It was a pleasant surprise last month (November 2023) when the World Health Organization (WHO) announced the establishment of a new Commission on Social Connection to address loneliness as a pressing health threat worldwide.
Concerns on social isolation and loneliness first gained attention during the Covid-19 pandemic when the glaring effects of these conditions were painfully felt.
And we are still experiencing the lingering psychological effects of the pandemic.
Therefore, this initiative to launch the commission to foster social connection is timely.
The commission will not only promote connection as a way to enhance community wellbeing, but also intends to consider social development, innovation and economic progress in the context of social connection.
Contrary to the perception that isolation and loneliness primarily affect older people in high-income countries, they impact the health and wellbeing of all age groups across the world.
According to the WHO, one in four older people experience social isolation worldwide.
Meanwhile, 5-15% of adolescents experience loneliness, although the health agency adds that these figures are underestimations.
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“High rates of social isolation and loneliness around the world have serious consequences for health and wellbeing.
“People without enough strong social connections are at higher risk of stroke, anxiety, dementia, depression, suicide and more,” said WHO director-general Dr Tedros Adhanom Ghebreyesus during the launch of the commission.
In the intricate tapestry of human existence, social connections play a pivotal role in shaping mental wellbeing.
With our expanding aged population in Malaysia, concerns of social isolation and loneliness become all the more relevant.
We also need to recognise that young adults and children are not excluded from the negative implications of these conditions.
What is social isolation?
It is a condition in which an individual experiences a dearth of social interactions, leading to a sense of detachment and loneliness.
This condition can manifest in various forms, ranging from physical isolation, where individuals are geographically separated from others, to emotional isolation, where a person may feel disconnected despite being physically present in a social setting.
Technological advances, while connecting people across vast distances, paradoxically contribute to a sense of isolation as face-to-face interactions decline in favour of virtual communication.
The human psyche is inherently social, and the absence of meaningful social connections can have profound effects on mental health.
Loneliness, a pervasive emotion in socially-isolated individuals, is linked to heightened stress levels, anxiety and depression.
Chronic social isolation has been associated with an increased risk of developing mental health disorders.
These include, but are not limited to, schizophrenia, bipolar disorder and major depressive disorder.
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The lack of social support systems can exacerbate existing mental health conditions, hindering recovery and exacerbating symptoms.
Social isolation can also impact cognitive functions, leading to difficulties in concentration, memory loss and impaired decision-making.
The human brain, evolved to thrive in social environments, undergoes neurobiological changes in response to prolonged isolation.
These changes may manifest as alterations in neural connectivity, neurotransmitter imbalances and an increased vulnerability to stressors.
Consequently, individuals experiencing social isolation may find it challenging to navigate the complexities of daily life, affecting their overall cognitive functioning.
Social isolation can also contribute to a decline in physical health.
Research suggests that socially-isolated individuals may be at a higher risk for cardiovascular (heart) diseases, weakened immune systems and premature death.
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The stress induced by loneliness can trigger inflammatory responses in the body, leading to a cascade of negative health outcomes.
Thus, the consequences of social isolation extend beyond the realm of mental health, permeating into the broader spectrum of overall wellbeing.
Mitigating social isolation
Recognising the detrimental impact of social isolation on mental health underscores the importance of proactive measures to deal with this issue.
Addressing social isolation in Malaysia requires a multifaceted approach that encompasses community-based initiatives, mental health awareness campaigns and the promotion of social inclusion.
For example, the formation of community clubs or groups based on common interests, hobbies or demographic characteristics, can go a long way in addressing social isolation, especially among senior citizens.
Existing community centres should be regularly utilised as spaces for people to gather, interact and participate in regular community events, such as cultural festivals, workshops and recreational activities, to bring people together and strengthen social bonds.
Regular community-led public awareness campaigns to destigmatise mental health issues and promote understanding of the impact of social isolation on mental wellbeing need to be encouraged.
This needs to be supported with the provision of educational resources in multiple languages to reach diverse communities and all segments of the population.
Media outlets can play an important role in disseminating information about available mental health resources, support services and helplines.
Relevant agencies can facilitate digital literacy programmes, especially targeting older adults, to enhance their ability in using technology for social interaction.
There is a need to promote responsible and positive online behaviour to create a safe and inclusive digital space.
However, the use of technology as a tool for meaningful connection must be emphasised, rather than as a substitute for face-to-face interaction.
Community-led outreach programmes can be effective in identifying isolated seniors and connecting them with community resources and interaction opportunities, including transportation services for those who may face mobility challenges.
Specific school-based initiatives could include integration of social and emotional learning programmes into the school curriculum to teach students essential interpersonal skills, empathy and the importance of social connections.
Along with this, anti-bullying campaigns to create a supportive and inclusive school environment that reduces the likelihood of social isolation among students, can be organised.
Work places too must be encouraged to implement employee wellbeing programmes that prioritise mental health support, stress management and work-life balance.
A workplace culture that values open communication, teamwork and positive social interactions among colleagues leads to mental wellbeing in an environment that constitutes a large part of adult life.
There is a need to implement strict policies to address systemic factors contributing to isolation, such as poor urban planning.
In Malaysia, almost every residential enclave has “Taman” (park) as part of its name.
The irony being the almost universal absence of an acceptable park or community space in these enclaves.
It is time for mandatory inclusion of adequate community space, avoiding surreptitious omission of such facilities because of sheer commercial interests.
In some Western countries and Japan, youth volunteers are mobilised to conduct community outreach to identify individuals at risk of social isolation and to connect them with appropriate services.
We too could establish mentorship programmes where volunteers provide support and companionship to those experiencing social isolation, particularly among those who remain immobilised in aged care facilities.
Crisis intervention hotlines and counselling services can be expanded, ensuring that they are culturally sensitive and accessible to diverse populations.
Collaboration among government agencies, non-government mental health organisations and the private sector is crucial for the success of this initiative.
By addressing the root causes of social isolation and implementing the supportive measures outlined here, we can collectively work towards building a society that values and prioritises community mental health and well-being.
Even before the Covid-19 pandemic, Japan took the bold step of appointing a minister to look into isolation and loneliness.
Other countries have junior ministers for mental wellbeing, distinct from the health portfolio, as they realised that social determinants of mental wellbeing can be far more important than the generally-understood medical approach.
The Malaysian Mental Health Association (MMHA) urges the government to establish a platform at the national level to specifically tackle this issue of social isolation and loneliness.
This initiative could be a cross-sectoral and multi-agency approach with the Women, Family and Community Development Ministry being the lead agency.
The pain of social isolation and loneliness is real and we should not take this lightly in our efforts to build a caring and cohesive society.
Prof Datuk Dr Andrew Mohanraj is a consultant psychiatrist, the MMHA president and Taylor’s University Impact Lab on Mental Health & Wellbeing director. For more information, email starhealth@thestar.com.my. The information provided is for educational and communication purposes only, and it should not be construed as personal medical advice. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
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