Transcript: The Covid-19 pandemic and its impact on mental health

00:00:02 Female voiceover 

Thanks so much for downloading and listening to this IOE podcast. 

00:00:12 Dr Bonamy Oliver 

Welcome to the podcast Psyched about Education. This series celebrates the academic excellence of the work carried out at the Department of Psychology and Human Development and the impact this work has on policy in practice. In other words, how can psychology make a difference? 

I'm Dr Bonamy Oliver. My own research is on family and school environments important for children’s psychological adjustment and mental health, and I'm your host for today. With me I have:

Dr Jo Van Herwegen, an associate professor in the Department of Psychology and Human Development whose research focuses on improving educational outcomes, especially for those with educational needs and disabilities. She's carried out international research on the impact of COVID-19 for those with SEND [Special Educational Needs and Disabilities]. 

Dr Keri Wong, assistant professor in the same department. Her research focuses on school children’s mental health and development of trust and how these predict disabling conditions like schizophrenia in later life or antisocial behaviors. Keri leads the UCL Penn Global COVID study, a three-time-point survey looking at the impact of COVID-19 on adults’ and families’ mental health, physical health and relationships.

And last but by no means least, Dr Maria Kambouri, associate professor in the Department of Psychology and Human Development, whose research focus is on pedagogies that use technologies to support learners with Special Educational Needs. Maria was the departmental graduate research tutor for many years, and so she's been particularly interested in the well-being of doctoral students and has run several projects on peer support and connectedness. The most recent one, funded by UCL Changemakers, started pre-COVID and is called the Better Together project. She and her team of masters and doctoral students joined Keri in carrying out the UCL Penn Global COVID study on doctoral students’ mental health. 

In this podcast we're going to be focusing on mental health and the impact of the COVID pandemic. So, welcome everybody, thanks for joining us. I'd like to start with a broad question, if I may. The media is full of talk about the impact of the pandemic on mental health. To what extent is this reflected in your own research findings? Jo, would you like to start off? 

00:02:28 Dr Jo Van Herwegen 

Ah, thank you, Bonamy. In our research we examined the impact of COVID-19 on anxiety and worries in individuals with Special Educational Needs and Disabilities as well as their siblings and their parents using parental report. We had over 10,000 families from across the world that took part in the research, and we found that older individuals were indeed impacted more by the COVID-19 situation. However, that was the case for all groups, including individuals with Special Educational Needs and Disabilities, as well as their typically developing siblings. And also, in both groups we saw that anxiety went up. So, we asked questions from before the pandemic hit, during the first lockdown in January to April 2020, as well as when we did the survey in July. And so we saw that the anxiety actually remained high. Of course, we also looked at what is causing this anxiety and we asked about the worries that different groups had. What we saw is that typically developing siblings had more concerns around family conflict and financial problems, but we didn't see that in our individuals with Special Educational Needs and Disabilities. They were worried about social relationships, but also very much worried about the closure of their institutions that supported them and that’s about schools obviously. 

00:03:56 Dr Bonamy Oliver 

Right, thanks very much, Jo. Keri, can I turn to you. In what way did your research reflect the impact of the pandemic? 

00:04:05 Dr Keri Wong 

Great, thanks Bonnie. So, I started the UCL Penn Global COVID study in April 2020 in response really to my childhood experiences of living through a similar situation of SARS as a teenager growing up in Hong Kong. I really wanted this time round to understand how this natural stressor of a pandemic may impact people's mental health over time and as well as the short- and longer-term impacts. Over 2,500 adults responded to our survey at three time points during the pandemic, each of them six months apart: we surveyed people between April to July 2020, October 2020 to January 2021, which also, interestingly, coincided with major national lockdowns in Europe as well – that part wasn't planned, of course – and finally in April to July 2021, which was when easing of lockdown started again. 

We had students, parents, teachers respond, primarily from the UK, the US, Greece and Italy, and we found some similarities and differences between gender and also age groups. In terms of gender, no single group reported being worse off or having more symptoms than others, except for women reporting higher levels of anxiety and also higher levels of empathy as well during the pandemic compared to men. In terms of age, younger, 18 to 24-year-olds, reported significantly poorer mental health in our sample compared to older participants in our sample, particularly those who were aged 55 years and above. So, these are, you know, more symptoms of anxiety, depression, aggression, poorer asleep, but also COVID-related stress, and they also reported being less trusting of others as well, and less physically active compared to pre-COVID times. 

We did not find any age differences for levels of empathy and loneliness, which doesn't mean that they're not impacted by COVID, just that there's no one age group that is worse off or better off in these instances. So, in fact, we've two papers showing that levels of loneliness actually fluctuate based on the duration of lockdown, and it is a key set of symptoms that are linked to mental health as well as our relationships with others in terms of trust. In other words, addressing loneliness perhaps may improve mental health outcomes as well as our relationships with others. 

00:06:52 Dr Bonamy Oliver 

Thanks, Keri, it's so interesting, isn't it? Maria, did you also see the impact of the pandemic for mental health in your work? 

00:07:00 Dr Maria Kambouri 

Yes, exactly, picking up on Keri's results of the pandemic on psychosocial aspects of life, our analysis of a smaller sample, which focused on doctoral students – and we had about 155, aged between 23 to 69, although it's towards the younger end of 30s – showed that indeed doctoral students are a vulnerable population. Previous studies showed one-in-three doctoral students is at risk of a common psychiatric disorder, particularly anxiety and depression, being six times higher than the general population. Of those who suffer, which is more important for our universities, only a third seek access to additional advice and go to any support services in the UK universities. So these results reflect the picture that we already knew about, but this collective stress of the pandemic has added to the existing situation and it is difficult to separate these factors. 

So what we've done is we looked at how cumulative, stressful educational events experienced in their doctoral training affected doctoral students’ anxiety and depression. And we also had a variable on coping skills that could tell us something about the impact on their health. Effectively, we will be able to boost their coping skills now that we know that there is such an effect. We concluded that it is this accumulation of events, rather than the experience of a singular event – such as finances and sort of personal and self-esteem [issues] and so on – that could lead to higher levels of mental health distress. 

00:08:51 Dr Bonamy Oliver 

Keri, as you mentioned, the pandemic has had several phases in the UK, from full lockdown to partial lockdown, to where we are now, wherever that is. From your research, can you share insights into how these different phases have impacted mental health? 

00:09:06 Dr Keri Wong 

Yes, sure. So, the patterns I spoke about earlier – young people reporting poorer mental health than older people were pretty much stable between April 2020 and July 2021. But it's also not all bad news. By the time locked down eased between April and July 2021, our data showed that young people’s levels of stress and aggressive behaviors decreased and that their trust in others also started to increase again. As lockdown continued to ease, we asked people to reflect on the year and tell us what support they needed in order to inform policy. Three clustering themes emerged: aside from about 14% who reported that they've coped well with the pandemic and they don't need further support that they don't already have, 38% told us their outlook on life has changed, sometimes for the better, other times for the worse. This related to their mental health assessment, their relationships, motivations and bereavement as well. Another 34% of our responses were about engaging with self-improvement activities. So, for example, trying something new, picking up a new skill or language, while about 7%, said the pandemic promoted more sedentary behaviors, limited their access and continued access to mental health support, and that's still a smaller but significant group. 24% spoke a lot about financial burdens, stress, but also the advantages of studying and working remotely. So, as you can see, it's a real mixed bag. 

00:10:52 Dr Bonamy Oliver 

Yes, absolutely. Maria, what did you see with the doctoral student sample, did it look similar? 

00:10:57 Dr Maria Kambouri 

Yes, I could add to that actually; we also found financial burden is, and has been known to be, obviously, one of the main factors, and as well as some interruption of access to research fields, which was obviously particularly disruptive for them at the moment – and quite a few of them had to use secondary data analysis and find other ways [to progress their fieldwork]. We didn't find particularly, you know, differences between the waves of this study over the period, but it looked like students are possibly-. Although they are affected, they're coping quickly. They're sort of picking up things better. So it's possible, it is possible to boost that ability to cope better, and I think that's what we're going to be focusing on. 

00:11:48 Dr Bonamy Oliver 

Jo, can I ask you: obviously you focus on Special Educational Needs and Disabilities. Are there differences in terms of who's been most affected and what we understand about people who are more likely to be vulnerable than others? 

00:12:02 Dr Jo Van Herwegen 

Yes, so in our research we did find that, for both typically developing children as well as those with Special Educational Needs and Disabilities, those who did have an existing diagnosis of anxiety or anxiety issues that came with their diagnosis were at greater risk for having more anxiety, more worries, a bigger impact on their well-being. But another factor that we found is important is parental anxiety, so where parents are more anxious we saw that children or offspring were more anxious as well. Of course, in our research we were using parental reports, so it may come as no surprise that we have this finding. But on the other hand, we do know that anxiety impacts the entire family and not just individuals themselves, and that was very clear from our data. 

However, in terms of whether different groups of individuals were impacted more or not, we have now two studies using different cohorts – so, we had one cohort from the very early onset of the pandemic in January 2020 to April 2020, but also repeated that with what we call maybe ‘lockdown two’, so January 2021 to April 2021 – and in both of these cohorts we did see that children with Down’s syndrome showed less anxiety compared to other groups with SEND. But importantly, the anxiety in individuals with Down’s syndrome was higher from before the pandemic. So, again, it's important to understand that maybe some groups are impacted less than others, but we see an impact in all groups of children here. 

00:13:43 Dr Bonamy Oliver 

That's a really interesting finding, thank you. So, I'm wondering what you all think we can do? What can we do next? 

Perhaps I could ask all of you in just a couple of words, assuming that we can't end everything to do with the pandemic tomorrow, what would you like to see put in place to mitigate the problems that you've seen? And how might we do that? Jo, maybe I can start with you this time. 

00:14:07 Dr Jo Van Herwegen 

OK, thanks. I think our research has shown how important schools are in terms of providing support for children as well as hubs for parents for information and support. And I think also the parents we talked to also told us some good stories around the fact that, because of the pandemic they have had more contact with their child’s school. They are more aware of where their child is in terms of their education and development, and I think maybe building on those strengths in terms of providing good connections between parents, children and schools might be a good way forward. One parent told me, actually, if we could see this as the start of a new era and take the good things from it, it might be a nice way forward. 

00:14:54 Dr Bonamy Oliver 

That's a nice message. How about you, Maria? 

00:14:57 Dr Maria Kambouri 

Our Better Together project will continue to provide support for students, through the group initiatives that encourage peer support, but also they're taking action […] to solve any problems faced in the doctoral journey, which is so important. For instance, we started mentoring this year, and the second year and third year students are mentoring the first years and these schemes exist elsewhere in the faculty as well. This will also keep the dialogue open in the relationship with supervisors and with other members of staff, which is, again, something that we need to work on. So, in general, very much together we can feel stronger. 

00:15:51 Dr Bonamy Oliver 

Right, thanks Maria. And finally, to you, Keri. 

00:15:55 Dr Keri Wong 

I think we have been in the same storm but not the same boat, as a phrase that we've heard time and time again during the pandemic, and I really do think it captures the current situation. But two words and some of my ideas. The first is empathy and the second, solidarity. So, our results highlight the importance of having and showing empathy towards others in our community. As you know, how people have been affected by the pandemic is not always obvious. And then solidarity. We need this at every level of society and globally, I think, to fight against coronavirus and also its new variants as well. So that's mine. 

00:16:36 Dr Bonamy Oliver 

Thank you all. One of the things I really like about what you've all said, actually, is that  there are obviously some very negative impacts, but thinking in positive ways and really trying to make a difference through those positive things is really important. So thanks very much, very, very interesting. 

I do have one final question for each of you. How has your work or psychology research in the area generally made a contribution to policy or practice? Maria, maybe I'll start with you this time. 

00:17:07 Dr Maria Kambouri 

Well, we're working on it, I think is the general answer. We're feeding back the results to university support services, with suggestions for new schemes and continuing with research in the area and promoting the plans for extra support for doctoral students. For example, in our department, as I mentioned before, we have the peer mentoring schemes that are working very well. And as well there's more specific training for supervisors to raise awareness on mental health. A lot of our supervisors have taken the mental health first aid and support schemes as well. So I think it's really a time of awareness, of opening up and understanding that things are more difficult in general. Also we have joined forces with other universities, and I'm hoping to join a project that would feedback directly to government for support, but it's still in plan. 

00:18:07 Dr Bonamy Oliver  

Thank you. Keri. 

00:18:09 Dr Keri Wong 

Well, our COVID findings have already been submitted, parts of it at least, as evidence to the UK Select Committee call on children and young people's mental health, and Bonamy and Jo are both on it as well. Our study findings have also been referenced in the UK Parliament Office for Science and Technology, in their rapid response blogs and reports – specifically that time was about vaccine hesitancy. Our study findings have also been featured on podcasts and with listeners upward of 37,000 plays. So, yes, we will continue to share our findings in this way as well to maximize the impact that it can have on society. 

00:18:52 Dr Bonamy Oliver 

Perfect, thank you Keri. Jo. 

00:18:56 Dr Jo Van Herwegen 

We've obtained funding for two further projects where we're actually developing and co-producing with parents some toolkits to help parents of children with Special Educational Needs and Disabilities as well as individuals who are older, in terms of getting them back active in society, if you were. And so that's part of some of the further research, putting that into action. But I also think where we were being helpful is that we've created with some researchers who have an interest or have researched Special Educational Needs and Disabilities across Europe to provide some guidance for teachers around how they connect, include children with Special Educational Needs and Disabilities in online learning, because I think it's something that might stay with us for a little longer. 

00:19:45 Dr Bonamy Oliver 

Unfortunately, I think you're right. Thank you, everybody. So interesting, such impactful work. I really enjoyed talking to you, so thank you so much for your time, all three of you. So that's it from us today. You've been listening to Psyched about Education. For further details or other podcasts from the Department of Psychology and Human Development, please see the links at the end of this podcast. Thanks very much. 

00:20:14 Female voiceover 

Thanks so much for downloading and listening to this IOE podcast.