‘What Happens Next?’: Can We End Loneliness?

Dr Susan Carland: Welcome back to What Happens Next?, the podcast that examines some of the biggest challenges facing our world and asks the experts what will happen if we don't change, and what can we do to create a better future?

I'm Dr Susan Carland. Keep listening to find out what happens next.

Speaker 2: ...Loneliness has reached epidemic proportions in Australia, that a local community app is working to overcome the problem.

Speaker 3: According to Feros Care, loneliness has become an epidemic in this country…

Speaker 4: …Research shows it can have a bigger impact on health than cigarettes.

Speaker 5: …A really tough time for a lot of people. This comes as academics suggest we're facing a loneliness epidemic. In fact, studies show that feeling lonely is a bigger risk for premature death than…

Dr Susan Carland: In last week's episode, we looked at some of the reasons why more people are reporting problematic levels of loneliness. Catch up now on part one if you missed it.

In today's episode, I'm talking to experts about whether or not the increasing awareness of the issue of loneliness will lead to action. And what can we do to address it anyway? It's not as simple as just being friendly to everyone on the street. Today we'll find out some of the ways researchers, policymakers and community leaders are tackling loneliness.

We mentioned last week that some countries, including the UK and Japan, are attempting to address loneliness with increased government support and policies. Does Australia need a minister for loneliness, too? What exactly would that entail?

Here's Labor's federal member for Scullin, Andrew Giles.

Andrew Giles: Hi, I'm Andrew Giles. I'm the federal MP for Scullin. I represent a reasonable chunk of the northern suburbs of Melbourne in the federal parliament, and I'm the spokesperson for cities and for multicultural affairs.

Dr Susan Carland: What do they do? What does a minister for loneliness oversee?

Andrew Giles: I think in the UK, and I'm more familiar with the experience in the UK, and I've had a little bit of dialogue with the, I think, current, although she may have ... they've had a reshuffle there… Baroness Barran, which I thought is the sort of name you remember.

Dr Susan Carland: [Laughter]

Andrew Giles: In the UK, I think that the role really reflects, as I understand it, an awareness that if government has responsibility to respond to loneliness, it's got to be about pulling together the things that government does, rather than building a new silo.

And as I understand it, and I've had the opportunity to have, as I say, some dialogue with one of the UK ministers, it's about pulling together an awareness that the programs government does, the information government holds, and applying that to this problem, working with civil society. As I also understand it, I think a similar process is being fired in Japan, but the appointment of a minister there is very much early days.

Labor’s platform has recognised that loneliness is a national issue for some time now, and doing that, I think, requires having the machinery of government that allows the various things the governments do that respond to loneliness to be tied together.

Now, I don't have a particularly strong view as to how that is to be done, but having a mechanism, whether it's bureaucratic or more political, I think is really important. Because I guess one of the things we've learned is that many of the things that act as agents against loneliness are things that happen already, and connecting people to those programs, or perhaps retooling programs, which seems to have been a big part of what they've done in the UK, can have a real impact just by bringing that lens to bear on existing projects.

The flip side of that, which they've also found in the UK is that when you shut down an institution like a local library, that's a great way to boost loneliness.

So having that understanding within government and enabling the bits of government that connect to how people form and maintain their social connections, we’re working that. That's something that I think is important. How it's to be done, I think that's a debate we're still to have in Australia.

Dr Susan Carland: Do you think there is something in the way that our modern cities are designed that may be exacerbating experiences of loneliness, and is there something we can do to change that?

Andrew Giles: For sure. The starting point is to remember, I think, that our cities should be built for people, and to have that at the forefront of our thinking when we talk about urban design.

I think often when we talk about cities – and I'm sure I'm guilty of this, too – we think about big bits of infrastructure as ends in themselves, not as means to enable people to do the things they want to do, or have to do, more effectively.

I think there's a debate that's going on about recognising that the present form of our cities doesn't respond to some immutable law of nature. It's evolved in response to a series of preferences and pressures. And when we apply different preferences by regulatory means, or simply by talking about these things in different ways, we can change them. There's obviously a debate about the extent to which our cities work much more effectively for men than for women, as one very obvious example.

But in the loneliness lens, there's some big-picture and small-picture questions that I think need to be asked. The first one is, does the form of our dwellings encourage people coming together? And if you think about how a lot of suburban housing estates are built, where you drive into your garage and walk from your garage into the living room, well, it's no surprise that many people don't know their neighbours, or perhaps didn't know their neighbours until the experience of lockdown gave them an opportunity to make those connections.

Similarly in the inner city and apartment buildings, there's a debate now which recognises that it's not all that good for people to be in, effectively, apartments next door to one another without any meaningful opportunity to congregate and build a sense of community and collective belonging.

So these small-scale debates, I think, are happening, and I think that's been a positive development of the pandemic, that people have realised the importance of place, particularly in our city, when we've had to spend a large period of time within 5 Ks of home.

The bigger one is to think about how the city as a bigger organism, as an economy, works, and how that can facilitate people spending time together incidentally and more easily, regardless of where they're coming from. Thinking about how public space works, how that public space can be open to more people, how leisure facilities can work to support people's needs for social connection. And I think libraries are a really big thing in that regard, not as places where people come once a fortnight to borrow books, but where places… people come together to do things as part of groups based on their interests, the language they would prefer to speak sometimes, or whatever.

And one thing that's really struck me as a local MP, and I suspect I'm not alone, is that we have a need for community space that massively outstrips the supply. We have so many groups in the community, perhaps, again, exacerbated by the time that's been spent physically apart, who want to be able to come together in their shared experience, their shared language, or their shared cultural, or whatever it is, interest. When we start to think about social connection being at the centre of what a city is all about, it's easy to see how we can redesign and reshape our cities to facilitate that, and to address the ailment that is loneliness in urban populations.

Dr Susan Carland: When I think about our suburbs, there are actually very few places of public congregation available. For example, in Melbourne, we have Fed Square, but that's only in the city. There isn't a Fed Square – which is a big sort of public space in the city of Melbourne, for those that aren't familiar with it – there isn't the equivalent of Fed Square in every suburb.

I wonder if what that does is, that forces us to utilise online spaces as our public square? Twitter becomes the public square. And while there's some good in that, they can also be incredibly toxic places, and we don't have the mediating balance of being with other people, physically in a public space that, as you said, if it's not built from the beginning, it's very hard to reclaim. You can't suddenly bulldoze 18 houses so we can have a public space in every suburb. So what do we do about that?

Andrew Giles: Yeah, well that's right. I think it's obviously easier to start on good foundations than to rebuild. But I think in some cases, the rebuilding is an important part of the story. I think we do need to make sure that there are those places where people can come together, and I talked about libraries earlier, and I think having a library accessible in all suburbs is something that really does matter as a space for people to come together.

And also recognising that at different stages in people's lives, people are looking to come together in different ways. I mean, there's a big body of evidence out there that links the number of social groups that we're involved in to the quality of our lives, particularly later in life.

But simply offering 15-year-olds access to ballroom dancing at year 3A at the scout hall at 11:30 in the morning on Tuesday, it isn't going to meet the needs, I would imagine – it's been a long time since I've been a 15-year-old – for their social connection. So understanding that people form relationships differently.

On the point you make about online engagement, I think it's really well-made – and I guess I'm also conscious, as someone who's closer to 50 than 40, that I don't know what it's like to be a digital native and I don't presume to speak on behalf of them – but I'm troubled by the evidence that suggests that younger people are lonelier. I am concerned that we don't know enough about the incredible potential of social media, where we can connect to people on the most obscure interests around the world easily seems to me to potentially .... to be outweighed, rather, by the toxicity that you refer to otherwise.

Trying to find a balance there, I think, is a huge challenge. It's a challenge for individuals, it's a challenge for parents, but it's a challenge for policymakers as well.

Dr Susan Carland: David Pearce is the founder of On the Low Down, an organisation that aimed to reduce the stigma surrounding conversations about mental health, especially among men. He believes men are less likely to report feeling lonely, mainly due to social barriers.

David Pearce: Hi, I'm David Pearce. I'm the founder and the director of On the Low Down. We are a preventative mental health initiative that connects at-risk people who are less likely to express issues that they're struggling with, with regard to their mental health, and we connect them to mental health services.

Dr Susan Carland: Can you start by telling us about the work that you do around loneliness?

David Pearce: I mean, for the last number of years, we've been working pretty hard to connect particularly men to mental health services. So that's a really important thing because men are demonstrating some pretty adverse mental health. Men aren't doing that great when it comes to some really, really important metrics as it relates to mental health.

So if you want to look at something like suicide particularly, which might be the really, really big one, then you're seeing some really, really significant statistical disparities between what's happening with women, and what's happening with men. So men are taking their own lives at a rate of three to four times that as women.

The other thing that they're saying is that men are doing certain things like seeking help a lot less, demonstrating a lot less help-seeking behaviour, and also a lot less interdependent decision-making behaviour.

Interdependent decision-making is really making decisions in the context of a relationship, and what a lot of all that boils down to is that men aren't demonstrating vulnerability. They're not communicating what's actually going on in their lives to other people, getting other people's perspectives, and then actually doing something about it.

So I've been working on… The last couple of years we've been running connection sessions, and then this last year we've been working for a lot of different peak health organisations running online mental health events that connect people, break down that stigma.

We've been having famous celebrities, Steve Moneghetti, Jordan Roughead, coming along to these events, which has been really, really, really wonderful. They talk openly from the heart about mental health and all that kind of stuff, and just demonstrate that it doesn't make you less of a man. Because of course it doesn't make you less of a man to seek help, to talk to other people. It makes you more of who you are because you become a better resource, and then bigger and stronger and more wonderful person.

Dr Susan Carland: If you could wave a magic wand and change one thing about how we talk to men about men in terms of their mental health, particularly around loneliness, what would it be? What would you do?

David Pearce: I would really like to see a lot less shaming terminology that gets thrown around. It really dissuades men from engaging and entering into the conversation. So I would like to see a really supportive and encouraging environment, which leverages from a lot of the really positive characteristics that already reside within the traditional male archetype.

So yeah, sure, we've talked about some of the negative, unhealthy characteristics, like you got to do it all by yourself, and you need to be an island, and totally independent and don't express yourself emotionally. There's also some really wonderful characteristics, like trust or loyalty. Strength is really, really great. Mateship is a really fantastic thing. So there's lots of really positive elements that we can leverage from there. So I think that would be something of my magic wand.

Dr Susan Carland: In our last episode, Dr Suzi Nielsen, deputy director of the Monash University Addiction Research Centre, discussed the links between physical pain, opioid abuse, and loneliness. Her research shows that reducing loneliness through social activity interventions can actually help reduce pain.

You mentioned how, unfortunately, medication is sort of the easiest or most accessible thing to deal with things like chronic pain. I wonder if having better social connections can be something of a mediating force against pain?

So for example, if you're a lonely person and you're experiencing pain, and the two are interconnected in some way, who knows which one led to the other? If you were prescribed a social bonding activity that you actually enjoyed, not something that you had to go to, but that's something that you enjoyed, is there any research on whether that can lessen the effect of physical pain?

Dr Suzi Nielsen: Absolutely. So this is a really growing area of research around what you've called social prescribing, and the way that intervention tends to work is you have a social connector who will link people in with a range of activities that they're interested in, and it's often not just saying here's a list of things you can do. It can be actually going with that person, introducing them, making it more accessible to go and seek those activities. Because often when you're talking about someone who maybe is experiencing depression and has chronic pain, it's not that easy to do just get up, get out of the house and go to a place with a group of strangers.

So those kinds of social prescribing interventions have really a growing amount of research, but also a growing amount of evidence to show that they work not only for pain, but for a lot of those other complicating factors that I mentioned.

So things like helping with anxiety or depression, in addition to pain. So we see this kind of benefit across multiple facets of people's lives, which have been challenging. I guess that kind of makes sense because a person is not their depression. A person has all of these things going on for them and that social connectedness can benefit them in multiple ways.

So yeah, I think that's really exciting that we have these solutions, we have a lot of evidence, and we have a lot of evidence starting to build that there's, not only for substance abuse, but also for a range of mental health conditions and for chronic pain that we'll see those benefits.

Dr Susan Carland: Life-course epidemiologist Dr Rosanne Freak-Poli's research suggests that some interventions can make a difference to an individual's loneliness and health. Is there a minimum number of social support that we know that the average person feels they need to not feel lonely, or is it really individual and specific?

Dr Rosanne Freak-Poli: So at the moment, a lot of the research tends just to look at people on a scale and look at the highest category versus the lowest category. That has actually prevented us from providing sort of public health messages around this.

I have had a little look at numbers and what I have found was that having at least four people that we can either talk to about our feelings or ask for help, so if you can do both of those things, they count twice, that's a really great number to have around you. With social connections, like physically just going out and going to at least community event in a month… So going to, say, your neighbourhood house and doing a course or connecting with at least four people, even by telephone, a month, these sorts of numbers have had significant effects on your… benefits to your health.

Dr Susan Carland: The global loneliness epidemic may not be as headline-grabbing as some other epidemics I could name, but it's just as treacherous. The good news? The policymakers and researchers who are paying attention to it are gaining ground. The better we understand modern loneliness' root causes and its knock-on effects, the better we'll be able to address it and support one another.

I had some wonderful interviews with our guest experts on this topic. We've also included some links to their research and initiatives. Take a look.

Thank you also to the Monash University Performing Art Center's David Lee sound gallery, where a portion of this season was recorded.

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