World-leading trial offers hope for the epidemic of loneliness 

In the aftermath of the COVID-19 pandemic, while the world breathes a collective sigh of relief, a different kind of pandemic continues to silently ravage the UK.

It is an epidemic that was exacerbated by the trials and tribulations of COVID-19, yet it existed long before the virus appeared on the scene. This is the epidemic of loneliness.

Research suggests loneliness is comparable to smoking and excessive alcohol consumption in terms of being detrimental to health and shortening lives. According to Age UK, more than 2 million people in England over the age of 75 live alone, and more than a million older people say they go for over a month without speaking to a friend, neighbour or family member - which may also mean it is a growing epidemic.

During the COVID-19 outbreak, spending less time with family and friends led to more feelings of loneliness than usual for many people, but particularly for those who had been isolating or shielding due to being considered clinically vulnerable.

Recognising the loneliness crisis during the COVID-19 pandemic, researchers at Hull York Medical School, the University of York’s Department of Health Sciences, Keele University, the University of Leeds, the University of Manchester, Tees, Esk and Wear Valleys NHS Foundation Trust, and Age UK developed the BASIL programme – a pioneering psychological support package aimed at helping to reduce loneliness in older adults who were shielding due to having long term health conditions.

The study was co-led by Professor Simon Gilbody, Professor of Psychological Medicine and Psychiatric Epidemiology at Hull York Medical School and Department of Health Sciences at the University of York, and Professor David Ekers, Clinical Director for Research and Development, Honorary Visiting Professor, Nurse Consultant, and Mental Health Speciality Lead for Clinical Research Network North East North Cumbria.

Professor Gilbody said, “As researchers, designing large-scale studies is within our capabilities.

“While we couldn't develop a new vaccine, we recognised the potential to design a psychological intervention to address the very real psychological impacts of loneliness that was affecting so many people.”

Urgent Public Health Research status

The BASIL programme was chosen to be part of the NIHR COVID-19 Urgent Public Health Research study list, a prestigious roster that included only a handful of studies in the UK aimed at addressing critical health challenges during the pandemic.

In response to the pandemic, the NHS stopped all research during the COVID-19 pandemic, apart from studies that have received Urgent Public Health Research status, so that their efforts were solely focussed.

Professor Gilbody said of the experience, “One of the incredibly impressive aspects of the NHS's response to the COVID-19 crisis was its unified commitment to tackling crucial research that could lead us out of this challenging situation.

“Having the Urgent Public Health status allowed us to do a big trial incredibly quickly across many sites across the NHS, achieving an incredible level of efficiency and expediency. The NHS proved to be a powerhouse with this focused effort.”

Notably, BASIL was the only trial of a psychological intervention given Urgent Public Health Research status.

Professor Gilbody said, “It was a real privilege, but one that required us to present a compelling case, highlighting the significance of our research in addressing loneliness as a priority for both the NHS and society at large."

Future outlook

While the COVID-19 pandemic may have subsided, the epidemic of loneliness persists. The BASIL team aims to provide evidence-based recommendations for policymakers, eventually influencing clinical guidelines and practices.

Their scalable solution has the potential to be adopted by voluntary community sector organisations and integrated into the NHS's preventive efforts against loneliness.

The work of the team to make a difference in loneliness continues, and they have contributed their findings from BASIL to a living meta-analysis, combining results from various studies worldwide and reinforcing the effectiveness of interventions targeting social interaction and activity to combat depression and loneliness.

But beyond their impressive research, the study has a personal significance for the researchers.

Professor McMillan said, “When COVID-19 hit, it felt akin to the question of 'What did you do during the war?' and I wanted to have a meaningful answer to that. This pandemic was the largest and most significant challenge we would likely encounter in our lifetime. It was crucial for us to contribute and do our part in responding to it."

Professor Gilbody agreed, “The BASIL programme, and all of our research in loneliness, holds personal significance for us as a team. Many of us have older relatives whom we were separated from during the COVID-19 pandemic, and we witnessed the social isolation and psychological distress they experienced. We wanted to help and make a positive impact.”

For more information about the BASIL study, visit the BASIL website, contact Professor Simon Gilbody or Professor Dean McMillian, or visit the Mental Health and Addiction Research Group.