Psychological care delivered by phone combats loneliness and depression

Depression and loneliness can be prevented using structured telephone-based psychological care, delivered over eight weeks, according to new research.

The results of the study, a major clinical trial carried out during the Covid pandemic, showed rapid and enduring improvements in mental health and quality of life when older people received weekly phone calls over eight weeks from a specially trained coach who encouraged them to maintain their social connections and to remain active.

woman sitting on land

The study, led by a team based at the University of York and Hull York Medical School and at Tees, Esk and Wear Valleys NHS Foundation Trust, also including the University of Manchester, found levels of depression reduced significantly and the benefits were greater than those seen for antidepressants.

Participants in the study reported their levels of emotional loneliness fell by 21 percent over a three-month period and the benefits remained after the phone calls had ceased, suggesting an enduring impact.

The Behavioural Activation in Social Isolation trial, known as BASIL+, started within months of the 2020 pandemic and was the largest trial ever undertaken to target and measure loneliness in this way.

People invited to take part in the BASIL+ study were aged over 65 with multiple long-term conditions. They had been asked to shield during Covid and were at a high risk of loneliness and depression.

The BASIL+ trial was supported by a £2.6m award from the National Institute for Health and Care Research (NIHR). Hundreds of older people were recruited to the BASIL+ trial from 26 sites across the UK during the pandemic.

Politicians and policy makers have become increasingly aware of the importance of loneliness, but have struggled to know ‘what works’ in its prevention. The World Health Organization has just declared loneliness to be a “Global Health concern” and has launched an international commission on the problem. It is anticipated that the results of the BASIL+ trial will feed into this process.

The research was jointly led by Professor Simon Gilbody from the University of York and Hull York Medical School and Professor David Ekers from Tees, Esk and Wear Valleys NHS Foundation Trust.

Professor Gilbody said: ‘We now know that loneliness is as bad for your health as smoking 15 cigarettes a day and depression is a silent killer. All of us working on the BASIL+ trial had older parents and relatives who became socially isolated during lockdown.’

‘Based on our previous research, we had a good idea what might work,’ Professor Ekers said. ‘With the support of the NHS and the NIHR we were able to test this in a large rigorous trial. The results are now available and this is very exciting. The UK led the world with the vaccine discovery trials. Similarly in mental health we have advanced the science of ‘what works’ in the area of loneliness, and we have learned much from the dark days of the pandemic.’

Image: Andrew Neel

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