The final item of business is a members’ business debate on motion S4M-09775, in the name of Margaret McDougall, on recognising the impact of loneliness on physical and mental health. The debate will be concluded without any question being put.
Motion debated,
That the Parliament notes with concern the impact that loneliness can have on physical and mental health; understands that approximately 10% of people over 65 in the UK, including in West Scotland, say that they are lonely or very lonely and 20% consider themselves occasionally lonely; notes figures suggesting that loneliness is as bad for health as smoking 15 cigarettes per day, can increase the risk of developing mental problems, including depressive symptoms and obsessive compulsive disorder, can more than double a person’s risk of developing dementia and increases the risk of suicide and depression among adolescents; believes that tackling loneliness and increasing social participation can reduce such problems and encourages healthy behaviour, such as stopping smoking, more physical activity and higher consumption of vegetables, and notes a recent VEnable report, which suggests that, when it comes to tackling loneliness, there is a major gap in services for old people that could be addressed by volunteering and befriending services.
17:03
I thank the Presiding Officer and members of all parties for their support in bringing to the chamber this debate on the impact that loneliness can have on physical and mental health. I am leading the debate in my role as convener of the cross-party group in the Scottish Parliament on volunteering and the voluntary sector, which recently received a presentation on the issue of loneliness and its impact on health and the associated financial costs from Liz Watson, chief executive of Befriending Networks. I thank Liz and the CPG for the support that they have provided for the debate. I also thank Macmillan Cancer Support and the Scottish Association for Mental Health for the briefings that they provided in advance of the debate.
Loneliness and social isolation are complex issues. They are difficult to measure but can affect anyone at any point in their lives. As I state in the motion, 10 per cent of people over 65 in the UK say that they are lonely or very lonely and 20 per cent consider themselves occasionally lonely.
The recent Volunteer Scotland VEnable report states that there is a “major gap” in services for older people and suggests that the gap could be addressed by volunteering and befriending services, which I will discuss later in my speech.
Loneliness does not affect just the elderly. Studies into the association between loneliness and sociality in middle age, childhood and adolescence show that loneliness in adolescence is strongly associated with suicidal thoughts and behaviours, independent of gender, ethnicity or socioeconomic status.
In adults, loneliness can increase the risk of developing mental health problems, including depressive symptoms and obsessive compulsive disorder, and can more than double a person’s risk of developing dementia. Worryingly, according to SAMH, isolation is becoming more common in adults. In SAMH’s “Worried Sick” report, a family support worker from Fife stated:
“We’ve also got some clients who live in a local estate and there’s no services there so that increases the feeling of isolation when people are stuck in their flat ... And that lack of network or support group just increases that feeling of isolation.”
That can also be said of people in rural areas where there are very few transport links, and I am sure that some of my colleagues will mention that problem.
Macmillan Cancer Support recently warned that we are on the verge of a loneliness epidemic and that an estimated 60,000 people are suffering from loneliness as a result of their illness, with 31 per cent of Scots indicating that they are lonelier since diagnosis. It is clear from Macmillan Cancer Support’s studies that loneliness can have a huge effect on the health and wellbeing of people living with cancer, with those who are lonely being three times more likely to drink more and five times more likely to skip meals.
Loneliness is a problem that can affect us all, whether young or old, rich or poor, sick or healthy, and it can affect us at any time in our lives. However, people with terminal illnesses or those who are elderly can be hit the hardest. When it comes to tackling the issue we need an all-encompassing strategy, because evidence shows that tackling loneliness is crucial to meeting the national outcome for people in Scotland to live longer, healthier lives.
I believe that the voluntary sector will be essential in helping us to deal with loneliness and social isolation. As I said, the Volunteer Scotland VEnable report suggests that gaps in services for older people
“are ones that would address loneliness and isolation; [this could be] a simple niche for volunteering.”
I argue, however, that we should look into using volunteering to address loneliness and social isolation in all age groups.
Currently, there is a postcode lottery as to who can get services such as befriending. They are funded in a piecemeal manner and there is no overall strategy in Scotland to tie everything together, hence the gaps in services. There may well be a cost associated with filling the gaps, but surely that is worth it when we consider that loneliness has a financial as well as a health cost, and that befriending and similar services contribute to improving the health and wellbeing of the population.
By tackling loneliness and promoting social participation we encourage healthy behaviour, such as stopping smoking, undertaking more physical activity and increasing consumption of vegetables. Dealing with loneliness has far-reaching effects on improving health and wellbeing. Only through a strategic and coordinated response to the issue of loneliness can we maximise opportunities for such activities as befriending for isolated people in all Scotland’s communities.
I ask the minister what consideration the Scottish Government is giving to placing volunteering at the heart of our health and wellbeing policy to tackle loneliness. Volunteering does not just happen; it needs to be properly supported and funded. To assist in that regard, has the Scottish Government considered including the reduction of loneliness as a Scottish Government indicator, so that we can measure the effects of policy? If it did that, perhaps we would live not only longer and healthier lives, but less lonely lives, too.
17:10
I thank Margaret McDougall for securing the debate and for her excellent work as convener of the cross-party group on volunteering and the voluntary sector.
I have kept a fairly close eye on health issues since 1999, but I had never seen any research on the links between loneliness and physical and mental health, so I thank Margaret McDougall for sending me the slides from the presentation at the cross-party group. They are worth reading out, because they shocked me:
“A US study recently found that loneliness can increase the risk of death by almost 10 per cent.”
I did not know that.
“Loneliness increases the risk of heart disease and puts people at greater risk of blood clots”.
“Loneliness is estimated to be as bad for people’s health as smoking 15 cigarettes a day”—
I certainly did not know that.
“A 2006 study of 3,000 nurses with breast cancer found women without close friends were four times more likely to die than women with 10 or more friends.”
I found that one really disconcerting.
“Around 10% of over 65s say they are lonely or very lonely, and another 20% are occasionally lonely”—
Margaret McDougall mentioned that one.
I always thought that dementia must be genetic, but according to research from 2005:
“The risk of dementia almost doubles in older people who are lonely”.
I am not sure that many people know that. I certainly did not know. I am not a clinician.
We also heard at the cross-party group that there is a major gap in services to tackle loneliness and isolation. Margaret McDougall mentioned befriending. We heard that Kincardine and Deeside Befriending’s hospital project reported that 100 per cent of service users felt more confident about going home from hospital, which led to a 14 per cent reduction in bed days lost to delayed discharge. By addressing one issue, we address another, which is hugely cost effective.
I am sure that Rhoda Grant will mention the wonderful befriending service that we have in Inverness, which is run by volunteers, one of whom, Alan Michael, reopened a day centre in Inverness, the Dunbar centre. Volunteering and befriending certainly provide one answer to the problem.
I would like the minister to consider the information that came from the research projects that we heard about at the cross-party group—I can pass it to him if he does not have it. Whether the research is about dementia, physical health, mental health or recovery from cancer, it should all be brought together in a single piece of research on the impact of loneliness on people’s health.
There are other complexities. At the cross-party group we heard about the impact of bereavement. Many people who are lonely after losing their partner of 30, 40 or 50 years find it difficult suddenly to go out and join a lunch club or day centre. They need support in doing that. Last night, when I was in Tesco, I noticed an advert for a tea dance for over-65s. There are also walking groups—joining a group does not have to cost a lot of money—and befriending services. Although many of the council lunch clubs and day centres are closing down, there are plenty of residential care homes. If people could go into those for lunch clubs, using them as day centres, we could make more use of the existing network.
I was shocked by the information that came forward today, and I hope that the matter will be addressed in a positive way by the minister.
18:15
I congratulate Margaret McDougall on bringing this important subject to the chamber for debate this evening and I pay tribute to all the work that she does on volunteering, which is central to dealing with the problem that we are addressing today.
Just before the debate, I was quietly singing “Eleanor Rigby”, that great Beatles song about loneliness—that probably tells people what age I am. The song reminds us that people have been aware of the general significance of loneliness for a long time. As Mary Scanlon said, however, research has not related loneliness to physical illness and some mental illnesses until relatively recently. Mary Scanlon helpfully mentioned some of the research reports, and I will mention a couple.
Before I do that, I will cite some figures that back up what has already been said. The Mental Health Foundation says that 10 per cent of British people—it is a United Kingdom figure—feel lonely and that half of people think that people are getting lonelier in general. The figure that Age Scotland has given us for the debate is that more than 80,000 people aged 65 and over describe themselves as often or always lonely. We know that loneliness affects a great many people.
The first study to which I refer was conducted by Professor John Cacioppo of the University of Chicago, who is a world-leading neuroscientist, although I did not know that until this week. He undertook a longitudinal study that looked at a large number of people over time and he found a relationship between high levels of the distress hormone cortisol and time spent in isolation. He also suggested that people in isolation sleep a lot less well, which may have been one of the factors leading to the increased stress. He has done a lot of research on the issue, and that is a brief summary of his work.
I was also interested to read of a report that was featured in The Guardian on Monday, which was published by CentreForum and is entitled “Ageing alone: Loneliness and the ‘Oldest Old’”. The report points out that the over-85s are probably the most affected by loneliness, and it states that lonely adults are more likely to undergo emergency hospitalisation. Given the amount of time that we spend talking about emergency hospital admissions, that is significant. The report also says that lonely people are more likely to be admitted early to residential and nursing care. The issue clearly has great ramifications, not just for individuals’ physical and mental health but for the whole health and care system.
Margaret McDougall quoted what the VEnable report says about the “major gap” in services for older people. I do not have time to go into the issue of people who have identifiable mental health conditions, but in a previous mental health debate we explored the fact that services for older people with clinical depression, for example, are not so readily available as services for younger people. That is one dimension of the problem, but today we are talking more about older people in general.
As the CentreForum report puts it, the answer to how we combat loneliness lies in the community, which is where volunteering is absolutely central. The VEnable report talks about regular face-to-face contact being crucial, in which context I mention two initiatives in my constituency that are run by the Pilmeny development project in Leith. One is a group on older men’s health and wellbeing that has been running for several years. I have visited it and have heard men say what a big difference it has made to their lives. The other initiative is a community connecting project that is funded by the change fund—I give credit to the Scottish Government for that—for over-65s who are isolated. The project involves befriending whereby the befriender goes with the individual to various activities in the community. For a limited period of maybe six months, the befriender tries to introduce the individual to various activities in the community with the aim of finding a longer-term, sustainable solution to their loneliness.
My time is nearly up, but I should also mention two of Age Scotland’s initiatives—it has probably got a lot more. The first is its Silver Line. Telephone conversations are not as good as face-to-face contact, but they are better than nothing. Age Scotland also has 850 member groups. The more activities and connections we can create for older people in the community, the more the problem of loneliness will be solved.
17:19
I congratulate Margaret McDougall on securing valuable debating time for what is an important but perhaps overlooked issue: the impact of loneliness on physical and mental health.
Mental health is the one aspect of our own health that most of us are guilty of ignoring and neglecting, assuming that our brain will never let us down and needs no care or attention to ensure that it functions as it should. In view of that falsehood, I have always been hugely supportive of campaigns and organisations that raise awareness of mental health issues and seek to assist those in need of information or assistance about their own mental health or that of someone they care for.
While the stigma of mental illness is being challenged and the public are becoming more aware of the conditions affecting us, understanding how our mind works and how to keep it healthy remains minimal. Reducing alcohol consumption and keeping an active mind through learning, reading or physical activity remain important lifestyle choices and techniques to ensure the maintenance of good mental health. However, it is clear that loneliness and its impact on our mental wellbeing are sometimes and somewhat disregarded.
The Scottish Association for Mental Health offers a five ways to better mental health guide on its website. Top of the list is “Stay connected”. That prominence is evidently warranted, with a litany of studies showing that loneliness and social exclusion are linked directly to a number of mental health problems, including anxiety, depression, dementia and Alzheimer’s disease. As a number of members have mentioned, it also has a severe impact on physical health.
As Margaret McDougall points out in her motion, loneliness is disproportionately felt by older people in our society. There are a variety of reasons for that. For example, the death of a partner or close friend, as Mary Scanlon mentioned, or retiring and leaving the working environment can cause loneliness. Simply becoming frail and finding it difficult to go out alone can cause an individual to become secluded and lonely. However, being alone and loneliness are quite different and merely being surrounded by people will not guarantee a feeling of camaraderie, connectedness or integration.
That said, even the smallest interaction can help us connect and interact with the world around us. Striking up a conversation with the cashier at a checkout, going along to a local football match, attending church or even joining a slimming club all give a sense of belonging and allow us to feel connected to the community, help us feel more grounded and offer perspective on issues in our lives.
It is important to remember that loneliness does not only cause mental illness in some people. All too often, those who struggle with mental illness feel stigmatised or are excluded from social activities, thus exacerbating their pre-existing condition. Therefore, we must also ensure that those with mental health issues are not marginalised or allowed to feel that they cannot participate and be an active and effective member of the community, sports team or volunteer group.
A variety of groups and facilities across communities in Scotland are open to those looking to meet new friends and interact with their neighbours and surroundings. When I carry out my surgeries in Beith community centre, a group of around eight older men and women can be found playing carpet bowls in the main hall next door—usually laughing raucously while I am trying to address constituents’ concerns.
The people in that group spend a few pounds between them to play bowls in a local hall, but there are other, more structured groups such as Garnock Valley Allotment Association which, to my mind, perfectly exemplifies the idea of community engagement and interaction, with dozens of members—the young, the not so young and the old—working together to grow fresh produce and improve their community environment, all while managing to keep fit and healthy, learn new skills and make new friends.
There cannot be any doubt that the more people we encourage to become involved in such groups, the better. On my visits to the allotments, some of the older people there suggested that, were it not for the allotment, they would be at home, on their own, watching daytime television, and one in every two of them would be taking anti-depressants to boot.
Although progress has undoubtedly been made in tackling the stigma and in improving treatment, mental illness and maintaining mental good mental health remain hugely misunderstood subjects. Loneliness is at the forefront of that. I again congratulate the member for raising the matter and giving us the opportunity to discuss them in what is a very interesting debate.
17:24
I, too, add my congratulations to Margaret McDougall on securing the debate. Loneliness is an important issue that we must tackle.
Loneliness is distressing and impacts on people’s mental and physical health as has been mentioned. We need to address it through preventative spend.
Loneliness is more pronounced in older people for a variety of reasons, including decreasing mobility; for those who live in rural areas, the loss of the ability to drive; and, of course, bereavement. Bereavement at any age is difficult, but for someone who has spent most of their life with a person who has just passed away, who depended on that individual for company and who is no longer active themselves, the impact can be catastrophic not only because of the grief that they feel but because of the loss of such company. After all, that person might have been the only one with whom they had any social interaction.
Esther Rantzen, who was instrumental in setting up the Silver Line Helpline, was recently in the Parliament, telling MSPs about how she wrote about her own loneliness following bereavement. She is an active, well-connected person who was devastated by the loss of her husband, and when her article was published, she was inundated with correspondence from others who had also experienced extreme loneliness. That prompted her to work alongside others to set up the Silver Line, whose telephone and online befriending advice service for older people has proved a lifeline for many. Indeed, Mary Scanlon mentioned the importance of the befriending services in Inverness, and I think that that is what makes the Silver Line so important. The volunteers themselves often benefit from providing the service as it gives them a purpose and helps them to establish friendships.
The point is that we need to tap into the army of volunteers that we have in our older generations; after all, these people have a huge amount of knowledge and the ability to help others, and they are looking for a purpose in their lives. A telephone helpline is an excellent resource, but many other organisations that are trying to tackle the same issue need volunteers to support them.
It is extremely important that people enjoy a social life, but that becomes harder as their mobility diminishes. I spoke recently to the Badenoch and Strathspey Community Transport Company, which has recognised the problem and organises for its client group outings for, among other things, fish teas. In fact, Maggie Lawson from the company told me about one client who, as she pulled her curtains one cold winter night when it got dark really early, began to feel depressed, only to remember that she was going to be picked up in an hour or so to go for a fish tea. She went out with a spring in her step; she had something to look forward to and did not feel so isolated and alone.
We cannot really attach a cost to that sort of activity; it gets people out of the house to meet others and enjoy a meal. That improves health and wellbeing and keeps people more mobile and active, and I find it sad that the funding for such organisations is under threat. If they lose that funding, the service will end, and the cost to the public purse of picking up the pieces and dealing with the mental health problems of these people as they become more and more isolated will be enormous.
Isolation is a big problem in the Highlands and Islands, where people live in remote rural communities. It is even more of a problem for women, who, because they tend to live longer, are much more likely to be bereaved. Many are also of the generation who are less likely to drive. Because of cuts to local authority budgets, initiatives such as lunch clubs and community car schemes are being closed and service provision is being focused on meeting need rather than on prevention. However, that is a false economy, because without more social interaction people will need much greater intervention much sooner.
The only social contact for many of our elderly is their home carer, but their time with clients is being slashed to a point where they are no longer able to help them get to the toilet, far less sit and chat with them and see how they are. We need to rethink how we deal with and prevent loneliness, and I am very grateful to Margaret McDougall for securing a debate that has allowed us to highlight and explore these issues.
17:28
Like others, I congratulate Margaret McDougall on securing time for this debate. I have listened with real interest to members’ speeches.
Loneliness is a complex emotional response to isolation and a lack of the kind of companionship or wider social network that many of us take for granted. It usually gives rise to feelings of anxiety; indeed, individuals who are feeling lonely can also feel anxious when they are surrounded by others.
We are all likely to experience a period of loneliness at some point in our lives. Although loneliness is not a mental health condition, it is a factor that can contribute to ill health. It can also be caused by a person’s ill health. Therefore, loneliness can lead to someone who might not be ill developing a condition as a result of the problems that are associated with it and it can be caused by a person’s physical or mental ill health.
We are aware of the research that shows that loneliness and social isolation can have a significant impact on physical and mental health, which Mary Scanlon and other members mentioned. Studies have shown that people who are socially isolated can experience more stress, have lower self-esteem and be more likely to have sleep problems than people who have strong social networks. All those things have a negative effect on a person’s general wellbeing and can contribute to physical ill health as well as to mental health problems such as anxiety and depression.
Given that we recognise the impact that loneliness can have, it is important that we ensure that we have a range of services to support people should they require to speak to someone to get help and advice. That is why we support services such as breathing space, which provides advice and support to people who might be lonely or experiencing low mood or depression. We want to provide them with a first stop in getting advice and support. We also support organisations such as Samaritans, which provides assistance to people on a 24-hour basis.
I turn to a point on which Malcolm Chisholm hit the nail on the head. Last year, I chaired the ministerial task force on health inequalities. In our report, which was published earlier this year, we described an important concept, but one that is often overlooked and undervalued—that of social capital. It was one of the four key priorities that we identified. Social capital is important when it comes to creating resilience in communities and in individuals. Volunteering, through which people can play a purposeful role in their communities, is a key part of that.
One of the challenges that we face in building better social capital in our communities is to move away from the tendency to think that bodies such as local authorities and third sector organisations should go in and do things for the people who live in those communities. Instead, we need to approach the issue from the perspective of building the assets that already exist in communities in order to develop their social capital.
I saw such an approach first hand in Fife in a project that has regenerated the value in a community. That has not happened because the council or a third sector organisation has come in and run a programme. The project has listened to what members of the community think are important to them and has engaged with them to facilitate that and take it forward in a way that best suits their needs. A key part of that lies in delivering greater volunteering opportunities for the people who live in the area and reducing the social isolation that some individuals can experience. That approach is important in tackling not only loneliness, but some of the health inequalities in society, which can themselves contribute to loneliness.
Older people can be at greater risk of becoming lonely. I want to focus on the impact that loneliness can have on their mental health. That is why, in our new mental health strategy, we set out a range of work that we wanted to do to support and promote better mental health and wellbeing for older people. To that end, we have established a working group that has the specific objective of implementing the commitments on older people in the mental health strategy.
Part of that work will involve the group focusing on producing a range of indicators that allow us to identify what progress can be made. Tackling issues such as loneliness will be an important part of that overall agenda.
Several members mentioned befriending projects. There is no national strategy on befriending, because it sits in a range of existing national strategies—it is in our national strategy on mental health and in our reshaping care for older people programme. In my constituency, a befriending project helps older people with their shopping and so on. It creates partnerships and friendships when individuals have lost them and become socially isolated. That should be seen as part of how services are delivered day in, day out.
I accept that loneliness can affect physical and mental health, but the reverse is also true. If we tackle some of the causes of ill health, we can generally also help to reduce the number who experience social isolation. That is why we support projects such as Community Food and Health (Scotland), which works in low-income communities to improve access to and take-up of a healthy diet. That is important.
With that organisation’s expertise, we have supported a number of projects, such as the Food Train, which has expanded from Dumfries and Galloway to six regions across Scotland—last year, its Glasgow branch was opened by my colleague Alex Neil. The Food Train provides a grocery shopping system and befriending, and it helps households to support older people in their communities.
Loneliness must be looked at in the generality of the range of measures that we are taking, whether they involve mental health, reshaping care for older people or how we build social capital to tackle health inequalities in our community. All that has a role to play in ensuring that loneliness is sufficiently addressed.
I hope that members are assured that we recognise the issue’s importance. We are determined that the measures that we take forward in our policy areas will help to address some of the problems that loneliness in our society causes.
Meeting closed at 17:37.Previous
Decision Time