The sixth meeting under the theme of ‘Talking about the Human Rights of Older Persons’ took place online on April 5, 2022 with Dr Michelle H. Lim. Dr Lim is Senior Lecturer in Clinical Psychology and leads the Social Health and Wellbeing (SHAW) Laboratory at Swinburne University of Technology, Australia. She is also a founding member of Ending Loneliness Together (ELT) and the Global Initiative on Loneliness and Connection (GILC). As an academic researcher and as a clinical psychology practitioner, she is interested in how loneliness can negatively impact social functioning and exacerbate mental health problems. She has been active in examining various solutions to loneliness-related mental health symptoms.
During the meeting, she introduced the rationale behind launching the Global Initiative on Loneliness and Connection (GILC) and its evolution to date. She also addressed her key messages and arguments in relation to her research and implications for the human rights of older persons.
1. Introducing Ending Loneliness Together (ELT)
Dr Lim is founding member and currently the inaugural chair and scientific chair of Ending Loneliness Together (ELT). ELT is a national charitable non-profit organization which started in 2016 in Australia. Loneliness had become a critical factor that affects mental and physical health across all ages. The research outputs and reports the ELT produced have been reference points for many governments around the world.
2. Introducing the GILC
Dr Lim is also founding member of the Global Initiative on Loneliness and Connection (GILC). Initially, a conversation started between the USA and Australia and it then developed into a global project with the intention to channel each other’s different strengths: Australia has strength in science (scientific research), the UK has rich experience in practice and the US has well-developed policies. Its engagement and activities have further expanded to the global level, with the WHO and the EU Commission paying attention to the work of GILC and related organizations joining it in the course of disseminating research outcomes to, and cooperating with, other institutions. The GILC is officially registered in Washington D.C. since 2021, currently having ten member organizations from Australia, New Zealand, Germany, USA, Finland, UK, Brazil, Canada, Denmark, France, Zimbabwe, and Japan.
At the launch of GILC, the WHO suggested to collaborate on the issue of social isolation and loneliness but given that this issue affects individuals across all age groups, the GILC and WHO decided to work together but expanded the focus to every age group beyond that of older persons. The partnership with the WHO is soon to be formalized. In addition, the GILC works closely together with the EU, providing free consultation to the latter in monthly meetings. For instance, it provides guidance and support to the EU in training researchers on chronic loneliness, conducting research on the relationship between social media and loneliness and measuring loneliness levels in different countries. Working together with these international and national institutions, the GILC tries to create global synergy in systematizing study and research on loneliness and social isolation.
3. Loneliness in Australia
It is unfortunate to note that many older persons in Australia are not well treated and their basic rights are not fully respected. However, there are some welcoming signs of more investment in and concern about older persons.. Loneliness is a major agenda ahead of the 2022 federal elections scheduled in May. There is the Parliamentary Friends of Ending Loneliness and there is increasing awareness in policy circles that loneliness and social isolation are of critical importance particularly to older persons. In fact, while the GILC addresses the issue of loneliness across all age groups, it is supported by the largest age care provider in Australia called Bolten Clarke. Older persons tend to suffer greatly from loneliness and social isolation as their social networks become smaller and they have to move from their communities into age care facilities. We are now at a critical juncture where we need to rethink loneliness and social isolation for older adults and how to better help them.
4. A Global Approach to Loneliness
Loneliness is a subjective feeling which is to a large extent influenced by culture and norms specific to country or region. For instance, older people living in a cultural environment where family bonds are weak between adult members tend to feel less lonely even if they do not see each other often. In this context, a global approach to loneliness might encounter difficulties in developing and implementing interventions that are globally applicable. However, a global approach to loneliness does recognize cultural nuances and accepts the fact that loneliness should be assessed through different cultural lenses and that solutions should reflect these cultural nuances: while loneliness is seen as a result of individuals’ fault or personal deficit in some countries, it is seen as a fault of society in other countries. However, regardless of where one lives and whatever the causes, people everywhere experience loneliness sometimes and to some extent. A global approach aims, as in the WHO’s Global Advocacy, to promote cultural shifts to some extent so that society takes more responsibility, and to influence all governments to make sure that they provide their populations, particularly older persons, with adequate social health and social care. A global approach also means that loneliness is not only a problem that affects people in high-income countries but also many individuals in low- and mid-income countries. While recognizing the diverse ways in which loneliness is dealt with and that different societies face different barriers to resolve it, it is important to understand that if loneliness is neglected there will be dire consequences in terms of mental and physical health.
5. Key Messages
The very start of addressing loneliness was based on Dr Lim’s own experiences as a practitioner with patients with serious mental illnesses. One of the interesting observations she made was that many people who suffered from loneliness were actually not socially isolated: they often lived with family members. This suggests that loneliness, which is a subjective feeling, is not dependent on how many people one lives with: people still feel lonely even if they are not socially isolated. Much research had shown that social isolation is bad for health but there was a lack of understanding that feeling lonely, regardless of objective conditions of social isolation, adversely impacts mental health. In a more conventional approach to mental health most effort was placed on treating mental health symptoms while not much attention was paid to loneliness. One of Dr Lim’s key messages is that the more one feels lonely the more one is likely to have a mental health issue six month down the line: loneliness is the cause and trigger of mental ill-health. What this also suggests is that treating loneliness can be an affordable and preventative way to deal with mental ill-health.
Another message Dr Lim advocates is that a new approach called a strength-based approach should be adopted for people who have mental health issues. In a more conventional approach psychologists tend to focus on patients’ problems such as their level of isolation and depression. Departing from this, the strength-based approach is to utilize the resources and strength that patients already have such as their friendships and relationships. Patients are asked questions not about how depressed and lonely they are but what they are doing ‘right’ and how and what they can do to build more meaningful social connections through existing friendships and relationships. An important lesson that can be drawn from this practice is that patients respond differently when questions are asked differently: just formulating questions in a positive manner without addressing psychological and psychiatric issues have had the effect of reducing patients’ psychiatric symptoms.
This approach can be applied to older persons and can be expected to have even more positive results. In fact, older persons have more resilience and wisdom so that they might feel less lonely even if they are more socially isolated. They are better able to manage their emotions and expectations. Moreover, older persons possess much to offer to society and young generations. Our society tends to perceive older persons primarily as the recipients of care but they are already providing care for other people and can be further empowered to contribute to society in a way that younger generations are unable to do.
6. Meaningful Social Relationship
There are many causes for loneliness: they can be internal, environmental, and systematic. External factors such as urban development policy (the way cities and buildings are designed) and environmental factors can affect the ways in which people relate and connect to each other thereby influencing their loneliness indirectly. For instance, having a small space where people can have minor interactions can lead to building more meaningful social relationships. It is also important to note that loneliness is socially determinate. For example, people with lower socio-economic background tend to have more difficulties in building meaningful social relationships: people with financial restraints might need to work, or have a limit in going out with friends. In this sense, social isolation, loneliness and social connection are related to every part of our society and everything we do. However, our society has not been good at teaching us how to build meaningful social relationship especially after retirement and in old age. In this respect, the role of the AGAC is important to raise this issue and help people to think about how to build meaningful social relationships to make our society mentally and physically healthy for all age.
7. The Future of the GILC
The GILC is seeking to expand membership. It is keen to reach out to other regions in Asia and Africa, and especially to low- and mid-income countries. One of the future tasks of the GILC would be overcoming regionally disparate representation as well as its Anglo-centrism by involving more countries. Any nationally based non-profit organization that deals with the issue of loneliness is eligible and welcome to join. In this context, it would be great if Korean not-for-profit organizations to join the GILC and if the ASEM Global Ageing Center functioned as a platform to introduce the work of the GILC widely to Korea as well as ASEAN countries.
Dr Lim has also expressed that she is interested in working closely with the AGAC on the areas of common interest, and especially for the forthcoming Forum on Human Rights of Older Persons: Present and Future whose theme is on the Human Rights and Mental/Emotional Health of Older Persons.
Hae-Yung Song (firstname.lastname@example.org)