Analysis of Real-Time Mental Health Trends during Public Health & Environmental Emergencies within England

Robertson, Campbell (2025) Analysis of Real-Time Mental Health Trends during Public Health & Environmental Emergencies within England. Doctoral thesis, University of East Anglia.

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Abstract

Mental health conditions have risen globally and in the UK since the 1990s, necessitating real-time surveillance methods to understand trends. Simultaneously, climate change and other human activities have increased the frequency and severity of environmental disasters, as well as the risk of pandemics caused by emerging pathogens. Given the psychological trauma associated with these emergencies, it is critical to analyse mental health trends before, during, and after these events to inform public health interventions and policy.

This thesis leverages daily healthcare data—syndromic surveillance and Electronic Healthcare Records (EHRs)—to assess mental health impacts of two events in England: COVID-19 and flooding. Temporal and spatial analyses explored associations with age, sex, deprivation, and population density.

We documented a method for performing an interrupted time-series (ITS) analysis during the COVID-19 pandemic and understanding the impact of different levels of restrictions on mental health presentations. During the COVID-19 pandemic, there was an overall decline in mental health demand but a shift from in-person services (GPs, Emergency Departments) to remote platforms (telehealth, out-of-hours GPs). We were also able to highlight differences between age group and sex during the pandemic. Flooding analyses identified elevated NHS 111 telehealth calls in flood-risk areas, even after adjusting for deprivation and density. A delayed surge in mental health calls occurred one year post the 2015/16 winter floods.

Syndromic surveillance and EHRs can help complement existing mental health surveillance and reporting, offering insights into the full range of healthcare access points utilised by the public. These surveillance sources can be used in disaster and emergency preparedness for a variety of health-related issues, evaluating the impact of exposures and effectiveness of interventions.

Item Type:	Thesis (Doctoral)
Faculty \ School:	Faculty of Science > School of Environmental Sciences
Depositing User:	Chris White
Date Deposited:	03 Feb 2026 09:31
Last Modified:	03 Feb 2026 09:31
URI:	https://ueaeprints.uea.ac.uk/id/eprint/101819
DOI:

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