Wellbeing focus: A view from London

By Dr Adrian Clark

When the COVID-19 pandemic hit the UK, many university campuses closed and students faced the difficult choice of staying where they were, or returning ‘home’ – often a race against the clock while national borders closed as quickly as the campuses.

By the time the UK was put under lockdown on 23 March, around two-thirds of the 3,500 students in the University’s intercollegiate halls of residence had left London. For my work as Student Health & Wellbeing Manager, the months that followed focused almost exclusively on the University’s response to the pandemic and, in particular, keeping these London-based students safe and well. This marked an extraordinary end to my first year at the University, in a role I began in July 2019 after 17 years training and practising as an emergency physician in the National Health Service.

Global effect

At the time of writing, there have been nearly 30 million confirmed cases of COVID-19, leading to over a million deaths worldwide. The cost to the global economy could ultimately be many trillions of dollars. These numbers do not begin to convey the human impact of COVID-19 on individuals and families everywhere. It seems that everything has changed; many of us feel adrift in an ocean of uncertainty, having long lost any feeling of ground beneath our feet; and there is a sense that things may never be the same as they were before the pandemic. The respected journalist and broadcaster Krista Tippett described this as a “species moment.”

Mental health impact on students

Around the world, this generation of students has needed to draw upon their resilience and resourcefulness like no other generation has for perhaps the best part of a century. Students have been exposed to the same anxiety, grief, uncertainty, and isolation as everyone else. Moreover, students have had to adapt quickly to new methods of teaching and assessment. For those students who remained in the University’s intercollegiate halls, many were vulnerable in some way or another: those without supportive families, or with family members at high risk of COVID-19, and international students whose countries had already closed their borders. Financial insecurity affected many, either because they could no longer rely on support from their families, or because the bars, restaurants, and shops that employed students had closed. Therefore, alongside the obvious need to reduce the risk of virus transmission within our buildings and contain any possible cases, it was important to address the potential psychological and social impact of the pandemic and associated public health interventions.

It is known that infectious disease outbreaks, and the public health interventions used to control them, can have a detrimental effect on people’s mental health. Mood disorders, anxiety disorders, and post-traumatic disorders have been observed to increase during and after epidemics, and pre-existing mental health problems can relapse or become more severe. These effects may be compounded by deterioration of social networks and reduced community cohesion. Those who are more likely to experience mental health consequences include people with a long-term health condition, those working in healthcare, people who suffer the loss of a loved one, and those with prior psychiatric history or exposure to trauma. All of these at-risk groups are represented in our student residential population.

Adapting with new procedures

Drawing on evidence in disaster psychiatry and crisis management literature, my team and I adopted a number of measures believed to reduce the mental health risk. This included regular virtual check-ins from our team of student Resident Advisors with students identified to be at especially high risk, uninterrupted access for students to speak with a Mental Health First Aider by video call if necessary, and advising students about small and simple practices to look after their wellbeing. We also directly addressed students’ fears about things like food availability and how an outbreak might be controlled in the intercollegiate halls.

We continued the provision of social and community events, moving these online, and provided early, clear, and regular communications with our students to promote a sense of self-efficacy, connectedness and hope, with frequent updates via campuslife.london.ac.uk

My team continued to work on campus every day throughout the crisis: our standpoint was that we could only keep an accurate view of the situation and continue providing support for our students by being on site. For those students who needed to self-isolate, we supported those in our catered halls by delivering meals to them; for those in self-catered accommodation, we helped them buy in groceries. We also set up a successful ‘bug buddy’ system, where residents could volunteer to support those in self-isolation with practical matters like shopping for food and medicines. This reduced the demand on staff time and we remain very grateful to those students who stepped up to help.

Safe to Stay

When we started looking ahead to the 2020–2021 academic year, we knew that the transition period for students starting university was going to be harder than ever. Anxiety is naturally high amidst so much uncertainty. Based on a comprehensive risk assessment, we developed Safe to Stay, a programme of interventions and activities designed to ensure that our residential accommodation can deliver holistic support to help students stay safe and well through a wide range of possible projected scenarios. The way we do things now may be different, but we are proud to be able to provide a safe, supportive, and inclusive community environment for our student residents to enjoy a happy, successful, and engaging university experience in the heart of London.

Dr Adrian Clark is Student Health & Wellbeing Manager, as well as Warden of Connaught Hall, at the University of London.