Transport and mental health
By Dawn Wylie, (MSc Psychology, MSc Transport, TPP, MBPsS, MICE, MTPS, FIHE)
Having spent 30 years as a Transport Planner, some colleagues thought I was ‘completely changing direction’ when I took a second MSc in Psychology in 2014, particularly when all my elective modules were in Mental Health. This couldn’t be further from the truth, since the links between transport and mental health are significant, albeit not necessarily obvious.
For Mental Health Awareness Week (13th – 19th May 2019), it’s worth a reminder of just how significant those links are, especially when we consider that it is estimated that 1 in 4 of us suffers from some form of mental health problem in any given year, and 1 in 6 of us are experiencing symptoms of common mental health disorders in any given week. There is some increased awareness in the transport world that the promotion of active travel such as walking and cycling is good for mental as well as physical health, but the transport system impacts on mental health in many more ways than that.
For example, I discussed the links between loneliness and transport in my previous blog. The Economics Foundation estimates the cost of loneliness alone on the UK economy to be £2.5 billion per year (2017 figures). The cost to the individual can be to their mental and physical health, with depression, alcohol abuse, sleep problems, asthma, autoimmune diseases, cardiovascular diseases, obesity, cancer and Alzheimer’s disease all being linked to loneliness.
Keeping people connected to their family, their friends and their leisure activities is vital in helping to overcome, reduce and prevent this loneliness epidemic, yet public services are being cut without taking these costs to the economy and to the individual into account.
When considering loneliness, and poor mental health in a wider context, we discussed the unintended consequences of transport decisions on mental health in “A Transport Journey to a Healthier Life” which we co-authored on behalf of the CIHT in 2016. In the report, we proposed that cost-benefit analyses for transport schemes should include the impact on mental as well as physical health.
The WPI Economics report “Building Better: The Role of Transport Infrastructure and Services in Improving Mental Health” (2019) concurs, concluding that improving transport infrastructure could reduce stress and anxiety and improve wellbeing for millions of people. They put the price on the UK economy from poor mental health at £66.5 billion per year, with £20 billion being attributable to public services. It is clear therefore that the provision of transport services is vital to maintain good mental health, and the quality of the transport provision is also paramount.
In 2018 the Transport Research Laboratory (TRL) looked at links between transport and mental health from a different perspective, undertaking qualitative research on the effect that poor mental health can have on travel behaviour as well as the impact that poor transport can have on mental health.
In their “Mental Health and Transport” report (2018) they concluded that poor mental health, in particular, anxiety and depression can influence choices on whether to travel or not, modal choice and driver behaviour. Those with anxiety were more likely to avoid travel, and when they did travel, they were less likely to chose modes where they may experience crowds, or need to make changes, or felt they had a lack of control over outcomes. This group were conversely less concerned about car delays than other groups. Interestingly, loneliness and isolation were cited as a significant concern for those with anxiety and depression, but this group felt less isolated and lonely when travelling by car than when travelling by any other mode.
Lack of information on all modes was also cited as a cause of increased levels of anxiety. In terms of driver behaviour, it was found that poor mental health could impact on cognitive processes making drivers overly hesitant, and impact on mood increasing the likelihood of engaging in aggressive and risky, or impaired driving behaviour. The prospect of autonomous vehicles was a cause for concern with some believing it would be detrimental to their mental health, associated with loss of control.
It’s easy to see how all these issues, when considered together, lead to a spiralling vicious circle. Poor, unattractive transport provision and lack of information can exacerbate mental health problems, which can lead to making more sedentary transport mode choices. This can lead to poorer mental health and fewer people using public services, which in turn, directly impacts the services receiving less funding or being withdrawn. This, ultimately, results in poor, unattractive transport provision. And so, the cycle goes on and on.
One thing is very clear – transport and mental health are intrinsically linked, and mental health impacts need to be considered in our work as transport practitioners, when developing policy related to transport and when designing and analysing transport systems.