MENTAL Health Awareness Week this year [16-22 May] focuses on relationships, emphasising the central role that families, friends, neighbours and colleagues play in our lives, helping us to maintain our mental wellbeing, and to cope with crises.
The Mental Health Foundation campaign urges us all to reflect on the different relationships we have with the people in our lives and celebrate the love, friendship and support they offer.
This simple message is innately understood – we know we are social beings and that we thrive on contact with others. Just as innately we can all understand loneliness – from being homesick the first time we are away from home; to the desperate loss when someone close to us dies.
But can we really understand loneliness as experienced by someone like Billy, one of our members? Before coming to our services, Billy rode around on the bus all day because it was free and at least he felt part of the community. He saw people and sometimes they spoke to him.
The fact that people, like Billy, have no-one in their lives to look out for them and keep them connected hardly seems possible, but a recent Scottish Government report highlights the scale of the problem and identifies some of the actions we can take to address it.
The Equal Opportunities Committee report of 2015 presents stark statistics: loneliness can double the impact of obesity, and can increase an older person’s chances of premature death by 14 per cent.
Loneliness is associated with increased risk of a wide range of mental health problems, poorer physical health and reduced life expectancy, particularly in relation to an increased risk of cardio-vascular problems.
The absence of close confiding relationships has also been found to be a significant factor in predicting depression and anxiety. Lacking social connections can be as damaging to health as smoking 15 cigarettes a day.
What pushes people so far into the margins of our communities that they can’t find their way back? We have long recognised the toxic relationship between deprivation, inequality and poor physical and mental health and so adding loneliness to this dispiriting list is no surprise.
Stephen McLellan from RAMH (Recovery Across Mental Health) adds an additional factor in his evidence to the Holyrood Committee: “There is a huge taboo about loneliness. Nobody wants to own up to or acknowlege being lonely, because that is almost an admission of failure or defeat.” The consequence of that is that people don’t ask for help and so slip further away.
The Committee’s report calls on the Scottish Government to prioritise loneliness and isolation alongside issues such as poverty and poor housing as part of the public health agenda in Scotland, and makes recommendations that call for better awareness, investment in prevention and developing responses that tackle all of these intertwined issues at base level: connecting people to their families and communities.
Dr Jonathan Leach, Lecturer in Mental Health with the Open University, addresses this issue in his book Improving Mental Health through Social Support. In the book, he presents evidence of how providing support to people to make and sustain connections through seemingly simple interventions such as providing a safe haven, listening, and providing opportunities to develop connections and friendships can transform people’s lives.
Both the Government report and Dr Leach discuss how we can develop this social connectedness and both stress the importance of understanding and investing in grass-roots initiatives that link people into natural support networks – not as an alternative to more formal care and treatment, but as an integral element.
Dr Leach concludes by recommending a return to employing community development workers to nurture the power of communities to identify local needs and support the vulnerable.
However, we are living in a time of unprecedented cuts to community projects and services, as budgets are squeezed and priorities are set without community involvement and it is the simple, social support services that are being lost.
Perhaps this is through a misunderstanding of how complex and effective seemingly simple social support can be; or perhaps because it is difficult to produce evidence of this effectiveness in terms that funders understand. Central to this is the familiar tension between formal and informal care; and the balance between funding services that address needs and those that work to prevent those needs arising in the first place.
We urge the Government to implement the recommendations of the Loneliness report, not just because it makes economic sense to invest in preventative community support; but because extreme loneliness has no place in a caring nation.
• Frances Simpson, CEO, Support in Mind Scotland