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Phone-based therapy ‘better than antidepressants’

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Depression and loneliness can be prevented using structured, telephone-based psychological care, delivered over eight weeks, according to a new study from the UK.

The research, led by a team based at the University of York and Hull York Medical School and at Tees, Esk and Wear Valleys NHS Foundation Trust, found 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 per cent over a three-month period and the benefits remained after the phone calls had ceased, suggesting an enduring impact.

Professor Dean McMillan is Professor of Clinical Psychology at Hull York Medical School and University of York designed and led the telephone support programme.

The researcher said: “An ounce of prevention is worth a pound of cure, and this trial shows how we can prevent both depression and loneliness.”

The Behavioural Activation in Social Isolation trial (BASIL+ trial) started within months of the 2020 coronavirus pandemic and was the largest trial ever undertaken to target and measure loneliness in this way.

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

The research was supported by a £2.6M award from the National Institute for Health and Care Research (NIHR) and 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.

Hundreds of older people were recruited to the trial from 26 sites across the UK during the coronavirus pandemic of 2020-21.

Politicians and policy makers have become increasingly aware of the impact of loneliness, but have struggled to know “what works” in its prevention.

The World Health Organization recently declared loneliness to be a ‘Global Health concern’ and 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.

According to the Jo Cox Commission, established in memory of the murdered politician, 9 million people are affected by loneliness in the UK and there is a cross governmental strategy to tackle loneliness, with a Ministerial appointment.

Professor Simon Gilbody from the 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.

“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 is CEO of the National Institute for Health and Care Research, which funded the study.

She added: “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.”

Dr Liz Littlewood, the BASIL+ trial manager from the Department of Health Sciences, University of York, added: “This is what the UK does well and it shows how the NHS, Universities and third sector organisations were able to work in partnership during the pandemic to tackle the big health challenges.”

The BASIL+ partnership included leading researchers from the Universities of Leeds, Keele, and Manchester and also the charity AgeUK.

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