Inquiry into loneliness and isolation

Stonewall Cymru’s response

Background

Stonewall Cymru is Wales’s leading lesbian, gay, bi and trans (LGBT) equality charity. We were founded in 2003, and we work with businesses, public bodies, schools, the Welsh Government, the National Assembly for Wales and a wide range of partners in communities across Wales to work towards our vision of a world where lesbian, gay, bi and trans people are accepted without exception.

Overview

1. Stonewall Cymru welcomes the opportunity to respond to this important inquiry by the Health, Social Care and Sport Committee into loneliness and isolation.

2. Lesbian, gay, bi and trans (LGBT) people are more likely to grow old with less robust support networks. They are also less likely to access support services due to fears of discrimination, lack of understanding and poor-quality care. This combination of factors means that LGBT people (especially older LGBT people) are often highly vulnerable to isolation and loneliness.

Scale and causes of isolation and loneliness

3. The Trans Mental Health Study (2012) found that on a scale from one (never feeling isolated) to seven (constant isolation) the mean score of trans respondents was 3.9, reflecting a high level of isolation among trans people.

4. Stonewall’s research Lesbian, Gay and Bisexual People in Later Life (2011) found that the life experiences of lesbian, gay and bi people differ from those of straight people in ways that render them much more vulnerable to isolation and loneliness as they grow older.

5. Older lesbian, gay and bi people are less likely to have children, less likely to see family members at least once a week, and more likely to live alone than their straight counterparts. Gay and bi men over 55 are almost three times as likely to be single as straight men.

6. It also found that older lesbian, gay and bi people are much more likely to rely on friends for care, support and social contact. However, many noted the difficulties in relying on friends for care who are also getting older and facing increasing support needs themselves. Furthermore, providing informal care without adequate support is a common cause of isolation and loneliness for carers.

Impact on mental and physical health and wellbeing

7. Lesbian, Gay and Bisexual People in Later Life also found that isolation and loneliness were likely to have negative effects on mental and physical wellbeing.

8. Lesbian, gay and bi older people were more likely than their straight peers to drink alcohol more often and more likely to have taken drugs in the last year.

9. Lesbian, gay and bi older people who were single were also more likely to smoke, to have taken drugs in the last year and to rate their mental health as poor than those in a relationship.

10. The Trans Mental Health Study also found high rates of self-harm, suicidal ideation, and other indicators of poor mental health and wellbeing among trans people, along with high levels of drug and alcohol use.

Public services

11. Lesbian, Gay and Bisexual People in Later Life found that lesbian, gay and bi people were nearly twice as likely as their straight peers to expect to rely on external services as they get older, including GPs, social services and paid help, and many of those surveyed identified that their lack of other support mechanisms would increase their own reliance on health and social care services.

12. Despite this, three in five lesbian, gay and bi older people believe that social care and support services would not be able to understand and meet their needs and many do not feel comfortable disclosing their sexual orientation to health and social care professionals including care home staff, paid carers and social workers.

13. Many of those surveyed identified fear of discrimination or a lack of acceptance as being the cause of their concerns, and Stonewall Cymru’s Unhealthy Attitudes (2015) research found that one in five health and social care staff in Wales have heard their colleagues make negative remarks or use discriminatory language about trans people, and one in ten have witnessed colleagues express the dangerous belief that people can be ‘cured’ of being lesbian, gay or bi.

14. It also found that just one in twenty patient-facing health and social care staff have received training on the health needs of LGBT people.

15. The expectation of poor-quality care increases anxiety and further undermines the mental health of those who are isolated: seven in ten lesbian, gay and bi people over 55 were concerned about needing care in the future.

16. It also leads to people delaying seeking help for their needs until it becomes absolutely necessary, when they require much higher levels of care. This undermines preventative approaches aimed at supporting and facilitating continued independent living and therefore entrenches isolation and increases the cost of care provision.

17. Finally, many LGBT people in care may not disclose their sexual orientation or trans status to care workers, and if they live in residential care or in shared accommodation, to other residents. This increases levels of isolation and loneliness, as it means that people feel less able to be themselves and to talk freely about their lives and experiences with those they spend time with.

Addressing problems of loneliness and isolation

18. An essential intervention in combatting loneliness and isolation among LGBT older people will be to ensure that all health and social care staff receive training on the care needs of LGBT people and to transform residential homes and specialist housing into spaces where LGBT older people feel confident that they can be themselves and be treated with respect and dignity.

19. As part of this, the Welsh Government should work with the newly-established Social Care Wales and the Care and Social Services Inspectorate Wales to ensure that embedding LGBT-inclusive practice is an essential component of the work to improve care services across Wales.

20. Furthermore, the Welsh Government should explore innovative models of care provision for LGBT older people by continuing to work with Disability Wales to develop cooperative models for people receiving direct payments, and exploring the potential of sheltered accommodation provision for LGBT people. These provisions recognise the close connections between of the need for care and support and the need for community and social interaction and are often identified by LGBT older people as options that would alleviate their concerns about receiving care.

21. Social groups provide an important opportunity for people to socialise and make friends in the community. Welsh Government should continue to work with local authorities and third-sector organisations to ensure a range of opportunities to socialise remain available to older people across Wales.

22. For many LGBT people, it is important to find community with other people who are LGBT and who might share experiences with them. It is particularly important therefore that social groups and community organisations for LGBT people that are accessible to older people are supported.

23. Stonewall Cymru’s Information Service serves as a database for these groups across Wales, and should be signposted as a resource to those who run groups, as well as to those who work in professional roles across social services and wellbeing so they can inform people experiencing loneliness of the opportunities available in their area.