This article was originally produced for the Canadian Housing Evidence Collaborative (CHEC).
Loneliness has become an increasingly urgent public health issue with lasting implications for individuals’ health, well-being and risk of mortality (Holt-Lunstad et al., 2015). Living arrangements are not always a predictor of loneliness, but living alone is one risk factor. With people living alone now the most common household type in Canada, finding ways of addressing loneliness at home is a housing issue. Almost 30 percent of the population fits into this category and most are seniors. What can Canada learn from the UK’s recent efforts to address loneliness?
Reporting on the psychology of loneliness in the UK
The 2017 Jo Cox Commission on Loneliness reported more than 9 million people in Britain “often or always feel lonely. “Given the growing severity of loneliness, the government launched a nationwide effort to reverse this trend and appointed Tracey Crouch as Britain’s first Minister for Loneliness in 2018.
As part of this effort, The Campaign to End Loneliness, hosted by the What Works Centre for Wellbeing, commissioned research from the “Loneliness and Social Isolation in Mental Health Network” at University College London (UCL). Together, this network of government, non-profit, and individual actors compiled their research findings in the Psychology of Loneliness report (PDF). This report focuses on seniors’ experiences and key recommendations for psychological interventions to combat the negative effects of loneliness, which are vividly portrayed in a series of moving public service announcements called ‘Be More Us.’
Defining social isolation and loneliness can be challenging and can also vary depending on the method used and the context. The Psychology of Loneliness report defines loneliness as a subjective feeling, compared to social isolation which is a more objective measurement of the quantity of an individual’s relationships. The focus of the report is on individual psychology, excluding the broader context of societal, cultural, or situational concerns. Central to the approach is the Perlman and Peplau (1984) “model for the causes of loneliness,” which suggests that a person’s characteristics, sociological and demographic factors, and cultural norms interact with a precipitating event (such as a period of bereavement) to provoke experiences of loneliness.
For practitioners in direct contact with communities at risk of loneliness, this report outlines three psychology-based recommendations: Cognitive Behavioural Therapy (CBT), mindfulness, and positive psychology. These strategies emphasize awareness of negative behavioural patterns, and the universal value of positive psychology to empower individuals to begin an “upwards spiral” out of loneliness. These psychology-based recommendations are categorized into three approaches for different groups and target audiences – (1) public campaigns for general population (2) adjusting an organization’s services to reflect a ‘psychology of loneliness’ approach and (3) direct support for individuals using psychological techniques (p. 28).
Specific recommendations for services at the organizational level for older adults or seniors range from accessible spaces to dedicating time or skills to encourage community engagement. Applied in a practical setting, positive psychology can look like the “Hereford and Worcestershire” pilot program, which paired older adults experiencing loneliness with trained volunteers or staff to talk about their feelings of loneliness. After the six-month program, some positive impacts included stronger relationships between volunteers and participants. There were further recommendations for practitioners, including a ‘social prescribing strategy’ to build skills such as awareness around loneliness stigma, listening, and discussion-building (p. 38).
This well-researched report travels a striking distance from global trends and research to micro-scale interventions with small groups of seniors. While positive psychology may have universal appeal, we worry that the recommendations here may limit the way we need to tackle something as complicated and subjective as loneliness. The opening and narrowing of focus in this report leaves us wondering and wanting more discussion of how loneliness is experienced by those who are not covered by these case studies. The focus on psychological interventions (CBT, mindfulness, and positive psychology) runs the risk of an overly individualized approach. The potential power of these recommendations is offset by strong questions about how the three, ‘one-size fits all’ recommendations can encompass the wide range of personal, local, and structural factors that create short or long-term experiences of loneliness. There is little mention or discussion about necessary organizational or institutional supports such as funding or policy change that can support long-term responses to loneliness.
The report imparted an impactful message on how a deeper understanding of loneliness is not only relevant to those vulnerable to or experiencing loneliness, but also the responsibility of professionals working directly with vulnerable communities to improve the quality of services. In short, we can understand these psychological interventions as one approach amongst many that helps move us closer to combating loneliness.
Connections to the Vancouver context
Vancouver has travelled a similar path of inquiry into how to tackle loneliness, but with some different strategies, frameworks, and lessons. In 2018, the City of Vancouver’s Seniors’ Advisory Committee commissioned a comprehensive report on Social Isolation and Loneliness Among Seniors (PDF) (SILAS). Rather than focus on individual psychological drivers of loneliness, this report, produced by Eddie Elmer, connects how societal, community, and individual factors merge and interact with each other to affect experiences of loneliness. They draw in part upon the diagram, “Overview of Risk Factors for Isolation and Loneliness,” to help visualize how factors at different levels compound to impact an individual’s experience of loneliness and isolation. The SILAS report includes 22 recommendations that include both psychology-based interventions and multi-level factors by including government interventions such as improving street safety and walkability in addition to individual, community, and organizational changes. Vancouver’s Hey Neighbour Collective originated as an answer to some of these recommendations, in fact, with a broad-based emphasis on sociability that goes beyond individual psychology.
The work of the Hey Neighbour Collective is kindred in spirit with the UK Campaign to End Loneliness and its goal to spotlight the psychology of loneliness. As a group with members who play professional roles in research, housing provision, local policy and advocacy, we gravitate toward strategies that draw across our areas of work to shift policy, programming, and practices to build social connections. Our partners who work in the non-profit housing sector also face a unique set of challenges in their work – issues from building design, to staffing, to dedicated funding and capacity. Central to our interests is looking at the larger societal structures, from federal, provincial, and municipal housing and neighbourhood policy to professional associations of housing providers, to informal networks of mutual aid and support, as these drive social connectedness or the inverse, social isolation.
What can Canadian housing researchers learn from this report?
The Psychology of Loneliness report outlines important considerations that Canadian community-engaged researchers can draw from. Maybe most strikingly, efforts taken to connect the work across networks of government actors, researchers, and practitioners, as is done in the UK via the “Loneliness and Social Isolation in Mental Health Network” at UCL, are dynamic and important. Combined with the potential implications for greater mindfulness in programming and services, and partnerships with the healthcare sector, the campaign’s interventions offer meaningful responses to loneliness at the micro level.