The COVID-19 pandemic has had a profound impact on the UK’s mental health, particularly loneliness. Data from spring 2021 found a million more adults were feeling lonely “often” or “always” compared to spring 2020. Now, a recent evidence review for DCMS, led by Professor Pamela Qualter, has set out what we know – and don’t know – about loneliness in the UK, and suggests priorities for policymakers in tackling this vast problem.

• Loneliness costs the UK up to £2.5 billion each year, through lost productivity, staff turnover, and other effects.
• Loneliness has increased during the COVID-19 pandemic, with between 7 and 25% of UK adults reporting feelings of loneliness.
• However, there are large gaps in our knowledge about which groups are more vulnerable to loneliness, the effects this has, and how effective different interventions are.

The 2018 Loneliness strategy was published by the government in response to recommendations by the Jo Cox Loneliness Commission, laying the foundations to tackle loneliness in England. We have expanded on what we know about loneliness since this strategy was launched, thanks to the growing evidence base. However, the COVID-19 pandemic has emphasised the scale of the problem of loneliness and we have set out what we need to know next.

Loneliness has increased during the pandemic, with between 7 and 25% of adults reporting feelings of loneliness. Loneliness leads to several and diverse health issues, including a predisposition to mental health disorders, hypertension, and sleeping difficulties. The impact that loneliness has on productivity is becoming clearer, with individuals who are lonely being less likely to do well at school, and more likely to be unemployed throughout their adult life than their non-lonely counterparts. Social isolation associated with the COVID-19 lockdowns is sure to exacerbate the issue of loneliness in the UK. Given the negative effect loneliness has on health and productivity, we need to learn more about how loneliness appears and how to combat it.

Which groups are more affected?

Studies on loneliness have previously looked at specific age groups individually. However, it is now possible to look at how loneliness changes over time. We can also assess how life events can have differing impacts on loneliness for different age groups; for example, how does being widowed at different ages influence loneliness? We know that loneliness in later life is higher for women with experience of economic hardship and conflictual paternal relationship, and men with experience of prolonged bullying. It is also apparent that certain activities only impact certain age groups  of people reporting loneliness – such that the need for social connections at ages 25-34 year affects performance on some social tasks, but does not affect performance of lonely people at other ages.

Effects of loneliness

It is clear that there is an association between loneliness and a range of mental illnesses, with people reporting loneliness at greater risk of depression. Conversely, there is a link between mental illness and loneliness, with those who are depressed being at greater risk of becoming lonely, highlighting the interconnected nature of loneliness and mental health. Loneliness also appears to be a predictor of suicidal ideation and behaviour across the lifespan, demonstrating the dangerous link between loneliness and mental health.

Factors affecting loneliness

The factors that influence loneliness are varied and complex, and there is a known link between social stigma and loneliness. Experiencing discrimination is one of the strongest predictors of loneliness, which often causes people to shy away from social interactions, while people who are lonely are often perceived as socially inept and poorly adjusted. The impact of sex, sexual orientation, and ethnicity on loneliness have been shown to vary significantly by geographic region highlighting the importance of stigma at the community level.

Living in more remote areas can affect loneliness, due to poor transport and digital connections which can adversely affect social interactions. However, young people also report feeling lonely in densely populated urban areas, while living in greener, more walkable areas reduces loneliness. The factors influencing loneliness are therefore numerous and complex, and solutions must take into account the varying needs of different regions and demographics.

Loneliness is also affected by employment, with studies demonstrating that regions with higher levels of unemployment for 16-24 year olds during the pandemic showing higher loneliness prevalence. In fact, being in work is linked to a lower risk of loneliness, with the nature of the job or work culture also impacting loneliness. As the nature of work rapidly changes, with people changing jobs more frequently and remote working on the rise, it is becoming clear that these different ways of working may impact loneliness. In particular, temporary jobs with short work periods have been found to be associated with loneliness.

The economic case for tackling loneliness

The true cost of loneliness is to the UK economy is unclear, although there are estimates of a cost of £2.5 billion a year due to loss in productivity and staff turnover. It is not known what the investment return is for loneliness interventions. Loneliness intervention trials should embed evaluations and economic analysis to ascertain the investment returns to gauge the economic feasibility of such measures. Currently, much of the existing evaluation literature has focused on small scale, short term evaluations, but there is a need for an assessment of longer term economic evaluation – perhaps coordinated between the Department for Work and Pensions, the Department for Digital, Culture, Media and Sport, and the Department for Health and Social Care.

Effectiveness of interventions  

A number of studies have investigated the effectiveness of loneliness interventions across several age groups with differing methods of intervention. However, most studies look at older people and in western countries. A study in 2021 concluded that interventions with the primary aim of reducing loneliness were effective across several age groups. To ensure effectiveness, such interventions will have to be targeted to the correct demographic and several interventions combined to reduce loneliness.

Recommendations

Tackling loneliness will require a targeted approach with the need to prioritise those in groups with pre-existing health conditions and those at increased risk of marginalisation and prejudice, because they are at a higher risk of loneliness and social isolation. Interventions should also be targeted to those known to be at the highest risk of chronic loneliness which we know leads to mental health problems, so interventions should prioritise children in care, care leavers, asylum seekers and refugees, people who are LGBTQ+, people with disabilities, and certain ethnic groups, as well as several other groups. Determining which interventions work best for certain groups will be key to a targeted approach, and the needs of each group will need to be addressed if interventions are to effectively tackle loneliness.

Place-based factors are likely to impact loneliness, but we need to learn more about those risk factors and how they specifically relate to loneliness. How does place impact relationships to loneliness we see in the data, and importantly, what do people need or want from their communities to prevent loneliness?

If we are to tackle loneliness, we need to develop tools that can measure the impact of loneliness on people’s lives. Integrating this into existing quality of life and well-being measures will give a better picture of the true impact of loneliness. High quality evaluations of loneliness interventions are also needed, if effective and robust interventions are to be developed at scale.

Tackling loneliness, along with its impact on mental health and the economy, requires better understanding of how loneliness develops and affects different groups. Crucially, we must also evaluate the cost effectiveness of interventions on loneliness. Combatting loneliness will ultimately lead to a better connected, healthier, and more productive society.