Helios - A Healthy Mind in a Healthy Eco-system

Helios - A Healthy Mind in a Healthy Eco-system

Contact
Valeria Righi
Main Organisation
Department/Sector/Unit
JRC.H1; JRC.F1; JRC.D3; JRC.C5; JRC.D1
Other Organisations
Università degli studi di Verona

Description

The COVID-19 pandemic and its prolonged lockdowns in Italy encouraged to reconsider the relationship between mental health, well-being and the ecosystems that constitute our living environment. Thus, HELIOS has explored how the presence of nearby nature and green space as well as the quality of the living environment have an impact on our mental health and well-being. The project did so by relying on an interdisciplinary approach based on citizen engagement and knowledge co-creation. The final aim was to offer insights for planners and policymakers for the design and management of places in times of a health crisis and beyond it.  

HELIOS included one citizen engagement process carried out over three phases, which took place in the city of Verona (Italy). Its objective was to bring the perspectives and voices of city dwellers into the research over the nexus between mental health and the living environment and ensure that local views and lived experiences were taken into account to complement quantitative measures of the relation between mental health and the quality of the environment.

HELIOS involved researchers of the Joint Research Centre (European Commission, Ispra site) with expertise in environmental quality, public health, and citizen engagement in science and policy. The research project is conducted in close collaboration with external experts in the fields of psychiatry (University of Verona) and citizen science. 
The case-study here reported concerns the results and learnings of the citizen engagement process, designed and implemented by a citizen science expert in collaboration with the  Competence Centre on Participatory and Deliberative Democracy.

Participation Spectrum

When and Where

Start Year
2021
End Year
2023

Policy Context

Policy Stage
Context of activity
Science or Policy Field
Specific Topic
Mental health and well-being; environmental quality

Participants

Participants
50
Who was involved
Communities or representatives involved
- About 20 individuals and local organizations were interviewed during the first phase of the citizen engagement process, which was aimed at acquiring contextual learning of the research site. The respondents were selected through online research and snowball sampling.
- Fourteen adult residents took part in the engagement process, which was built on the photovoice method (see next section). The average age of participants was 57 (range 24 - 76 years). Almost all the participants are professionally or amateurly interested in the theme dealt with by the HELIOS project. For instance, some of them were psychotherapists, someone have promoted or joined civic movements for improving the urban quality of Verona in the past; others belong to environmentalist associations, others are photographers.
The final project event was attended by about (TBC) participants, among residents, stakeholders, researchers, and policymakers.
How were the Participants selected?
Through what means citizens knew about the call for participation?
Several means were used in order to invite citizens to join. A project webpage was created to host an open call for participation targeted to the general public. The call was disseminated by sending personal email invitations and setting up meetings to present the project to key local organisations and individuals, based in different areas of the city. It was key to leverage on existing local networks and partnering with local organisations that widespread the call to their members. Word of mouth was encouraged by providing a standard message to be disseminated through email and WhatsApp messages.

Methodologies

Events
4
Methodology description
The citizen engagement process drew on the visual elicitation method Photovoice. Residents who took part in it documented through photos and related narratives the features of their living environment that they think affect mental well-being. This Photovoice project was conducted through two face-to-face workshops carried out in spring 2022, two online meetings carried out in winter 2022 and a final exhibition that took place in March 2023 (date to be confirmed).

- In workshop 1, the research team explained the project aims and facilitated a discussion among participants over the type of environments they inhabited during the COVID-19 lockdown. During the following two weeks, participants were encouraged to take 2 to 4 photos of the places in Verona that affected their mental well-being. Participants were given a Photo-Kit where they could find all information about the project aims, data use, ethics measures, and instructions to take photos.

- Workshop 2 consisted of two parts. In the first one, participants reflected, discussed, and analysed their local environment with the support of the photos they produced. To guide group discussions triggering questions were used, such as: How does the represented place make you feel? What aspects of the environment contribute to this feeling? How does it relate to your well-being, now and during the lockdown? The second part of the workshop consisted of co-creating solutions that respond to the problems identified during the analysis of photos and collecting ideas for the final photo exhibition.

- As part of the follow-up with citizens, two online meetings were carried out with participants, focusing, among others on the organization of the final event.

- The final event will be held in a municipal hall in the centre of Verona and was aimed at presenting the project outcomes to policymakers, key stakeholders, local media, and the general population. A central part of the event will be dedicated to the presentation of the citizen engagement process and outcomes, and the inauguration of the photography exhibition. The exhibition, representing the legacy of the project, takes both a virtual form and a set of pocket-size cards with a map of the city of Verona annexed to them. More information will follow in due time.
Tools Used

Impact

Main Outcomes and Lasting Achievement
The purpose of the citizen engagement activities was to support the research process, by mobilizing all relevant knowledge and producing new ones by involving citizens, local organizations, and experts from different fields (public health, mental health, environmental quality).

The results of the engagement process are to be understood as exploratory and not definitive. They show that the natural, social and built environments in which people live influence to a great extent their emotional state. In particular, the results highlight the importance of considering not only the physical attributes of the environment (e.g., square meters of green spaces, pollution particles) but also how it is experienced. In other words, the appearance of places (e.g. building design, care of spaces, visual harmony), their functional characteristics (e.g. walkability, opportunities for socialising), and collective dimension (e.g. citizens’ participation, urban management and planning) can influence the way how people feel in an environment. Overall, these findings revealed that residents’ framing of environmental quality in relation to mental well-being was different from the one initially conceptualised in HELIOS, in which the environment was mainly discussed in terms of green spaces, air and noise pollution. Thus, the findings demonstrate the benefits of engaging citizens to broaden the scientific gaze on the research agenda.

Other tangible outcomes:
- 7 policy recommendations built from the results of the engagement project and discussed with the group of participants.
- A virtual exhibition, currently in the making, that will be hosted on the CC-DEMOS site presenting the HELIOS project main outcomes, i.e., the photographs, and related narratives, created by participants.
- A pocket-sized exhibition consisting of a box containing a map of the city and 31 georeferenced postcards representing the pictures taken by participants
- An online toolkit: all the materials used to carry out the HELIOS engagement activities are made available for download to facilitate future use by other actors and foster replication and appropriation of the process.
How were the outcome taken up within the process they were carried out?
The finding of the engagement process can be used in later stages of HELIOS study for discussing its quantitative results or for fine-tuning the statistical model. New indicators have been integrated into the quantitative model for environmental quality assessment, namely: i) housing density ii) solar radiation, as a proxy for lack of light concern expressed by participants, iii) proximity to the Adige river, as a way to address water as a qualifying element of Verona.
Other Feedback
Communication with participants was maintained throughout the duration of the project. A detailed report was delivered to them with all the materials collected during the workshops, as well as initial findings of the photovoice process.
A two-pager presenting the project goals and main outcomes, aimed at local policymakers, was shared with participants to 1) inform them about the communications and interactions that took place between the researcher team and the local administration and 2) share some results of the quantitative part of the research. The final event served as a return of the research results to the general public, including people not involved in HELIOS activities.
Were the methodologies used elsewhere?
All the materials used to carry out the HELIOS engagement activities (e.g., canvas of the workshops, photo-kit) were made available for download to facilitate future use by other actors and foster replication and appropriation of the process. The photo-kit was used, after adaptation, by a Spanish research institution to carry out a photovoice project.

Assessment

Reason for such challenges and solutions
The engagement strategy adopted, which required people to participate in multiple meetings over an extended period of time, challenged the recruitment process as some people decided not to join due to time constraints. Moreover, it required sustaining participation over time. On the bright side, the people who engaged did so because they wanted the research to make a real change for the city. By the end of the process, they were so motivated that they expressed interest in continuing the project to see the change happen. They have also helped mobilize other people to participate.

Recruitment was also challenging because of the need to build local support networks from scratch in a short period of time. Word of mouth resulted to be the most effective method for recruiting participants. In this respect, it was key to identify local champions with local influence who disseminated the call among key channels and networks. It was also important to disseminate the call through communication channels that are relevant in the local context (e.g., identify the social media most used locally).
Despite the will of the participants and the methodology being fit for replication, project continuity is difficult to assure, given the lack of financial support and someone to take the lead.

As for the difficulties encountered in the study of the topic at stake, we found that participants found it difficult to engage in activities on sharing their mental health concerns, especially in relation to the pandemic period, thus at posteriori. Emphasis was placed on creating a safe space where participants could meaningfully share their voices, thanks to the particular way in which the engagement process was designed, namely i) it aligned with interests and concerns that exist within the group of participants, ii) promoted agency allowing participants to make decisions and engaging them in co-learning, iii) gathered participants through a series of events that facilitates trust building, iv) encouraged continuous communication with participants throughout the duration of the project.

Another challenge was that participants could not see the impact of their contributions to the scientific process as quantitative research findings were made available only at the very end of the project. In view of a missed feedback loop between the scientific process and the citizen engagement one, a suitable engagement strategy was designed that could work independently of the scientific process that was carried out in parallel.
Lessons Learn
1. Citizens’ framing of environmental quality was wider than the one conceptualized by researchers, thus demonstrating that involving citizens in research can contribute to broadening the scientific gaze on the research topic. In particular, the findings invite researchers to go beyond the focus on air, noise, and green areas when studying environmental quality and include other factors belonging to the cultural, functional, aesthetical, social, and political dimensions of places.

2. Photo-elicitation confirm to be an attractive, effective, and easy-to-implement and replicate method for engaging citizens in research, fostering critical debate and reflection on the living environment, as well as deriving policy recommendations.

3. Participatory processes, especially those that aim to foster community reflection and change, are often attended by people who are already committed and interested in the topic at stake. The results thus may not be transferable to the whole population as other voices may not be represented in them. Nevertheless, the findings should be considered a suitable basis for further investigation and validation. Clarifying the value of the findings is crucial to managing the expectations of researchers and policymakers.
Recommendation
- Addressing topics of interest to the local community contributes to sustaining citizen participation over a prolonged period of time.
- Build on existing networks and community champions to recruit participants
- Creating a variety of communication materials is key to supporting word of mouth (e.g. project website, WhatsApp messages, email template messages).