The COVID-19 pandemic has greatly affected lives and challenged access to healthcare in many low and middle income countries, including Pakistan and Bangladesh. People with severe mental illness (SMI) are at particularly high risk of being affected, as are mental health services. SMI refers to illnesses such as schizophrenia and bipolar disorder that affect people's thinking (often experiencing delusions and hallucinations) and severely reduce their life chances. This study builds on our existing collaborations and research set-up in South Asia, to deliver: 1. A survey in people with SMI, and interviews with them and their families to explore understanding and response to public health advice, and the pandemic's impact on health, behaviours e.g. smoking, access to healthcare, security, income and quality of life. 2. Surveys at mental health hospitals and staff interviews to explore impacts on mental health services. 3. Workshops with key stakeholders to jointly produce research questions that are important to them, and interpret findings. We have already established 'Community Panels' comprising people with SMI and advocacy organisations, who will advise on the research. We will also strengthen expertise in the research team and policy makers to make use of research findings in practice. Findings will inform approaches to reduce the impact of the current and future pandemics, and be of value to people with SMI, health providers and policy makers in South Asia and other LMIC. They will be publicised using print and social media, reports, TV & radio and academic journals.

1. A survey in people with SMI, and interviews with them and their families to explore understanding and response to public health advice, and the pandemic's impact on health, behaviours e.g. smoking, access to healthcare, security, income and quality of life. 2. Surveys at mental health hospitals and staff interviews to explore impacts on mental health services. 3. Workshops with key stakeholders to jointly produce research questions that are important to them, and interpret findings. We have already established 'Community Panels' comprising people with SMI and advocacy organisations, who will advise on the research. We will also strengthen expertise in the research team and policy makers to make use of research findings in practice. Findings will inform approaches to reduce the impact of the current and future pandemics, and be of value to people with SMI, health providers and policy makers in South Asia and other LMIC. They will be publicised using print and social media, reports, TV & radio and academic journals.