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Respond to the mental health emergency
The global COVID-19 pandemic has not just had an impact on people's physical health. Increased stress, loss of coping mechanisms, and reduced access to services has also had a significant impact on the mental health of people of all ages, but particularly on the most vulnerable.
In the UK, a quarter of 17-19 year-olds (1.25 million) experience significant levels of depression and anxiety – yet less than one third of these receive any professional support or treatment. Rates of common mental health problems are increasing, especially in young women. A recent longitudinal survey comparing mental health in 2018-2019 to April 2020 found that 16-24 year olds reporting clinically meaningful levels of distress increased from 25% to 37%. The most common problem is depression, which is the leading cause of disability in young people and produces major impacts across the lifespan. To tackle this global challenge, early interventions need to promote well-being and prevent poor mental health that are scalable to large numbers of young people.
In addition, research has revealed that older people are not being referred for mental health support nearly as frequently as their younger counterparts, despite achieving better outcomes when they are referred.
Researchers at the University of Exeter are leading a pan-European project to recruit young people aged between 16 and 22 years to use the MyMoodCoach app - an app is designed to prevent anxiety and depression and improve wellbeing.
MyMoodCoach brings together the latest research on self-monitoring, self-help techniques and cognitive behavioural therapy so that young people can learn about their own emotions, develop resilience, and build well-being. Meanwhile, the app’s data will help researchers learn more about mood, emotion and mental health in young people. Understanding what influences young people’s emotions and wellbeing is particularly relevant now because of the impact of the COVID-19 pandemic on young people. A recent study by NHS Digital, involving the University of Exeter, found that in July this year, 27 per cent of young women and 13 per cent of young men, aged 17 to 22, had a probable mental health disorder.
Research has shown that helping young people to manage their emotions better, for example, by worrying less, or by adopting more helpful mind-sets can reduce rates of depression and anxiety in high-risk groups by up to 50% over the next year.
The project involves 13 collaborators from across 8 countries in Europe: the UK, Germany, Spain, Denmark, Czech Republic, Greece, Switzerland and Belgium. Professor Ed Watkins, who led on Exeter's research said the majority of the apps currently available for young people had not been rigorously tested and there was little evidence to support their use: “The ECoWeB project is the first to combine all of these approaches in a mobile app that is both evidenced-based and designed to look great and appeal to younger people. It has the potential to be a breakthrough moment in mental health research, supporting young people to live better lives in their relationships, work and social lives.”
Getting out and about in nature can help to counteract the impact of the busy, stressful lives people now lead. In 2018, research found that nearly 75 per cent of people in the UK have at some point felt so stressed they’ve been overwhelmed or unable to cope with everything happening in their life.
Dr Mathew White is an environmental psychologist at the European Centre for Environment & Human Health (ECEHH), part of the University of Exeter Medical School. He recently led research that found spending two hours per week in nature, whether that is on the beach, in a woodland or an inner city park, gives a positive boost to both mental and physical health and wellbeing.
The study used data from nearly 20,000 people in England and found that it didn’t matter whether the two hours was made up of a single visit or took place over several shorter visits. Researchers were also surprised at how consistent the findings were across all the demographic groups they looked at.
Mathew said: “We studied young and old, male, female, urban and rural dwellers, those in deprived versus rich neighbourhoods, but perhaps most importantly, those with long-standing illnesses or disabilities. We were worried our effect was just that healthier people visited nature but this finding suggested that even people with long-term health conditions also seem to benefit from a 120 minute a week ‘dose’.
“Spending time in natural environments can decrease heart rate, blood pressure, the stress hormone cortisol, and generally improve psychological wellbeing. Partly it encourages more exercise, but also modern living places so many cognitive demands on us, getting out and about is downtime for our brain, giving us the chance to have space to think.
“The type of natural environment does make a difference. We’ve plenty of previous evidence to suggest that the marine environment as well as uplands and mountains are the best, but with this data most people are going to urban parks and it’s still working, even if this is just sitting on a park bench or having a picnic.”
Further Exeter research has determined that watching high quality nature programmes on TV can uplift people’s moods, reduce negative emotions, and help alleviate the kind of boredom associated with being isolated indoors. It has also shown that experiencing nature in virtual reality could have even larger benefits, boosting positive feelings and increasing people’s connection to the natural world.
This virtual reality could help to boost the wellbeing of people who can’t readily access the natural world, such as those in hospital or in long term care. But it might also help to encourage a deeper connection to nature in healthy populations, a mechanism which can foster more pro-environmental behaviours and prompt people to protect and preserve nature in the real world
The PROTECT study has been expanded to help study the impact of COVID-19 isolation on the health and wellbeing of older people, and find new ways to support them.
The investigation comes after Age UK found that half of adults aged 55 and over have experienced mental health problems – even in a pre-lockdown era. Meanwhile, previous pandemics have resulted in a significant rise in mental health issues, including suicide, alcoholism and self-harm. The ultimate aim of PROTECT’s new study will be to design new ways to support people through lockdown, which remains a reality for many older people who are shielding.
Older adults often face issues such as loneliness, financial insecurity and dealing with major life changes which can be risk factors for mental health, and can face barriers to accesses services. These can all be worsened during the coronavirus pandemic.
Researchers are asking the cohort – amongst the largest of its type in the UK – about their experiences of self-isolating and the immediate impact on mental health. It will include questions about their mental health during the pandemic, on how frequently they leave the house, the extent of isolation practices they are observing, their caring responsibilities, and their level of loneliness. The information will be used to shape future support interventions.
“Weeks or months of adhering to isolation policy could have a really significant impact on the mental health and wellbeing of older people, particularly on top of the loneliness and isolation that some older adults already experience. Over the longer term, reseachers will also be able to tell if these policies have any impact on memory, and whether these policies have any impact on mental health.
The PROTECT study is open to anyone in the UK aged 50 or over with no previous diagnosis of dementia. More information about the study and how to take part can be found at www.protectstudy.org.uk.