Most people with psychosis want more contact with other people.
For the past few years I have been part of a multi-disciplinary team testing the effectiveness and cost-effectiveness of a social intervention supporting people with psychosis to develop and maintain social contacts.
The SCENE intervention is delivered by mental health practitioners in a series of meetings over six months and focuses on supporting people to make new social contacts in their community. It draws upon motivational interviewing and solution-focused approaches to support people to identify interests and opportunities for social engagement.
We are evaluating the outcomes of this in a randomised controlled trial. The full protocol for the trial has been published this week by BMJ Open and can be accessed here.
Randomised controlled trials are sometimes seen to be controversial as researchers select at random who recieve the intervention and who does not. However, this process helps to produce comparable groups for an unbiased evaluation of outcomes. It is permitted when there is genuine uncertainty as to whether or not a new intervention is effective.
So far, over 480 people have been recruited to participate in the trial. But there is still time to get involved as recruitment is on-going until April 2022 in NHS mental health trusts across England.
Desire for social contact
The trial is based on evidence that most people with psychosis want more social contact. We conducted a large survey of almost 550 people with psychosis earlier in the study which found that 68% expressed a desire for more social contact.
We found that people with lower quality of life were more likely to express a desire for more contacts. However, they were less likely to feel confident in increasing them because of perceived barriers or feeling content with current circumstances.
It is not clear if a coaching intervention will support people to overcome barriers and connect with others. So that’s why we’re testing it!
Social isolation
In the middle of the study, Covid-19 came along. To stop infection, we have rightly been told not to have contact with others outside of our households. Lockdown has helped to control the spread of infection, but it has also had a harmful effect on our mental health and has exacerbated loneliness.
Recognising the importance of social connections for our mental health and wellbeing, the trial continued throughout the pandemic. We adjusted to remote working so that coaches could continue to support people. Instead of face to face contact, they sought online connections for people. As face to face activities re-started this year, people were supported to overcome their anxiety about meeting with others in order to engage with them.
Now that Covid cases are rising again and social contact is being restricted, our work reminds us of the importance of social contact for our mental health, and that telephone, online or socially distanced contact is OK. We have another couple of years to go until the findings of the trial are published. But we don’t have to wait for this to know that social contact is important. As further restrictions on our contact with others looms, let’s look out for those around us who are at risk of becoming lonely or isolated. We are all in this together.
References
This study is funded by a National Institute for Health Research Programme Grant for Applied Research and more information can be found on the study website.
Fascinating read – as always Martin – but particularly in respect of the desire for more social contact among people who experience psychosis. It re-enforces our belief at Grow Social Capital that you don’t tackle isolation by addressing loneliness but by addressing togetherness. A key question to those, like me, who are perhaps uninformed about the condition is: how can we help people who experience psychosis be and feel more connected and involved with communities?
Hi Russell,
Many thanks for your comment. I agree that ‘togetherness’ is the important component here and is more likely to lead to sustained improvements in quality of life (the ultimate goal of the approach being trialled in this study). The approach we are taking is to support people to engage more with activities within their local community. People isolate themselves due to self-stigma and the discrimination they face from others (among other reasons), so we have a role to play to create communities which accept everyone. Local people and organisations need to welcome people irrespective of diagnosis or any other personal characteristic, though mental health services also have a role to play in supporting people to access places and spaces they feel excluded from. Mental health awareness training may be a good place to start for some communities, but, in general, I think people should consider how they need to adapt what they do to ensure they are inclusive of all members of the community (which is not always straight-forward).
All the best,
Martin