Loneliness is an epidemic, too

It’s hard to believe that in our hyper-connected, always turned-on digital world, Australia is in the midst of a loneliness epidemic. In an alarming pre-pandemic survey (yep, even before lockdowns and social distancing kicked in), more than half of Australians experienced feelings of loneliness at least once a week. When you add in the extra COVID stressors of the past year, it’s easy to see how the mental health needs of our population have dramatically escalated. And it begs the question, do the ends really justify the means?

With the research telling us one-in-four people consider themselves chronically lonely, it’s unsurprising we’re now starting to pay attention to the directly correlated increased risks that brings of physical and mental health conditions. These include cardiovascular disease, inflammatory illness, premature mortality, depression and anxiety, and cognitive decline.

Countries around the world are starting to take action as a result — the UK appointed a minister for loneliness in 2018 with Japan following suit in response to the rise in suicide as a result of the COVID pandemic. Here in Australia, peak advocacy group the Consumers Health Forum of Australia, together with private health insurer Medibank, have called for a nationally co-ordinated plan to address the loneliness epidemic.

So how can it be done?

With rising inequality, increased mental anguish and prolonged instability, a cultural shift away from siloed institutional systems, towards integrated primary health and social care networks can offer promising benefits. Grappling with this silent and insidious epidemic is an enormous task for governments to deal with and the complexity of contributory factors means tackling the issue with any real success requires a collaborative cross-sectoral, multi-stakeholder approach.

In a positive step forward, this week Victoria announced a rollout of local mental health hubs providing clinical and non-medical care in regional areas, to address the “missing middle” in community mental health. When thinking about the vastness of WA, this model is worthy of consideration. Unfortunately, the heroes in the social services sector do a lot of the heavy lifting, and governments have typically relied on under-resourced community organisations to plug the gaping hole. 

Even so, interventions are often targeted at vulnerable and marginalised groups, meaning that you either need to be in a state of absolute crisis, or suffering from extreme social or financial hardship, to access the professional care and support these expert services offer. Pharmacological interventions alone often fail to address root causes of mental illness and slap a bandaid over symptoms rather than critically resolve the issues.

But we have an opportunity to break the paralysis of symptom management and embrace new, innovative enterprise and service delivery models to achieve vital wellbeing. Community capital in the form of grassroots collectives provide part of the puzzle, and community gardens and men’s sheds, knitting nannas and dance groups all contribute to a healthy social fabric.

The “social prescribing” movement, well established in places including the UK and Netherlands, offers a viable way forward. Patients are referred by their health provider to a “link worker”, who, armed with a community prescription pad, assesses their social and emotional wellbeing needs, as well as learning and skills development. We’re starting to see an uptake of this common-sense approach in Australia, with programs like the Community Link Booth initiative at Fiona Stanley Hospital, which aims to address isolation and inequity, as well as reduce GP and ED visits.

It’s clear a major reorientation of primary health is needed if we are to really improve quality-of-life outcomes for patients and carers, and reduce the economic burden on our health system. We can make big changes if we take bold action to move from transactional economics to a resilient system built on the value of relationships.

Lifeline: 13 14 11

This article was first published in The West Australian in Renée Gardiner’s weekly column in Agenda, 6 March 2021.