Human health is intimately linked with the environment [1]. This includes the spaces
in which one lives, learns and works. All of the key environments in which we occupy
and interact with drastically changed when the World Health Organisation (WHO) [2]
declared Covid-19 a pandemic in March 2020 and when subsequent government lockdowns
and other physical restrictions were imposed. Our relationship with our environment
changed suddenly and in unexpected ways – and may never be quite the same again.
In broad terms, these changes to the nature of the environment in which people live,
learn and work came about as a consequence of pandemic control measures. To minimise
the impact of a new, very infectious disease people were asked or required to remain
at home, to work from home (if possible), to maintain a distance between themselves
and others and to limit use of outside spaces, say, for exercise use only. In many
countries, schools and universities were closed, education moved online and this meant
many families were faced with real issues about how to balance online work with the
need to ensure online education happened as well. Travel was restricted nationally
and internationally, and a range of legal measures were introduced to enforce compliance.
In many countries, people were asked to wear masks indoors and in public places for
the first time which introduced a new social norm.
In this series on Covid-19 and Mental Health published in the journal UCL Open: Environment
(see https://doi.org/10.14293/S2199-1006.1.SOR-EARTH.CLIEN0H.v1), we highlight findings
from the UCL–Penn Global Covid Study, a 12-month longitudinal study of the impact
of Covid-19 on social trust, mental health and physical health, launched in April
2020 [3]. In collaboration with six institutions from Italy, Singapore, the USA, China
and the UK, the study looks at the short- and longer-term effects of Covid-19 on individual’s
mental health and social relationships with others by collecting time-sensitive survey
data to understand how a large-scale change in the global environment can have impacts
on health during a pandemic’s early stages.
The series, funded by the UCL Global Engagement Fund, examines some of the linkages
between people’s physical and social environment and their mental health that have
been revealed during the Covid-19 pandemic. Some of these findings will likely read
across to the journal’s broader special series on Covid-19 interactions with our environment
(https://ucl-about.scienceopen.com/covid19-specialseries) to facilitate interdisciplinary
discussions concerned with the persistent global impact of the Covid-19 pandemic.
In addition, this series also publishes alongside the research articles, ‘discussant’
articles recording the policy relevance and study implications about the lessons learned
of the impact on our mental health of the Covid-19 driven change in our environment.
Provided by invited policy makers and other subject experts attending the Study’s
online summer webinar series which was held online between the 2nd June and the 28th
July, 2021 and composed of five online webinars (one webinar covering each of the
series articles). This is a first and novel attempt at this new journal format to
publish research project findings alongside recorded implications and the possible
impact of it.
The Covid-19 pandemic is a naturalistic stressor that has disrupted our home, leisure,
work and educational lives. This deadly airborne ‘invisible’ virus that survives in
the spaces we live, learn and occupy has caused psychological distress and uncertainty
to individuals because the virus does not discriminate based on ethnicities, background
or age. The lead question for this series was: how has the Covid-19-altered environment
impacted health and relationships?
In each of the five articles in this series, we discuss the impact and consequences
that environmental changes brought about by the Covid-19 pandemic has triggered forced
government lockdown restrictions and the impacts that these have had on our health
and relationships.
The study of coronavirus and the associated environmental consequences of government
responses in terms of lockdowns and restrictions is of vital importance in thinking
about where resources should be deployed for pandemic recovery. What is clear in this
pandemic is how Covid-19 has changed the various environments in which we occupy,
play, live, learn and no longer have access to – and the consequences this has on
our health and relationships. Particularly, the health inequalities, mental health
access and support issues, technology gap between social strata, cuts in funding for
third-sector support groups and structural inefficiencies in various sectors – that
have traditionally been brushed under the rug before the pandemic – have been brought
into sharp focus during this pandemic.
A central and integral question to humans as a social species is what impact does
the lack of social contact as a consequence of forced Covid-19 lockdown restrictions
have on our physical and mental health? Unsurprisingly, loneliness emerges as an important
factor in more than one way as reported in the series articles. For example, in Carollo
et al. [4], the authors used novel machine learning techniques to understand the impact
of lockdown duration and restrictions on adults from Greece and the UK and revealed
that loneliness and depression were key symptoms that fluctuated during the pandemic.
Even prior to the pandemic, there were discussions about a worldwide ‘loneliness epidemic’.
Kasley Killam, founder of Social Health Labs, in a discussant article [5], recognised
the need to facilitate initiatives to tackle loneliness as part of ‘social’ health
and offered insights into existing local, national and international initiatives in
place to reconnect individuals. Social health, she argues, is of equal importance
to mental and physical health, and perhaps a priority area for post-pandemic recovery
strategies when considering the importance of local community spaces in promoting
social connections in the population and pandemic recovery.
The wealth of initiatives tackling global loneliness to increase our social health
is further elaborated on in Wong et al. [6]. Here, the authors found that individuals’
feelings of loneliness were centrally linked to distrust in others in the community
and also depressive symptoms, which in turn were associated with other mental health
symptoms (e.g., anxiety, stress about covid, insomnia). Trust in the community has
always been pivotal to facilitating community peace and cohesion in society. Interestingly,
but perhaps not surprisingly, a discussant article by Mitch Cooke (Head of Sustainability,
Greengage Environmental) observed a shift in focus on people’s attitudes towards modifying
the immediate home environment – as people are now spending more time ‘working from
home’ – and ensuring these are now compatible multifunctioning workspaces [7]. He
discusses how this shift in people’s needs can impact architectural decisions to an
emphasis on ‘greening’ the indoor home space (previously more of a focus on outdoor
green spaces) as potential environmental decisions to improving health. Conversely,
Dr Emma Barkus, (Associate Professor, University of Northumbria) discusses the short
and longer-term advantages and disadvantages of loneliness [8]. This is a state that
is evolutionarily advantageous as it reminds us to reconnect with our community, socially,
but failure to do so, perhaps in changing our environments, may mean that feelings
of self-perceived loneliness can persist and in turn impact our personality and the
way in which one views the world. It is clear that the Covid-19 pandemic restrictions
have blurred the line between indoor ‘home’ space as one for relaxation and a space
to retreat, with other spaces associated with work, play and education. Many individuals
and families have had to carefully negotiate, and in some cases redesign, their relationship
with their home environments.
Our series of studies also examined subpopulations and the micro-environments in which
they operate in. How has the Covid-19 restrictions, which dictated who and which environments
we can or cannot access, impacted vulnerable groups who may be living in more complicated
home environments? In Portnoy et al. [9], we investigate whether the Covid-19 ‘stay
at home’ order was particularly challenging for families with young children, and
how this relates to parent’s mental health using transactional models applied on two
waves of strict lockdown periods. By accounting for both parent-effects and child-effects
across timepoints, the authors begin to understand how the pandemic household environment
can change family dynamics over time. The idea that the important relational interactions
between family members may be impacted within the confines of the home when families
are spending everyday of every week under the same roof. This is contextualised within
possible policy implications in government support for families with young children
as discussed by Dr Yahayra Michel (School of Criminology and Justice Studies, University
of Massachusetts Lowell, USA) [10]. Dr Michel highlights the complexity of family
systems and potential family interventions ought to be multifaceted and working across
disciplines and agencies and available to both children and parents during times of
challenge. For us to be better prepared for future pandemics and should work from
home mandates become more commonplace, better communicative and collaborative working
relationships need to be in place now (e.g., with social services, families, children
and schools).
A similar conversation was had when thinking about students. In spaces of learning,
such as universities, access to resources and mentors had become limited and research
student projects were often grounded to a halt, if not moved to a virtual environment.
In Sideropoulos et al. [11], the authors examine the wellbeing of doctoral students
(i.e., PhD students) to examine how the cumulative stressors resulted from the Covid-19
pandemic may explain student’s health, especially when a high proportion live with
existing mental health issues already. For the doctoral student community, the cumulative
stressful events experienced at the macro–meso–micro levels and the perceived uncertainties
during the Covid-19 pandemic increased levels of depressive symptoms (not anxiety),
which was particularly true of individuals with poorer coping and attentional skills
– potential areas of intervention. These findings were not unique to students in higher
education but were also replicated in international studies of non-WEIRD (Western,
Educated, Industrialized, Rich and Democratic) societies as Tara Beteille (Senior
Economist, The World Bank) points out in her discussant article on schoolteachers,
children and support [12]. The Covid-19 pandemic forced educators and students to
negotiate the balance between online and offline learning environments and our patience
as well as motivation to stay ‘connected’ albeit virtually. This area of research
extends the longstanding debates about the efficacy of hybrid models of learning (e.g.,
distance learning) and, post-pandemic, challenges the strengths and limitations of
virtual vs face-to-face learning environments.
It is no surprise that lockdown restrictions – a legally imposed physical detachment
from others aimed to keep everyone safe in order to decrease coronavirus transmission
in the community – have taken a toll on everyone. In Wong et al. [13], the authors
present a rich qualitative summary of the variety of impacts that study respondents
have experienced when reflecting on the pandemic 12 months after. Crucially, the authors
also identified the variety of support that respondents would need in order to recover.
These included beyond financial support, but continued mental health access, flexible
working and childcare support, and technology training and access. These comments
were echoed by Deborah Alina (MBE and CEO, Independent Age) and Morgan Vine’s findings
on the mental health of elderly populations, who are most often neglected in public
discourse and living in environments that were not covid-safe [14]. Through their
research, they found that lockdown restrictions meant that elderly populations faced
extremely challenging situations during the pandemic as their lack of access to technology
combined with poor physical connection also took a toll on people’s wellbeing. Professor
David Murphy (Former President and Covid Response Lead, British Psychological Society)
[15] and Nigel Atter (Policy Advisor, British Psychological Society) [16] shared their
perspectives from the British Psychological Society – the society for psychologists
and psychology in the UK. Both speakers spoke about the numerous supports offered
during the pandemic in the form of psychological helplines, knowledge for the public
(e.g., coping strategies, psychological workshops and online resources), as well as
new policy recommendations which were taken by the society to better inform the government
and organisations on their Covid response and recovery strategy. It remains to be
seen whether major changes to the environment can indeed facilitate better health
and recovery in the months to come. The articles in this series do highlight a few
key areas of focus for recovery plans.
Evidently, this series captures the ongoing changing environment due to the Covid-19
pandemic and associated government restrictions on individual’s and group’s health
(physical, mental and social). This huge change to the environments in which we live,
play, work and learn, has had notable changes in our health, and we are far from completely
understanding what the short- and longer-term effects of the pandemic will be. However,
a consistent theme throughout all publications in academia and industry, is the increasing
need to come together as disciplines, to converse, to share good practices and co-create
workable solutions for all in a mindful way. There is existing support for mental
health at both the community and national level. Instead of cutting funding for local
third sectors who are doing good work, we need to resource those and ensure they are
well supported now and in time for future pandemics. Educating the population through
clear messaging around expectations during the pandemic in terms of mental health
can help individuals and families cope with and better manage symptoms fluctuations.
Reasonable policies around time spent outdoors, even if brief, may have considerable
impacts on individual’s health and wellbeing and more widely. But most importantly
of all, this series has highlighted the importance of bringing different perspectives
to the same table, as we design strategies to recover, be more resilient, and build
back better.