A National Strategy to Address Loneliness and Social Isolation

31 January 2021

Loneliness has a detrimental impact on health and wellbeing, productivity, and functioning in daily life. One in four Australians aged 12 to 89 experience problematic levels of loneliness. At any given time, the estimated prevalence of problematic levels of loneliness6 is around 5 million Australians. While the financial burden on Australia’s health service has not been quantified, equivalent costs to Medicare in the USA have been estimated at $6.7 billion annually.

Given the high prevalence rates of loneliness and the exacerbation of this issue as a result of the COVID-19 pandemic, Ending Loneliness Together is urging the Federal Government to deliver a more sustainable, effective and efficient response to address loneliness and social isolation in Australia.

The Issue

Loneliness and Social Isolation is a Signature Concern of the COVID-19 Crisis

The COVID-19 crisis has brought loneliness and social isolation to the centre of our attention and serves as a powerful reminder of just how important meaningful social relationships are to our sense of self and purpose in life.

The spread of the virus has resulted in ongoing measures aimed at reducing social interactions in order to curb infection, including social distancing, quarantine, and self-isolation. While these restrictions are proving effective for ‘flattening the curve’ of infections, emerging outbreaks have highlighted the difficulty in controlling the virus spread and emphasised significant and growing concerns about the impact on loneliness, social isolation, mental health and community wellbeing. In particular, there is a disproportionate impact of social restrictions on vulnerable groups, such as older adults, people with mental ill health, and those who live alone.

Mental Health Impact

The detrimental impact of the current pandemic on mental health outcomes is consistent with the impact of quarantine reported in previous infectious diseases outbreaks (e.g., Severe Acute Respiratory Syndrome)9 . Social restrictions invariably exacerbate mental health symptoms associated with depression, anxiety, stress, anger, and post-traumatic stress disorder.

One in two Australians reported feeling lonelier since the onset of the COVID-19 pandemic. For Australian residents aged 18-81 years surveyed between March and April 2020, loneliness increased the likelihood of developing a clinical depressive disorder by eight times and a clinical social anxiety disorder by five times. Unfortunately, based on previous infectious diseases research, it is likely that poor mental health triggered by COVID-19 will be persistent even after the immediate public health crisis ends.

More Australians are expected to report emerging mental ill health as the pandemic progresses. Those who did not have prior mental health disorders are expected to report more loneliness, financial and work-related stress, and problematic mental health symptoms. First-time help-seekers struggling with loneliness may be reluctant to access services through specialist mental health service providers and may not identify relevant community solutions or service providers.

Currently, mental health providers do not offer low intensity or short-term support for loneliness and have a focus on reducing distress and addressing safety, as opposed to adopting a preventative approach to addressing loneliness. These providers were overly burdened and under resourced even before the pandemic. In a similar vein, community organisations who offer programs to address loneliness are not equipped to reliably measure loneliness or evaluate the effectiveness of their activities and are under-resourced to implement these programs more widely in order to make an impact. Thus, a new and more integrated approach to addressing loneliness and its effects on mental health is needed.

Workplace Social Impact

The COVID-19 pandemic has also significantly disrupted the way we work. In a recent Australian COVID-19 work survey, 76% of participants reported experiencing moderate or severe psychological distress as a result of reduced work hours or losing their job. Unemployed Australians reported experiencing four times more severe psychological distress (31% of participants) than those who were employed (8% of participants aged 18 to 65 years old).

Remote working has increased exponentially since the onset of COVID-19, from 20% to 45% in Victoria and from 20% to 39% in New South Wales, adding new challenges and barriers to our ability to connect and maintain social relationships. Crucial to understanding these effects is recognising that those working from home and unemployed workers can suffer significant stress arising from changes to their social identity, reduced social support, networks, and loneliness.

The Cost

Health Service Utilisation Costs

According to the Mental Health Inquiry Report, mental ill-health and suicide cost the Australian economy between $43 billion to $70 billion in 2018-19, including the direct cost of healthcare expenditure and other services and supports ($16 billion), the cost of lost productivity due to lower employment, absenteeism and presenteeism (ranging from $12 billion to $39 billion), and the informal care provided by family and friends ($15 billion).

There is an additional economic burden of mental health service use associated with loneliness. A systematic review on the economic costs associated with loneliness highlights that loneliness is associated with excess healthcare costs. Loneliness is associated with an increased number of general practitioner visits and frequent use of hospital services in older adults and people with psychotic disorders in particular, independently of other sociodemographic factors and health needs. Tackling loneliness could therefore assist with reducing waiting time and improving access to health services.

Fortunately, investment in loneliness initiatives provides clear value for money. In 2019, economic modelling conducted by the National Mental Health Commission shows that for every $1 invested in programs that address loneliness, the return on investment is between $2.14 to $2.87 respectively.

Work Productivity Costs

While extensive economic modelling of loneliness in Australia has yet to be comprehensively quantified, the costs are expected to be significant enough to warrant our immediate attention, especially as it relates to workforce productivity. The New Economics Foundation Report estimated the cost impact to employers from poor health and wellbeing associated with loneliness. In the UK, loneliness cost non-private employers £2.53 billion and private employers £2.10 billion per year. This includes the cost of working days lost due to poor health associated with loneliness (non-private: £20 million; private: £16.5 million), cost of caring responsibilities due to poor health associated with loneliness (non-private: £200 million; private: £183 million), loneliness due to lower job satisfaction and productivity (non-private: £665 million; private: £549 million), and volunteer staff turnover (non-private: £1.62 billion; private: £1.32 billion).

Investments in loneliness initiatives lead to clear economic benefits for Australia and are critical to Australia’s recovery, yet specific capacity to deal with growing rates of loneliness has not yet been systematically designed, created, or widely implemented.

The Solution

A National Strategy to Address Loneliness and Social Isolation

Loneliness has a detrimental impact on health and wellbeing, productivity, and functioning in daily life. One in four Australians aged 12 to 89 experience problematic levels of loneliness. At any given time, the estimated prevalence of problematic levels of loneliness is around 5 million Australians. While the financial burden on Australia’s health service has not been quantified, equivalent costs to Medicare in the USA have been estimated at $6.7 billion annually . Given the high prevalence rates of loneliness and the exacerbation of this issue as a result of the COVID-19 pandemic, Ending Loneliness Together is urging the Federal Government to consider addressing two additional major gaps to deliver a more sustainable, effective and efficient response to address loneliness and social isolation, in order to promote the social recovery of all Australians, including:

  1. A lack of community awareness and skills on how to manage loneliness and social isolation; and
  2. The absence of uniform standards and guidelines within community and mental health systems.

In our 2021/2022 Funding Submission, we propose four specific solutions which can be implemented to cover these gaps. We propose addressing these two gaps can be delivered within a wider national strategy to reduce loneliness and social isolation.

The benefits of a National Strategy to Address Loneliness and Social Isolation for the future of all Australians are multiple. The road to recovery from the COVID-19 pandemic will be long and arduous – with significant costs to the Australian economy. Ending Loneliness Together calls for the Federal Government to consider significant investments to advance this work to ensure an effective and extensive impact on combatting the next public health issue facing Australians.