Loneliness and Social Isolation
Most of us are lucky to have good friends, family and colleagues in our lives that provide us with the emotional support we need and we often take for granted the range of social opportunities that we can access. We know that not everyone is as fortunate.
Research shows an increased threat to Scotland’s health from loneliness and social isolation. Triggers for loneliness include significant life changing events such as bereavement, and disability / illness. Research shows that social isolation and loneliness can lead to, for example, people eating, drinking and smoking more that can then result in poor physical health and that feelings of loneliness are also linked to poor mental health. 300,000 people contact the Samaritans each year with loneliness as the main reason. The Samaritans advise that loneliness can lead to depression and to other mental health problems accounting for 90% of suicides. They report that the risk of suicide is higher among men and is rising among older men, particularly those in areas of social isolation and ask ‘how can we address the health needs of older men who may be becoming increasingly isolated?’
Loneliness of course affects people of all ages and backgrounds and the broader impacts of loneliness include increased use of health and social care services e.g. GP / NHS24 / A&E / unscheduled admissions. If people have no one to turn to in a crisis to give them the reassurance and emotional support they need, it is more likely that they will contact emergency services. We are part of a multi-agency ‘Experienced Based Co-Design’ project in North Lanarkshire that is examining why some people frequently attend A&E in distress but who do not need clinical intervention and who are not admitted. This includes people: in poverty; with poor mental health; with addictions; who are homeless; and elderly people living on their own. Findings from staff interviews conducted so far confirm that loneliness and social isolation are relevant factors. The aim of the project is that service users and staff will work together to develop services that better meet the needs of these people by providing the right care at the right time in the right place and avoid presentation at A&E.
Some of the loneliest of all are those that are housebound through physical disability and who need help and support to access social events but that support, sadly, is not always available or comes at a cost that many can’t afford. Appropriate transport is currently a massive barrier. North Lanarkshire has an enviable third sector subsidised transport service but it is stretched to capacity and often wheelchair accessible taxis are the only option. Some people will need accompanied by their carer if they are to participate in social events but who meets this cost assuming SDS is not in place? What more can we do to enable people who are lonely and socially isolated get the support they need to access local community services?
We have started a joint pilot project in one of the localities with an Independent Care at Home provider, the Third Sector community consortia and Locality Link Officers to identify people receiving care at home services that might benefit from becoming involved in social activities in their local area or from a befriending service. This is exciting work that will provide us with an evidence base to help inform future planning and delivery.
Research has shown that unpaid carers and family members are also at risk of depression, social isolation and loneliness as they give up their own social activities as their caring responsibilities increase, and as they struggle to cope with the decline and death of a loved one. Loneliness and social isolation after the unpaid caring role no longer exists can be extreme. It is important to make sure that people register as carers but this can be difficult as they often don’t see themselves as such. There are excellent support services available for unpaid carers in North Lanarkshire. I have been working with staff at North Lanarkshire Carers Together to help facilitate awareness-raising about this within the Independent sector.
The good news is that people do care. In Scotland, the problem is recognised and many partners, agencies and community groups are working together to do something about it. This year the Scottish Government’s Equal Opportunities Committee instructed an Enquiry about Social isolation and loneliness – the first of its kind in the world, and subsequently released funding to help tackle loneliness and social isolation. It has also pledged to create a National Social Isolation Strategy to ‘ensure a holistic approach across government to problems of loneliness and isolation”. It anticipates that the integrated Joint Health & Social Care Boards will play a key role in taking action. Consultation is planned for February 2017.
At a local level it is apparent to me that those delivering health and social care across North Lanarkshire in the statutory, third and independent sectors are acutely aware of this growing situation and of the potential for it to worsen as more people are living longer at home. There are already many huge hearted people working every day doing everything they can to support people and help improve their quality of life in line with the National Health and Wellbeing outcomes. My hope is that we can do it better together and I am looking forward to being part of that with independent providers and our partners across North Lanarkshire.
Local Integration Lead for North Lanarkshire – Linda Scott [email protected]