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Telephone-based care can prevent loneliness and depression finds major study

older man on phonecall

Published: 02 February 2024

Structured telephone-based psychological care can prevent loneliness and depression, according to an NIHR-funded study.

The Behavioural Activation in Social Isolation trial or BASIL+ was a major clinical trial carried out during the COVID pandemic. The trial found that when older people received weekly phone calls over 8 weeks, their mental health and quality of life improved. They received calls from a specially trained coach who encouraged them to maintain their social connections and remain active. 

The researchers found that levels of depression reduced significantly and the benefits were greater than those seen for antidepressants.

Participants in the study reported their levels of emotional loneliness fell by 21% over three months and the benefits remained after the phone calls had stopped, suggesting a lasting impact.   

Addressing loneliness and depression during the pandemic 

The BASIL+ trial started in the 2020 pandemic and was the largest trial ever carried out to target and measure loneliness in this way. The study, published in the journal The Lancet Healthy Longevity, is a major step forward in finding out what works to prevent loneliness.

People invited to take part in the study were aged over 65 with multiple long-term conditions. They had been asked to shield during COVID and were at a high risk of loneliness and depression.   

The study was the only mental health trial prioritised by the NHS as part of its Urgent Public Health programme - a cornerstone of its fight against COVID.  435 older people were recruited to the trial from 26 sites across the UK during the COVID pandemic of 2020-21.  

The study was led by a team from the University of York and Hull York Medical School and Tees, Esk and Wear Valleys NHS Foundation Trust. The BASIL+ partnership also included leading researchers from the Universities of Leeds, Keele, and Manchester. The charity AgeUK also supported the study.  

The epidemic of loneliness

Politicians and policymakers have become increasingly aware of the importance of loneliness, but have struggled to know ‘what works’ in its prevention.  The World Health Organization has just declared loneliness to be a ‘Global Health concern. As a result, they have launched an international commission on the problem.  

It is anticipated that the results of the BASIL+ trial will feed into this process, as BASIL+ is the largest trial ever undertaken to combat loneliness.  There is also a cross governmental strategy to tackle loneliness,. 

Professor Simon Gilbody, lead researcher, University of York and Hull York Medical School said: “We now know that loneliness is as bad for your health as smoking 15 cigarettes a day and depression is a silent killer.  All of us working on the BASIL+ trial had older parents and relatives who became socially isolated during lockdown.”

“Based on our previous research, we had a good idea what might work,” Professor David Ekers, lead researcher, Tees, Esk and Wear Valleys NHS Foundation Trust added. “With the support of the NHS and the NIHR we were able to test this in a large rigorous trial. The results are now available and this is very exciting.  The UK led the world with the vaccine discovery trials. Similarly in mental health we have advanced the science of ‘what works’ in the area of loneliness, and we have learned much from the dark days of the pandemic.’”

Professor Lucy Chappell, CEO of the NIHR, said: "These results are an important step forward in understanding what works in tackling and preventing loneliness and depression. The research is also a great example of how public money allows researchers, healthcare professionals and the public to work together across institutions and organisations to deliver results that will really make a difference to people's health and wellbeing."

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