4. Features of support to tackle social isolation and loneliness
The consultation included a range of responses, and our analysis identified that a main focus of responses was the support needed to tackle social isolation and loneliness. The main features of support needed included: policies and regulation, sustainable funding, education and training, and both designing and delivering support.
The consultation responses also identified six key stakeholders, all of whom have interlinked responsibilities for delivering these features of support. We highlight key stakeholders (where relevant) throughout the remainder of the report.
Figure 2: Summary of features of support and stakeholder responsibility
Policies and regulation
Policy and regulation are required to set expectations and establish the standards for recognising and tackling social isolation and loneliness in Scotland. National and local government, the private sector and employers were seen by respondents as central to achieving this. The government was especially viewed as needing to take the lead through national and local laws and policies, as well as enforcing existing policies.
National and local government
Respondents suggested ways the government could address social isolation and loneliness by demonstrating leadership and addressing factors that contribute to this issue. Respondents expected the government to lead by example by embedding considerations about social isolation and loneliness into developing policy. For example, the government could make it a ministerial requirement to complete an impact assessment for social isolation and loneliness, in the same way as is required for children's rights.
In consultation responses, austerity featured both directly and indirectly, through general references to funding cuts or general lack of funding of public services and third sector organisations. Respondents felt cuts to funding were contributing to social isolation and loneliness, particularly as it relates to public transport and community spaces, which is discussed in more detail in Chapter 5. Austerity was seen to be limiting third sector organisations' ability to respond to social isolation and loneliness due to cuts and lack of sustainable funding, discussed in further detail in the next section. Responses revealed an expectation for government to increase funding to core public services like transport and mental health services as well as funding of third sector organisations.
Trauma was recognized as a cause of social isolation and loneliness in some situations, and responses included a recommendation for more trauma informed responses to situations and of loneliness and social isolation. Respondents also felt that the government could update or develop policies aimed at addressing specific factors contributing to social isolation and loneliness. For example, a suggestion shared was to limit the number of holiday homes in an area. Respondents also felt that the government could be better at enforcing existing equality legislation and duties to ensure they are followed through, for example by ensuring hearing loops are widely available in public spaces and increasing disabled access to buildings.
Economic and city focused investment was suggested as a contributing factor to depopulation in rural areas and increasing the risk of social isolation and loneliness.
Respondents also suggested bureaucracy that restricts the design and delivery of support be reduced. Respondents felt that there was a need to simplify processes to make it easier for third sector organisations to provide support that strengthens social connections. Respondents felt the government should strive to reduce barriers faced by volunteers and organisations to carry out volunteer activities like transport schemes.
"Volunteers are being put off by insurance policies. A drivers' scheme cannot function without disclosure certificates and public liability insurance. How can we remove those barriers while protecting vulnerable individuals?" (Event)
Another suggestion was to make it easier for volunteers to obtain background checks, for example the Protecting Vulnerable Groups (PVG) scheme, to enable visiting people in their homes. Finally, views from some third sector organisations noted the government could streamline funding applications and ensure that they are proportionate to the level of funding.
"It currently feels like a mountain to climb for just one application." (Organisation)
Third sector organisations who responded, with limited time and resources to complete applications, felt hindered by excessive bureaucracy creating barriers to delivering support.
Respondents felt that where appropriate, a social inclusion and loneliness strategy should link to connecting strategies, such as those on child poverty, alcohol, suicide prevention, safety and mental health. When making strategic and commissioning decisions, there should be a duty to tackle the issues of isolation and loneliness.
Private Sector and employers
Consultation responses also suggested that the private sector and employers have a responsibility to establish a work culture that does not contribute to social isolation and loneliness and to help identify and support for those who may be in need. Respondents felt the private sector and employers should create opportunities for employees to make social connections, for example by setting up interest groups or sponsoring social activities like quizzes, sports teams or volunteering. Respondents also felt the private sector should support volunteering opportunities for employees by, for example, allowing volunteering during work hours.
"In England, a call-centre has partnered up with a local Age UK to encourage its staff to offer telephone befriending to older people in work time." (Individual)
In addition to encouraging social interaction and volunteer activities, respondents felt it was essential for employers to have flexible, inclusive and family-friendly working policies. As an example, employers should allow flexible working hours for parents and carers and be more understanding when a crisis occurs in employees' home lives. Another example suggested that employers should remove or limit zero hour contracts so employees have more stability. Respondents felt employers should do more to make hiring and working policies inclusive for people with disabilities, home workers, and blind and deaf people.
ASTRiiD, a charity connecting businesses with professionals who have long term health problems but who still have many skills to offer employers. They believe that the value of work is far more than the wages that are paid. Work provides routine, challenges and rewards and help gives its members a positive mental attitude.
Finally, respondents felt that the private sector should integrate social isolation and loneliness into existing health and wellbeing policies, and help to spread awareness and understanding of the issue among employees. Employers could monitor overall staff health and wellbeing - including social isolation and loneliness - through an anonymous employee survey. Employers should also consider how to identify and support employees who may be in need and signpost them to company or local resources.
As discussed in Section 4.1, austerity and cuts to funding were identified by respondents as limiting the ability of third sector organisations to respond to social isolation and loneliness. In addition, a recurring theme in consultation responses was the need for investment and sustainable funding to support national and local initiatives aimed at tackling social isolation and loneliness. Third sector and charity organisations are helping to combat social isolation and loneliness at a local level and doing important community work, but they require greater financial support to sustain and grow their impact. This approach may not only empower communities to work together to meet the needs of their community but may also support engagement with existing services.
Government and the private sector have a role to play to invest in existing, effective community organisations and infrastructure to ensure the continued existence of essential services.
"Vital and well equipped services shutting down due to lack of funding. Mental health costs soaring as a result of this." (Individual)
Respondents felt there was a general lack of funding and that third sector organisations could expand their reach if they had access to greater funding. Some of this funding was expected to come from the government, but some responses also named the private sector as having a role in funding initiatives aimed at social isolation and loneliness as part of their corporate social responsibility.
Third sector organisations cited a need for stable funding, rather than short term grants, to ensure they are not operating 'hand-to-mouth' and can sustain and eventually scale up their work.
"The service we provide is only reaching the tip of the iceberg of people who would potentially benefit. We receive council core funding for about half our turnover, the other half being raised by ourselves. This is an annual hand-to-mouth existence." (Individual)
"We see too many good community projects come and go because they simply can't scale or provide the depth of evidence needed to move beyond initiation / innovation funding." (Organisation)
In addition to providing funding to third sector organisations, respondents felt the government has a responsibility to extend its existing investments to tackle social isolation and loneliness. For example, mental health services, such as counselling, were seen to need increased funding to get rid of current long waiting lists. It was also felt that the government should extend the Integrated Care Fund (ICF) to fund a range of projects and partnerships. Another suggestion was to increase the rate of carers' allowance, currently at £64.60 a week, for those who have significant carer responsibilities and are unable to work. Respondents felt that the government must increasingly invest in communities to address the root causes of social isolation and loneliness.
Some of the consequences of processes and practices underpinning voluntary sector funding, and service design were noted. Limited, and ring fenced, voluntary sector funding was seen to create a voluntary sector that must target its provision, and as a result exclude individuals who have a need for the service, but who may not fit into target criteria, on the basis of their age or other identity characteristics. For example, as a consequence of service provision contracts, access to community transport services may be confined to individuals or groups through restrictive eligibility criteria. Services could therefore be focused less rigidly, to work in a more inclusive and collaborative way.
Social enterprises, which are funded through their trading, were seen by respondents as well-positioned to deliver valuable services and support to communities. Respondents felt more can be done to promote and support social enterprises in Scotland.
A social enterprise (SE) is a trading business - selling goods and services - whose primary objective is to achieve social and/or environmental goals. Profits from the SE are reinvested in the business or in the beneficiary community - and not distributed to private owners, shareholders or investors.
Physical safety was seen to be critical and a need for increased funding for community policing initiatives as a means of strengthening the confidence some urban communities have in the safety of their neighborhood.
Education and training
Education and training were viewed as necessary for raising awareness of social isolation and loneliness as issues, establishing a culture of caring, and helping link people at risk with relevant support. Overall, respondents felt that there was a need to increase the visibility of social isolation and loneliness as issues that exist and affect everyone, and that everyone has a role to play in preventing and responding to them.
Key stakeholders have similar roles to play in raising awareness of these issues. The government was expected to take a leadership role in raising awareness, and an example shared by respondents of how it could do this was from a national awareness campaign. Due to the cost of undertaking such a campaign, it may not be feasible, but the sentiment behind the suggestion is important to consider: that something needs to be done to increase visibility of social isolation and loneliness across Scotland.
'See Me' Social Movement in Scotland to end mental health stigma and discrimination. They are funded by the Scottish Government and Comic Relief and managed by the Scottish Association for Mental Health (SAMH) and The Mental Health Foundation.
Another example of a suggestion was to institute a week focused on raising awareness of social isolation and loneliness, much like what has been done for mental health and mental health awareness week.
The private sector, health and social care providers as well as schools are also well placed to raise awareness of social isolation and loneliness - for example, by hosting awareness seminars or by placing information posters in practices, workplaces, or schools. These stakeholders were seen as well placed to intervene and refer people to relevant support where a need is identified. For example, responses commonly cited 'social prescribing' and felt health and social care providers could do more to link patients with sources of support in their community and embed social prescribing into their practice.
Social Prescribing is where an individual is connected to services or activities in the community which are likely to help with the health problems they are experiencing. These activities are prescribed as a non-clinical alternative to a medical prescription.
Recognising that health is impacted by a range of factors, social prescribing draws on a wide range of community assets to focus on an individual's physical and mental wellbeing. These include opportunities for the arts, physical activity, outdoor activity, learning, volunteering, social support, mutual aid, befriending services and self-help, as well as support with benefits, legal advice, etc.
To support those in need, there was felt to be a need to increase the capacity of well-placed people in the community, like healthcare workers or employers, to recognise and respond to those in need. The government could help fund training and education and share best practice examples. Health and social care providers could screen for social isolation and loneliness in routine assessments. Training is needed for health and social care providers, as well as the private sector and schools to enable employees to recognise the signs of social isolation and loneliness, sensitively respond and signpost to local provision. One example shared highlighted the initiative to raise awareness of dementia as a good example that could be replicated with social isolation and loneliness.
"Just as Dementia Awareness training has been rolled out to businesses in Scotland, could replicate similar awareness training for those exhibiting signs of loneliness, and train employees to have short, simple dialogue with customers / people who exhibit traits." (Organisation)
Raising awareness of social isolation and loneliness in Scotland and building the capacity of those in the community in a position to intervene will help to ensure those in need of support are connected to available resources.
Physical safety was seen to be critical and a need for increased funding for community policing initiatives as a means of strengthening the confidence some urban communities have in the safety of their neighborhood.
Designing and delivering support
Responses to the consultation also offered views on what good support looks like, and things to keep in mind when designing and delivering support aimed at social isolation and loneliness. Communities know the needs of their local area and residents, and the government has the capacity to enable communities to design support that works for them, by conducting asset mapping, sharing best practice and helping to scale up effective support through funding. Respondents felt government should be driving forward its expectations of good quality support, with communities putting it into practice in a locally relevant way.
Those suffering from social isolation and loneliness did so for wide-ranging and intersecting reasons, and there was agreement from consultation responses that there was not going to be a 'one size fits all' approach to designing support. There is a need for a range of support and opportunities for connecting, both formal and informal, that are accessible and inclusive. There was no consensus about what should be designed, though responses identified key features of support that may help enable connections to flourish. This included organising support around a theme or topic of interest in addition to support targeted at key demographics or characteristics. More opportunities for casual interactions, in addition to formal, structured activities, was appealing and seen to embed responses to social isolation and loneliness into the day-to-day. Finally, all support should have an inviting tone and be in a neutral and accessible setting.
In Dundee, the Main Street Café in Coldside Parish Church was developed as a direct response to a local wellbeing survey that found that many people in surrounding streets were socially isolated. A steering group was formed that accessed funding for a co-ordinator and established a successful community café operating two days a week currently on a donation only basis. Volunteers help run the café and a partnership with Fairshare means that food parcels and other items from a local supermarket are available for those present to take away free of charge. A rota of services provides access to information, advice and support on issues such as benefits, housing, literacy and community activities.
As discussed in Section 4.2, access to stable and sustainable funds was seen as crucial for third sector and community organisations to deliver support aimed at tackling social isolation and loneliness. In addition, effective delivery was characterised by locally relevant provision and co-located or clustered support. Support was seen as most effective if it was grouped together with other forms of support or near to other community amenities or services. This helps existing services pool their expertise and resources more easily, and helps the individuals in need to more easily access different types of complementary support.
"It's often too taxing or time consuming to make many journeys, so if services were clustered it would be easier." (Individual)
Furthermore, signposting people to locally relevant support was seen as crucial to ensuring those in need of support receive it. Many responses called for more social prescribing and greater investment in link workers to carry out this work. Another suggestion was to identify and leverage community champions - people who are familiar with support and the needs of their community. To enable social prescribing, responses to the consultation suggested creating a central database highlighting the range of local provision available to the community.
Kate's Kitchen in Annan is a charitable organisation that runs a drop-in facility. They seek to identify and support people who are vulnerable to social isolation and loneliness. They provide one-to-one sessions, help with life skills and sign-post people to other agencies. They organise activities that help to build confidence and self-esteem, and to develop relationships. To help facilitate this work they operate a café on Tuesdays and Thursdays, and run craft sessions on Fridays.
Responses to the consultation felt that more could be done to harness the time and resources of volunteers. While health and social services are fundamental to effectively preventing and responding to social isolation and loneliness, resources are outstripped by demand. Volunteers were seen, especially by organisations, as crucial to the successful delivery of support. Consultation responses suggested more creativity in operationalising this resource, as well as reducing bureaucratic processes which impedes this (as discussed in Section 4.1). Micro-volunteering opportunities were repeatedly referred to as a realistic and appropriate way forward.
In addition, respondents felt that Jobcentres could do more to encourage people to volunteer and that the impact of volunteering on unemployment benefits should be clarified, so people who have the time and willingness to volunteer can do so to the benefit of their community. Some respondents also saw volunteering as not only helpful to a community, but also for the volunteer, for example as a pathway to employment. Respondents felt more could be done to promote and incentivise volunteer activities.
Government was expected to take a leadership role in addressing social isolation and loneliness through policy-making and funding, but also to support private and third sector organisations in raising awareness and increasing their capacity to respond to this issue. The government should play a lead role in shaping what effective support looks like and reducing barriers to delivering support.
Self-directed support is considered less appropriate for recovering substance misusers and people with a terminal illness or deteriorating health. For these individuals, intensive, tailored and one-to-one support is more appropriate. It was suggested that informal peer support is most suitable for such groups who may face stigma, and who need to feel understood and accepted by others (most likely people in similar circumstances or with similar experiences) before being able to build relationships and become more socially integrated.On a practical note, it was suggested that a Social Isolation and Loneliness Assessment Tool, for use by sector professionals, or a checklist of behaviors that could indicate social isolation and loneliness, for use by the general public concerned about family and friends, would be helpful tools to identify those in need of support.
Email: Ben Cavanagh