For the past 18 months we have been living through the Covid-19 pandemic. This has curtailed many of the activities that we have previously taken for granted. For months, the Government’s key message was ‘Stay at home’. Even if we went out, most of the places that we wanted to go to, were closed. Public transport services were reduced and face coverings were required. If we did venture out, for exercise for example, we were told to keep two metres away from other people.
Following the successful roll-out of the vaccination programme, we are no longer required to stay apart from people from other households. The Government no longer requires us to wear face coverings, although some transport operators, such as Transport for London (TfL), still do. Before Covid-19, most people went out whenever they wanted to. The pandemic has made many people feel nervous about doing so.
While there are excellent arguments for discouraging car use and encouraging walking and cycling, we must not forget that, for a quite a large proportion of the population, these changes make life even more challenging
Even before the pandemic, however, there were people who found it challenging to go out. Many people have anxiety issues that prevent them from leaving home. In a survey on travel by people with mental health conditions, about 90% of the respondents said that their health condition prevented them from leaving home on occasion, and over 30% said it happened frequently. The survey was carried out on-line in 2018, before we had heard of Covid-19.
Is mental health a major issue? According to the Health Survey for England, 26% of all adults have been diagnosed with at least one mental illness during their lifetime, while a further 18% say that they have experienced a mental illness without being diagnosed. These people will have family and friends who may be called upon to provide support. This all means a significant proportion of the population are affected by mental health issues, directly or indirectly.
What did the survey discover made people so anxious that they could not leave home, even before the pandemic? The biggest issue was the attitudes and behaviour of other people. Another factor was the concern that they might not be able to obtain support when they needed it. These issues partly arose because two out of three of the respondents suffered from panic attacks which made them feel self- conscious. They just wanted somewhere quiet where they could recover, which is not always easy when out and about in a big city. About half the respondents had difficulty communicating with other people. That is going to be so much harder having been told for over a year to keep away from other people. Face coverings have made it even more difficult.
Another big issue for many people with anxiety issues is having to deal with changes from their regular journeys. The levels of service of buses and trains have been reduced during the pandemic. Currently many transport operators have shortages of staff because they are being ‘pinged’ by the NHS Covid-19 App telling them to self-isolate. This has led to changes to services, often at short notice. For a person who needs their bus or train journey to be exactly as advertised, that makes life even more difficult.
So, what can be done to help people with anxieties about going out? First, we need a high level of understanding and tolerance from other people. Throughout the pandemic, we have been asked to consider other people, by staying a safe distance from them and wearing face coverings. Most people complied, but quite a few did not. Some people were exempt from wearing face covings because of long-term health issues and disabilities. Some of them were subject to abuse from others for not wearing a face covering. Having a mental health condition can make wearing a face mask covering difficult. Anxiety and depression are not visible, so there needs to be understanding from others who do not always know the full situation.
A second area where help can be provided is through up-to-date, accurate information about transport services, particularly when they are different from usual. This would help everybody but would be particularly useful to people who require certainty about their journey. Nowadays most of us have a smart phone and can check information both before and as we travel, receiving ‘alerts’ when things change. However, not everyone has a such a phone, because they cannot afford or are unable to use one. This means that information should be distributed through posters and leaflets as well as through the internet.
Some people have agoraphobia which means that they must travel by car from home to their destination, with parking very close to where they want to go. Some of them have ‘Blue Badges’ enabling them to park in disabled parking spaces, but many do not. The pandemic led to many local authorities closing streets and restricting parking, often in schemes that were not well thought through. Some schemes have now been removed, but many remain in place. While there are excellent arguments for discouraging car use and encouraging walking and cycling, we must not forget that, for a quite a large proportion of the population, these changes make life even more challenging.
One of the best ways to provide support for people with anxieties who are uncertain about what to do or where to go, is to provide well-trained staff at key points throughout journeys. They can supply up-to-date information and provide support when required.
The keys to helping people who feel reluctant to go out to do so, is for all of us to be thoughtful towards others, and for government, both central and local, to remember life is challenging for people with anxiety and similar issues, and to include them when forming policies and taking actions.
For more information about the research mentioned see:
Roger Mackett is Emeritus Professor of Transport Studies at University College London
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