All by myself: tackling loneliness and social isolation in Scotland

A person sitting alone in a room - Image credit: Pixabay

People seem to have more ‘friends’ than ever these days and yet two-fifths of Scots admit to feeling lonely.

Social media can create the illusion of sociability, but a fifth of people say they have limited social contact with their neighbours.

Politicians cheer when employment rates rise, but when every young person is working to make ends meet, they have less time to care for, or even visit, an isolated relative or friend.

The government, councils and health boards are finding it increasingly difficult to plug the gaps, with a rising elderly population, squeezed budgets and Brexit threatening to evict and restrict European carers, creating the risk that elderly and disabled people will have less human contact than ever.

The Scottish Government is aware of this challenge and has launched a consultation on reducing loneliness and isolation, drawing upon research which shows 11 per cent of adults in Scotland often feel lonely, and 38 per cent feel lonely sometimes.

Nearly a fifth (18 per cent) of people have limited regular social contact in their neighbourhoods, and over a fifth (22 per cent) feel that they don’t have a strong sense of belonging to their local community.

Eight out of ten carers have felt lonely or socially isolated as a result of looking after a loved one.

Anne Simpson, 67, who lives in Musselburgh, has mostly lived alone since her marriage ended shortly after her family moved over from Northern Ireland in the late 1980s.

Since then she has suffered from agoraphobia and has periods where she won’t go out for months.

“It’s hard to make friends when you move somewhere new,” she says.

“I have become isolated, but I have come to terms with the fact that depression is something that I have to live with.

“I’ve struggled with depression since my late teens, so it isn’t just an old age thing, but obviously when you’re older and isolated, it’s hard at times.

“My husband was much more outgoing than me, so when we split up I did suffer, I was depressed at times and I found it hard to make friends.

“After we broke up, I had periods when I was quite agoraphobic and found it very difficult to leave the house.

“Now I can go out, but I find it very difficult to make appointments and say I’ll go on a particular date at a particular time.

“I don’t like crowds. If I want to go shopping, I’ll get up early in the morning when it’s quieter. I have a car, but I get my main shopping delivered.

“I have a nice home and I am very happy in it, but I don’t have friends locally and my daughter lives up in Monifeith so I don’t have many visitors.

“I’m friendly with people rather than having close friends in Scotland that I would see regularly.

“I wouldn’t say I’m unhappy at the moment – I’m not – I’ve sort of come to terms with my own limitations, but sometimes it is a shock when you stop and think, and realise how little contact you’ve had with other people.

“I did try to join a few groups, but because of my problem going out, it was hard for me to be consistent.

“It takes a lot out of me talking to people and I’ve got out of the habit of socialising now.

“I always think people won’t like me, or I’ll say the wrong thing, or talk too much.

“In my marriage I was put down a lot and I lost confidence in myself, so sometimes it’s easier to just not risk being rejected.

“The isolation sort of creeps up on you. When you’re depressed, you find that you physically can’t go out, and I think I also pushed people away at times because I didn’t want them seeing me very depressed.”

Unlike many older people, Anne has embraced the internet, which has allowed her to have daily contact with her family, but only through a computer screen.

by Tom Freeman

Society & Welfare

Loneliness can be a lifetime condition

“I came kicking and screaming to the internet, even though I have a degree in physics and maths and I was a teacher at one stage, but it was all pre-computing,” she says.

“With the internet I’m very included in my daughter’s life because I get texts and video clips of the kids every day and they get down when they can to visit.”

Anne previously lived in the Craigmillar area of Edinburgh, where she was introduced to a befriending service called Phone Link, run by Caring in Craigmillar.

“I wasn’t sure about it, but it’s been a blessing,” she says.

“There have been various people over the years, but there is one girl who has been there from the word go and she’s like a friend.

“It’s nice to know that there is somebody out there if there was a problem. When I have had family problems, they have been aware, and it’s just nice if somebody is around to say the right things if you’re feeling a bit down.

“They’re trying to roll it out more widely across Edinburgh because it’s been such a success. I assumed it was a service that ran in all areas, but it isn’t, so they’re trying to spread the word.”

Caring in Craigmillar has recently expanded its outreach as far as Leith and is an example of the kind of community organisation that the Scottish Government wants to nurture with its loneliness strategy.

In her foreword to the strategy, Jeane Freeman, Minister for Social Security, said: “The Scottish Government recognises it has an important role in creating the conditions for change to happen and supporting communities to flourish and we are committed to doing that… but the biggest impact can only be delivered if we enable communities themselves to lead this work.”

The consultation encourages communities to tell the Scottish Government what would make a difference to them and to use the strategy as a platform to drive change.

“We know that getting support into local communities can make a difference,” says Freeman.

“Grassroots initiatives run by organisations firmly rooted within communities can have a hugely positive impact on people who are socially isolated or experience regular feelings of loneliness.

“But this is about more than money or projects. The reality is that we all have responsibility to ensure that our communities are more connected and cohesive, and that principles like kindness get greater traction in society.

“Whether it is saying hello to your neighbour, taking the time to get to know a regular customer at work, reaching out to someone you haven’t seen in a while or just a small act of kindness that can make a stranger’s day, all of this can go a long way to helping everyone feel part of their community.”

Caring in Craigmillar has been operating for over 20 years and its staff work 365 days a year to call isolated people, hear about their day, pass on news from their community and, increasingly, remind them to take their medication.

Staff also make home visits if they are unable to reach regular users from their core Craigmillar catchment on the phone.

“Phone Link wasn’t set up to be a medication prompt, but home care is really struggling at the moment, so we’re seeing more of that,” says manager Kellie Mercer.

“We phone people to remind them to take their medication rather than a home care company sending someone to stand over them.

“That does contribute to the social isolation problem, but these people wouldn’t have anyone going out to see them anyway.”

Caring in Craigmillar contacts have risen by around 40 per cent in the last year, but Mercer puts this down to better marketing rather than a concerted push by publicly funded home care providers to plug the gaps in their services with a free phoneline.

“Home care needs a bit of work and Edinburgh council is doing the best they can, as far as I’m aware, so we’re just happy to step in,” she says.

“If we can’t get through on the phone, our staff will go out and check on the person within the Craigmillar neighbourhood partnership area.

“We’ve now expanded the phone service to Leith, but we can’t physically send someone out that far if we can’t get hold of someone, so we would call their primary contact such as a relative or a neighbour.”

The Edinburgh-based Befriending Network website lists 24/7 befriending services throughout the UK, but they remain a rare breed and are often forced to work in isolation and compete for funding, rather than share their expertise and resources to provide a more comprehensive service.

“There’s no telephone service like Caring in Craigmillar anywhere else in Edinburgh,” says Mercer.

“We’ve done quite a big marketing drive for our expansion down to Leith with leaflets in pharmacies, doctors’ surgeries, and council offices.

“We’ve had quite a few referrals from the Hospital to Home project, where people are struggling to get a full care package.

“We will step in to maybe prompt patients to take their medication until a full care package is put in place.

“I would like to expand Phone Link as far and wide as we could possibly go, but right now with our funding, we just have to concentrate on getting the word out to as many people in north-east Edinburgh as we can.”

Isolation doesn’t just impact on mental health.

It can make the isolated more vulnerable to criminals and cold-callers, who exploit the fact that someone lives alone and is largely defenceless to burgle the house or cajole them into handing over their personal details over the phone.

“We were contacted by the family of an 80-year-old who was punched twice in the face by a guy who went into his house to try to steal from him,” says Mercer.

“His family aren’t able to see him all the time, but they heard about Phone Link and asked if we could help, so it demonstrates we’re getting about a bit more.”

Isolated people also live shorter lives even if they aren’t being preyed on by violent thugs.

“Loneliness is a killer,” says Woody Caan, editor of the Journal of Public Mental Health.

“People who are isolated are more likely to die in any given year and they are also more susceptible to two types of ill health: cardiovascular disease and depression, both of which are big problems in Scotland.

“Isolation tends to get worse with age. We live in a society where older people are very much left to their own resources.

“The Mental Health Foundation is very concerned about what happens to older people when they leave hospital, and we should have a more active system for looking after these people.”

Mercer says the vast majority of their callers are not technologically minded so better online services are not the way forward.

“Most of them struggle to use a cordless phone,” she says.

“There might be some people who are better equipped, whose families have time to show them how to use the internet, but the majority of people we speak to really aren’t doing much on a daily basis, so we signpost them to activities in the local community and try to give them a bit of motivation.”

Social media is no substitute for face-to-face contact, says Caan.

“I published a study recently of someone with 500 Facebook friends who described their life as lonely.

“There is no question it fulfils a function, but it’s a very poor substitute for friendship and belonging at all ages.”