Loneliness epidemic in Scotland shows why community participation is so crucial to the future of public health

Common Weal head of policy and research Ben Wray looks at a new report from MSPs highlighting the loneliness plight in Scotland, particularly among the elderly community. He argues that participation is the key to tackling a growing epidemic

THE evidence to the Scottish Parliament's Equal Opportunities Committee on loneliness provides an insight into the lives of those who we don't see: Scotland's lonely people, and it is grim.

Research from Age UK last year was cited by those giving evidence to the committee: 80,000 people aged 65 and over living in Scotland felt lonely "always" or "often". 350,000 said their TV was their main form of company.

Beyond the figures, the stories hit home at the severity of the issue for many of Scotland's elderly population. One charity worker told the committee about a man who would "sit on the bus all day and travel around the city, because that was all he had to do with his day and it was free with his bus pass."

There was various stories of individuals who would go to their GP or A & E, not because of illness, but because they wanted someone to talk to.

And it doesn't take a genius to understand the relationship between loneliness and poverty: the committee heard a story of a women who for six months was so isolated that she didn't have any electricity and ate by taking sandwiches out of bins.

"While this issue is acute for our elderly population, it affects younger people to, particularly ethnic minorities and the LGBT community, who have found themselves socially isolated from a very young age".

The effects of loneliness in exacerbating mental and physical health problems are obvious - the committee found a clear link between social isolation and dementia, malnutrition and mental illness. Human beings are social animals - they aren't meant to be on their own.

While this issue is acute for our elderly population, it affects younger people to, particularly ethnic minorities and the LGBT community, who have found themselves socially isolated from a very young age with a strong link to bullying, the committee found.

The ramifications fall on increasingly stretched health services, and are only likely to increase without concerted action as the number of over 65's increases rapidly.

The committee called for a specific Scottish Government strategy to the problem, and the government said it was all ears : "This is an important issue, with no easy answers, however we are committed to exploring what more we can do to tackle this serious issue which still affects too many in Scotland," a spokesperson said.

There is "no easy answers" in the sense that not one or other policy will in itself be a solution, but there is obvious answers about what sort of general policy approach is needed to tackle isolation - a strategy with community participation at its heart.

"Whether it's housing, social care, local government or just community centres and facilities, with a strategy based on inclusivity and participation, communities can be built that encourage people to get together and spend time with one another".

Whether it's housing, social care, local government or just community centres and facilities, with a strategy based on inclusivity and participation, communities can be built that encourage people to get together and spend time with one another, and for relatively little public funding compared to the savings it would make.

The Guardian organised a roundtable last year with a panel of experts to talk about how to tackle social exclusion and isolation - it was clear that community participation was right at the top of the agenda. Here's a few examples of what solutions they advocated:

Tracey Robbins, programme manager, Joseph Rowntree Foundation: "Neighbourhood action can reduce the impact of loneliness and build more resilient communities. Regardless of the neighbourhood, the evidence suggests that the greatest impact was the result of the community development approach alongside staff support. The process is crucial to neighbourhood approaches to loneliness. The approach offers good value for money. A relatively small investment can release significant citizen action. However, it won't happen on its own. Good facilitators are key and the process takes time. Resourcing is essential."

Mick Ward head of commissioning, adult social care, Leeds City Council: "Community led initiatives are critical. In Leeds the heart of these are Neighbourhood Networks. 27 organisations led by older people covering the whole city commissioned (2.3 million) to tackle social isolation."

"Regardless of the neighbourhood, the evidence suggests that the greatest impact was the result of the community development approach alongside staff support. The process is crucial to neighbourhood approaches to loneliness. The approach offers good value for money." Tracey Robbins Joseph Rowntree Foundation

Clare McNeil, senior research fellow, Institute for Public Policy Research: "The German government has set up over 500 'multi-generational homes' which bring together all age groups - from babies to 80-year-olds - and act as public living rooms. They seem to work because they bring together often isolated groups like new mums, single parents and their children, migrants, recent retirees and the elderly under one roof and evaluations are positive."

What all these examples have in common is that they are about finding ways to bring people together in welcoming and inclusive environments. Our whole approach at Common Weal is about utilising the skills and ideas of our population: elderly people have a wealth of experience to offer our communities that is wasted through social isolation.

Note: this isn't David Cameron's Big Society, which involves getting elderly people to 'volunteer' doing jobs that should be done by paid employees. Infact, Age UK found in their review into social isolation and loneliness that volunteering predominantly engaged elderly people who were all ready actively engaged in their community, rather than those who are isolated. The answer is to provide an environment in which elderly people can be an organic part of; not work.

"Age UK found in their review into social isolation and loneliness that volunteering predominantly engaged elderly people who were all ready actively engaged in their community, rather than those who are isolated. The answer is to provide an environment in which elderly people can be a part of; not work."

More specifically, we need to do something about our fragmented social care system in Scotland - it should be as important as the NHS but it's not giving a fraction of the attention or funding, to all of our deficit.

Just putting elderly people in care homes which make them more isolated than they were in their own home isn't always the best solution. We've discussed with some people who work in the field the idea of an elderly placement scheme where working-age adults take in elderly people to live with them and the government pays them for taking on the responsibility. That way they remain part of an active community. Or we could create jobs by paying people to spend ten hours a week supporting elderly people into being part of local community activities. Again, it would pay for itself in the long-term.

Finally, tackling poverty amongst the elderly community is part of tackling isolation - if you can't afford to buy food, or if your so cold you just want to stay under a blanket all day, your hardly in a position to engage with your community. (As a side note, it is a crying shame that 'the UK state pension is the fourth worst in the EU' didn't become a key slogan of the yes campaign during the referendum.)

We don't proclaim to have all the answers on this issue (and would welcome input and ideas), but we are convinced that Common Weal's general approach - active, engaged citizens living without the fear and anxiety of fuel or food poverty running every part of their lives - is the approach needed to start to address the epidemic of loneliness.