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Evidence of what works

Adults :: Social Isolation :: Evidence of what works

Reducing social isolation and loneliness can reduce the demand for health and social care interventions and the evidence shows that there are a number of interventions that can have a positive impact on reducing social isolation or loneliness, although the quality of the relationships in the interventions is a vital component. Also, some caution is needed when interpreting the research outcomes because there are a variety of populations that may have a different response to interventions (ie those who are very frail, those from different cultural backgrounds).

1. Befriending schemes

Butler (2006) found that befriending schemes can have a positive impact on reducing loneliness.[1] Befriending schemes are an intervention, that introduce an individual to one or more individuals, with the aim of increasing additional social support through the development of sustaining an emotion-focused relationship over time. They can include home visits by volunteers or paid workers or telephone or group support and often provided by community or voluntary organisations such as Age UK.

2. Community Navigators

Community Navigators are usually volunteers who provide 'hard-to-reach' or vulnerable people with emotional, practical and social support, acting as an interface between the community and public services and helping individuals to find appropriate interventions. There is evidence that people who used community navigator schemes became less lonely and socially isolated following such contact (Windle et al 2008).[2]

3. Supportive group services

Supportive group services (such as lunch clubs, bereavement support groups), and social group schemes which aim to help people widen their social circles can be effective in reducing loneliness and social isolation. A study by Savikko et al. (2010) showed a support group that offered social group activities ('art and inspiring activities', 'group exercise and discussion' and 'therapeutic writing and group therapy') reported that 95 per cent of the participants (mean age 80) felt that their feelings of loneliness had been alleviated during the intervention.[3] Pitkala et al. (2009) found that group based interventions that included art and cultural activities (eg music sessions, cultural events and sights, and production of their own art) and exercise and health discussion groups, (eg walking, strength training, swimming, or senior dancing) had a significant reduction in measured hospital bed days, physician visits and outpatient appointments.[4] A systematic review by Dickens et al (2011) found that sessions offering social activity and/or support within a group format were effective in alleviating social isolation.[5]

4. Mentoring schemes

Mentoring schemes involve working with people with the goal of providing clients with the necessary skills and abilities to ensure that they are able to continue and sustain any achieved change following withdrawal of the service. There is evidence that mentoring schemes can have a positive impact in improving symptoms of depression and after 12 months follow-up.[6]

There is very limited evidence on the cost-effectiveness of interventions to reduce social isolation or loneliness and it is relatively complex to measure accurately. Knapp et al (2010) demonstrated the economic impact of Befriending Interventions and Community Navigators, compared with what might have happened in the absence of any such service.[7] Along with the costs of 'formal' service provision, those unpaid 'resources' and 'opportunity costs' provided by family and/or informal carers were included. They found that a typical service for befriending would cost around £80 per older person within the first year and provides about £35 in 'savings' due to the reduced need for treatment and support for mental health needs. Pitkala et al. (2009) estimated cost-savings of supportive closed groups and found that there was a saving of €62 per person due to a reduction of hospital bed days, physician visits and outpatient appointments.[4] This saving took the cost of the intervention into account.


References

[1]   Butler SS. Evaluating the Senior-Companion Program: a mixed-method approach Journal of Gerontological Social Work 2006; 47 (1-2): 45-70.
[2]   Windle G, Hughes D, Linck P, et al. Public health interventions to promote mental well-being in people aged 65 and over: systematic review of effectiveness and cost-effectiveness 2007; University of Wales Bangor: Institute of Medical and Social Care Research.
[3]   NSavikko RT, Pitkala K. Psychosocial group rehabilitation for lonely older people: favourable processes and mediating factors of the intervention leading to alleviated loneliness International Journal of Older People Nursing 2010; 5 (1): 16-24.
[4]   Pitkala RP. KH, Tilvis R. Effects of pyschosocial group rehabiliation on health, use of health care services, and mortality of older persons suffering from loneliness: a randomised, controlled trial Journal of Gerontolgy: Medical Sciences 2009; 64A (7): 792-800.
[5]   Dickens RS. GC, Campbell J. Interventions targeting social isolation in older people: a systematic review BMC Public Health 2011; 11: 647.
[6]   Greaves C, Farbus L. Effects of creative and social activity on the health and well-being of socially isolated older people: outcomes from a mulit-method observational study The Journal of the Royal Society for the Promotion of Health 2006; 126 (3): 136-142.
[7]   Knapp BA. PM, Snell T. Building community capacity: making an economic case, PSSRU Discussion Paper 2772 2010; London: PSSRU.