State of a Generation: Upheaval, uncertainty, and change

Themes of adulthood - A study of four life transitions and their impact on our mental health.

As part of the Mental Health Foundation’s 70th anniversary, we commissioned a series of reports, each looking at some key factors that can challenge and support our mental health at different stages of life. This is the second of these reports, focused on what has traditionally been referred to as ‘working-age adulthood’. It is intended as an exploration of a selection of life transitions that can have a profound effect on our mental health, and a call to action for how we can better protect and promote good mental health in the context of these life experiences.

We selected four life transitions – pregnancy and early parenthood, unemployment and job loss, moving home and housing problems, and bereavement to investigate in-depth. We recognise that there will be many other experiences in adulthood that are equally as impactful, however we believe there are lessons to be learned from these four which translate across many different types of life transitions. They are significant because they represent key moments of upheaval, uncertainty, and change which many of us will encounter during this period of our lives. They have also become more salient in the context of the coronavirus (COVID-19) pandemic.

We worked in partnership with Citizens Advice Wandsworth, Pregnancy Sickness Support, The Motherhood Group, and Cruse Bereavement Support to hold online discussions with people who have experienced each of these life events. We also worked with the Cochrane Common Mental Disorders group at York University to review the existing academic research on what works to support mental health across each of these experiences and brought this together with a nationally representative polling of 3,879 UK adults aged 18-64 from Deltapoll.

Despite on the surface being very different experiences, we found several common themes across pregnancy and early parenthood, unemployment and job loss, moving home, and bereavement in terms of how moments of transition in adulthood are often accompanied by feelings of worry, lack of control, and uncertainty. These feelings are natural responses to change but can also be distressing and can adversely affect our mental health, particularly when we do not have the social and formal support we need at such times. 

Our polling found that while most of us did feel supported during these times in our lives, a substantial minority of UK adults did not benefit from any type of formal, or informal, support during their own experience of these life events, particularly those from the lowest-income households. This is crucial because across all four themes, social support from family and friends, and support from voluntary and outreach services (such as peer support and advice lines) were central in helping people to navigate these times of transition in their lives.

All of us need a basic level of support during times of transition and uncertainty, which recognises each of us as individuals, and helps to build our capacity to navigate change. For many (though not all) of us, this will come from our families, friends, and communities; however, some of us may need additional help from more formal sources. Ensuring this range of culturally appropriate universal and targeted support is available is crucial to promoting and protecting mental health during life transitions experienced in adulthood. For this reason, we want to see – at national and local levels - a whole-government approach to addressing the issues that protect and pose a risk to our mental health, which should include:

  • Improved funding for, and greater provision of, voluntary and outreach services, including peer support, which provide valuable and impartial support for those experiencing a broad range of life transitions.
  • Families, friends, and wider communities (including community leaders) being recognised as vital resources in helping to prevent mental health problems during life transitions experienced in adulthood, and for support to be provided to help them recognise when people are struggling.
  • Every locality working with their local community, particularly those from low-income households, to better understand their experiences and the types of support they would find helpful, and to identify any barriers to accessing wellbeing and resilience services and other more informal types of support.

Pregnancy and Early Parenthood Summary

Pregnancy can be joyful and exciting, but also, understandably, a time of worry and uncertainty, which can negatively affect the mental health of expectant parents, particularly when women experience traumatic or difficult pregnancies and births.

We want to see:

  • A more diverse, less idealised, range of pregnancy stories and images, from and of both men and women, shared in advertising, magazines, newspapers, and social media to help expectant parents to live with more realistic expectations about pregnancy and birth, and feel less alone and/or disappointed when things don’t go as expected or planned.
  • Families, friends, and communities supported to recognise when new parents are struggling.
  • Greater valuing and more  provision of local spaces and groups that enable the creation of supportive informal communities, combined with services or projects that provide active listening, educational resources, and support to new and expectant parents.
  • Continued improvement in the development and availability of culturally relevant care at all stages of pregnancy and childbirth and postnatally. This should encompass routine care and mental health care for parents who need additional support during the perinatal period but do not have a diagnosed mental health problem.

Job Loss and Unemployment Summary

Job loss and unemployment can have a profound effect on mental health, contributing to feelings of loss, lack of purpose, anxiety, and uncertainty. Especially where the loss of employment leads to financial difficulty and housing instability.

We want to see:

  • a strong support net for those who lose their jobs, both during and after the pandemic,  taking into account active learning from the impact of COVID-19 financial support packages. We support recent calls from Citizens Advice to make Universal Credit uplifts permanent, ensure benefits keep pace with the cost of living, and build upon the existing support with energy bills in place for low-income households, to help prevent people falling into debt with their energy providers.
  • every locality having a clear roadmap of how to navigate redundancy and unemployment which includes details of available services and support, co-produced with those who have lived experience of job loss.
  • targeted support for people who experience unemployment that prioritises their mental health alongside the provision of practical support in navigating unemployment, skills training, and benefits systems.
  • more high-quality research on what approaches work to support the mental health of people experiencing unemployment and support people into employment in ways that prioritise their mental health and wellbeing.

Moving Home and Housing Problems Summary

Regardless of context, moving home can be a stressful experience. However, while a positive new chapter for some, when a move is not due to personal choice, or involves limited individual control (for example, financial difficulty, relationship breakdown or eviction), it can be a traumatic experience with lasting effects on mental health. More broadly, the communities we move from, and move to, and the resources and social support available within them have an important influence on our mental health.

We want to see:

  • increased awareness of moving home as an important stressor in people’s lives, and a recognition that those moving under challenging circumstances may need additional support for their mental health.
  • improved funding for and greater provision of voluntary and advice services, which provide valuable and impartial support to those experiencing housing difficulties.
  • continued widespread efforts to reduce housing disadvantage and instability to ensure that everyone in the UK has a safe and stable home, building on learning from policies implemented in other nations such as indefinite tenancies and rent control policies, and from the impact of temporary rules on evictions implemented during the COVID-19 restrictions. We support calls from Citizens Advice to provide further hardship funding for local councils to help support people in arrears or behind on council tax.
  • further high-quality research into the effectiveness of housing interventions for promoting and protecting mental health that consistently captures outcomes related to mental health and integrates a broader range of research methodologies.

Bereavement Summary

Bereavement is a personal journey that often changes in non-linear ways over a period of months and years,  which can have lasting effects on mental health. Strong informal support from family and friends, and accessible, culturally appropriate formal support for those who need it, is crucial to supporting mental health following a death.

We want to see:

  • increased societal awareness of grief, and normalisation of a wide range of common grief responses to help those experiencing grief feel less alone. We echo calls from Cruse Bereavement Care to create more compassionate communities where everyone knows enough about grief to play a part in supporting people around a death.
  • continued and improved local funding for high-quality bereavement support, including for voluntary services providing counselling and/or peer support, that recognises the variability of bereavement experience and is tailored to meet the needs of different groups.
  • A review of the effects of bereavement and the programmes and guidance in place for supporting bereaved people, particularly in the context of increased rates of bereavement due to the ongoing COVID-19 pandemic.

As an important element of this, we support Cruse’s call for a national review of employment practice relating to bereavement, to improve the way that bereaved people are treated at work so that it conforms to best practice. Every organisation should have a bereavement policy in place which clearly outlines what employees can expect when someone close to them dies.

Read our Methodology report - The aim of this report was to explore a selection of life transitions in adulthood which can influence mental health and suggest actions for how we can better promote and protect good mental health in the context of these life experiences.