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(It’s not) only the lonely’: thinking about loneliness in a NHS foundation trust

If only society was friendly and non-judgmental then maybe we wouldn’t feel lonely’, commented one participant at a recent workshop discussing the meaning of loneliness for a large NHS foundation trust.  As the number one concern for its service users, the organisation has committed to exploring how to respond effectively and creatively. But that comment captures the difficulty.  Isn’t loneliness a personal matter for individuals?   Yes it is, but at the same time it’s also about (the lack of) relationships with other people, so service responses need to think about the implications for organisational culture and practice.  As a personal issue (maybe even responsibility), isn’t it harder for a large organisation to respond flexibly?  If it’s about the interaction between individuals and others, won’t it get lost among the whole breadth of policies and activities involved in delivering health services?

MutualGain has recently been commissioned to help find some answers.  The brief attracted us because it resonates with our social purpose ‘to empower organisations and communities to reconnect in the social space that lies between the state and the individual. Ultimately, we aim to promote greater participation and active citizenship within our democracy and increase social capital for the mutual benefit of all.’ Focusing on those highlighted words seems particularly relevant for getting under the skin of this issue.

Loneliness has been a bit of a hot topic lately.  Spurred by the Jo Cox Commission and the Campaign to End Loneliness, the Government launched its own strategy in November 2018[1] with a minister to drive it forward (it’s currently Baroness Barran, the third politician in the role).  Coinciding with the strategy launch, the BBC undertook its Loneliness Experiment surveying 55,000 people worldwide with one third of respondents reporting that they feel lonely often or very often.[2]  Earlier in the year, the Office for National Statistics explored the ‘characteristics and circumstances associated with feeling lonely’, estimating that five per cent of English adults ‘often’ or ‘always’ do.[3]  In 2017 the New Economics Foundation calculated that loneliness costs employers £2.5 billion every year.[4]

Our initial desktop review revealed that these are just some highlights from the range of research, strategies and resources.  Some facts seem surprising.  For example evidence suggests that young people are more affected while the majority of service interventions focus on older people.  That the three profile groups at particular risk of being lonely are widowed older homeowners living alone and unmarried, middle-agers with long-term health conditions and younger renters with little trust and sense of belonging to their area appears more obvious. 

Sceptical voices also exist.  One blog writer, published by the Solitudes Past and Present project at Queen Mary University, believes ‘loneliness has become a proxy, not so much for the contradictions in the social relations of our times, as for the intensifying crisis in the distribution of wealth and the management of public services.’[1] Is the focus on the lonely individual therefore simply a means of ignoring the impact of austerity on communities and the services within them?  Indeed when the BBC interviewed Tracy Crouch, the minister in charge at the time of the Government Strategy launch, she didn’t really deny it.

This is but a taste of the debates about loneliness but it is striking that there is no one agreed definition (perhaps because the experience is an individual one).  One of our tasks is to help facilitate the trust agreeing its own version.  The debate is ongoing but the findings of a University of Sheffield study of interventions to reduce social isolation and loneliness among older people has particularly inspired us.  After asking ‘what makes interventions successful?’ they concluded that the keys to success include interventions adapted to the local context, older people involved in the design and implementationdriven by action and creativeness towards seeking a common goal.  Sounds a bit like mutual gain, doesn’t it?

Written by Michael Keating