New trial paves the way for preventing loneliness amongst older people

Researchers have successfully trialled an intervention which can prevent the onset of depression and loneliness amongst the most vulnerable in society.

The Behavioural Activation in Social Isolation (BASIL) study has published its first findings in the PLOS Medical journal which shows that loneliness can be prevented with a psychological intervention delivered by trained support workers over the telephone.

The team developed a talking therapy, delivered by trained support workers, from a variety of professional backgrounds, over the telephone. The participants were contacted weekly and were encouraged to maintain their social contacts and to stick to a daily routine which included rewarding activity. The programme lasted for up to eight weeks and had been designed in partnership with older people who had direct experience of social isolation, loneliness and depression.

Loneliness is increasingly seen as a threat to population health and the Covid-19 pandemic and the restrictions that have been imposed have highlighted the importance of good mental health and social connection. Rates of depression and loneliness have increased during the pandemic, particularly for those who self-isolated for fear of catching the virus.

Keele University’s Professor Carolyn Chew-Graham is part of the National Institute Health Research (NIHR) funded research team led by Professor Simon Gilbody from the University of York & Hull York Medical School, and Professor David Ekers from the Tees, Esk and Wear Valleys NHS Foundation Trust and the University of York. The team, already working in this area at the start of the Covid-19 pandemic, noticed that enforced isolation due to shielding or self-isolation could cause disruption to daily routines, loss of social contact and loneliness which can all contribute to mental ill-health.

Professor Carolyn Chew-Graham, Professor of General Practice Research said: “Covid-19 has unfortunately impacted on the mental health of older people. We know that social isolation can cause people to suffer from loneliness, low mood and anxiety. In this study, we tested how we can maintain older people’s mental health during this difficult time.”

Professor Gilbody, said: “Our University-NHS partnership was ideally placed to respond to societal challenges of Covid-19. Older people and those with long term conditions entered enforced isolation, and this was very disruptive to people’s lives. We predicted increased rates of loneliness and depression for this vulnerable population, and we knew what might work to prevent this.

“Care in the NHS must be informed by the highest quality of evidence and we did not waste any time in deciding to set up a clinical trial to test this out. The research undertaken in the NHS is the envy of the world, and it has led the way in understanding how best to respond to the pandemic.”

The first results of the pilot trial are now available, and building on these exciting early results, a much larger trial follow-on trial is currently recruiting at over 12 sites across England and Wales. The study will include over 600 older people and is the largest study ever undertaken to tackle loneliness and depression in this way.

The research was funded by a £2.6m grant from the National Institute for Health Research. The BASIL-C19 trial was the first trial of its kind to test the effectiveness of a psychological intervention to maintain population mental health during the pandemic. Building on these exciting early results, a much larger trial follow on trial is currently recruiting at over 20 sites across England and Wales.