Voluntary sector interventions to address loneliness and mental health in older people: taking account of emotional, psychological and social wellbeing

Abstract

Aims: (1) To explore the relationship between loneliness and mental health in older people accessing interventions delivered through the voluntary sector. (2) To understand how these interventions can take account of mental health, discussing the relative strengths of a number of different one-to-one and group-based interventions. Methods: Qualitative case study of Age Better in Sheffield (ABiS), an initiative to address loneliness and isolation among older people (aged above 50). 37 beneficiaries of voluntary sector interventions participated in the study: 17 had accessed a one-to-one intervention and 20 had accessed group-based activities. Results: One-to-one therapeutic interventions are beneficial when loneliness is associated with low psychological and emotional wellbeing stemming from trauma and other complex pre-existing issues that have left individuals unable to build social relationships and networks. One-to-one peer-to-peer interventions are beneficial for individuals whose loneliness is linked to low psychological and emotional wellbeing but for whom their issues are less complex. Group-based interventions are beneficial when loneliness is linked to social wellbeing and individuals want to build social networks and relationships and contribute to their community. Participants should be supported to access other forms of support if the benefits of the initial intervention are to be sustained. Conclusions: There is an interconnected relationship between loneliness and the emotional, psychological and social components of mental health that should be taken into account in the design of interventions. A range of one-to-one and group-based interventions are necessary to meet the varying needs and circumstances of older people experiencing loneliness. Public health commissioners should invest in an ecosystem of voluntary organisations providing different types of loneliness intervention if the epidemic of loneliness is to be addressed.

Community‐based responses to loneliness in older people: A systematic review of qualitative studies

“…Findings from each study highlight the value and role of their specific intervention in reducing loneliness in their participant group. These relate to camaraderie (Milligan et al., 2015; Nurmi et al., 2018; Reynolds et al., 2015), social engagement (Cattan et al., 2010; Dayson et al., 2021; Gracia et al., 2010; Hwang et al., 2019; Khan & Bolina, 2020; Lester et al., 2012; Malyn et al., 2020; Preston & Moore, 2019) and connectivity (either to others or the wider community) (Ballantyne et al., 2010; Bolton & Dacombe, 2020; Coll‐Planas et al., 2021; Lapena et al., 2020; McGoldrick et al., 2015; Wiles et al., 2019). Structural enablers, which seek to establish the appropriate environment for reducing loneliness, emerge as the following three themes: autonomy, new social connections, and belonging.…”

“…For example, participant 2 welcomed the chance that when invited to talk about loneliness, ‘Very often [Facilitator] will say something like “do you want to talk about it or do you want us to talk about the writing” and so we get the choice of whether we talk about that emotion’ (Malyn et al., 2020: 7). Indeed, the availability of ‘disguised’ support was valued by participants as an important enabler (Dayson et al., 2021; Preston & Moore, 2019). Disguised support refers to support not explicitly labelled as a loneliness intervention, but a more generic service in which people can access the kind of support that might indirectly reduce feelings of loneliness.…”

“…Participants valued the opportunity to engage with new people. For some, this was other older people outside of their family circle (Coll‐Planas et al., 2021; Dayson et al., 2021), with group facilitators (Malyn et al., 2020) or like‐minded people from similar walks of life, like those attending variations of the ‘Men's Shed’ programme (Milligan et al., 2015; Nurmi et al., 2018; Reynolds et al., 2015). For Jim, an attendee of Milligan et al.…”

“…How they differed depended on how these interventions sought to address loneliness in their specific community. For example, some based their response on (a) what the community lacked (Bolton & Dacombe, 2020; Cattan et al., 2010; Gracia et al., 2010; Hwang et al, 2019; Lapena et al., 2020; Lester et al., 2012; Malyn et al., 2020; Preston & Moore, 2019); others on (b) how that particular community experienced loneliness (Ballantyne et al., 2010; Coll‐Planas et al., 2021; Dayson et al., 2021; Khan & Bolina, 2020; McGoldrick et al., 2015; Wiles et al., 2019); and others on (c) a more contextual approach that encompassed both (Milligan et al., 2015; Nurmi et al., 2018; Reynolds et al, 2015).…”

A qualitative exploration of the barriers and facilitators to self‐managing multiple long‐term conditions amongst people experiencing socioeconomic deprivation

“…A nuanced relationship exists between social capital and health and may vary according to certain physical health conditions 38 . Feeling lonely has been linked to early mortality 39 and existing interventions to address social isolation are typically aimed at supporting older people due to their increased risk of loneliness/isolation 40 . Most participants were of working age but could not engage in the labour market, leading to both economic and social exclusion.…”