Working with social isolation and loneliness in older people’s mental health services

Isolation and loneliness are common problems in both older people and individuals with mental health problems. However, little research has focused on how these issues might be addressed in clinical practice with older adults with complex mental health problems. Here we set out to understand how social isolation and loneliness present and how they could be better addressed from the perspective of older adults with complex mental health problems and the clinicians working with them. Semi-structured interviews were conducted with nine healthcare professionals and 11 service-users from an older people’s mental health team and analysed using reflexive-thematic analysis. Results showed that professionals found social isolation easier to understand and work with than loneliness and tended to address both issues by targeting behaviours (i.e. what service-users could do differently). The psychological dimensions of loneliness (i.e. service users’ thoughts and feelings) received less attention, although service-users emphasised these aspects. Other themes included the challenges faced by professionals in fostering social connections because of limited resources. We conclude that a greater awareness of the psychological dimensions of loneliness in older people with complex mental health problems is needed, as well as the resource challenges faced in creating social connections beyond mental health services.