Dr Lisa Garnham: Coping with the COVID-19 pandemic - the central role of home
Dr Lisa Garnham from the Glasgow Centre for Population Health (GCPH) reflects on research around the importance of ‘home’ for mental health and how this evidence could shape our response to the COVID-19 outbreak.
The COVID-19 pandemic has meant that most of us are spending much more time at home. At the same time, many of us are also experiencing higher levels of stress and anxiety than usual, caused by both the pandemic itself and the measures being taken to control the spread of infection. So what might our previous research on housing have to tell us about how to reduce the long-term negative impacts of this period on public health and inequality?
We recently published the findings of the ‘Housing through Social Enterprise’ study, a three-year mixed methods research project carried out in partnership with the University of Stirling and Glasgow Caledonian University. It looked at the ways in which housing organisations support private and social housing tenants and, in turn, how this impacts on their housing experience and their health and wellbeing.
The study showed that whether people are able to establish a sense of home in their tenancy has a deep impact on mental wellbeing. These impacts work through two main pathways. Firstly, the home is something that we can feel proud of: it reflects our identity, what we value and how others see us. When the home is not or cannot be something we’re proud of, it is often a source of shame and a sense of failure.
Secondly, the home is a place of respite and sanctuary, where we can take refuge from life’s ups and downs, recharge and take stock. Where the home cannot offer respite, we often have nowhere else to recuperate from pressures, stresses and shocks, making it harder to cope effectively. This is especially the case now, when we cannot recuperate by visiting friends or family, taking time out in a local community centre or cafe, or explore the outdoors at our own pace.
How can this evidence shape our response to the COVID-19 outbreak?
Our research showed there are four key housing needs to be met so that people can establish a sense of home and get health and wellbeing benefits from it. They are:
- excellent physical condition of the property, both inside and out
- suitability of the neighbourhood for the needs of that household
- affordability of the home, including ongoing and one-off costs
- and a strong, trusting relationship with the housing provider
All four of these have been affected by the COVID-19 pandemic and the measures taken to attempt to control the spread of infection. As there have already been a number of pieces published on various aspects of the first three of these, I’m going to focus here on the last of these four – a strong, trusting relationship between a household and their housing provider.
This trusting relationship has become even more relevant than before the pandemic, as COVID-19 has significantly altered the ways in which we communicate with each other, as well as eroding our usual routines, practices and expectations. The uncertainty and anxiety this has brought has impacted on both tenants and those working to support them in their tenancy, putting that relationship under strain at a time when the support it provides and the sense of home it can bring are needed more than ever.
The ‘Housing through Social Enterprise’ study showed that people needed to be able to trust their landlord, letting agent or housing support agency in order to take advantage of any support they had to offer and to be able to communicate what they needed, when they needed it. This required housing organisations to listen fully to what people were telling them and to act upon it.
We found that organisations that took a person-centred approach were most effective in meeting people’s needs in this way. They saw a person’s needs in-the-round and tried to support them holistically with any challenges they were facing. At their best, they didn’t confine their work to meeting only housing needs, but tried to support households with other aspects of their life and wellbeing too.
These might include help in travelling to hospital appointments, support in dealing with difficult personal relationships, resolving problems with non-housing debt, or support to find voluntary or paid work, for example. As the COVID-19 pandemic unfolds, the number of challenges that people need support with, as well as their diversity and novelty, are only likely to increase. These challenges are likely to pose significant risks to both the stability of tenancies and people’s health and wellbeing in the long term.
Housing as a tool to improve and protect public health
In a practical sense, building and maintaining relationships, including taking a person-centred approach, is going to be all the more difficult while we physically distance ourselves from one another and cope with having our lives disrupted so completely. However, for many tenants, having a trusted person to turn to for emotional and practical support is going to be increasingly important as this crisis lengthens from weeks into months. As our research showed, housing providers are extremely well placed to provide that support.
Moreover, living in a home that feels like a safe and stable sanctuary is going to be vital for the mental wellbeing of tenants across the rental sectors. Being able to see and use the home as a place of respite from day-to-day stresses and strains is now more important than ever, but it relies, at least in part, upon tenants being able to trust their housing provider during this uncertain time.
As such, building and maintaining these relationships is going to be vital in containing the negative impacts on mental wellbeing from this pandemic, and in supporting our recovery in the months and years to come. This will undoubtedly be a significant challenge for housing organisations to deliver, especially during a period in which normal working practices are effectively suspended and usually reliable income streams are under intense pressure.
In considering the ways in which public health policy might support our recovery from this crisis, it is crucial to recognise that housing is much more than a physical shelter from the elements. After publishing our research findings, we developed a series of recommendations in consultation with housing organisations, public health professionals and tenants. Among them was the need for public investment in housing support. Housing has the potential to be a recuperative sanctuary, underpinned by a trusting relationship with a housing provider for every tenant. But this requires time, space and, crucially, investment to develop to its fullest potential, which is now more important than ever.
- Dr Lisa Garnham is a public health research specialist for the Glasgow Centre for Population Health and co-author of the CaCHE report, Tenant participation in the private rented sector.
- Read all of our articles relating to COVID-19 here.