What is loneliness?
Loneliness is defined as an aversive, subjective experience1.
It is about the disparity between ideal and actual social relationships especially in terms of the quality of connection2. Prevalence estimates indicate many Australians experience high levels of loneliness and it impacts people from all walks of life3.
Loneliness can be transient or chronic. A wealth of international research suggests chronic loneliness is damaging to many aspects of physical and mental health4. It has been related to higher risk for early mortality5. It is therefore vitally important that community service providers (and any who are in contact with those who are experiencing high levels of loneliness) focus on intervening and helping alleviate loneliness.
How to identify people at risk for loneliness?
Identifying people at risk for loneliness can be difficult, this may be related to the stigma (i.e. people may be unlikely to self-report).
We know that people from all walks of life experience loneliness and most people are likely to experience it at some point across their lifespan.
Although it impacts many people, there are certain indicators that have been associated with chronic loneliness6. That is, across research studies and when studying different groups of people, certain demographic/ social characteristics have been associated with higher levels of loneliness.
Some of these include:
- Living alone
- Low income
- Low mobility
- Being a carer
- Being geographically isolated
Identifying people at risk may be an important first step.
As mentioned, loneliness is a subjective experience and has a range of causes so identifying risk factors alone is not sufficient. Further assessment to determine whether those individuals are in fact experiencing loneliness and what the best intervention might be is then needed. Some people may tell you that they are lonely, or it may be easy to elicit in a conversation, but if not then formal measurement tools may assist.
There are measurement scales that have been devised to assess the level of loneliness or isolation that a person may be experiencing. These range from 3-questions to longer 20-question measures7. The benefits of using such tools includes allowing comparisons to other research samples and looking at changes in loneliness over time. The disadvantages include the resistance of people to self-report loneliness and the possibility that attempting to measure their experiences in this way may increase a feeling of stigmatisation and alienation8.
Collaboration with other organisations and health care providers is another important way to identify those at risk.
Key considerations for working with people experiencing loneliness:
- Loneliness is stigmatised, that is, it may be difficult for people to admit to being lonely and they may be resistant to using services with the word ‘lonely’ explicitly mentioned9.
- Money can be a barrier to social connection, consider free or very low-cost interventions and services10.
- Evidence suggests people are lonely for a variety of reasons, as such there is no ‘one size fits all’ answer when working with lonely people11.
- For many, only access to more connection with others may not lead to significant change. Cacioppo and colleagues (2015) write: “...interpersonal contact or communication per se is not sufficient to address chronic loneliness in the general population”12.
Tools and interventions:
There is limited research, especially in Australia about what interventions help people experiencing loneliness.
Most interventions can fit into four broad categories13, these include:
- Increasing opportunities for social access
- Enhancing social support
- Improving social skills
- Addressing maladaptive social cognitions (recurring thoughts and beliefs about social interactions that are unrealistic or unhelpful)
Some suggestions for intervention in Australia include:
- Community initiatives that specifically target those experiencing loneliness, such as FriendLine, Good Karma Network and Neighbourhood Connect
- Referral for psychological support, Cognitive Behaviour Therapy and other psychological therapies have been shown to be effective in helping people reframe maladaptive thoughts
- Working directly with clients to help increase confidence, skills and decrease anxiety related to making social connections
- Increasing access to the internet through training and support
- Identifying opportunities for social access that match with the skills or interests of the person
- Decreasing barriers to support (financial, accessibility, health etc.)