Isolation and mental distress: executive summary

Not alone? Isolation and mental distress
Executive summary [1]

Isolation causes mental distress, and the stigma and social exclusion linked to mental health problems can make isolation worse. This self-reinforcing cycle condemns millions of people with mental health problems to a life of social segregation.

A new survey for 2004 from Mind [2] indicates that 84 per cent of people with mental health problems feel isolated. Yet more worrying is that 80 per cent of respondents from this survey reported that isolation actually impedes their recovery from mental health problems. This new research confirms that people with mental health problems are among the most isolated in society. This figure dwarfs the general public’s experience of isolation, which comes in at just 29 per cent. [3]

“Isolation leaves me with only my own mind for company, and the thought of it spins around and around and I am unable to offload it to anyone. When I have been really sick, the thing I wanted most in the world was for someone to come and talk to me, so I could tell them what was going on and not have to suffer alone.” [4]

Mental distress itself contributed to isolation for 79 per cent of people in the Mind survey, but this was not the whole picture for most people. For many people, a combination of additional factors – lack of understanding from others, discrimination, poverty and social exclusion – added to their isolation.

Seventy-seven per cent of respondents cited lack of understanding from others about mental health issues, and several reported that they had lost friends or even contact with family as a result.

“I find I’m isolated because of people’s reaction to me having a mental health problem, I get mocked, pushed and stared at, so feel isolated and I can’t go out much or make friends so I get more depressed as a result.” [5]

Fifty-eight per cent of respondents said that discrimination on mental health grounds was a factor in their mental distress, and 80 per cent of Black and minority ethnic respondents made this link.

“My neighbours have at times called me a 'lunatic' or 'insane' because I used to see a psychiatrist. I realise they're too stupid to understand so I ignore them. I've tried to explain but it's useless. They even tried to get a petition together to have me moved!” [6]

Fifty-nine per cent of people mentioned lack of money as an additional isolating factor, 54 per cent cited lack of work and 42 per cent mentioned both lack of transport and poor housing as isolating factors. Respondents made it clear that social exclusion is both a cause and an effect of mental distress.

“Within mental health, which is poverty related, I have been in poor housing and low benefits, this creates an isolation in itself and separates you from the community, this makes you feel rejected by people and made to feel different.” [7]

In the Mind survey, the most isolated group of people appeared to be young people (92 per cent). People in rural areas also did badly, with 90 per cent feeling isolated. Almost 90 per cent of people from Black and minority ethnic communities also reported feeling isolated, with 61 per cent of this group saying that their isolation
was exacerbated by other forms of discrimination.

For most people, the answers to isolation lie in social activities, friendships and relationships. But for many people with mental distress, this can be difficult. While 74 per cent of Mind survey respondents identified the importance of friends and contacts, they also identified the need for support in making or keeping these.

The second most important answer to isolation, mentioned by 66 per cent of respondents was ready access to a telephone – a basic facility which one in ten of respondents overall, and one in five Black and minority ethnic respondents, reported they did not have.

Large proportions of Mind survey respondents reported on the helpfulness of both statutory and voluntary mental health services in combating isolation. However, the picture was not all positive. Fifteen per cent of respondents reported that these services aggravated isolation because of the attitudes of professionals, the impact of being locked up or of being misdiagnosed. Leaving hospital to set up life in the community with little or no support was also reported as being a particularly vulnerable time.

Shockingly, over two thirds of respondents reported that, during the preceding two years, they had been denied services that they had previously found, or would have found, helpful. Ironically, a third of this group had been told that they were “better” or that their problems were not sufficiently severe.

Mind’s recommendations

Government:

• Government must increase its commitment to anti-stigma activities in England and Wales, particularly among young people and in schools, to counteract the discrimination faced by people with mental health problems and to promote social inclusion.

The Department of Health:

• To develop better mental health services for young people.
• To make social inclusion a central element of health and social care.
• To ensure telephones and other low cost, high impact ways of minimising isolation are provided for people with mental distress.
• To ensure wide access to health and social care services which offer social interaction and development of social skills, especially informal activities such as drop-ins.

Public services, including transport, housing, the benefits system, employment services, the police, leisure services and health and social services:

• To audit their provision to identify and eliminate systemic discrimination against people with mental distress.
• To introduce initiatives to ensure this group can gain full access to services.
• To employ people with experience of mental distress in staff training and planning of services to ensure services fully meet needs.

1 The full report, Not alone? Isolation and mental distress, can be read in pdf format here.
2 In February 2004, 6,789 questionnaires were sent to Mind’s networks. The networks are made up of members of Mind Link, Diverse Minds, Mind in Action, Rural Minds, Welsh-based networks and 209 local Mind associations. Respondents in these networks have experience of mental distress. By 16 February 2004, 532 completed questionnaires had been returned, a response rate of around 8 per cent. The survey was also available via Mind’s website with 24 questionnaires obtained from this source.
3 Over the period 12 to 17 February 2004, NOP conducted face to face interviews with a representative sample of 964 members of the public asking them about their experience of and opinions about isolation.
4 Mind survey respondent, female,18 to 24, White British.
5 Mind survey respondent, female, 24 to 34, White British.
6 Mind survey respondent, female, 45 to 54, White British.
7 Mind survey respondent, male, 33 to 44, Black or Black British.