Factors that influence mental health of university and college students in the UK: a systematic review.

BACKGROUND: Worsening mental health of students in higher education is a public policy concern and the impact of measures to reduce transmission of COVID-19 has heightened awareness of this issue. Preventing poor mental health and supporting positive mental wellbeing needs to be based on an evidence informed understanding what factors influence the mental health of students. OBJECTIVES: To identify factors associated with mental health of students in higher education. METHODS: We undertook a systematic review of observational studies that measured factors associated with student mental wellbeing and poor mental health. Extensive searches were undertaken across five databases. We included studies undertaken in the UK and published within the last decade (2010-2020). Due to heterogeneity of factors, and diversity of outcomes used to measure wellbeing and poor mental health the findings were analysed and described narratively. FINDINGS: We included 31 studies, most of which were cross sectional in design. Those factors most strongly and consistently associated with increased risk of developing poor mental health included students with experiences of trauma in childhood, those that identify as LGBTQ and students with autism. Factors that promote wellbeing include developing strong and supportive social networks. Students who are prepared and able to adjust to the changes that moving into higher education presents also experience better mental health. Some behaviours that are associated with poor mental health include lack of engagement both with learning and leisure activities and poor mental health literacy. CONCLUSION: Improved knowledge of factors associated with poor mental health and also those that increase mental wellbeing can provide a foundation for designing strategies and specific interventions that can prevent poor mental health and ensuring targeted support is available for students at increased risk.

Factros that influence mental health of university and college students in the UK: a systematic review

BackgroundWorsening mental health of students in higher education is a public policy concern and the impact of measures to reduce transmission of COVID-19 has heightened awareness of this issue. Preventing poor mental health and supporting positive mental wellbeing needs to be based on an evidence informed understanding what factors influence the mental health of students.MethodsWe undertook a systematicreview of observational studies that measured factors associated with student mental wellbeing and poor mental health. Extensive searches were undertaken across five databases. We included studies undertaken in the UK and published within the last decade (2010–2020). Due to heterogeneity of factors, and diversity of outcomes used to measure wellbeing and poor mental health the findings were analysed and described narratively.ResultsOur search identified 2567 citations, following the removal of duplications. Following screening by two reviewers, we included 30 studies, most of which were cross sectional in design. Those factors most strongly and consistently associated with increased risk of developing poor mental health included students with experiences of trauma in childhood, those that identify as LGBTQ and students with autism. Factors that promote wellbeing include developing strong and supportive social networks. Students who are prepared and able to adjust to the changes that moving into higher education presents also experience better mental health. Some behaviours that are associated with poor mental health include lack of engagement both with learning and leisure activities and poor mental health literacy.ConclusionImproved knowledge of factors associated with poor mental health and also those that increase mental wellbeing can provide a foundation for designing strategies and specific interventions that can prevent poor mental health and ensuring targeted support is available for students at increased risk. A critical risk factor for poor mental health,identified in this review was social isolation and a powerful protective factor was a sense of belonging. Strategies that support the development of supportive networks for young people in university settings is vital for positive mental health.

The relationship between homeworking and m health and wellbeing before and during the Covid-19 pandemic: a systematic review

BackgroundUnderstanding the impact of working from home on health and wellbeing is of great interest to employers and employees alike, with a strong need for up-to-date guidance. The aim of this review was to identify, appraise and synthesise existing research evidence that explores the impact of home working on health and wellbeing outcomes for working people and health inequalities in the population.MethodsWe searched databases, reference lists, UK grey literature;and completed citation searching of included papers. We extracted and tabulated key data from the included papers and synthesised narratively. Associations reported in the literature were displayed by constructing mind maps of each individual association which had been identified. The findings were combined with an a priori model to develop a final model, which was validated in consultation with stakeholders.ResultsOf 96 studies which were found to meet the inclusion criteria for the review, 30 studies were published before the Covid-19 pandemic and a further 66 were published during the pandemic. The quality of evidence was limited by the study designs employed by the authors with the majority of studies being cross sectional surveys (n=59).Fifteen studies which considered the potential for working at home to have different effects for different subgroups suggested that working at home may have more negative consequences during the Covid-19 pandemic for women and in particular, mothers. There was very little evidence on age, ethnicity, education or income in terms of moderating home working effects, and very limited evidence from before the Covid-19 pandemic.The concept of lack of choice around working from home was implicit in much of the literature– even though it was not directly measured. There were no clear patterns of wellbeing measures which changed from positive to negative association (or vice versa) during the pandemic.ConclusionThe evidence base for the associations between home working and health-related outcomes has expanded significantly as a result of the need for those whose work could be done from home to work at home during the Covid-19 pandemic. Our findings suggest that there are three sets of factors relating to the external context, the role of employers, and the circumstances of the employee which contribute to determining whether someone works at home and what the associated impacts on health and wellbeing may be.

Rehousing older social housing tenants: a mixed-methods study

Background In the context of a social housing crisis, partly caused by insufficient affordable homes, the UK must meet the housing needs of an ageing population. Rehousing schemes run by social housing providers are an important means to support older (>55 years) tenants to move to appropriate homes. Hackney Council (London, UK) runs or supports many of these schemes. This study aims to assess how well the schemes are working by exploring the processes involved and their health-related outcomes. Methods In this mixed-methods study, we interviewed practice-based stakeholders who work across four rehousing schemes in Hackney. A postal survey was delivered to older social housing tenants who had moved through one of the schemes. Responses to the survey questions were analysed in Excel. A photovoice component (ie, photographs taken by participants that were discussed in interviews and focus groups) of survey respondents captured their experiences of being rehoused and its health-related effects. Written consent was obtained from all participants. Ethical approval was obtained from the Ethics Committee of the University of Cambridge School of the Humanities and Social Sciences. Findings Since June 4, 2020, we interviewed 14 practice-based stakeholders and surveyed 798 older tenants. We had 75 (9·4%) valid responses, of which 31 respondents were women, 10 were men, and two preferred not to say (there was missing data for 32 respondents). 16 survey respondents then participated in the photovoice group. Interviews with practice-based stakeholders were analysed using NVivo (version 12) and highlighted the importance of providing personalised support to tenants. Several outcomes were reported by stakeholders, including increased social connectedness, and improved tenant wellbeing. Challenges included there being insufficient suitable homes for tenants to move into, and problems posed by COVID-19. The survey identified positive elements (eg, being given choices) and challenges (eg, poor communication) in the rehousing process. It also identified beneficial outcomes (eg, having a warmer home without stairs) and unwelcome outcomes (eg, increased loneliness). The photovoice component and data collection with non-movers provided detailed additional insights, some captured in visual material (eg, one tenant described the community activism that had led to the restoration of an old football pitch on the site). Interpretation The findings will inform efforts by social housing providers to optimise the rehousing experiences of older social housing tenants and maximise health-related outcomes. This will be achieved through extensive engagement with practice-based stakeholders, including through an end-of-project photovoice exhibition and a national stakeholder workshop. Funding NIHR School for Public Health Research.

Rehousing older social housing tenants: health-related processes and outcomes

BackgroundIn the context of a social housing crisis, the UK must meet the housing needs of an ageing population. Rehousing schemes run by social housing providers are important means to support older (aged 55+) social housing tenants to move to appropriate homes. A better understanding of how well these schemes work is needed. This paper is based on a study (01/2020–12/2021) of the health-related processes and outcomes linked to the rehousing of older social housing tenants in Hackney/London through four local authority-supported schemes: Downsizing;Regeneration;Housing Moves;Seaside & Country Homes.MethodsA mixed methods design entailed a scoping review, based on a search of scientific databases (MEDLINE, EMBASE, Scopus, CINAHL, PsychINFO) and the grey literature, and a narrative synthesis of results. Interviews with practice-based stakeholders across sectors (n=11) were conducted. A survey of older social housing tenants who have moved through a rehousing scheme (n=766), analysed in Excel, generated descriptive statistics and themes for qualitative exploration. A Photovoice component with 16 survey participants, currently underway, has been designed to capture the participants’ rehousing experience and its effect on their lives. It entails interviews and focus groups. Interviews and a focus group are being conducted with older social housing tenants who were interested in being rehoused, but opted against moving (‘non-movers’;n=5). All qualitative data are analysed thematically in NVivo12. All methods have been adjusted to comply with Covid-19 rules.ResultsThe review yielded three peer-reviewed papers and 13 reports, thus revealing a gap in knowledge around the health-related effects of rehousing older social housing tenants. Interviews with practice-based stakeholders highlighted promising approaches in the rehousing schemes, such as highly personalised support, and challenges, including a lack of suitable homes for tenants to move into. The survey yielded 62 valid responses (8.1%). As well as helpful elements (e.g. being given choices) and challenges (e.g. poor communication) in the rehousing process, it identified welcome (e.g. a warmer home) and unwelcome (e.g. loneliness) health and wellbeing outcomes. The findings will be broken down by rehousing scheme. They will be supplemented by detailed insights from the Photovoice components and data collection with non-movers.ConclusionThe study was designed to generate insights that can inform efforts by Hackney Council and other social housing providers to improve rehousing schemes for older tenants and optimise their health-related effects. Channels through which findings will be shared with decision makers and the public include a national workshop and a photo exhibition.