral disorders by the use of NPS and even those are not widely used due to lack of knowledge among health professionals, resulting in lack of adequate medical assistance for NPS users.  
• continued stigmatisation/discrimination in health institutions and judgmental attitudes toward people who use drugs from the general public, still remain a barrier for those who may be in need of mental health services. 

These and other significant factors influencing the provision of mental health services should be assessed, carefully studied, and relevant recommendations formulated for further optimization of mental health support services provision with an emphasis on people who use drugs (incl. OST clients and NPS users), including war refugees from Ukraine, in different backgrounds as mentioned above. 

Objectives and key tasks of the consultant: 

EHRA is looking for a consultant to develop approaches of ensuring optimal access to mental health care services by conducting a mapping of existing systems of the mental health care and its management in selected countries and  implementing an assessment of existing and potential structural, legal, language, stigma-related and other barriers hampering the access of people using drugs (incl. OST clients and NPS users) residing in a country and war refugees from Ukraine to mental health services, in emergency situations related to COVID pandemic and war crisis as well as identify existing best practices/innovations in provision of mental health services to indicated target populations.  

Mapping and assessment should be implemented in selected countries: Poland, Czech Republic, Estonia, Moldova.  

The consultant is expected to perform the following objectives, in accordance with the timeframe below: 

1. Develop an outline and a methodology for implementing mapping and assessment, to be conducted by country analytics/coordinators individually for selected countries. 

Mapping of the mental health care existing system and management for each of the selected countries should describe available current possibilities to receive mental health services from a patient’s perspective (patient’s pathway at different levels of services’ provision – starting from community level up to specialised services) for the following categories: 

• system of mental health services for a regular population in a given country, serving as an introduction and providing background to further provisions; 
• people using drugs, including such sub-groups as OST clients and NPS users; 

• refugees, incl. war refugees/temporarily displaced person from Ukraine, with limited access to regular health care. 

Limitations or changes in access to mental health services system which had been introduced in emergency situations as a result of COVID pandemic restrictions should be mentioned and explored in this section.  

Methods of data collection for the mapping may include: 

• desk review of all relevant publications, legal documents and other materials being publicly available, including web-sites of relevant governmental institutions. 
• interviews with the key informants (if needed). 

Assessment of barriers/innovations should explore: 

• existing and potential structural, legal, language, stigma-related and other barriers hampering access to mental health services of the mentioned key populations; 
• existing and potential barriers hampering the access to mental health services for war refugees and people on a temporary stay due to emergency situations seeking relevant MH services in the specified countries; 
• existing best practices/innovations in MH provision which have proven its effectiveness and responsiveness to the needs of the mentioned key populations and (war) refugees.    

2. Develop TOR for selecting country analytics/coordinators in four identified countries, based on outline and methodology developed under p.1. TOR should be finalised in consultation with EHRA.

Mapping and assessment in each selected country will be conducted by a country analytic/coordinator individually while a consultant will offer mentorship and assistance (see p. 5).  

3. Participate in the selection process of country analytics/coordinators as a member of the evaluation team. 

4. Facilitate the discussion on methodology relevance and its implementation process and conduct a training for selected countries’ analytics/coordinators on methodology implementation. 

Training will be held offline as a separate event run concurrently (prior or after) with Access to Mental Health Expert Meeting planned tentatively for August 29-31, 2022. Expenses related to consultant’s participation in Access to Mental Health Expert Meeting/training
(travel, accommodation, etc.) will be covered by EHRA separately. 

Participate in the Meeting deliberations/brainstorming sessions on barriers impeding access to mental health services for the mentioned key populations. 

5. Provide further mentorship and accompaniment for countries’ analytics/coordinators in their work on completing mapping and assessment in specified countries. 

6. Based on results of Access to Mental Health Experts’ Meeting and selected countries’ Reports, develop comprehensive recommendations on optimization of mental health services provision to people using drugs (incl. OST clients, NPS users) involving war refugees from Ukraine, in emergency situations connected to COVID and war crisis.    

Deliverables: 

• Outline and a methodology for implementing mapping and assessment;  
• TOR for selection of country analytics/coordinators; 
• Program and materials for the Training on methodology implementation for countries’ analytics/coordinators;  
• Regional Report, including outline of mental health care system, assessment of barriers, existing best practices and recommendations on optimization of mental health services provision.  

The language of the resulted documents should be English. 

Timeframe 

1. By July 20, 2022 – develop an outline and a methodology for implementing mapping and assessment and submit for feedback to EHRA. 
2. By July 30, 2022 – develop  TOR for selection of country analytics/coordinators. 
3. By August 10, 2022 – develop program and materials for the Training on methodology implementation for countries’ analytics/coordinators. 
4. By September 5, 2022 – conduct Training on methodology implementation for countries’ analytics/coordinators, participate in Access to Mental Health Expert Meeting (exact name and dates TBD). 
5. By October 25, 2022 – complete individual Country Reports;  
6. By November 1, 2022 – submit draft of the Regional Report, including outline of mental health care system, assessment of barriers, existing best practices and recommendations, for discussion and feedback from EHRA.  
7. By November 20, 2022 – complete the final version of the Regional Report, including outline of mental health care system, assessment of barriers, existing best practices and recommendations on optimization of mental health services provision. 

Cost of services 

The cost of services will be calculated on the basis of the consultant’s optimum number of working days and his or her confirmed daily rate. 

In addition, EHRA will cover travel and accommodation cost during training.  

Evaluation criteria / requirements for candidates: 

 Submitted applications will be evaluated by the evaluation panel of the Eurasian Harm Reduction Association. 

 A two-stage procedure will be utilized in evaluating the proposals: 

•  evaluation of the previous experience (portfolio) via technical criteria – 80% in total evaluation. 
• comparison of the costs (best value for money) – 20% in total evaluation. The EHRA will evaluate the proposal regarding the best value for money (price in euros and other factors are taken into account). 

 Cost evaluation is only undertaken for technical submissions that score a minimum 90 points out of a maximum of 100 as a requirement to pass the technical evaluation. A proposal which fails to achieve the minimum technical threshold will not be considered further. 

Consultants with proven work experience in the topics of mental health and key populations (people who use drugs, OST clients and NPS users) would be given a priority. 

This announcement shall not be construed as a contract or a commitment of any kind. This request for proposals in no way obligates EHRA to award a contract, nor does it commit EHRA to pay any cost incurred in the preparation and submission of the proposals. 

The above-mentioned parameters should be clearly explained in a Letter of Interest and CV submitted by a prospective consultant.  

To be eligible as a EHRA consultant, any organization or individual must comply with the Eurasian Harm Reduction Association Code of Ethics which you can find at the following link: https://old.harmreductioneurasia.org/ehra-code-of-ethics/ 

Additionally, the consultants should have: 

• No conflict of interest (should be declared in the Letter of Interest); 
• Fluency in English and/or language/-s of the countries selected.  

How to apply 

Applicants must submit the following documents: 

– CV, 

– Letter of Interest. The CV and application should clearly reflect the competency of the candidate necessary to complete this task, as well as include the proposed number of working days for each stage, cost per day in EUR and timing of their implementation. 

Please submit your proposal to the info@harmreductioneurasia.org    

In the subject line of your e-mail please indicate the RFP number and your name.  Otherwise, the application will not be considered.