Background
Methods
Ethics
Setting
Participants
Procedures
Data collection
Analysis
Research team and Positionality
Results
Sample characteristics
Characteristic | Participants (N = 20) |
---|---|
Gender – N (%) | |
Male | 8 (40) |
Female | 12 (60) |
Age group – N (%) | |
18–24 | 2 (10) |
25–35 | 6 (30) |
35–44 | 7 (35) |
45–54 | 3 (15) |
55–65+ | 2 (10) |
Ethnicity – N (%) | |
White British | 11 (55) |
White other | 4 (20) |
Black African | 2 (10) |
Black Caribbean | 1 (5) |
Asian Indian | 1 (5) |
Other | 1 (5) |
Occupation – N (%) | |
Consultant Psychiatrist | 2 (10) |
Other Psychiatrist | 3 (15) |
Clinical Psychologist | 2 (10) |
Mental Health Nurse | 5 (25) |
Social Worker | 2 (10) |
Occupational Therapist | 2 (10) |
Non-qualified staff | 3 (15) |
Other (CBT Therapist) | 1 (5) |
Years worked in Mental Health Services - Mean (SD) | 12.33 (10.34) |
Years worked at current EIS - Mean (SD) | 2.58 (2.61) |
Form of Employment - N (%) | |
Full-time | 17 (85) |
Part-time | 3 (15) |
Qualitative findings
Overview
“They [service users] say, well, I’ve got nobody, I’m alone … They won’t come out and say, I’m lonely, but they come and say, I have nobody, nobody cares about me. Even if you ask about a neighbour, nobody there … don’t know anybody.” (Mental Health Nurse, Team A).
“And then you can see in their eyes that they’re lonely, when you ask them, how do you spend your day? Then they will say, mostly staying at home, indoors, maybe watching TV. Not interacting with anybody, living an isolated life, or just playing games.” (Specialist Psychiatrist, Team D).
“… I think there’s a big part of the population we look after that perhaps see just us. And I don’t think they may have other meaningful contact with other professionals or anyone else …” (Consultant Psychiatrist, Team B).
“I mean, the patient had friends, but there was definitely a disconnect in terms of emotional support … that she kind of felt like having to kind of live a secret life in front of her friends … Kind of this is me, I’m fine, but really, she’s experiencing these really horrible voices saying certain things.” (Social Worker, Team C).
“And you might look at someone and it’s, oh my God, they spend five, six days a week on their own … They must be lonely. And I’ve had situations where people have said to me, I’m not lonely at all, really … So, I guess, number one, it needs to be identified as the service user’s perspective, that they feel lonely.” (CBT Therapist, Team D).
“… is about how well connected they are before their illness … that’s where if they didn’t have strong friendships to start with and then they got ill and their illness kind of took them into hospital for a period of time and took them away from their normal life so to speak that’s when they then come back to that and back into community. That’s when they really talk about kind of loneliness.” (Mental Health Nurse, Team D).
“...[loneliness] is going to affect their mood and the way that they [service users] manage things, so they might feel lower in mood as an effect of being lonely, they might feel less able to deal with things and manage things, because they feel unsupported …” (Occupational Therapist, Team C).
“… a good example is a patient who recovered and who has been discharged, but he felt lonely for years, and then you discharge the patient without taking into consideration that that loneliness was also a trigger for his illness … so, eventually if they continue to feel lonely … then obviously there is a risk factor … which could be a contributing factor for a possible future relapse.” (Specialist Psychiatrist, Team A).
“… Because clients can develop a relationship with their voices which can sometimes fill the gap of loneliness. Sometimes people say, actually, I like my voices because it’s like having friends around me, and they can have the connection with the voices themselves.” (Clinical Psychologist, Team C).
“I have one service user who feels she can’t talk to her husband because whenever she talks to her husband, he throws the fact that she has a mental problem or a disability back into her face, so she feels reluctant to share with him any information. And obviously you’re in a relationship, and so being unable to share that information does make that person feel quite lonely.” (Non-Qualified staff, Team A).
“He [service user] is probably been quite lonely for quite some time … and he talks to himself, and people in his community sort of berate him for that … yes, he feels quite judged by his community because he’s not achieved … So, he wouldn’t go out until late at night, so his people wouldn’t see him.” (Mental Health Nurse, Team D).
“He was withdrawing because he was comparing himself with how he used to be, and with others. And so, therefore it was easier to just opt out and avoid … so then you’d get into the cycle of withdrawing, losing your confidence, and then becoming lonely.” (Clinical Psychologist, Team A).
Service responses to loneliness
“...the social group hasn’t been helpful for the lady that’s at home all the time because she’s unable to go out. But certainly, for the other gentleman that’s very lonely and doesn’t have any friends or family, he’s found the groups extremely helpful and he tends to, when he’s well enough he tends to come to the groups and contributes and socializes that way.” (Social Worker, Team A).
“...If we refer into the cooking groups run by the local borough, they want a care coordinator to attend the session with them, because they have some misguided ideas about mentally ill people using kitchen equipment … so that’s quite … disheartening, from our point of view.” (Mental Health Nurse, Team D).
“… I personally think that more active psychology could help, psychology in any form … it has the capacity … to change the way they [service users] perceive themselves, and their social contacts …” (Non-Qualified staff, Team B).
“… they’re often quite tight knit church communities, who took very seriously the idea of visiting people in hospital and looking after people. And a lot people especially from African demographic spend a lot of free time in church ….” (Mental Health Nurse, Team B).
What else could be done?
“And the solution [to loneliness] needs to be driven by people, and I guess it’s very useful to ask about it … from the simple things like why don’t we have a badminton group...And maybe if we listen to people we’ll set up cafés next, or we’ll do other things that perhaps would be a lot more useful in addressing loneliness.” (Consultant Psychiatrist, team B).
“It’s everybody’s responsibility to reduce loneliness … there’s something around certain events that happen in London that I think people feel a sense of community … So, there’s something at that level, but also within a family, within a group of friends. So, this is the café, this is the pub, the landlords …” (Clinical Psychologist, Team A).
“Something with a social aspect would be helpful for loneliness … but something that’s not just mental health specific. Because I just think that marginalizes people … like, I had a conversation with one of my clients about joining a book club. So, stuff like that.” (Mental Health Nurse, Team D).
“... Like, I see him [the service user] once every other week. And he said to the psychologist, when asked, what do you do with your time? He said that he hangs out with me. And I just thought that was really sad, because... You know, when I’m paid to, you know....” (Occupational Therapist, Team D).