A Connected Scotland: tackling social isolation and loneliness and building stronger communities

Context

Our vision

We want a Scotland where individuals and communities are more connected and everyone has the opportunity to develop meaningful relationships regardless of age, status, circumstances or identity

Scotland is a country which aspires to be inclusive in all areas of life. We want to build a modern, welcoming nation where everyone has the opportunity to flourish and live a high quality life. The strength of our social relationships and connections has a central role in determining our quality of life. Because of this, we want to help create a Scotland where individuals and communities are more connected, in which everyone has the opportunity to develop meaningful relationships regardless of age, status, circumstance or identity.

Ultimately, change happens on the ground. Whilst the Scottish Government has an important role to play, we want to let communities lead. We want them to take charge, to effect change, and to tell us what they need to do that. Creating connected and social communities is the business of everyone - whether you're an individual, a community group or delivering a public service. We want to reduce social isolation and loneliness because it's the right thing to do; it will help us become the Scotland we want to be, and because it will contribute to improving health, wellbeing and quality of life for the people of Scotland.

What is social isolation and loneliness? ^[3]

Definitions

Social isolation refers to the quality and quantity of the social relationships a person has at individual, group, community and societal levels.

Loneliness is a subjective feeling experienced when there is a difference between an individual's felt and ideal levels of social relationships.

We know that despite the strong link between social isolation and loneliness, they can be experienced independently from one another: it is possible for people who are well connected socially to feel lonely and for people with relatively small social networks to rarely experience loneliness. However, because humans are inherently social beings, we can all experience periods of loneliness from time to time. This temporary state is referred to as transient loneliness and often arises when someone who has strong social connections is unable to interact with their networks for a period of time. Typically, this is relieved once social interactions return to normal. However, prolonged periods of loneliness can lead to a permanent state of chronic loneliness which is much more difficult to address. People can lose their social connections for a variety of reasons, including major life transitions, bereavement and disability. In order to alleviate feelings of chronic loneliness, cultural and systemic change must be brought about and opportunities have to be made readily available that encourage people to build new social connections.

Question 4: Do you agree or disagree with our definitions of (i) social isolation and (ii) loneliness? Please provide comments, particularly if you disagree.

What we know

Social isolation and loneliness are issues that can affect anyone at any point in their life. Different factors can place individuals at greater risk, including major life transitions, personal characteristics and health conditions. The broad nature of social isolation and loneliness makes them difficult problems to tackle, especially as the responsibility does not lie with a single policy area within government, or a single organisation.

The reality is that social isolation and loneliness permeates all ages, stages and groups in our society. Children and young people increasingly report feelings of loneliness, and far from it being the 'best days of their lives', students entering further or higher education can often find building and maintaining their first adult social networks challenging. Significant life events such as becoming a parent for the first time, retirement from employment and loss of family and friends can leave many in a place where they feel alone and isolated. Moreover, traumatic events - be it abuse, a period of imprisonment, homelessness or addiction - can lead to a situation where isolation compounds the challenges of recovery or reintegration into society.

Globally, we are more connected than ever before - with greater access to information and technological resources that enable us to keep in touch across time zones and continents. Yet, technology has also presented significant challenges despite the prospects it holds for social progress. Many people increasingly feel that digital convenience has overtaken face to face contact, and technology can actually become a factor in increasing isolation ^[4] . Those who do not utilise technology or feel less comfortable doing so can easily be left feeling excluded in a world where online communication is quickly becoming the norm.

But even those who are fully engaged with digital forms of communications can feel isolated. The concern that social media can undermine wellbeing and lead to increased mental health issues in vulnerable people has been widely publicised in recent years ^[5] . In order to embrace the transformative potential of technology, and to realise Scotland's full potential in a digital world, we have to explicitly develop the online resilience of our citizens to lessen the impact technology can have on social exclusion.

Social isolation and loneliness can affect people in a number of ways. There are well documented mental health impacts, including becoming more susceptible to depression, and a greater likelihood of developing clinical dementia for older people who are lonely. There are also surprising physical health impacts that are comparable to obesity or smoking ^[6] .

We also recognise that there are a series of complex needs that human beings have. If we focus our strategy on any single group or need, then we are limiting the effectiveness of our interventions. In order to make a tangible difference to people who are socially isolated, our approach has to take the full spectrum of needs into consideration. One of the starting points for developing this draft strategy was therefore gaining a comprehensive understanding of the prevalence of social isolation and loneliness in Scotland.

Acting on the recommendations of the Equal Opportunities Committee report, the Scottish Government commissioned an evidence review which was completed by NHS Health Scotland ^[7] . This told us that:

• 11% of adults in Scotland often feel lonely, and 38% feel lonely sometimes (Mental Health Foundation 2010)
• 6% of adults have contact with family, friends or neighbours less than once or twice a week (Scottish Health Survey 2013/15 data combined)
• 18% of people have limited regular social contact in their neighbourhoods (Scottish Social Attitudes Survey, 2013)
• 22% feel that they don't have a strong sense of belonging to their local community (Scottish Household Survey 2015) ^[8]
• 48% of people exhibit a degree of social mistrust, which is connected to level of social contact and feelings of belonging to the local community (Scottish Social Attitudes survey, 2015)
• 27% of people volunteer (Scottish Household Survey 2015), and 46% have been involved in some kind of community action to help improve their local area (Scottish Social Attitudes Survey, 2015)
• a significant minority of children are vulnerable to social isolation because of poor peer support or bullying (Health Behaviours in School Age Children, 2014)

There are a range of other evidence sources. These include:

• the Our Voice Citizens' Panel indicated that 1 in 10 people in Scotland often feel lonely ^[9]
• particular groups of people may be at increased risk of social isolation and loneliness - socio-economic disadvantage, young mothers, those with poor physical and mental health, people with disabilities, children with few friends, those living alone, those who have been bereaved, men over 50, minority ethnic groups, and those from LGBTI communities ^[10]
• research suggesting that "8 out of 10 carers have felt lonely or socially isolated as a result of looking after a loved one" ^[11]
• figures from Childline revealed that last year there were 295,202 counselling sessions (2016-17), of which 4,063 were about loneliness. The majority of the sessions concerning loneliness (73%) were with girls
• in the first half of 2016, 31% of the 16,000 calls received to Silver Line Scotland included loneliness as a key theme
• in the second half of 2016, 33% of calls to the National LGBT Helpline were from people experiencing loneliness and social isolation
• in 2010, Samaritans commissioned a UK-wide evaluation of its emotional support services (telephone and email) ^[12] . It found that 6% of respondents cited loneliness and/or isolation as their main reason for contacting Samaritans. Some callers describe themselves either having no access to informal support networks or considering the other people in their life to be unsupportive. Poor social relationships and/or relationship breakdowns were often cited as the start of their problems, as many felt they had no one to talk to
• GoWell carried out a study of loneliness in deprived areas of Glasgow which found that:
  • 31.5% of working-age adults who were disabled or off work for long periods due to illness were "frequently lonely"
  • people that reported high levels of anti-social behaviour in their community and those who did not feel safe walking alone at night "were more likely to report loneliness by between 30 and 50%"
  • 17% of men and 15% of women living in deprived areas reported "frequent loneliness" ^[13]

Question 5: Do you agree with the evidence sources we are drawing from? Are there other evidence sources you think we should be using?

In developing this Strategy, we are conscious that whilst the Equal Opportunities Committee's Inquiry was the first of its kind in the world, there are distinctive approaches to tackling social isolation being taken both elsewhere in the UK and in other parts of the world. Examples include:

• in Wales, the Health Social Care and Sport Committee conducted an inquiry into loneliness. It highlighted a number of issues, including the benefits of social prescribing, transitional support for retirement, exploring different housing models, and the potential for legislation to make a difference.
  It has recently published its report, which sets out a number of recommendations for the Welsh Government to take forward ^[14]
• in Northern Ireland, the then Executive published a framework to tackle rural poverty and social isolation in 2016.
  This focused on promoting positive mental wellbeing, increasing opportunities for social engagement and support at risk groups (including farmers and disengaged young people)
• in the United States of America, the national suicide prevention strategy recognises 'connectedness' as a theme, and the US Air Force programme focuses on strengthening social support for serving officers and veterans. There is a similar programme targeted at American Indian and Native Alaskans
• in the Republic of Ireland, Respond! Housing Association undertook research into how to combat social isolation and loneliness within social housing. It emphasised the importance of consultation, flexibility in devising solutions, partnership working and human contact
• in Japan, social isolation and loneliness are recognised as an increasing issue and strategies focus primarily on older people. Promoting 'worry free living environments' community based activity, and access to cultural facilities like libraries are all seen as important
• in New Zealand, research has highlighted the importance of volunteering, quality of relationships (as opposed to quantity) and contentment with life. Befriending was also recognised to be valuable following an evaluation by the Minister of Health

Question 6: Are there examples of best practice outside Scotland (either elsewhere in the UK or overseas) focused on tackling social isolation and loneliness that you think we should be looking at?

What we've heard

The Equal Opportunities Committee of the last parliamentary session made an important contribution to kick starting this work. The evidence it received during its inquiry led it to conclude that social isolation and loneliness are significant problems in Scotland and that individual citizens, public services and the Scottish Government should take collective responsibility for improving the situation. The Committee stated that: social isolation and loneliness is everyone's issue; it should not be ignored or tolerated; and that a change in attitude is needed to consider it as part of the public health agenda in Scotland alongside issues such as poverty and poor housing.

Befriending Networks held a national summit on loneliness in 2016, and Voluntary Health Scotland hosted a breakout seminar at 'The Gathering' earlier in 2017. On 15 December, the Jo Cox Commission on Loneliness published a call to action ^[15] for Governments and society to tackle loneliness. The Scottish Government held an event in April 2017 to ask stakeholders what they thought a National Strategy on social isolation and loneliness should contain. Some of the contributions highlighted that:

• a Strategy should be joined up and have clear indicators for improvement - measurement of change is important. These issues cut across many areas of policy and practice, so setting the Strategy within context is essential
• it is vital to frame the discussion and the work undertaken in a positive way - talking about social connections, community cohesion and building a kinder society
• definitions are important, including understanding the difference between chronic and transient loneliness
• it should focus on preventing social isolation and loneliness from happening in the first place, and work to raise awareness of the issues. Culture change and embedding kindness are important
• understanding the way social interaction works today is necessary, along with some of the opportunities and barriers
• this agenda should be prioritised at a local level
• there are tools we can use to effect change, including digital technology
• there needs to be recognition that these issues are relevant at different ages and stages of a person's life, and a person's individual characteristics (like age, gender, sexual orientation, gender identity, disability and race) are also relevant
• there are many groups, ranging from those with dementia to former offenders, who require attention. Geography is relevant, as there are issues depending on whether a person lives in an urban or rural area
• things that can make a difference include volunteering, education around relationships, allocation of resources in the right way, addressing stigma, encouraging contact and sharing skills between different groups and communities, accessible communications, and training for front line professionals

In all of this, there was a very strong passion and commitment to tackle these issues, as well as a great deal of front line expertise. We want to harness this and support it.