 Rydyn ni'n gweithio ei ddymian ei wneud pergylchedd yng nghymwyntau. Rydyn ni wedi'i ddau o gweithio ei wneud pergylchedd ynghymwyntau yng Nghymwyntau yng nghymwyntau yn roi ynghymru, a oeddw'i ddau o'r ddau o'r ddaw o'r geometry a sydd o ddymian ei ddaw i mewn i'r ddaw ar gyfer sydd yn digwydd o gweithio, neu yn ei ddaw i yn dod o'r looksbwrdd o'r gweithl Abu Ghazafrwynt. I would like to thank the Presiding Officer and members across all parties for their support in bringing this debate on the impact that loneliness can have on physical and mental health to the chamber today. I am leading the debate on my role as convener of the volunteering and the voluntary sector cross-party group. The CPG recently received a presentation on the issue of loneliness and its impact on health and associated financial costs from Liz Watson, chief executive of befriending networks. I would like to thank Liz and the CPG for the support that they have provided for this debate today. I would also like to thank both Macmillan Cancer Support and Sam H for the briefings that they have provided in advance of the debate. Loneliness and social isolation are complex issues. They are difficult to measure but can affect everyone at any point in their lives, as I stated in the motion before us today. Ten per cent of people over 65 in the UK say that they are lonely or very lonely and 20 per cent consider themselves occasionally lonely. The recent Volunteer Scotland V Enable report states that there is a major gap in services for older people. The report suggests that this gap could be addressed by volunteering and befriending services. I will go on to discuss this idea later in my speech. Of course, loneliness is not just an issue that affects the elderly and studies into the association between loneliness and sociality during middle childhood and adolescence show that loneliness in adolescence is strongly associated with suicidal thoughts and behaviours independent of gender, ethnicity or socioeconomic status. In adults, loneliness can increase the risk of developing mental health problems, including depressive symptoms and obsessive compulsive disorder and more than double a person's risk of developing dementia. Worryingly, according to Sam H, isolation is becoming more common in adults. In their worried sick report, one family supporter worker from Fife stated that, we have also got some clients who live in a local estate and there are no services there, so that increases the feeling of isolation when people are stuck in their flat. That lack of network or support groups just increases that feeling of isolation. That can also be said of people living in rural areas where there are very few transport links. I am sure that some of my colleagues will mention this today. Macmillan Cancer Support recently warned that we are on the verge of a loneliness epidemic and, in estimated, 60,000 people are suffering from loneliness as a result of their illness, with 31 per cent of Scots indicating that they are lonelier since diagnosis. It is clear from the study carried out by Macmillan Cancer Support that loneliness can have a huge effect on the health and wellbeing of people living with cancer, with those who are lonely being three times more likely to drink more and five times more likely to skip meals. Loneliness is a problem that can affect all of us, whether young or old, rich or poor, sick or healthy, and it can affect you at any time in your life. People with terminal illnesses are those that are elderly and can be hit the hardest. When it comes to tackling the issue, we need an all-encompassing strategy because evidence shows that tackling loneliness is crucial to meeting the national outcome for people in Scotland to live longer, healthier lives. I believe that the voluntary sector will be essential in helping us to deal with loneliness and social isolation. As I stated earlier, the Volunteer Scotland V Enable report suggests that gaps in services for older people are ones that address loneliness and isolation. That could be a simple niche for volunteering. I would argue that we should be looking into utilising volunteering to address loneliness and social isolation in all age groups. Currently, it is a postcode lottery as to who can get services such as befriending. They are funded in a very piecemeal manner and there is no overall strategy within Scotland to tie everything together, hence the gaps in services. There may well be a cost associated with filling these gaps, but surely it is worth it when we consider that loneliness has a financial as well as a health cost. Losing and similar services contribute to improving the health and wellbeing of the population. Through tackling loneliness and promoting social participation, we encourage healthy behaviour such as stopping smoking, more physical activity, and it even increases the consumption of vegetables. Dealing with loneliness has far-reaching effects on improving health and wellbeing. Only through a strategic and co-ordinated response to the issue of loneliness can we maximise opportunities for such activities as befriending for isolated people in all of Scotland's communities. To conclude, I ask the minister today what consideration the Scottish Government is giving to placing volunteering at the heart of our health and wellbeing policy to tackle loneliness. Volunteering does not just happen, it needs to be properly supported and funded. Finally, to assist in this regard, has the Scottish Government considered including the reduction of loneliness as a Scottish Government indicator so that we can measure the effects of policy? Then perhaps we will not only live longer and healthier lives, but less lonely lives, too. Many thanks. We now turn to the open debate and I call Mary Scanlon to be followed by Malcolm Chisholm. Thank you, Presiding Officer. I would like to thank Margaret MacDougall for securing this debate, and I would also like to place on record the excellent work that Margaret does as the convener of the cross-party group on volunteering. I have to say that I have kept a fairly close eye on health issues since 1999, but I had never seen any research relating comparing loneliness to physical and mental health. In that respect, I thank Margaret MacDougall for sending me the contribution that was made at her cross-party group. I think that it is worth spelling out, because it certainly shocked me. A US study found that loneliness can increase the risk of death by 10 per cent. I certainly did not know that. It increases the risk of heart disease and puts people at greater risk of blood clots. Loneliness is estimated to be as bad for people's health as smoking 15 cigarettes a day. I certainly did not know that. I think that one that really concerned me was a 2006 study of 3,000 nurses with breast cancer found that women without close friends were four times more likely to die than women with 10 or more friends. I actually found the information really, really disconcerting. As Margaret MacDougall has already said, around 10 per cent of over 65 say that they are lonely or very lonely and another 20 per cent occasionally lonely. I always thought that dementia was either genetic or whatever, but the fact that dementia almost doubles in older people who are lonely and again researched from 2005. However, I am not sure that many people know that. I certainly did not, and I am not a clinician. That takes us really to the gap in services for loneliness and isolation. I know that Margaret MacDougall has certainly mentioned befriending. An example was given about Concardin and Deeside at hospital project. There was increased confidence of people going home in 100 per cent of their service users, and that led to a 14 per cent reduction in bed days lost to delay discharge. He is addressing one issue, and it is hugely cost effective. I am sure that Rhoda Grant will also mention the wonderful befriending service that we have in Inverness. It is run by volunteers, one particular volunteer called Allen Michael, who reopened a day centre in Inverness called the Dunbar Centre. I think that volunteering and befriending is certainly one of the issues, but what I would like to see is the information that I have here—I am happy to pass it on to the minister, I am not sure if he has that—but I would like to see all of the information from all of those research projects, whether it is about dementia, physical, mental health and recovery from cancer. I would like and I would hope that the minister will bring together all aspects relating to the effect of loneliness into one piece of research and to look at the impact on people's health from that research. Although, as I said, volunteering is one answer, there are other complexities and bereavement that was mentioned. For many people who are lonely, they have had the same partner for 30, 40 or 50 years. It is very difficult for them to suddenly go out and join a lunch club or a day centre, and I think that there needs to be support for that. I also think that more could be done in terms of lunch clubs. I noticed an advert last night when I was in Tesco for T-dances for over 65s, but walking groups do not have to cost a lot of money and the befriending service. Before I sum up, I think that we need to make, although many of the council lunch clubs and day centres are closing down, there are plenty residential care homes. If people could go in for a lunch club or a day centre, if we could make more use of the existing network that we have, I was shocked at the information that came forward today, and I hope that it will be taken forward in a positive manner by the minister. I congratulate Margaret MacDougall for bringing forward this important subject for the debate. I also pay tribute to all the work that she does in relation to volunteering, because that is clearly central to dealing with the problem that we are addressing today. Just before I should say the debate, I was quietly singing Eleanor Rigby's great Beatles song about loneliness, which probably tells you what age I am, but it reminds us that people have been aware of the issue and significance of loneliness in general terms for a long time. As Mary Scanlon said, relating it particularly to physical illness, but even to some mental illnesses, it is relatively recent, certainly, in research terms. Mary Scanlon helped to mention some of the research reports. I will mention just a couple, but before that, I will give some figures that back up what has already been said. The Mental Health Foundation said that 10 per cent of British people—this is a UK figure—feel lonely, and half of people think that people are getting lonelier in general. The Age Scotland figure that we have sent to us for this debate is more than 80,000 people—65 and over—describe themselves as often are always lonely. We know that that affects a great many people. The two studies are referred to one by Professor John Cackie Oppo of the University of Chicago, who is a world-leading neuroscientist, although I did not know that until this week. He did a longitudinal study, so he was looking at a very large number of people over time. He found a relationship between high levels of the stress hormone cortisol and time spent in isolation. He also suggested that people in isolation were sleeping a lot less well, which may have been one of the factors, of course, leading to the increased stress. He has done a lot of research on that, and that is a very brief summary of his work. However, I was also interested in a report that was featured in The Guardian on Monday of this week by the centre forum called Aging Alone. It was pointing out that the over-85s are probably the most affected, and it also said that lonely adults were more likely to undergo emergency hospitalisation, which, given the amount of time that we spend talking about emergency hospital admissions, is very significant. It also said that lonely people were more likely to have early admission to residential and nursing care. Clearly, that has great ramifications to the issue, not just for individuals' physical and mental health, but for the whole health and care system. Margaret MacDougall quoted the V&A board report about major gaps in services for older people. I have not got time to go into the whole issue of people who have identifiable mental health conditions, because in a previous mental health debate we explored the fact that services for people with clinical depression, for example, are not so readily available as for younger people. That is one dimension, but today we are concentrating more on the generality of older people. The answer, as the centre forum put it, is to combating loneliness, lies in the community. That, of course, is where all the volunteering is so absolutely central. The V&A board report talks about regular, face-to-face contact being crucial. I just mentioned two initiatives in my constituency from the Pomeini development project in Leith. One is a group on older men's health and wellbeing, which has been running for several years and I have visited it myself and heard from particular men saying what a big difference that has made to their lives. However, they also participate in community connecting, which is a project funded by the change fund, credit to the Scottish Government for that, for over 65s who are isolated. That involves befriending. The befriender goes with the individual to various activities in the community, so it is a limited period, maybe six times with the befriender, trying to introduce them to various activities in the community, trying to find a more long-term sustainable solution to their loneliness. My time is nearly up, but I should also mention Age Scotland that I mentioned at the beginning, because they have two initiatives, probably a lot more. First, their silver line. Telephones are not as good as face-to-face compact, but they are certainly better than not having anything. Also, of course, Age Scotland has 850 member groups, so the more we can create activities and connections for older people in the community, the more that problem will be solved. Thank you, Presiding Officer. I begin by congratulating Margaret MacDougall on securing this valuable debating time for what is clearly an important but perhaps overlooked issue, the impact of loneliness on physical and mental health. Mental health is one aspect of our own health that most of us are guilty of ignoring and neglecting, assuming that our brain will never let us down and needs no care or attention to ensure that it functions as it should. The view of this falsehood has always been hugely supportive of campaigns and organisations that raise awareness of mental health issues and seek to assist those in need of information or assistance regarding their own mental health or that of someone they care for. While the stigma of mental illness is being challenged and the public are becoming more aware of the conditions affecting us, understanding how our mind works and how to keep it healthy remains minimal. Reducing alcohol consumption and keeping an active mind through learning, reading or physical activity remain important lifestyle choices and techniques to ensure the maintenance of good mental health. However, it is clear that the issue of loneliness and the impact on our mental wellbeing is a matter that is sometimes and somewhat disregarded. The Scottish Association for Mental Health offers a five ways to better mental health guide on the website. Top of that list is Stay Connected. That promise is evidently warranted, with a litany of studies showing that loneliness and social exclusion are directly linked to a number of mental health problems, including anxiety, depression, dementia and Alzheimer's disease. As we have already heard from another of members this evening, it also has a severe impact on physical health. As Margaret MacDougall pointed out in her motion, loneliness is disproportionately felt by older people in our society. There are a variety of reasons for this, for example the death of a partner or close friend, as Mary Scanlon touched on, or retiring and leaving the working environment can cause loneliness. Indeed, simply becoming frail and finding it difficult to get out alone can cause an individual to become secluded and lonely. Of course, being alone and loneliness are quite different things, and merely being surrounded by people will not guarantee a feeling of camaraderie, connectedness or integration. However, even the smallest interaction can help us to connect and interact with the world around us. Striking up a conversation with a cashier at a checkout, going along to a local football match, a tiny church or even joining a slimming club all give a sense of belonging and allow us to feel connected to the community. Help us feel more grounded and offer a perspective on issues in our lives. Of course, it is important to remember that loneliness does not only cause mental illness in some people, although often those who struggle with mental illness feel stigmatised or are excluded from social activities, thus exacerbating their pre-existing condition. It is therefore clear that we must also ensure that those with mental health issues are not marginalised or allowed to feel that they cannot participate and be active and effective members of the community, sports team or volunteer groups. There are a variety of groups and facilities across communities in Scotland open to those who are looking to meet new friends and interact with their neighbours and surroundings. Indeed, when I carry out my surgeries in Beard community centre, a group of around eight older men and women could be found playing carpet bowls in the main hall next door, usually laughing or obviously while I'm trying to address constituents' concerns. While this group spends a few pounds between them to play bowls in a local hall, there are other more structured groups such as Garnock Valley Allotment Association, which to my mind perfectly exemplifies the idea of community engagement interaction. With dozens of members—young, not so young and old—working together to grow fresh produce and improve their community environment, all whilst managing to keep fit and healthy, learn new skills and make new friends. I don't think that there can be any doubt that the more people we can encourage to become involved in groups like this, the better. Indeed, in my visits to the allotments, some of the older people suggested that if we weren't for the allotments, they would be at home on their own watching daytime television and one or two of them taking antidepressants to boot. Whilst progress has undoubtedly been made in tackling the stigma in improving treatment, mental illness and maintaining mental good health remains hugely misunderstood subjects, and loneliness is at the forefront of that. As such, I regularly congratulate the member for raising the matter and giving us the opportunity to discuss those matters and what is becoming a very interesting debate. Many thanks. Finally, before I call the minister, Rhoda Grant. I also want to add my congratulations to Margaret McDougall for securing this debate. It is a really important issue, and we need to tackle it. Loneliness is not only distressing, but it can impact on people's mental and physical health, as we have already heard. Therefore, addressing it is actually preventative spend. Loneliness is more pronounced in older people, and it can be for a variety of reasons. Decreasing mobility, loss of ability to drive in rural areas, or indeed bereavement. bereavement at any age is difficult, but for someone who has spent most of their life with someone else who has passed away, who was no longer active themselves and was dependent on that individual for company, the impact can be absolutely catastrophic. Not only due to grief, but also due to the loss of the company, and sometimes that person might have been the only person that they had for social interaction. Esther Ranson, who was instrumental in setting up Silverline, talked in the Parliament recently and told us about how she wrote of her loneliness following bereavement. She is an active, well-connected person who was devastated by the loss of her husband. When her article was published, she was absolutely inundated with correspondence from others who had experienced extreme loneliness, and that prompted her to work along with others to set up Silverline. Silverline provides a telephone and online befriending and advice service for older people, and it has proved a lifeline to many. Mary Scanan mentioned in her speech the importance of befriending services, mentioning those in Inverness, and I think that that is what makes Silverline so important. Often the volunteers themselves benefit from providing the service because it gives them a purpose and creates friendships for them as well. We have an untapped army of volunteers in our older generations. People are looking for purpose of a huge amount of knowledge and also have the ability to help others, and we need to tap into that resource. A telephone line is an excellent resource, but many other organisations have also been trying to tackle this issue and need volunteers to support them. It is extremely important that people enjoy a social life, and it becomes harder as mobility diminishes. I was speaking recently to the Baden Ochanstraspe community transport company, and they recognise this and organise outings for their client groups such as fish teas, and Maggie Lawson was explaining to me one of the client's reactions when pulling her curtains one cold winter night when it was getting dark really early, beginning to feel quite depressed. Suddenly I remembered she was going to be picked up in an hour or so to go out for a fish tea and actually went with a spring in her step she had something to look forward to in the evening and didn't feel so isolated and alone, and in a way you can't really attach a cost to that because it gets people out of the house meeting others and also enjoying a meal, and this will improve health and wellbeing and also keep people more mobile and active. It's really sad that organisations such as this are finding their funding under threat, and if they lose that funding that service will end. If that happens the price to the public purse will be enormous picking up the pieces of the physical and mental health problems that people develop as they become more and more isolated. Isolation is a big problem in the highlands and islands where people live in remote rural communities, and this is even more so for women because they tend to live longer, they are much more likely to be bereaved. They're also of the generation that are less likely to drive. Because of cuts to local authority budgets things like lunch clubs and community car schemes are closing and service provision is being focused on meeting need rather than prevention, it's a false economy because people will be in need of much greater intervention much sooner without those more social interactions. However for many of our elderly their only social contact will be their home carer. Their time with clients is also being slashed to a point where they're no longer able to help them to get to the toilet far less to sit and chat and see how they are. We need to rethink how we deal with loneliness and how we prevent it, and I'm very grateful to Margaret for bringing forward this debate that allows us to highlight and indeed explore those issues. Many thanks and I now invite Michael Matheson to respond to the debate minister in around seven minutes please. Thank you, Presiding Officer. I like others offer my congratulations to Margaret MacDougall in securing time for this debate and I've listened with real interest to the contribution that members have made this evening. Loneliness is a complex emotional response to isolation or to a lack of companionship or a lack of a wider social network that many people can just take for granted. Usually it also involves anxious feelings and can even result in anxiety when individuals are actually surrounded by other individuals as well. All of us are likely to experience a period of loneliness at some point in our own life. Although loneliness in itself is not a mental health condition, it is a factor that can contribute to the cause of ill health, but it is also a fact that loneliness can also be caused by someone's ill health in itself. It has both got a causal effect for those who may not already have an ill health but can develop one as a result of the problems with loneliness that are associated with loneliness and loneliness can also be caused by someone's ill health, whether it be physical or mental ill health. We are aware of the research that has been referred to tonight by Mary Scanlon and others that loneliness and social isolation have a significant impact on physical and mental health. The studies have shown that people who are social isolated can experience more stress, have lower self-esteem and are more likely to have sleep problems than people who have strong social networks. All of those things have a negative effect on a person's general wellbeing and can contribute to mental health and physical health problems and can contribute to specific conditions such as anxiety and depression. Having recognised the impact that loneliness can have, it is important that we make sure that we have a range of services that are there to help to support individuals should they require to speak to someone to get support and advice. That is why we support organisations such as breathing space in order to be there and to be able to get advice and support for individuals who may be lonely, experiencing low mood or depression so that they are able to get that first stop as a place of getting some advice and support for them. There are also organisations such as Samaritans that we support and the work that they can provide on a 24-hour basis for individuals. I want to turn to a specific point that I think Malcolm Chisholm hit the nail on the head with. That was for those members who may have considered the ministerial task force on health inequalities, which I chaired last year in its report, which was published this year. We describe what is an important concept, but one that is often overlooked and undervalued. That is the concept of social capital, which is one of the four key priorities that the ministerial task force on health inequalities has identified. Social capital is an important element of creating resilience within communities and also within individuals. A key part of that social capital is the role of volunteering, the purposeful role that individuals can have within their community. Part of the challenge in taking forward how we build better social capital within our communities in Scotland is to move away from the tendency to think that organisations and bodies, whether they are local authorities or third sector organisations, should go and do things in local communities for the people who live in that local community, but instead look at it from the perspective of the assets that already exist within that community and look to build those assets in order to develop the social capital within that community in itself. I saw that first hand, for example, in Fife and a project that has regenerated the value within a local community, not because the council or a third sector organisation has come in and run a programme or a project, but they have listened to the local community and what they see as being important to them and engaged with them in how that can be facilitated and taken forward in a way that best suits their needs. A key part of that is delivering greater volunteer opportunities for those who live there and reducing the social isolation that some people can experience. That is why I think that it is an important element not only in tackling loneliness but it is also an important element in tackling some of the health inequalities that we face in our society that can also contribute towards loneliness in itself as well. I also want to turn to the issue of older people who in particular can be at greater risk from loneliness and in particular the impact that it can have on their mental health. That is why, within our new mental health strategy, we set out a very clear range of work that we wanted to take forward in helping to support and promote greater mental health and wellbeing for older people. In order to take that particular area of work forward, we have established a working group that has the specific objective of taking forward the commitments around the mental health strategy around older people. Part of that work will be to focus on producing a range of indicators that allow us to look at what progress can be made and tackling things like loneliness will be an important part of that overall agenda. Several members have also mentioned issues such as offending projects. There is not a national strategy on offending. The reason being is because offending sits in a whole range of already existing national strategies. Within our national strategy around mental health, within our reshaping care for older people, for example my own constituency, there is a offending project there that is for older people to help them with their shopping etc but creating partnership and friendships in a way where individuals have lost that and become socially isolated. It should be seen as part of the day-in-day-out business of the way in which services are delivered. Although it is said that loneliness can affect physical and mental health, the reverse is also true. If we tackle some of the causes of poor health then generally we can also help to reduce those who experience social isolation. That is why we support projects such as the community food and health project, which is about working in low-income communities to improve access to take up healthy diet, which is an important element of that. With its expertise we have supported a number of projects and an example is the food chain, which has now been expanded to reach from Dumfries and Galloway to six regions right across Scotland, including Glasgow branch, which was opened last year and was opened by my colleague Alec Neill. The food chain is also a grocery shopping system that is being created through befending and helping to support households to look at how they can support older people within their own individual communities. The whole issue of loneliness has to be looked at in the generality of the range of different measures that we are taking, whether it be mental health, reshaping care for older people, the way in which we build social capital in tackling health inequalities in our community, all have a role to play in making sure that that issue is sufficiently addressed. I hope that members will be assured that we recognise the importance of that issue and we are determined to make sure that the measures that we can take forward in our policy areas will help to support and address some of the problems that are caused with loneliness in our society today. Many thanks. That concludes Margaret McDigle's debate on recognising the impacts of loneliness and on physical and mental health. I now close this meeting of Parliament.