How can loneliness impact mental health? We asked our Practice Specialists
The theme for this year’s Mental Health Awareness Week is loneliness. The Think Ahead Practice Specialists, our in-house senior social workers with years of experience working across social work and mental health services, shared their thoughts on the real life impacts of isolation on mental health, and how we can better support people to connect with creative and innovative solutions.
I worked in and managed older adult mental health services, and what I always wanted to do was make sure that we weren’t just using a medical model in our work. We asked ourselves what we could do to give people a sense of control and choice in their lives, not just treatment options, and one of the recurring issues was loneliness.
Clearly bereavement is a huge thing that can impact the mental health of older people, but physical disabilities or illnesses which might impact their mobility and ability to access things in the community can also dramatically shrink someone’s world. The conventional route for services with this sort of person can sometimes feel too transactional, and often ends in a referral to a day centre (although many have now closed) or the offer of a basic care package which often focuses on practical tasks and personal care. What we try to do as social workers is take a more personalised and creative approach.
An example from my time in Hackney was a young man who was interested in what he could do to support older adults. He was also the compere at a well-known gay nightclub in London. Using his skills and networks, he was able to set up an event which was a cross between a live cabaret and afternoon tea, with actors, costumes, entertainment and beautiful food, all reminiscent of their time in the 1950s as younger adults. We were able to refer people to a wonderful and unique way of reducing loneliness and promoting connections.
I think it’s important we’re also able to empower older people in the service process. When I was a social care lead in an NHS trust working across older adults mental health services, we had an expert-by-experience group which rapidly grew in size, experience and influence. They were able to challenge processes and shape their services, but perhaps just as importantly, share their experiences with each other in a meaningful way through a positive network.
I think considering longevity in life is key to tackling loneliness – what does healthy, happy life look like in later life? We try to think of ways with them to celebrate their lives, share their experiences, and make connections, and the solutions can be more creative than a day centre.
I think loneliness can be a particular problem with men, who can sometimes be too proud to ask for support. They feel they have to ‘soldier on’. With trauma or bereavements, there’s an initial period where there can be lots of people around you, but when they move away it can leave people very vulnerable. As a social worker, we try to think differently, and see if we can help people with a social approach.
I worked with a 65-year-old man who was experiencing very low mood and was feeling suicidal. His wife had passed away, he had no family in the area, and a very small network of people who knew him, so he was very isolated. He lived in a big house which he was struggling to cope with, and this was causing him financial difficulties. This man didn’t technically have any medical care needs, and was independent, but being so lonely made life really difficult for him.
After doing a robust risk assessment and starting to build a relationship with him, it became clear very quickly that he loved art. He’d been an art teacher and his house was full of really beautiful artwork. We helped arrange some visits to an assisted living home where he could teach some art classes to the people living there. His classes became so popular, and he was spending so much time there, we eventually helped him to move into the facility. He’s now sold his house which has made him a lot more financially stable, is going on holidays, and is selling his art again. His mood improved, his physical health improved, and by using the social model and exploring options he wanted, we were able to bring out his strengths again.
When we think about loneliness, we often instinctively think about older people, but I think what the pandemic has highlighted is that there are so many ways in which social isolation can affect anyone, whatever their age. It provided a bit of a moment to stop and think about people who might be isolated, and consider what they might be able to do to help, but as the pandemic has lifted we are beginning to see the long-lasting impacts.
Initially lots of us were able to use technology to socialise and access support, and this will have definitely been helpful for those who were too anxious to leave their homes. As social workers we had to be innovative in the way we support people, and while there was a delay as online support groups were set up, some services even reported better attendance to these sessions. In my area we were also able to set up some befriending phone calls, even reaching out to people who weren’t currently accessing services.
But for people already living with a mental illness, living in isolation was overall very, very difficult during the pandemic. Worrying about catching covid will have significantly increased people’s anxieties, and not being able to access community services face-to-face, particularly for those where meetings were some of their only regular contact with people, would have been very challenging. Some may not have had the social capital to access online tools too, and we have to make sure not to forget about them as we move out of the pandemic and services become stretched with demand.
Consider, for example, a young person who lives alone with an eating disorder, with uninterrupted access to social media during the pandemic. The constant narrative of ‘lockdown weight’ combined with increased health anxiety – it’s clear that it’s not going to be a good outcome, so it’s no surprise there has been a huge spike in referrals for disordered eating. Examples like this, or people who are anxious about restrictions being lifted or vaccinations, and its clear how isolation and mental health problems can in turn impact our physical health too.