Psychological care delivered by phone can help combat loneliness and depression, study finds

Depression and loneliness can be prevented using structured telephone-based psychological care, delivered over eight weeks, according to new research.

The results of the study, a major clinical trial carried out during the COVID pandemic, showed rapid and enduring improvements in mental health and quality of life when older people received weekly phone calls over eight weeks from a specially trained coach who encouraged them to maintain their social connections and to remain active.

The study, co-authored by Keele's Professor Carolyn Chew-Graham OBE, was 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. The researchers 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% over a three-month period and the benefits remained after the phone calls had ceased, suggesting an enduring impact.

The Behavioral Activation in Social Isolation (BASIL+) trial started within months of the 2020 pandemic and was the largest trial ever undertaken to target and measure loneliness in this way. The results have been published in the journal The Lancet Healthy Longevity.

People invited to take part in the BASIL+ 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 BASIL+ trial was the only mental health trial prioritized by the NHS as part of its Urgent Public Health program—a cornerstone of its fight against COVID. Hundreds of older people were recruited to the BASIL+ trial from 26 sites across the U.K. during the COVID pandemic of 2020–21.

Professor Carolyn Chew-Graham OBE, Professor of General Practice Research at Keele University, said, "Seeing the results of the BASIL+ trial represents the culmination of a strong collaboration between our northern universities to tackle one of the major threats to health and well-being. We will continue to work together to ensure the results of our trial translate to improve the lives of older people after the pandemic. Good science, such as this, is a team endeavor."

The research was jointly led by Professor Simon Gilbody from the University of York and Hull York Medical School and Professor David Ekers from Tees, Esk and Wear Valleys NHS Foundation Trust. Professor Gilbody 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."

Professor Ekers said, "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 U.K. 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."

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