A Conversation About… Social Isolation, Loneliness and Mental Health

Disclaimer: The following transcript has been autogenerated and may contain occasional errors or inaccuracies resulting from the automated transcription process.

Host (00:01):

Hi there. Welcome to Mental Health Professionals Network podcast series MHPNs aim is to promote and celebrate interdisciplinary collaborative mental health care.

Dr. J.R. Baker (00:18):

Welcome to this episode of MHPN presents, a conversation about social isolation and loneliness. My name is J.R. Baker, and I am the CEO of Primary and Community Care Services, the Australian Social Prescribing Institute of Research and Education and an adjunct associate professor at Southern Cross University. I am hosting this episode and when I was approached to do so, MHPN asked who I’d like to join me and the first person I thought of was Rosanne Freak-Poli and I’m delighted to welcome her here today.

Dr. Rosanne Freak-Poli (00:47):

Hi J.R. It’s great to be here.

Dr. J.R. Baker (00:49):

Today we’ll be talking about social isolation and loneliness and Rosanne, I’ve long admired your work in this field, including some of your earlier work I think you did on happiness, and I think you had access to the Rotterdam study, is that right? Correct.

Dr. Rosanne Freak-Poli (01:03):

NHMRC kindly funded me on a fellowship to go overseas to the Netherlands where I had access to the Rotterdam study, which is a longitudinal cohort, following people at that time was for over 20 years and I was able to look at factors earlier in life that may influence health later in life that were maybe a bit

different, which is what I love doing is looking at things that we don’t know are risk factors for health. When it came to happiness, I didn’t see an association, so it’s semi-beneficial to know that sort of personality disposition is not linked, but it is linked to health behaviours. So, I was able to unpack that a little bit in the Rotterdam study.

Dr. J.R. Baker (01:47):

And so, you’re a life course epidemiologist. Can you tell us a bit about what that means?

Dr. Rosanne Freak-Poli (01:52):

I fluctuate between a life course epidemiologist and a social epidemiologist. There are slight differences, which I won’t go into that today, but essentially, I’m interested in social determinants of health, which are all these other factors that happen over our life course. So not looking at one point in time and how that influences our health. So, I am sure you have changed your eating habits or your exercise habits over your lifetime and a lot of times we just look at one point of our life, but really these are changing habits and how that affects your health in the long term may change as well over time.

Dr. J.R. Baker (02:29):

Yes, my eating habits, I still eat like I’m playing sports seven times a week, but it’s not quite working out that way. So, what got you into the field of epidemiology?

Dr. Rosanne Freak-Poli (02:38):

I saw that social isolation and loneliness started to have a bit of evidence behind it for being a risk factor for cardiovascular disease, mainly is where I came from. So, I’m looking at hard- what we call hard outcomes, diagnosable outcomes and I was interested in exploring that a little bit further at the time, which we can unpack in a minute. They use these terms, social isolation, social support, loneliness a little bit interchangeably, which I have a bit of an issue with. Do you agree with that statement J.R.?

Dr. J.R. Baker (03:09):

Yeah, I think the language is quite fluid and I suppose the constructs underpinning everything are a bit all over the place. So probably is worth unpacking that. Do you wanna do that now?

Dr. Rosanne Freak-Poli (03:20):

Yeah, let’s unpack that so we can have a good understanding of what we’re talking about. So how would you describe social isolation?

Dr. J.R. Baker (03:27):

Social isolation, I would just say that’s the sort of objective absence of relationships or sort of supports the structures that leaves someone feeling, I’ve gone subjective already, but it leaves someone objectively isolated. So, I guess the simplest sense, some things are made to isolate people. So solitary confinement would be the, the cleanest example in a prison system of what real isolation looks like.

Dr. Rosanne Freak-Poli (03:49):

Yes, I would agree that it is social structure in a sense. The way that we live at the moment, sometimes we can have very few contacts with people and if you’re having few contacts that would be then social isolation and then there’s social support, I guess is another key concept that we discuss. Do you want to have a go at defining that one for us J.R.?

Dr. J.R. Baker (04:10):

I tend to look at that as a sort of complex one. So, it could be anything from, if you think of supports, I tend to think it could be your mum giving you nurturance and guidance. So that’s one side of things. Or there’s the brother or sister who helps you move your house, which is a different type of constructive and instrumental support. But then there’s the actual emotional supports of having other people around you who could potentially discuss things and support you in various ways. And I guess you could keep going and going, but I have a feeling you’ll have a cleaner, simpler definition.

Dr. Rosanne Freak-Poli (04:39):

All those things they’re great. I guess the one thing I’ve noticed that comes up in the scales that we used to measure is this sense of self-worth from the social context. And I don’t think that that’s really discussed a lot, but there is an element that you are not only supportive, but you are able to support other people and there’s value in that support.

Dr. J.R. Baker (05:00):

That’s interesting. Yeah, we have a bunch of SKillness groups in Queensland and New South Wales where we actually try to provide opportunities for people to learn different skills in their sort of areas of interest or passion. And one of the things that seems to come out is that there is that validation of the skill sets someone has. So, there’s that confidence that people giving that feedback can provide, which builds the confidence and self-efficacy, but just as much people seem to really like to give back to others and to actually foster those sorts of things. So, it’s a beautiful dynamic relationship and that sort of social support domain that I don’t think we attend to a measure very much honestly. Most of the research always seems to default to the lucky third category, which is loneliness. So, do you wanna go for loneliness first?

Dr. Rosanne Freak-Poli (05:44):

Well, I guess this is how I describe it is an unwanted feeling of being socially isolated and having low or lacking social support. So, it’s definitely a subjective measure and importantly someone could be considered socially isolated on a scale and consider having low social support on a scale, but they don’t feel lonely. And that’s where I think sometimes it’s difficult to get our head around how subjective these feelings are.

Dr. J.R. Baker (06:13):

Yeah, absolutely. Or you could be lonely in a big group of people. So, I suppose the perfect high school movie from almost every Disney or other film has always been the person surrounded by people and not isolated in the slightest bit but still feeling like there’s no one around who has that quality of a relationship or that they can really turn to that sort of feeling of, yeah, that that subjective feeling of kind of feeling isolated but not necessarily being isolated in the inverse. It is interesting ’cause you can be quite happy to be going off and camping for six months and not see another person if that’s your sort of temperament. So, it really does come down to the person. Alright, so we’ve covered off on some of the concepts we’re gonna talk about to start with. It might be good just to talk about some of your reflections on the effects of loneliness on a person and social isolation of course. How does it affect them mentally? Then what are some of the other sort of follow on effects?

Dr. Rosanne Freak-Poli (07:00):

Yeah, I guess the thing that I start with when it comes to how socialising affects us is really around it being part of our quality of life. So, if you look at how we measure quality of life, social connection is one of the key factors.

Dr. J.R. Baker (07:17):

I mean in terms of quality of life, it’s interesting you say that. I’ve spent most of the last couple days looking at how leisure has changed I guess in the last 50 years. And once upon a time the cinema was a cool important thing I guess because you would go out and maybe have dinner, some people would dress up for the cinema and they could make a whole night out of it. It was a date night, it was a friendship night, it was couples getting together, you know, it had a lot of meaning. And now cinema, you know, we see the red carpet shows but what’s a bit different now is it’s not necessarily a social connection exercise. It could be downloading something quickly from a streaming service, watching it, consuming it and never ever seeing it again of forgetting it existed. So, there’s something about the change in quality of life, so to speak, I guess in terms of consuming things as opposed to actually being able to enjoy the benefits of social life and in in reality leisure. I don’t think many of my friends go play golf and tennis every weekend. I don’t think many of my friends go play bingo. Definitely not. I don’t even know if many of my friends go walk around the shopping centre anymore because a lot of them get stuff off from internet websites or Amazon or whatever else it is. So, in terms of quality of life, what does social wellbeing look like in, in the grand scheme from your perspective?

Dr. Rosanne Freak-Poli (08:30):

Yeah, I think there are good points about how our lives have changed and with these new technologies, specifically the last 20 years, we’re finding that the way we interact with people are changing. And I do wanna acknowledge though at the same time that the internet and online social media can provide safe spaces for people who are marginalised. So, in some respects it can provide subgroups of people that find their people online that those social connections may differ. I think that FaceTime or the programmes where you can see people that are speaking like Zoom and such are good, but once you get onto text messaging and these online forums, I’m not sure if there’s as much benefit.

Dr. J.R. Baker (09:21):

Yeah, I suppose that the less human it is really the more complicated those sorts of things are in terms of reading what people are actually saying and trying to read between the lines with text-based messaging and those sorts of things, you lose a lot of the verbal cues and the visual cues. You can’t hear a tone of voice; you can’t really see what’s happening. And so, you can connect on a concept, but you can’t necessarily actually understand the same way what someone’s saying or what they’re feeling. So, you lose those sort of relational touch points. That is a bit of an issue in terms of what you just said about marginalised groups of people who might not always be able to find their people. A hundred percent. That makes sense because the internet’s the great enabler of I guess finding whatever you’re looking for ultimately.

(10:01):

And you can get quite specific in that sort of thing and wasn’t particularly planning to ask this, but what about the opposite consequence of that do you think? Because I guess in being able to find that so to speak, bonding social capital where you can find people of super similar interests and belief structures and lives and identities. In a sense the contrasting kind of social capital is that bridging capital, which is like the people who might not really be like you, but you have something else in common. My favourite thing since you’re down Victoria way right now, footy. The footy is the great unifier I guess down there. So, you can all go to the MCG, and everyone can barrack for the same team, but someone might be super rich, someone might be super poor, someone might be Catholic, someone might be Jewish, you know, insert whatever sort of differential sort of identifiers. So, the internet really makes it easy to kinda find very like I guess but the footy and once upon a time I think religion when people used to be frequenters of church you could have differences in class and experience and gender and all sorts of things. What do you think about that sort of moving away from bridging capital towards that really clean bonding capital and what the effects of that could be?

Dr. Rosanne Freak-Poli (11:12):

Yeah, it’s actually a very scary future when you put it like that because we already know that we live in bubbles and so how far your bubble extends to in include people that are not like you is the question, right? So, my bubble only extends so far, yours so far, do they meet, and the internet restricts that bubble and then we have these robot holes or these social media sites that push content that’s more like you. So, you start thinking that the world’s more like you and then you can’t see the world from other people’s perspectives. So, there is a scary future there where we are taking away physical contact and leaving our house to go experience the world in real life, so to speak, which is what we saw during COVID, I guess, that bubbles got very small.

Dr. J.R. Baker (11:58):

Yeah. How interesting. And the impacts and empathy you just raised. I mean that’s what, I go to empathy ’cause I think go back to Carl Rogers always trying to describe everyone being an island unto themselves and you could try to build a bridge across, but it wasn’t always the most obvious thing, and you could never really understand how to stand in someone else’s shoes. But at least those opportunities were super there before COVID in particular and they’re coming back now, but the footy matches during COVID definitely not a thing. In fact, it was a time I guess when you could really get into a very small bubble because it was your interests that were technically possible. They’re digitally connected I suppose, and physically disconnected and your family or your support structures. So, talk to me a bit about COVID <laugh>.

Dr. Rosanne Freak-Poli (12:42):

I’ve got a question for you around COVID.

Dr. J.R. Baker (12:43):

Yeah okay

Dr. Rosanne Freak-Poli (12:44):

Because, I mean, I’m in Melbourne so we had some of the harshest restrictions and I know some people that have reevaluated that they were engaging too much before COVID. So now that the restrictions are over, they have do less, which is great if that’s of benefit to them. And at the same time people really, really love socialising and then they weren’t able to do it and now they’re back to full capacity again even more because they missed it. I’m wondering if it was like that in your experience outside of Melbourne. But also, whether we really care about people that were lonely in COVID and are not lonely now? Like that transient, is what I’m thinking, that transient loneliness isn’t really an issue.

Dr. J.R. Baker (13:28):

Oh, two good questions. The easy one is covered for me. I mean it was a really peaceful time. I have to say traffic was good and there’s horrible things don’t get me wrong. There was lots of things that weren’t great about it but like the quality-of-life convenience stuff was actually, I think it brought out bad traits because I was so used to a quiet shopping centre that once people were back, I was like, Ooh, do I really actually wanna go shopping that much? Possibly not. You know, I learned that sort of comfort with distance and not wanting to necessarily be in a crowd of a thousand people going into Myer for some sort of sale or something, bush walking and, and getting out nature and doing the stuff that was available. The gift of COVID, if there was a gift, was some people define anxiety as having too many choices and so COVID reduced a lot of the choices.

(14:14):

So how many times a week am I going to the grocery store? Probably one, what can I do for fun? Well, I can play games online with someone or I can go out for a walk doing exercise in the bush. But yeah, there was always so many options. The gym wasn’t necessarily on the table, but you could do pushups, or you could do jumping jacks. And, so I think there was a comfort in not having to think and decide as much and not having to battle traffic and not having to battle crowds. And there was a simplicity of life, which is different though of course to being in the longest lockdown in the western world. That’s a whole different exercise. I think having the, the freedom of movement still that definitely helps because that paradigm of control and feeling outta control and learned helplessness leading to those sort of negative effective things that wasn’t as present. So, I think there was a whole second set of complicated things going with that loss of control and loss of social connection and that feeling of being on a rollercoaster that was a small box that you were locked into. That’s a whole different access to us. But I dunno if I answered your first question but-

Dr. Rosanne Freak-Poli (15:15):

Oh, yes you did. But I’ll, I’ll make a point about your first, you know, answer is that you’ve made a comment about this lingering effect of COVID so you’re still questioning, you know, how much we interact. We become much more aware of our interactions, not only like if we’re benefiting from them, like are we wanting to socialise with this person but also just going to the normal grocery store or out of our house. And I guess that is the problem is if we are doing less of those then we are not having those by mistake bumping into people, which is also part of being in a community and those social interactions that are just not planned. And I guess someone that is socially isolated, if they leave the house with the intention of hopefully bumping into someone and then there’s less of us moving around to bump into, then it is creating a little bit more of a problem for those people that are already socially isolated in our communities.

Dr. J.R. Baker (16:12):

Yeah, as you said that I kept thinking of all the virus movement pictures with the velocity and the balls bouncing around and the infection rates and that was the argument was if you don’t move about and you stay at home, you know that was a taught known behaviour. So, it is interesting and definitely my movements are definitely different now. I think that the hardest thing is I did let go of some of my favourite hobbies and not as a result of not liking the hobbies it was ’cause I reconsidered the people who were at the hobbies. and I just said something about bridging capital, all the rest of it, but I realised I didn’t like how they treated or acted towards other people to such an extent that it wasn’t in my tolerable threshold anymore. So, I’d excused lots of behaviours before that and it’s a bit concerning actually that I’ve given up a lot of my passions on the basis of that. So, if anything I’ve taken that away. I can reflect on that now for the next couple weeks. I feel like you had a second COVID question after what that took me on,

Dr. Rosanne Freak-Poli (17:09):

I did have a second COVID question <laugh>. It was around transit loneliness or transit social isolation, doing COVID restrictions. Like, do we care if someone is now with the restrictions removed, not lonely anymore?

Dr. J.R. Baker (17:26):

Yeah. Do we care in general about all sorts of components of that? I suppose I mean the good news with COVID is I think it shined a light on that feeling of disconnection or wanting a longing or I’m trying to remember, I had to try to speak to someone using Google translate in Portuguese the other day and I think they described it as that feeling of extreme longing. That’s how they actually simplified it. For me, it was a very odd conversation clearly if I’m speaking in translated Portuguese to someone. But anyway, the bigger issue isn’t belonging. I think it’s when it’s extinguished and when we’ve kind of accepted that social disconnection, but we still don’t feel well about it, I guess. So, there’s a set of people that COVID really made us hone in on and we focused on particularly people who were older and who might be isolated but with other people.

(18:13):

So, people in aged care facilities we, we were really concerned about, and it was the first time that question came up of what if their family can’t visit? You know, and that’s almost a gift. If you have family living locally who can visit, that’s a kind of wonderful thing. So, it’s a horrible thing to lose it. But there’s a plenty of people who don’t have any family nearby at all. And some of the work we’re doing in southeastern New South Wales, which has been brilliant, we’ve been finding lots of people who don’t have family nearby. The family moved to big cities, they moved to Melbourne, and they moved to Sydney and they’re not living in a regional area anymore. And as the person gets older, their family might have moved off and left them in a regional sort of setting and their friends have gotten older and their friendship networks have shrunk.

(18:55):

You know, their loved ones have passed away, some of their friends have passed away, are moved into aged care facilities. They themselves get to that point in life where they might be moving into an aged care facility and it, it creates this sort of question of how to connect practically in a particularly complicated time. So, a lot of the people we’ve been working with during social prescribing and linkage and care coordination services are in those sorta things. They don’t have the money necessarily to go move to Sydney, you know, they might be living in a modest nice happy regional house and with a very limited network. So, it raises all sorts of questions in terms of the, the movement of priorities because sometimes you wonder what the attractions are of the big city life and there’s tonnes of them, you know, there’s cafes and restaurants and art galleries and concerts and all that stuff.

(19:42):

I mean at the same time there’s this weird isolating environment where there’s not neighbourhoods, there’s not a town of 200 or 500 or a thousand people where you know everyone’s name. There’s not that natural someone checking in on you because they recognise that you don’t look like yourself because they see you that much being in the middle of a million people or 6 million people as it might be, but not actually being connected to anyone. So, I was hoping you might talk to me a bit about how you see loneliness and socialised isolation working in metro environments and regional environments. And you can go as wide, as narrow as you’d like, but be curious to hear your thoughts.

Dr. Rosanne Freak-Poli (20:21):

I was asked this question today actually about the location, like a special Australian demography, geographical demography and how that interplays with social isolation and loneliness. And I don’t think we have the answer. I know that there’s some research that says one way and then it says the other way. So, depending on what you wanna write you can reference it but really, we are not completely sure, And I think it’s because it really comes back to this theory that I have about our evolutionary behaviour of being in small groups to survive. And this fact that Kari Karo said that loneliness is almost like a signal, like thirst and hunger is triggering a need for us to socialise because it’s like an evolutionary trait. So, I think in regional and remote areas they may be more community, they may be talking to each other, they may be small villages that we were living in you know, a hundred years ago, 200 years ago where there were 300 people in your village, and you sort of knew everyone and it was large enough to be different but small enough for you to be in a community.

(21:32):

And maybe that’s what’s being simulated out in regional areas. And then in the city it’s a bit like being alone in a crowd where you really have to make the effort to get to know your neighbours. Literally the people next door you may never talk to unless you go out of your way to meet them. And in a way it takes two because the neighbours have to wanna know you <laugh> and not be too busy in their full-time jobs that we work overtime in. So, I’m not sure what the answer is there. And I do think that that’s something that we need to unpack a little bit more in Australia, especially when we’re looking at research that comes from overseas. They’re talking about if you look at like at the population density, so much more dense even in the cities but also suburbs are a lot more dense than what we’re talking about in Australia.

Dr. J.R. Baker (22:14):

Interesting. There’s something about cities, to me it’s probably the real thing. Oddly enough today I was having a discussion about convenience and value. It’s a bit of an odd one ’cause people always talk about volume and value and healthcare tends to be, you know, measured in terms of volume. So how many occasions serviced or how many sessions did you have with someone, or Medicare items have you billed? And then that’s sort of the output that we measure health service success with when we don’t have any other metrics, which is a lot of the time and convenience seems to be the number one driver. So whether we wanna watch a TV show, it has to be now we wouldn’t dare as to wait a week until the next week and wait for the commercials that people used to sell. Everything has to be instant and when we want food, we want it now.

(22:57):

So, Uber will deliver it. You know, the city in a sense is even like the Amazon Prime key area where you can get same day deliveries a lot of the time. So, does that mean you’re getting the best thing? Is there value in that that that’s not something that seems to be the question? And where is the value in having neighbours that you would they help you if there was a fire? Would, would they even knock on your door? It is interesting evolutionarily; I would assume that part of the value of being together was looking out for each other. That was probably the number one value. And even if you think in in some rural communities that there’s no one else to help you put out a fire, then you have to help each other put out a fire. And if there’s no one else there to help you rebuild a fence that gets locked down, then you have to help each other to build a fence.

(23:43):

And in the city, all you can is get a really quick latte in some regards, which I don’t know, I mean it’s not a bad thing, don’t get me wrong. Or maybe it is because I don’t know if anybody needs that much sugar and coffee anyways. In the course of the week, what do you see as some of the sort of things that might be lost? I know you said you can be a stranger in a big city, and you could have people everywhere, but what would be some of the benefits of that sort of smaller model of, of living and what do you see as being lost as a result of moving away from that?

Dr. Rosanne Freak-Poli (24:10):

So, I think there is this element that in bigger cities we do have more stuff to choose from, right? So, I might go to four different supermarkets in a week and if I went to the same supermarket, it might be a big supermarket that I might eventually get to know a teller, right? But I sort of don’t live my life like that in the city. I’m sort of like sporadic. I’m on my way home, I’ll just drop off at this convenient one or maybe I’ll go to the supermarket in the city where my trains connect. Whereas in a smaller community you may have less choice and then you do get to know the people behind the counter. You get that sense of familiarity. They may notice that you’re not coming in and then they may ask you about that, I hope everything’s been okay, I haven’t seen you for a while.

(24:59):

And it sort of opens up those conversations that turn into maybe friendships somewhere along the way that we just don’t get, we don’t get that opportunity in the bigger city. So that sense of community. Yes. The other thing is that in a city people are much more transient with their suburbs, I’ve noticed. So even if you’re living in Melbourne, you may live in five very different areas in your life within Melbourne. Whereas someone in a regional area, they’re probably not going to change from one regional area to another. You’re probably gonna stay in that regional area and still access the same shop. So, it’s like this lifetime of accumulation of faces and people you know and potentially generations that you get to know. What’s one of the things that you think we might be losing?

Dr. J.R. Baker (25:43):

Simplicity. I could misquote a bunch of authors right now. I think it was in a book Walden Pond and there was a quote, I’ll probably get it wrong, but that’s okay, it’ll be stored in perpetuity now in this recording. But it was simplify, simplify, simplify, simplicity, simplicity, simplicity. Something to that extent because the concept was living out in nature, the world is a bit simpler and easier. You know, water is the thing you drink, food is what you grow, the people who can buy are the company you have, and you keep a couple chairs there for any visitors. And it’s something nice about having one IGA or something or one corner shop where you shop from that doesn’t have 52 well of oils. Like it sounds appealing to me not to have as much choice to be honest. I know it’s supposed to be the epitome of convenience and civilization is something to have a million choices. But it sounds like torture, just talking to you. I wonder if the reason we need all this AI stuff is because we’ve created so much choice as a consumer and what’s instantaneous stuff that now we need a computer to help actually figure out what to do and to write and to think. So-

Dr. Rosanne Freak-Poli (26:46):

You’re reminding me of an Obama quote I read, he had two colour shirts when he was in office, and I think two colour suits and he said that’s enough. Exactly the same. There’s multiple of them because he says I make enough choices in a day; I don’t need to be making a choice about what he wears. And no one noticed <laugh>, I don’t think. I never noticed it until I saw the quote and then I looked back and saw, yeah he does and have two coloured shirts and two coloured suits. So much easier. And there is something to simplicity and honing in about where you want to put your energy in making choices that maybe that provides.

Dr. J.R. Baker (27:21):

Yeah, and it’s that anxiety definition which is anxiety is too many choices ultimately in the indecision point because until you decide too many opportunities, it’s not a good thing. I mean it sounds like a good thing being offered 10 great jobs at the same time sounds amazing, but then having to think through all the permutations and what would be best for you and what’s best for your loved ones and where does that mean you relocate and all the extra stuff. Sometimes too many choices isn’t as great as it sounds. Not trying to say I want a world with no choice. Definitely not trying to say that, not a proponent for that. But it’s interesting ’cause not choosing between more than two shirts sounds lovely and in reality, I don’t know how much extra value a third, a fourth or a fifth shirt would offer.

(28:04):

That’s the interesting thing. There’s that around that vertical identity formation now with the internet, which is before you just had to benchmark against your schoolmates or your neighbours or whatever else. And now you can benchmark against Prince Harry and this celebrity and that person and all the good that Instagram does for promoting good food pictures. It also promotes all sorts of other stuff where you have constant comparison. Like not everyone can have a new LV bag or Hermes bag. The point is I suppose there’s a million expensive things that you can ever have enough money in the world unless you’re in that very lucky percentage of people, the top 0.001% to get and we all get to work harder ’cause you mentioned longer hours, just putting together the whole conversation in my head right now. So, we’re working harder to have more choices to buy expensive stuff, which is probably about the same as if we had less choice than actually have some time with other people.

(28:55):

So, it’s really a question of choice in a sense. And we’re choosing a lot of the times work, which is important. I’m a big fan of work, it probably puts me in a minority of people, but I love work. But yeah, I think I’d pick friends over having to figure out the rest of the stuff and I can deal with one olive oil. So, I guess just to bring it all together, assuming for whatever reason we’re feeling a bit isolated and lonely. And just to go sort of the extreme side now, because I don’t think we actually talked about some of the health long-term consequences. What’s the bad picture if we don’t change things, if we don’t actually sort of support that re-engagement or reconnection for people? So, if they do feel lonely and they are isolated, well what’s the end result? What does that look like?

Dr. Rosanne Freak-Poli (29:37):

When I’ve done some of my research, I’ll draw specifically around an Australian sample of 70-year-olds or more in Australia that are healthy. They had no other impending doomsday coming in the next five years. And so, there’s no real reason that they’re not socialising or doing other things. And what we found was that most of them were in good social health so that they weren’t lonely and were socially connected and had support. But the ones that didn’t, they were much more likely to have cardiovascular disease within the next four years. So, there is something mechanistically behind socialising and we’re still unpacking that. We know there’s pathways through risk factors so that if you are socialising other than you know the youths socialising around alcohol, when we do socialise, we, we generally are doing better lifestyle behaviours. So, we may be exercising, like to go visit someone, you physically have to get there.

(30:41):

You may exercise with people; you may eat better in front of people. We all know that eating by yourself, you may get a packet of chips out rather than <laugh> pack of dip and biscuits. So there are elements, there’s causal pathways but maybe there is that unmeasured factor that it is part of our genetic history to socialise, survive. So that’s just one element and I was revisiting some of my research from the Rotterdam study and in Sweden also looked at longitudinal cohort there and the risk of being lonely was associated with double the risk of dementia, which is crazy if you think about what we know about dementia, we know so little that that actually prevents dementia and to think that socialising can prevent dementia. I don’t know why we’re not doing more. To really focus on that as a risk factor for our health and wellbeing is a modifiable risk factor.

Dr. J.R. Baker (31:37):

No, absolutely. Now that you mention it, I guess, sort of leisure things that we’ve kind of started the conversation with, they are the things that give you that multis sensorial activation, you know, going out and gardening with friends, you’re smelling, you’re picking, you’re touching, you’re touching soil and sure as you get older you might not wanna be kneeling on the ground all the time and you might move to knee pads and then to a seat. But that sort of touching and interacting is great dancing, very social and great singing, great drawing, painting, doing crossword puzzles, playing jeopardy, all that stuff actually does activate all sorts of different sort of aspects of your brain effectively, honestly. ‘Cause you are using all those different senses and, and cognitive capabilities.

Dr. Rosanne Freak-Poli (32:22):

Even walking down, the street and smiling at people honestly improves your cognitive function. Like they’ve put little helmets on people and it with electrodes and looked at it. So, there is something about the way we interact with humans that matters for our brains and our bodies. And one of the things that I have been thinking a little bit more is that people probably just don’t know all the things that are available and the free things that are available through local councils, libraries, neighbourhood houses, park, run, these are national services that most communities have access to and people that aren’t utilising them. So, there are things out there that don’t cost money. And I’m coming back to what you were talking about this cost. Anyone can socialise, like it’s not a cost barrier I guess if you have more money, you have more opportunities to socialise with hobbies, it may be more expensive, but in every community that the councils are attempting to find affordable options for people and that subsidised options at community houses for example or free things at the libraries. So just be aware that they’re there for whenever you want to look into them. <laugh>.

Dr. J.R. Baker (33:34):

Fantastic. And just to sort of close thing this off, for anybody who’s listening who might be working with somebody who’s lonely or isolated I think those are great suggestions. Is there anything else you’d add in terms of where they might point their client or patient or however, they refer to the person that they’re trying to help improve their quality of life? What would be your takeaway message? I suppose for anybody listening.

Dr. Rosanne Freak-Poli (33:55):

At the moment? We’re a bit behind the UK who’s got this great infrastructure happening to get social prescribing, which is getting GPs and allied health professionals on board with conquering social isolation and loneliness through these connections like inviting them to partake as part of their social care model. We’re a bit behind that. So, at the moment some GPs are open to it, some people aren’t. But at the moment unfortunately it’s going directly yourself through the neighbourhood houses and the community. Would you say that that’s the best method at the moment?

Dr. J.R. Baker (34:30):

Yeah, so there’s neighbourhood houses and community centres and PCs and all the stuff that existed once upon a time. I think if you think about where people would congregate for that bridging social capital, it was your churches and your scouts and your red crosses and all these sort of RFS, CFA, it depends what state you’re in, but your fire services and your volunteering organisations and your history tours, you know, where people would share their sort of learnings and they might teach you about the history of the architecture of building or the significance of an old landmark or whatever else. And some of that still exists and some of that you can get pretty free and cheap and some of it you can create that capital for other people I suppose. But yes, I would say there’s not a one size fits all directory and there’s definitely not a workforce that we’ve commissioned like in the UK and other places to help people find all the opportunities available in the short term.

(35:25):

I think it’s just relying on some good common social sense in a sense, trying to find out what matters to people, spark some interest and it’s trickier now because you have to overcome those divides. Even footy teams are a divide I suppose. So, you can’t even just say go find some footy fans. You better make sure, particularly in Victoria, that they barrack for the same team. Yeah, this, the whole world is still out there, it’s all there. And sometimes it’s just a bit of coaching around confidence or the actual self-efficacy to get out there and to try stuff again and that, that makes all the difference. So, I guess rely on capabilities and intuition and instinct that people you’re working with, and they’ll probably know what they enjoy and they, they might just need that sort of hand on the shoulder just to realise they can go and do that sort of stuff, particularly if they’ve lost practise with social skills, which was so easy during COVID to forget.

Dr. Rosanne Freak-Poli (36:13):

And I think that also if you are, you know, worried about someone, you know, if you’ve got someone in mind inviting them to go to something with you and being there the first time, they go is probably the golden thing because if they go once, they see it’s not so scary and then maybe they’ll go again. Maybe might need to go a second time. But I do think it can be difficult for people if they haven’t been socialising to remind themselves <laugh> of how to do it. And having someone there to do it with is golden.

Dr. J.R. Baker (36:47):

Fantastic. Alright, thank you so much for their conversation and thanks everyone for joining us on this episode of MHPN Presents A Conversation About social isolation and loneliness. You’ve been listening to me, J.R. Baker and

Dr. Rosanne Freak-Poli (37:00):

Me, Rosanne Freak-Poli.

Dr. J.R. Baker (37:02):

We hope you’ve enjoyed this conversation as much as we have. We’ve covered a lot of ground which we trust as of interest and hopefully of use to you. If you wanna learn more about Roseanne or I or if you just wanna access resources that we can list, go to the landing page of this episode and follow the hyperlinks, MHPN values your feedback. So, on the landing page, you’ll also find a link to a feedback survey. Please follow the link and let us know whether you found this episode helpful, provide comments and or suggestions about how MHPN can best meet your needs. Thank you for your commitment to an engagement with interdisciplinary person-centered mental healthcare. It’s goodbye

Dr. Rosanne Freak-Poli (37:38):

From me, Rosanne Freak-Poli,

Dr. J.R. Baker (37:40):

And J.R. Baker.

Host (37:43):

Visit mhpn.org.au to find out more about our online professional program, including podcasts, webinars, as well as our face-to-face interdisciplinary mental health networks across Australia.