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Loneliness

Social Isolation and COVID-19

Postwar social psychiatry research can help us cope with our current crisis.

The COVID-19 pandemic and the resulting lockdown has been a challenge to both our physical health and our mental health. In my next few posts I am going to discuss some themes that have emerged, starting with social isolation.

Following the Second World War, there was a great deal of research conducted by social scientists and mental health researchers into the link between the social environment and mental health. The ultimate goal of this body of research was to identify the causes of mental illness and take steps to prevent them. This approach to mental health was called social psychiatry. One of the findings made by social psychiatry researchers was that social isolation and loneliness were associated with poor mental health.

On the surface, this should not have been too surprising. Most of us, even those of us who wouldn't mind living on a quiet island somewhere, know that being alone and without human contact for too long is not good. What was more surprising was that this was the case both in rural settings as it was in bustling metropolises. Just as the Stirling County Study, which studied a sparsely-populated corner of Nova Scotia, found that social isolation was problematic, so too did the Midtown Manhattan Study, which researched the Upper East Side in New York City.

Such findings complicated other research findings of the time, which suggested that it was the physical crowding of cities that was bad for mental health. Urban planners during the 1950s and 1960s worried that the density and slum conditions of modern cities could generate mental health problems, just as they exacerbated the spread of infection. Many of these ideas were based on the findings from rat experiments , which indicated that overcrowding resulted in such psychological disruption that it was ultimately fatal.

But just as we are seeing that urban density per se does not automatically lead to the transmission of COVID-19 (see the relative success of Hong Kong, Japan, and South Korea in controlling the virus), other research indicated that overcrowding did not affect humans in the same way as rats. In fact, the Midtown Manhattan Study found that people could feel isolated despite being in a crowded city. It was this, along with poverty, inequality, and other social factors, that contributed to poor mental health, not living on top of one another. Ironically, when urban planners razed slums to the ground to build new, "healthier" housing (the "projects" of North American and the housing "schemes" of Europe), they also damaged the social bonds that had been keeping such "slums" together for generations.

Similarly, while lockdown has increased the isolation and loneliness of many people, it is important to tease out what we actually mean by this. Many people have found that, while COVID-19 has kept them from meeting their friends at the bar or pub, it has given them the opportunity to connect with friends and family virtually, even if only to check up on them. Of course, this is only possible for people with access to, and the skills to employ, information technology. Others have found that they have connected more with nature, especially that which is in close proximity to where they live. Of course, this isn't the case for people living in neighborhoods without access to parks or the great outdoors. Still others have bonded through hobbies, such as baking sourdough bread or learning another language. Of course, people trying to cope with homeschooling, abusive family situations, or working from home in chaotic domestic environments have not have such luxuries.

In other words, when we think about social isolation, we need to also think about issues, such as poverty, inequality, sexism, racism, ageism, and disability, that make social isolation a very different experience for different people. In order to tackle social isolation, therefore, we need to get to grips with these issues as well. Universal basic income might be a step in the right direction, as I and many others have argued throughout the pandemic. But it is only the start to developing a society that is better able to prevent mental illness, a society informed by social psychiatry.

References

Adams, Jon and Edmund Ramsden (2009). Escaping the Laboratory: The rodent experiments of John B Calhoun and their cultural influence. Journal of Social History 42 (3): 761-92

Ramsden, Edmund and Matthew Smith (2018). Remembering the West End: social science, mental health and the American urban environment, 1939–1968. Urban History 45 (1): 128-49

Smith, Matthew (2016). A Fine Balance: individualism, society and the prevention of mental illness in the United States, 1945–1968. Palgrave Communications 2: 1-11

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