Living in a cold and damp home: frameworks for understanding impacts on mental well-being

Objective: To carry out a review of recent studies that have explored relationships between mental well-being and how this may be affected by living in cold and damp homes. Attention is focused on intervention studies in which heating and insulation improvements were carried out and impacts on well-being assessed. Study design: Drawing mainly on a Cochrane Review published in 2013, nine studies of sound methodology are identified and significant effects discussed. Methods: The review outlines the current frameworks for understanding mental well-being which prevail in psychology and psychiatry, describing the distinctions that can be made between mental well-being and its elements, namely positive mental health and negative mental health (the latter also known as mental disorder). The review then organizes findings from nine studies into the separate domains of positive and negative mental health, giving due consideration to the quality of the research, instruments used to measure mental health, methodological, and ethical issues. Results: These first nine studies indicate early consensus. Living in cold and damp housing contributes to a variety of different mental health stressors, including persistent worry about debt and affordability, thermal discomfort, and worry about the consequences of cold and damp for health. Improvements to energy efficiency are often associated with significant improvements in mental well-being. Conclusions: Impacts affect both positive and negative mental health. A cumulative stress framework is hypothesized, within which the mental health impacts of improved energy efficiency can be better understood. Crown Copyright (C) 2014 Published by Elsevier Ltd on behalf of The Royal Society for Public Health. All rights reserved.