Survey In England Research Articles

Epidemiology of Body Dysmorphic Disorder and Appearance Preoccupation in Youth: Prevalence, Comorbidity and Psychosocial Impairment

Little is known about how common and impairing body dysmorphic disorder (BDD) is in the general population of youth. We evaluated the prevalence, comorbidity, and psychosocial impairment associated with BDD and more broadly defined appearance preoccupation in young people. Data were drawn from the 2017 Mental Health of Children and Young People in England survey. BDD and psychiatric comorbidity were assessed in 5-19 year olds (N = 7,654) according to DSM-5 criteria, using a clinician-rated standardized diagnostic assessment. Psychosocial impairment was measured with a quantitative scale, and indexed by reported self-harm and suicide attempts, and service utilization, assessed using structured interviews. The point prevalence of BDD was 1.0% (95% CI 0.8 - 1.3%). BDD was significantly more common among adolescents than children (1.9 vs 0.1%; OR = 22.5, p<0.001), and female than male participants (1.8% vs 0.3%; OR = 7.3, p<.001). Approximately 70% of young people with BDD had psychiatric comorbidity, most commonly internalizing disorders. BDD was associated with self- and parent-reported psychosocial impairment, self-harm and suicide attempts, and service utilization. Appearance preoccupation was more common than full-syndrome BDD, but showed similar age and sex effects, patterns of comorbidity, and associated impairment. BDD and appearance preoccupation are relatively common, especially among adolescent girls, and associated with substantial co-occurring psychopathology, risk, and impairment. Improved screening is needed to increase detection and diagnosis of BDD, and to facilitate access to evidence-based treatment.

Assessing the Prevalence of Cannabis Use Through a Survey About Criminal Activity Versus One About Alcohol, Tobacco, and Other Drugs

Background: The prevalence of cannabis use in the United Kingdom might be underestimated using the Crime Survey of England and Wales. The current study examined whether responding to questions about their cannabis use as part of a crime survey would be less likely to report that they use cannabis compared to those responding to the same questions that are part of a survey about health. Methods: Participants were randomized to be told that the items about cannabis use came from a crime survey versus from a health survey. In addition, the sample was recruited using a representative online sampling method and compared to published rates of self-reported cannabis use collected as part of the Crime Survey for England and Wales. Results: There was no significant difference (p > 0.05) in the proportion endorsing cannabis use between those told the items came from a crime survey versus a health survey. However, self-reported rates of cannabis use collected as part of the online panel (51.3% ever use; 11.9% past year; age range 18–64 years) appeared higher than those reported based on results from the Crime Survey for England and Wales (37.2% ever and 5.8% past year; age range 18–59 years). Conclusion: The current study did not find evidence that manipulating whether participants were told that the items asking about cannabis use came from a survey asking about criminal activity versus one about health had an impact on self-reported cannabis use. However, as prevalence estimates generated by the Crime Survey of England and Wales do appear to be an underestimate of actual levels of cannabis use in the United Kingdom, further research is merited on this topic.

Mental Health Admissions to Paediatric Wards Study (MAPS): a protocol for the analysis of Hospital Episode Statistics (HES) data

IntroductionChildren and young people (CYP) presenting with a mental health (MH) crisis are frequently admitted to general acute paediatric wards as a place of safety. Prior to the pandemic, a...

The role of character‐based personal mitigation in sentencing judgments

AbstractPersonal mitigating factors (PMFs) such as good character, remorse and addressing addiction help sentencers evaluate an offender's past, present and future behavior. We analyzed data from the 2011–2014 Crown Court Sentencing Surveys in England and Wales to examine the relationship between these PMFs and custodial sentences passed on assault and burglary offenses, controlling for other sentencing relevant factors. Beyond revealing the distribution and co‐occurrence of the three PMFs, it was found that good character, remorse and addressing addiction all had a significant mitigating effect. The effects of addressing addiction were the strongest of the three across both offense types, while good character had a stronger effect on burglary than assault. In addition, some mitigating factors appear to be underweighted when they occur together. We consider the implications of these findings for sentencing policy and practice.

Continuing professional development for special educational needs and disabilities within the school workforce: The results of a national survey in England

AbstractContinuing professional development (CPD) is considered an important part of improving professional practice and its importance has been highlighted in Department of Education policies in England. However, very little research has explored what CPD school staff access and consider as effective for their roles. This research addressed this gap by conducting an online survey of child‐facing school staff in England. The survey was completed by 637 participants. The results indicate that there is a mismatch between what the staff consider as impactful CPD and the CPD to which they have most access. School leaders and SENCos are key people in delivering CPD in schools, and the findings of this study show that it is important to provide them with appropriate skills and knowledge to ensure that the most accessible CPD is also the most effective for the school workforce.

Children and young people’s reported contact with professional services for mental health concerns: a secondary data analysis

Children and young people’s mental health services have been under increasing pressure following COVID-19. Understanding, for which channels help is sought from, will highlight services needing support. This study aims to explore the professional services that parents of children, and young people get help from when they have a concern for the child’s/their mental health. Secondary analysis of data is taken from Mental Health of Children and Young People in England Survey, 2017. 7608 reports of mental health-related contact with professional services from parents of 5–16 year-olds and self-reports from young people aged 17–19 were available. Service contact was reported by Diagnostic and Statistical Manual of Mental Disorders (DSM-V) diagnosis, age, gender and ethnicity. Less than two-thirds of children and young people with a DSM-V diagnosis (63.5% (95% CI 58.6–68.1) aged 5–10, and 64.0% (95% CI 59.4–68.4) aged 11–16) reported contact with any professional services. The figure was lower for those aged 17–19; 50.1% (95% CI 42.8–58.2), p = 0.005. Children and young people aged 5–16 from Black (11.7%; 95% CI 2.4–41.4), Asian (55.1%; 95% CI 34.7–73.9) and Mixed (46.0%; 95% CI 32.4–60.3) ethnic groups reported less contact with professional services compared to those from the White group (66.9%; 95% CI 63.5–70.2). Patterns of service access during the three main educational stages aid with understanding service need during childhood. These lower levels of reported service access for young people aged 17–19 with a DSM-V diagnosis and those in ethnic minority groups demand further investigation.

Brief interventions for smoking and alcohol associated with the COVID-19 pandemic: a population survey in England

BackgroundFollowing the onset of the COVID-19 pandemic, in March 2020 health care delivery underwent considerable changes. It is unclear how this may have affected the delivery of Brief Interventions (BIs) for smoking and alcohol. We examined the impact of the COVID-19 pandemic on the receipt of BIs for smoking and alcohol in primary care in England and whether certain priority groups (e.g., less advantaged socioeconomic positions, or a history of a mental health condition) were differentially affected.MethodsWe used nationally representative data from a monthly cross-sectional survey in England between 03/2014 and 06/2022. Monthly trends in the receipt of BIs for smoking and alcohol were examined using generalised additive models among adults who smoked in the past-year (weighted N = 31,390) and those using alcohol at increasing and higher risk levels (AUDIT score 38, weighted N = 22,386), respectively. Interactions were tested between social grade and the change in slope after the onset of the COVID-19 pandemic, and results reported stratified by social grade. Further logistic regression models assessed whether changes in the of receipt of BIs for smoking and alcohol, respectively, from 12/2016 to 01/2017 and 10/2020 to 06/2022 (or 03/2022 in the case of BIs for alcohol), depended on history of a mental health condition.ResultsThe receipt of smoking BIs declined from an average prevalence of 31.8% (95%CI 29.4–35.0) pre-March 2020 to 24.4% (95%CI 23.5–25.4) post-March 2020. The best-fitting model found that after March 2020 there was a 12-month decline before stabilising by June 2022 in social grade ABC1 at a lower level (~ 20%) and rebounding among social grade C2DE (~ 27%). Receipt of BIs for alcohol was low (overall: 4.1%, 95%CI 3.9–4.4) and the prevalence was similar pre- and post-March 2020.ConclusionsThe receipt of BIs for smoking declined following March 2020 but rebounded among priority socioeconomic groups of people who smoked. BIs for alcohol among those who use alcohol at increasing and higher risk levels were low and there was no appreciable change over time. Maintaining higher BI delivery among socioeconomic and mental health priority groups of smokers and increasing and higher risk alcohol users is important to support reductions in smoking and alcohol related inequalities.

An investigation into patterns of Alcohol drinking in Scotland after the introduction of minimum unit pricing.

In 2018, Scotland became the second country to implement minimum unit pricing (MUP) for all types of alcoholic beverages. The aim of this study was to examine the effect of the policy. Three national household-level surveys were used: Scottish Health Surveys (2008-2021), Health Surveys in England (2011-2019), and Northern Ireland Continuous Household Survey (2011-2015). First, a generalized ordered logistic model examined patterns of drinking solely in Scotland from 2008-2021 covering current drinking, drinking categories and the weekly consumption (in alcohol units). Secondly, difference-in-difference (DID) analysis was employed to examine changes in "social drinking" behaviours in Scotland after the announcement in 2012 (2011-2015, Northern Ireland and England as comparators) and after the adoption of the policy in 2018 (England as a comparator, with two timeframes 2016-2019 and 2013-2019). Overall, drinking in Scotland began to decline prior to 2012 and dropped further with the enactment of MUP in 2018. In response to MUP, the likelihood of abstention increased along with a slight decrease in the prevalence of heavy drinking. The overall amount of drinking fell by about 8% after 2012 and 12% after 2018 (as compared to 2008-2011 level), with a significant decline seen in moderate drinkers but not of those who drank at hazardous or harmful levels. The DID analyses confirmed the reduction in current drinking in Scotland starting since 2012 and continued post-MUP in 2018. This study points to the impact of MUP in Scotland with a potential role for 'policy signalling' by the Scottish Government's with a multiple-buy discount ban and MUP's announcement since 2011-2012. Indications of impact include a clear decline in alcohol consumption levels and a small but noteworthy change in prevalence of overall drinking and heavy drinking.

Experiences and opinions of general practitioners with patient online record access: an online survey in England

ObjectiveTo describe the experiences and opinions of general practitioners (GPs) in England regarding patients having access to their full online GP health records.DesignConvenience sample, online survey.Participants400 registered GPs in England.Main...

Mental Health Admissions to Paediatric Wards Study (MAPS): protocol of a prospective study of mental health admissions to paediatric wards in England using surveillance and qualitative methods

IntroductionChildren and young people (CYP) presenting with a mental health (MH) crisis are frequently admitted to general acute paediatric wards as a place of safety. Prior to the pandemic, a...

Prevalence and characteristics of co-occurrence of smoking and increasing-and-higher-risk drinking: A population survey in England

BackgroundSmoking and drinking alcohol both significantly contribute to mortality and morbidity, and there is a need to characterise the sociodemographic and health-related characteristics (e.g. mental distress) of people who do both in order to target resources. This study reports the prevalence and characteristics of adults in the general population in England who both drink alcohol at increasing-and-higher-risk levels and smoke. MethodsWe used cross-sectional data from a monthly, nationally representative survey of adults in England (n = 37,258; April 2020-March 2022). Weighted data were used to report prevalence and unweighted data were used to report descriptive statistics for sociodemographic and health-related characteristics. ResultsThe prevalence of both smoking and increasing-and-higher-risk drinking was 4.6% (95% CI = 4.4–4.9; n = 1,574). They smoked a mean of 10.4 (SD = 8.86) cigarettes per day and had a mean AUDIT score of 12.8 (SD = 5.18). Nearly half (48.2%, n = 751) were trying to cut down on their smoking and 28.0% (n = 441) on their drinking. A quarter (25.3%, n = 397) had received General Practitioner advice on smoking while 8.7% (n = 76) had received advice on their drinking. Nearly half (48.6%, n = 745) reported experiencing psychological distress in the past month and 44.6% (n = 529) had a diagnosed mental health condition, both of which were higher than among all adults (28.1% and 29.1%, respectively). ConclusionIn England, from April 2020 to March 2022, the prevalence of both smoking and increasing-and-higher-risk drinking was 4.6%. This group appears to experience high rates of mental health problems and targeted support is needed.

Data Collection in Care Homes for Older Adults: A National Survey in England

Context: In many countries, there is a specification for information that should be collected by care homes. So-called ‘minimum data-sets’ (MDS) are often lengthy, and report on resident health and wellbeing, staff, and facilities. In the UK, the absence of any easily accessible data on the care home population was highlighted at the start of the COVID-19 pandemic. Care homes faced multiple requests for data from external agencies who had little knowledge of what care homes were already collecting. Objective: This study aimed to identify the range (and method) of data collected by care home organisations, in a country without a mandated MDS. Methods: Online survey of care homes (with/without nursing) in England. Care homes recruited via research and care home networks, social media. Questions covered data content, storage, and views on data sharing, analysed with descriptive statistics. Findings: 273 responses were received, representing over 5,000 care homes. Care homes reported extensive data on the health, care and support needs of individual residents, their preferences, and activities. Clinical measures and tools adopted from health were commonly used, but few collected information on quality-of-life. Care homes reported uses of these data that included monitoring care quality, medication use, staff training needs, budgeting, and marketing. Concerns over privacy and data protection regulations are potential barriers to data sharing. Implications: These findings challenge the notion that incentives or mandates are required to stimulate data collection in care homes. Care home organisations are collecting an extensive range of resident-level information for their own uses. Countries considering introducing social care records or an MDS could start by working with care home organisations to review existing data collection and evaluate the implications of collecting and sharing data. A critical approach to the appropriateness of health-related tools in this setting is overdue.

Estimating the effects of preventive and weight-management interventions on the prevalence of childhood obesity in England: a modelling study

The effects of the systematic delivery of treatments for obesity are unknown. We aimed to estimate the potential effects on the prevalence of childhood obesity of systematically offering preventive and treatment interventions to eligible children in England, based on weight or health status. For this modelling study, we developed a cross-sectional simulation model of the child and young adult population in England using data from multiple years of the Health Survey of England conducted between Jan 1, 2010, and Dec 31, 2019. Individuals were assessed for eligibility via age, BMI, and medical complications. Weight status was defined based on clinical criteria used by the UK National Institute of Health and Care Excellence. Published systematic reviews were used to estimate effect sizes for treatments, uptake, and completion for each weight-management tier. We used all available evidence, including evidence from studies that showed an unfavourable effect. We estimated the effects of two systematic approaches: a staged approach, in which children and young people were simultaneously given the most intensive treatment for which they were eligible, and a stepped approach, in which each management tier was applied sequentially, with additive effects. The primary outcomes were estimated prevalence of clinical obesity, defined as a BMI ≥98th centile on the UK90 growth chart, and difference in comparison with the estimated baseline prevalence. 18 080 children and young people were included in the analytical sample. Baseline prevalence of clinical obesity was estimated to be 11·2% (95% CI 10·5 to 11·8) for children and young people aged 2-18 years. In modelling, we estimated absolute decreases in the prevalence of obesity of 0·9% (95% CI 0·1 to 1·8) for universal, preventive interventions; 0·2% (0·1 to 0·4) for interventions within a primary-care setting; 1·0% (0·1 to 2·1) for community and lifestyle interventions; 0·2% (0·0 to 0·4) for pharmaceutical interventions; and 0·4% (0·1 to 0·7) for surgical interventions. Staged care was estimated to result in an absolute decrease in the prevalence of obesity of 1·3% (-0·3 to 2·4) and stepped care was estimated to lead to an absolute decrease of 2·4% (0·1 to 4·8). Although individual effect sizes for prevention and treatment interventions were small, when delivered at scale across England, these interventions have the potential to meaningfully contribute to reducing the prevalence of childhood obesity. UK National Institute for Health and Care Research.

Use of SARC services by victims of sexual violence: Auditing the ethnicity of Saint Mary's Sexual Assault Referral Centre's clients

IntroductionSaint Mary's Sexual Assault Referral Centre (SARC) in Manchester provides services to adults and children who have suffered sexual assault. The ethnic composition of those who attended the centre was audited in 2001 and 2003 to measure how well it serves different ethnic groups. This paper provides an updated audit using 2019 data. MethodologyCensus data for Greater Manchester, and data from the Crime Survey of England and Wales (CSEW) showing rates of sexual assault for different ethnic groups, were used to predict the ethnic composition of sexual assault victims in Greater Manchester. These predicted figures were then compared with the ethnic composition of Saint Mary's SARC 2019 client base to measure how well the SARC is serving different groups. This comparison was repeated using data from the 2001 SARC client base to explore change over time. ResultsThe analysis shows that South Asians and Chinese individuals are underrepresented in the SARC client base, and that this issue has become more pronounced over time. Every other group is overrepresented. ConclusionThe underrepresentation of South Asian and Chinese clients at Saint Mary's SARC is concerning. Making the service more accessible to those from these ethnic groups should be a priority for the centre.

Measuring changes in adult health and well-being during the COVID-19 pandemic and their relationship with adverse childhood experiences and current social assets: a cross-sectional survey

BackgroundAdverse childhood experiences (ACEs) can impact mental and physical health, leaving people with less resilience to health challenges across the life-course. This study examines whether individuals’ levels and changes in levels of mental health, physical health and sleep quality reported across the first year of the COVID-19 pandemic are associated with ACEs and moderated by social assets such as having trusted family and friends.MethodsA cross-sectional household telephone survey in England (a North West local authority) and Wales (nationally) using landline and mobile numbers stratified by health areas, deprivation quintile and age group and supplemented by an online survey. Data were collected from 4,673 English and Welsh residents aged ≥ 18 years during national COVID-19 restrictions (December 2020 to March 2021). Measures included nine types of ACE; self-reported mental health, physical health and sleep quality at time of survey (in pandemic) and one-year earlier (pre-pandemic); numbers of trusted family members and friends, knowledge of community help; and COVID-19 infection.ResultsACEs were strongly related to moving into poorer mental health, physical health, and sleep categories during the pandemic, with likelihoods more than doubling in those with ≥ 4 ACEs (vs. 0). ACEs were also associated with increased likelihood of moving out of poorer health and sleep categories although this was for a much smaller proportion of individuals. Individuals with more trusted family members were less likely to move into poorer health categories regardless of ACE counts.ConclusionsACEs are experienced by large proportions of populations and are associated with poorer health even in non-pandemic situations. However, they also appear associated with greater vulnerability to developing poorer health and well-being in pandemic situations. There is a minority of those with ACEs who may have benefited from the changes in lifestyles associated with pandemic restrictions. Connectedness especially with family, appears an important factor in maintaining health during pandemic restrictions.

Alcohol and smoking brief interventions by socioeconomic position: a population-based, cross-sectional study in Great Britain.

Alcohol and smoking brief interventions (BIs) in general practice have been shown to be effective in lowering alcohol and smoking-related harm. To assess prevalence of self-reported BI receipt among increasing or higher-risk drinkers and past-year smokers in England, Scotland, and Wales, and associations between intervention receipt and socioeconomic position. Cross-sectional study using data from a monthly population-based survey in England, Scotland, and Wales. The study comprised 47 799 participants (15 573 increasing or higher-risk drinkers [alcohol use disorders identification test consumption score ≥5] and 7791 past-year smokers) surveyed via telephone in 2020-2022 (during the COVID-19 pandemic). All data were self-reported. Prevalence of self-reported BI receipt was assessed descriptively; associations between receipt and socioeconomic position were analysed using logistic regression. Among adults in England, Scotland, and Wales, 32.2% (95% confidence interval [CI] = 31.8 to 32.7) reported increasing or higher-risk drinking and 17.7% (95% CI = 17.3 to 18.1) past-year smoking. Among increasing or higher-risk drinkers, 58.0% (95% CI = 57.1 to 58.9) consulted with a GP in the past year, and of these, 4.1% (95% CI = 3.6 to 4.6) reported receiving BIs. Among past-year smokers, 55.8% (95% CI = 54.5 to 57.1) attended general practice in the past year; of these, 41.0% (95% CI = 39.4 to 42.7) stated receiving BIs. There was a tendency for patients from socioeconomically disadvantaged backgrounds to receive more alcohol (adjusted odds ratio [aOR] 1.38, 95% CI = 1.10 to 1.73) or smoking BIs (aOR 1.11, 95% CI = 0.98 to 1.26), but for the latter the results were statistically non-significant. Results did not differ notably by nation within Great Britain. BIs in general practice are more common for smoking than for alcohol. A greater proportion of BIs for alcohol were found to be delivered to people who were from socioeconomically disadvantaged backgrounds and who were increasing or higher-risk drinkers.

P15 Women’s satisfaction with the management of urinary tract infections during the COVID-19 pandemic: a qualitative analysis of free-text comments from a national survey in England

Abstract Background Urinary tract infections (UTIs) are one of the most common bacterial infections affecting women. The COVID-19 pandemic altered how healthcare was accessed and delivered with rapid adoption of remote technologies. This study explored women’s satisfaction with the care they received for UTI in general practice during the pandemic. Methods We analysed 799 responses to an open-ended question regarding women’s satisfaction with the management of their most recent UTIs. A thematic analysis was inductively conducted and supported by NVivo V.12. Results Most women (72.7%) were satisfied with their UTI management. Main study themes related to consultation, management, patient’s feelings, and safety during the pandemic. Themes on positive aspects of care were related to thorough assessment and treatment by a doctor and having a positive experience with the healthcare provider (HCP). Themes on the negative aspects of care were related to long waiting times, use of virtual consultations, and patients feeling uninformed and invalidated about their UTIs. Conclusions Patient satisfaction was closely linked to a positive face-to-face HCP interaction, prompt assessment and treatment, and discussion about prevention and self-care. To improve satisfaction, systems and consultations should account for patient choice in the HCP they consult with, allow for additional information about when and why a urine test should be provided, and ensure there is a platform for discussing patient preferences for antibiotic prescription or alternative therapy. Using resources to discuss these topics with patients may help address these issues, including risks and benefits of antibiotics, alternative treatments, prevention and self-care.

Intermittent point prevalence surveys on healthcare-associated infections, 2011 and 2016, in England: what are the surveillance and intervention priorities?

Point prevalence surveys are an important surveillance method for determining the burden of healthcare-associated infections (HCAIs). To outline the key results of two point prevalence surveys in England (2011 and 2016). All National Health Service and independent sector hospitals in England were eligible to participate. Data were collected between September and November in both 2011 and 2016 based on the protocol and codebook devised by the European Centre for Disease Prevention and Control. Analysis was performed using Stata Version 13 and SAS Version 9.3. A mixed-effects model was applied, which allowed estimation of organization-specific means and accounted for the heterogeneity in the responses from different organizations. A total of 100,755 case records were included (52,433 in 2011 and 48,312 in 2016). The estimated prevalence of HCAIs was slightly higher in 2016 [6.89%, 95% confidence interval (CI) 6.21-7.57%] than in 2011 (6.41%, 95% CI 5.75-7.06%). In both surveys, the prevalence of HCAIs was highest in adult intensive care units (23.1% in 2011, 21.2% in 2016), and pneumonia/lower respiratory tract infections was the most common cause of HCAIs (22.7% in 2011 vs 29.2% in 2016). Inpatients in acute hospitals were older and had higher risk of dying in 2016 compared with 2011; however, the proportion of inpatients with HCAIs or on antibiotics did not differ significantly. The burden of HCAIs in English hospitals increased slightly between 2011 and 2016. However, the proportion of inpatients with HCAIs or on antibiotics did not differ significantly.

Trends in socioeconomic inequalities in behavioural non-communicable disease risk factors: analysis of repeated cross-sectional health surveys in England between 2003 and 2019

BackgroundPrevious studies have shown that those in lower socioeconomic positions (SEPs) generally have higher levels of behavioural non-communicable disease (NCD) risk factors. However, there are limited studies examining recent trends in inequalities. This study examined trends in socioeconomic inequalities in NCD behavioural risk factors and their co-occurrence in England from 2003–19.MethodsThis time-trend analysis of repeated cross-sectional data from the Health Survey for England examined the relative index of inequalities (RII) and slope index of inequalities (SII) in four NCD behavioural risk factors: smoking; drinking above recommended limits; insufficient fruit and vegetables consumption; and physical inactivity.FindingsPrevalence of risk factors has reduced over time, however, this has not been consistent across SEPs. Absolute and relative inequalities increased for physical inactivity; relative inequalities also increased for smoking; for insufficient fruit and vegetable consumption, the trends in inequalities depended on SEPs measure. Those in lower SEPs experienced persistent socioeconomic inequalities and clustering of behavioural risk factors. In contrast, those in higher SEPs had higher prevalence of excessive alcohol consumption; this inequality widened over the study period.InterpretationInequalities in smoking and physical inactivity are persisting or widening. The pattern of higher drinking in higher SEPs obscure the fact that the greatest burden of alcohol-related harm falls on lower SEPs. Policy attention is required to tackle increasing inequalities in smoking prevalence, low fruit and vegetable consumption and physical inactivity, and to reduce alcohol harm.

Trees and forests’ contribution to well-being during the COVID-19 pandemic in England: how did people adapt to change?

Abstract COVID-19 was declared a global pandemic on 11 March 2020 and has meant entire populations have experienced a significant change in lifestyle. Restrictions in England occurred through a series of phases from a lockdown through to the opening of shops and facilities. The initial restrictions led to a strong media focus on nature and getting outdoors for exercise and mental well-being. Alongside this but not related to COVID-19, there is a strong policy focus on forest creation and expansion in England with debate about where new forests might be created, what benefits they might provide, and to whom. In this research, we explored, for those with an existing interest in nature, whether this connection to nature and specifically to trees and forests could support people in coping with the restrictions they faced during the pandemic. We carried out an online survey in England in June/July 2020 and received 3333 qualitative comments. We then carried out 25 follow-up interviews in August/September 2020 with a sample of those who had completed the survey. We use the Kübler-Ross change curve as a lens to explore people’s reactions and responses to the significant changes brought about by the COVID-19 crisis, with a focus on their experiences relating to trees and forests. The results highlight that some people did move through the four stages of change outlined in the Kübler-Ross framework, although not always in a linear process, from shock and denial, to resistance, to exploration, and adaptation. The change curve model proved useful in this study but also had some limitations. Engagement with forests supported some adaptation as well as exploration through people undertaking new activities, visiting local spaces, and spending more time outdoors with their children. We also found that the benefits of engaging with trees and forests could help to support people’s well-being in times of high anxiety. The study highlights the importance of trees and forests as part of people’s lives, and the role they can play in supporting them when faced with major challenges.