Loneliness and social isolation in mental health: proposal for a network for cross-disciplinary collaboration and capacity development

Lead Research Organisation: University College London
Department Name: Division of Psychiatry

Abstract

People are said to be lonely when they feel unpleasantly lacking in meaningful connections with other people. They are described as socially isolated when they have little social contact. Lonely people are more likely to be socially isolated, but the two do not always go together. Researchers have found that these states have significant impacts on physical and mental health. Some of this research is about loneliness and some about social isolation - we plan to look at both alongside each other, as it can be difficult to disentangle their effects. The strongest evidence is on the impact of loneliness on physical health. For example, people who are persistently lonely tend to die earlier and have more heart disease.

There is less research on loneliness and social isolation in mental health, but it's clear there are many links. For example, people who are lonely and/or socially isolated are more likely to become depressed, and depressed people who are lonely/lacking in social support recover less well than others. So by helping people to feel less lonely, some people could be prevented from developing mental health problems. Among people who already have mental health problems, strategies aimed at reducing loneliness and/or social isolation may help recovery. Some such strategies have been developed, for instance by charities. However, we don't yet have good evidence about how good these strategies are at reducing loneliness and social isolation, and about which are best for which people. We also don't know much about the extent to which they prevent people from developing mental health problems, or improve life for people who already have them.

Challenges in trying to improve this evidence are the many different influences on loneliness and social isolation. For instance, people's genetic make-up, the way they tend to think about other people, their caring responsibilities, their disabilities, the architecture and layout of the area they live in, and their income and education are just some of things that influence whether people become lonely or isolated. Possible ways of helping are also very varied. Talking treatments seem to help some lonely people. Other ways of helping include supporting people in rebuilding former relationships, or in getting involved in the arts, sport or religious practice. Digital ways of connecting may help some people. Another approach is to try to make a whole community, or even a country, friendlier and less divided.

No one is an expert in all fields relevant to loneliness and social isolation and their relationship to mental health, and that's why this call is a great opportunity for us to get together a network that includes many different kinds of relevant expert. We will hold a series of events where people bring together their expertise to map out what we already know between us about this field. We will also involve throughout our activities a group of people with personal experience of mental health problems. They will work with researchers, and with charities and public organisations who are active in this field, to work out the priorities for further research that brings together different types of expertise.

Once we've mapped the evidence and established research priorities, we will advertise to researchers within and outside our network an opportunity to carry out small projects that will help move this field forwards. There are some excellent young researchers in this field who have joined our network - we aim especially to support them and other potential future leaders in applying for funding. The final stage will involve presenting the network's work widely. This will include papers and a conference for other researchers, meetings with policy makers, and discussions with professionals and the public about our findings and potential next steps. Our blogger collaborators the Mental Elf and Mark Brown, and our roles in policy research will help us at this stage.

Planned Impact

The longer-term impact we are aiming for relates to two overlapping groups of people - people with mental health problems, and people in the general population who are lonely and/or socially isolated, or at risk or becoming so. By loneliness we mean a subjective feeling of not having sufficient meaningful contact with other people. By social isolation, we mean an objective lack of social contacts. The two are related but distinct: someone may choose solitude and thus be isolated but not lonely, or they may feel lonely despite considerable contact with others. We plan to study the two concepts alongside each other as they are often hard to disentangle in interpreting research evidence.

Regarding people with mental health problems, our ultimate aim is to find ways of reducing loneliness and social isolation. In terms of impact, loneliness is by definition unpleasant, so that reducing the current high rates among people with mental health problems is in itself a significant goal. Loneliness and social isolation are also associated with poor physical health and high levels of health service use, so that there are potential physical health and also economic benefits from reducing them. There is also emerging evidence that loneliness and social isolation impede recovery among people with mental health problems, another reason why targeting them may have a substantial impact. A better understanding of the interrelationships between mental health problems and loneliness and social isolation, and evidence on which strategies are most effective are means by which we hope our network will eventually result in these positive impacts for people with mental health problems.

There is also potential impact from our network's activities for people in the general population who are lonely and/socially isolated. There is evidence that such people are at greater risk than others of developing mental health problems. It is therefore possible that by reducing loneliness and/or social isolation, some mental health problems can be prevented. We hope that our network will result in evidence allowing this possibility to be further assessed. It may be that in such preventive work it would be most fruitful to target groups who are particularly vulnerable to loneliness and social isolation. These include people with disabilities, carers, new parents, refugees, students and older adults.

As our proposal is to establish a research network rather than to conduct a major study, we do not envisage achieving all these impacts within the life of the network. We do expect some short to medium-term impacts, including from dissemination to practitioners, policy makers and the public reports from experts from a wide range of disciplines on the current state of evidence on loneliness and social isolation and mental health. We hope that this will stimulate innovation and an intensified focus on the area. The relatively small projects that we will fund in the second stage of the project will also make advances in the field that may have impacts on practice and prevention.

However, the major impacts of the network are longer term. In the process of developing this application, we have brought together a substantial group of researchers from a wide range of disciplines field who were in many cases not aware of relevant work in related fields. By bringing together and enhancing this network, and stimulating discussions with people with lived experiences and providers of innovative services, we anticipate a wave of new work in this field that integrates biological, psychological and social approaches to explanation and intervention much better than before. We hope this will contribute to the impacts described above.

The network will also make an impact through support for a very promising cohort of early careers researchers. A very significant expected impact will be to contribute significantly to researcher capacity in this field.

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