Ground-breaking trial cuts pandemic loneliness

A simple form of talking therapy reduced loneliness in older people left isolated during the pandemic, initial results of a new study have revealed.

People were contacted weekly over the telephone by trained support workers and encouraged to maintain their social contacts and to stick to a daily schedule, which included both routine and enjoyable activities.

The intervention developed in the BASIL-C19 (Behavioural Activation in Social Isolation) study lasted for eight weeks and was designed in partnership with older people who had direct experience of social isolation, loneliness and depression during the pandemic.  

The pandemic, and the restrictions it led to, has highlighted the importance of good mental health and social connection. Research conducted before Covid-19 hit identified 1.4m older adults in England were experiencing significant loneliness with impacts on their mental health. 

Research since the pandemic shows that rates of loneliness and depression have increased, particularly for those self-isolating.

A team of researchers and clinicians anticipated that the pandemic would adversely affect the mental health of older people and re-focussed their research expertise to examine the psychological impact of enforced isolation, disruption to daily routines, loss of social contact and loneliness.

The team included academics from the Universities of York (including Hull York Medical School), Leeds, Keele and Manchester, and Tees, Esk and Wear Valleys (TEWV) NHS Foundation Trust, in partnership with charity AgeUK.

They designed a very brief intervention to combat depression and loneliness. Older people appreciated the offer of telephone contact and found the intervention to be helpful in maintaining daily routines and social contact.

Preliminary results, published today in the PLOS Medicine, show evidence of improved mental health and a strong indication that rates of loneliness were reduced substantially in the first three months of the study. 

A much larger follow-on trial is currently recruiting at 12 sites across England and Wales, to include more than 600 older people as part of the largest study of its kind ever undertaken to tackle loneliness and depression.

The study was led by Professor Simon Gilbody, director of the mental health and addictions research group at the University of York and Hull York Medical School, and Professor David Ekers, clinical director for research and development at TEWV NHS Foundation Trust and honorary professor at York. 

The University of Leeds’ contribution was made by Professor Andrew Hill, Dr Gemma Traviss-Turner and researcher Leanne Shearsmith, from its School of Medicine.

Leanne Shearsmith said: ‘Older people commonly experience loneliness and this will continue to be an issue once the pandemic is over. This study is a great step towards being able to offer older people something to help them stay active and connected with the world and the things they enjoy.’

Professor Gilbody said: ‘Our University-NHS partnership was ideally placed to respond to societal challenges of Covid-19. Older people and those with long term conditions entered enforced isolation, and this was very disruptive to people’s lives.

‘We predicted increased rates of loneliness and depression for this vulnerable population, and we knew what might work to prevent this. Care in the NHS must be informed by the highest quality of evidence and we did not waste any time in deciding to set up a clinical trial to test this out. 

‘The research undertaken in the NHS is acknowledged to be world-leading in terms of its scale, rigour and impact. The NHS has led the way in understanding how best to respond to the pandemic. The first results of the pilot trial are now available, and there is now emerging evidence that it is possible to prevent loneliness and potentially improve mental health.’

Professor Carolyn Chew-Graham, a GP and researcher in the mental health of older people based at Keele University, added: ‘Covid-19 has unfortunately impacted on the mental health of older people. We know that social isolation can cause people to suffer from loneliness, low mood and anxiety.

‘In this study, we tested how we can maintain older people’s mental health during this difficult time.’

The research, which is published just after Sunday’s World Mental Health Day, was funded by a £2.6M grant from the National Institute for Health Research. The BASIL-C19 trial was the first of its kind to test the effectiveness of a psychological intervention to maintain mental health during the pandemic.

Photo Credit – Priscilla Du Preez