In this year’s Children’s Mental Health Week, Pamela Qualter, Professor of Education at the Manchester Institute of Education and principle investigator on the BBC Loneliness Experiment, would like people to take a moment to think about loneliness: how does it affect children’s wellbeing and how might we help them manage those lonely experiences successfully? Often, when we think about loneliness we conjure up images of older people, but loneliness affects most of us at different points throughout our lives; many children and young people experience loneliness. Although loneliness is not in itself a mental health issue, it affects wellbeing, and research has shown that it feeds anxiety and depression. It also impacts physical health – not to the extent it does in older age – but there are important implications for wellbeing. In this blog, she discusses what loneliness is and is not, how is it linked to physical and mental health during childhood and adolescence, and what we might do about it.

• The relationship between loneliness and mental health looks to be reciprocal and complex, with loneliness predicting poorer mental health and mental ill-health predicting loneliness.
• The UK Government’s strategy for tacking loneliness demonstrates a commitment to understanding loneliness among its citizens and in developing appropriate interventions to mitigate loneliness.
• It will be important to evaluate the intervention strategies included in the Government’s strategy, and psychological interventions should also be considered and evaluated.

What is loneliness? How is it different from social isolation or being alone?

Social isolation emphasises the small size of an individual’s social network, whilst being alone is a description of the amount of time one spends by oneself. Few inferences about loneliness may be drawn from those variables because loneliness is an evaluative concept that reflects the discrepancy between an individual’s expectations of the quantity and/or quality of their social relationships and their actual experience. Thus, loneliness is (1) an unpleasant feeling, and (2) occurs when people perceive their social relationships to be deficient, either because they (a) have fewer friends than they would like or (b) because the quality of their current social relationships is insufficient.

Loneliness has been in the news for many years because it has been linked, empirically, to physical health. There is certainly a wealth of research supporting the relationship between loneliness and physical health among adults, with prolonged loneliness – loneliness that lasts many weeks or months – linked to increasing blood pressure, higher incidence of coronary heart disease, and more frequent use of healthcare systems. Continued activation of physiological systems, including the hypothalamic–pituitary–adrenocortical (HPA) axis, contribute to inflammatory processes and are thought to be the leading mechanism by which loneliness is linked to ill-health. But, what do we find for children and adolescents reporting loneliness?

My research shows that experiencing loneliness throughout childhood predicts poorer self-reported health, and increases the number of GP visits, and negative health behaviour including smoking and alcohol consumption. Loneliness during childhood is also related to poorer quality sleep, which, of course, has impacts for general wellbeing and academic performance.

In the UK Government’s strategy for tacking loneliness they emphasise the need to develop and evaluate interventions for people reporting loneliness, including children. Their recommendation is to provide opportunities for individuals who cannot connect with others. There is little empirical evidence those interventions are effective, but because previous studies did not distinguish between different groups of people, the government might be right to try these interventions again and see if they are effective. It is possible that providing opportunities such as these may be effective for certain groups, including children, and there is a need to ensure robust evaluation of that work.

There are few psychological interventions that appear to be offered to people reporting loneliness, and the Government’s report does not discuss those. However, psychological intervention is likely to be successful for certain people reporting loneliness, particularly those experiencing prolonged loneliness. In my work, I have suggested several psychological interventions that are likely to be effective for lonely youth, reducing the impact of loneliness on mental health issues.

The promotion of social and emotional competence, via an effective curriculum, is also likely to prove successful at mitigating loneliness. As a prevention measure, the teaching of strategies to reduce loneliness could be effective and ensure youth have a toolkit of potential solutions they can access when they feel lonely. Current interventions designed to accentuate the positive social features in the environment have been shown to be successful at increasing reaffiliation, and, thus, should work to reduce loneliness. In their strategy document, the Government talks about the introduction of loneliness into the PSHE curriculum. The introduction of tasks such as those noted above should prove successful if implemented as part of that proposed curriculum.

Interventions that address maladaptive social cognitions are also likely to be effective in helping children and adolescents who experience prolonged loneliness. People who report prolonged loneliness have been shown to think very negatively about social situations and themselves, believing that loneliness cannot be remedied. Knowing that, it is no surprise that a meta-analysis of loneliness interventions showed programmes targeting maladaptive social cognitions were the most effective at reducing feelings of loneliness.

Conclusion

The UK Government appears committed to understanding loneliness among its citizens and in developing appropriate interventions to mitigate loneliness. As they move forward, it will be important to evaluate the intervention strategies they have committed to and review how they link directly into the theories of loneliness. I propose that psychological interventions are also considered and evaluated in the future and are developed for all age groups. I also hope that the proposed PSHE curriculum that will include loneliness builds on what we know about the psychological underpinnings of loneliness so that we can help children and adolescents vulnerable to loneliness and mental ill-health.

Further information

Pamela is presenting her work on children’s experiences of loneliness at the MQ Conference during Children’s Mental Health Week.  Ahead of the conference, she has been interviewed about her work.