RECORDED Tue 17 Dec 2024
SUMMARY KEYWORDS: Loneliness, social connection, health conditions, mental health, social resilience, peer relationships, chronic disease, social isolation, stigma, social anxiety, school connection, technology, adolescents, social care, national strategy.
SPEAKERS: Michelle Lim, Megan Gilmour
Megan Gilmour 00:00
This episode is proudly brought to you by the TPG Telecom foundation dedicated to creating opportunities to improve the health, wellbeing and education of Australian communities in need.
Hi, I’m Megan Gilmour, MissingSchool, Co-founder and CEO, and this is Live & Learn. This is the podcast that unearths insights at the intersection of health and education, building a powerful alliance to keep kids with complex health conditions connected to school from anywhere. The podcast is recorded on Ngunnawal land, and we acknowledge and pay respect to the traditional owners of this land and the land on which you’re listening.
Megan Gilmour 00:49
Welcome to our weekly webcast, a place to zero in on the interplay between health and education and to amplify the voices of those supporting school students to navigate their educational journeys despite complex health challenges, and today on Live & Learn, we have Michelle Lim with us.
Associate Professor Michelle Lim is the CEO and Scientific Chair of Ending Loneliness Together, a Principal Research Fellow and Co-director of the Social Health and Wellbeing Group at the University of Sydney’s School of Public Health, and a practicing clinical psychologist with over 20 years of experience.
Michelle has led key Australian reports on loneliness, advises governments and industries, and is considered the country’s leading scientific expert in the field. Internationally, she has co-founded the global initiative on loneliness and connection, and serves on the World Health Organisation, social connection, technical advisory group.
Welcome Michelle. We’re so excited to have you on Live & Learn.
Michelle Lim 01:58
Thank you for having me, Megan, I’m really excited to be here for MissingSchool’s Live & Learn.
Megan Gilmour 02:05
Well, we’re here, as I said, Michelle, to talk about supporting school connections for students with complex medical and mental health conditions. So, let’s dive right into the questions.
Tell us about the impacts of loneliness and why it’s something every Australian needs to know and care about.
Michelle Lim 02:27
Brilliant. And before we even kind of go into that, just to make sure that everyone knows what loneliness is, it is a subjective feeling of distress that comes up for you when you feel your relationships do not meet your current social needs. So, it’s something that is a subjective experience, different from social isolation, where you might be physically alone.
And so, in the last probably 20 years, we’ve already known for a very long time in the scientific field that social isolation is actually bad for our mortality, our health, our wellbeing, but now it’s not just being physically alone that actually hurts us, but also feeling alone that also hurts us. So, I would say, in the last 20 years has been a huge acceleration of interest of science and research into this area looking at the impact of loneliness on both our physical and mental health.
Megan Gilmour 03:27
That is certainly something that every Australian needs to know and care about. And thank you so much for setting up this conversation with what is a deep capture of loneliness. And at the same time, simplifies it, I guess.
Michelle Lim 03:46
Yes, I think just to add on as well, and hopefully people do understand this well, because, loneliness itself is not a pathological condition, it’s a very innate feeling that does come out so that we can do something different and take action to do something about our relationships.
But when we kind of talk about addressing loneliness, what we really are going to try to do is to address or basically slow down the onset of what we call more persistent loneliness, or basically delay that, or arrest the development of making sure that if we do feel lonely, we’re not staying lonely.
So, what we’re really trying to do is address kind of more persistent loneliness, as opposed to saying that we’re not allowed to feel lonely, because actually we all do, you and I, and anybody who has a beating heart should feel lonely at any given point.
Megan Gilmour 04:41
Yes, and I think that’s a really hopeful place to start as well. So many people probably do assume things about loneliness. You’ve tapped into that a little bit in your first answer there. But what’s the million-dollar question you get from, I guess, parents or loved ones of people experiencing loneliness, or just people experiencing loneliness?
Michelle Lim 05:04
Well, we know there’s a lot of shame and stigma and misconceptions about what loneliness is and what it’s not. So in our last year in the State of the Nation report that we released at Ending Loneliness Together, we found that one in two Australians would actively conceal their loneliness and feel ashamed when they do feel lonely, they feel like they don’t have anyone to talk to or to turn to, that if they are not by themselves physically, they have no right to feel lonely.
And that’s a huge misconception, because while they are related, so if you are physically alone it may lead you to feel more lonely, so you’re more predisposed, it doesn’t work the other way around. So just because you’re lonely doesn’t necessarily mean then you become more and more socially isolated.
In fact, loneliness itself – you can be lonely in the crowd, lonely in the family, lonely at school, lonely at the workplace, lonely in your community. So, it’s about this idea where we don’t really know who is lonely unless we ask them. Because, you know, it takes a lot of really trained eyes to kind of do a rough guess that someone might be lonely.
But you know, people, even when they are lonely, often say they try to deny it, or they maybe sometimes don’t even recognise it in themselves, because they themselves don’t think that that’s how they should be feeling.
Megan Gilmour 06:30
And I imagine there’s some masking that goes on there too, with that complexity of attributing it to other things or perhaps acting out in a way that might not support connection, but it’s a cry for help around loneliness, and I’m sure we’ll get into that a little bit more as we, as we move through.
In your work, and when you’re hearing these things, what’s the most important thing that you want people who are lonely, who are feeling lonely, to know?
Michelle Lim 07:10
I really want to normalise that experience for them. I think that it is really important to know that they’re meant to feel this way. This is our system working appropriately. We should feel hungry, we should feel thirsty, and we should feel lonely. And what it really means is that we need to sit back and reflect about what we need, because perhaps our social environment is really not catering to what we really desire.
You know, for young people, sometimes they desire more relationships. For older people, they desire more high-quality relationships. So, it’s around, how do we get those relationships that we desire? If we don’t get those? What’s the next step?
Sometimes it’s important to remember that we don’t have to make big changes or actions for us to get there. Often, the solution is very feasible, small steps that we just make little bits of effort to kind of get to where we want. And maybe finding that meaningful, healthy social connection is one of those things that we chip away at.
We’re not meant to have our next best friend right away. This is something that we work towards over a period of time, where we bake those sorts of meaningful social interactions into our routine and build relationships very organically over bits of periods and kind of, you know, changing strangers into acquaintances, acquaintances into friends. We kind of take those steps and not put too much pressure on ourselves.
Megan Gilmour 08:50
Yes, wonderful. And what I’m hearing there is that being connected is a skill to develop, and I suppose that requires us to tell ourselves a different story about loneliness, as you’re saying, which is, it’s completely normal if the experiences in your life aren’t matching your desires, which you’ve said, can change across the lifetime as well. The kinds of things that connect us can change the relationships, quality versus quantity and all those sorts of things.
And that there’s not something wrong with us if we feel lonely. That’s what I’m hearing too. I think that sort of experiencing loneliness as if it’s an outcome of our inadequacy would stop us from practicing those skills that you’re mentioning as well, so that what we’re saying to ourselves about our worth or something else.
Michelle Lim 09:58
Yes, I think we’re really, you know, how a lot of people feel about loneliness is really a consequence of many years of misconceptions being reiterated in the media. You know that ‘oh, you’re a loner or you’re by yourself, so you must be a lonely person, and nobody wants to be friends with you’.
That actually is a very unhelpful connotation. In fact, you know, it doesn’t help, and people forget that again, we might feel lonely in that moment, but what happens is that there’s a lot of things that are outside our control that means that we stay lonely so things that we can’t control, and maybe not even about our personality or about anything about us, that actually keeps us lonely.
So, you will know, for many of your listeners out there, that almost one in three Australians will report loneliness at any given time, but one in four Australians report what we call persistent loneliness. So that is loneliness that if we follow this group, you know, one in four Australians will say they’re lonely up to 16 weeks from when we first asked them.
So, it’s something about the environment that doesn’t support them to build those meaningful social connections, and there are barriers, as you would know, with many young people, many, many people who might have health issues, for example, not being able to access school or not being able to quickly go out into a rich social environment. They’re living in impoverished neighborhoods, or they’re living in an environment where they don’t have a lot of control.
So normal to feel lonely, not helpful to stay lonely.
Megan Gilmour 11:46
Yes, incredibly important distinction there, and also some rather impressive statistics to put some perspective around the fact that loneliness is a universal experience – feeling – like you’ve said. But persistent loneliness is something else.
And then to just come back and link in the very important fact that prolonged loneliness has physical health implications as well as mental health implications, and that that is why it’s so important to for us to express our agency in addressing that.
Michelle Lim 12:36
Yes, I was just going to add to your point, I think when we feel like we don’t have those meaningful social connections, we tend to process that as a bit of a threat in our brains. It’s a biopsychosocial stressor.
So that’s why you have these implications to our health, to our mental health and wellbeing. We’re less incentivised to want to stay well, we’re less incentivised to exercise, to eat well, to do all those health regulation behaviors that are really critical to us.
Megan Gilmour 13:08
Thank you for putting words to that. I’m just going to check in – a biopsychosocial pressure – is that what you said?
Michelle Lim 13:17
Stressor
Megan Gilmour 13:18
Oh okay, a biopsychosocial stressor that then leads to other health engagements, or otherwise, things that are healthy or not.
Michelle Lim 13:32
Exactly: less likely to follow your medication schedule, those sorts of things to go to the doctor because no one’s nagging you and pressuring you to go.
Megan Gilmour 13:42
Yes, and I guess, because that’s hard wired in what we’re saying is that humans are designed for connection.
Michelle Lim 13:52
Yes, absolutely, you’re right. So again, we’re back to, you know, needing those healthy, meaningful social relationships is critical to us humans for survival. That’s how we thrive. That’s how we flourish. It’s really, you know, in our DNA to be with people who take care of us, who have our back, who we can turn to and talk to when there’s this trouble.
But when we feel like we don’t have that, in whatever context we’re in, whether it’s at school or work or home, that’s where we know that it will lead, or will be more predisposed to future health problems.
Megan Gilmour 14:28
Yes. And I think you said that for prolonged periods, we experience it as a threat. Did I hear that correctly?
Michelle Lim 14:37
Yes. In many ways, even in the short periods we experience it as a threat, but when we don’t do anything about it, this is where stigma and shame really doesn’t help, because we put that upon ourselves as really us as a community, saying, ’Oh, it’s so shameful to be lonely, or you shouldn’t feel that way. You should be fine because you’re in the family and you’ve got kids’ or ‘you’ve got friends at school; you should not feel that way. Why should you feel that way?’
And we put that on us, this outer community saying you shouldn’t feel that way, when, in fact, that stress is normal for us to feel it’s actually a good thing and a healthy thing for us to do something and to react to it, but we’re not allowed to. We don’t know where to go or turn to, where do we get help, because it’s shameful to say that ‘I’m lonely, I need friends.’
So, you know, we need to find a way of having this conversation where, if I ask you, ‘Oh, do you feel lonely?’ And if you say yes, my immediate response is to say, ‘Oh, what should we do together’ and not take it personally? Because sometimes people take it personally, and go, ‘Why should you feel lonely? You’ve got me’. You know – that sort of stuff.
Megan Gilmour 15:54
Ah, yes, yes, I hear what you’re saying, yes. I predict that we’re going to get into a little bit more detail about what the components, or what social connection is, like what are the features of that, and why would loneliness occur even in a crowd or with a family in your home. And so that’s really interesting to me, and I’m sure to the audience.
Before we jump into that, we’d love to know, Michelle, what puts you into the world of loneliness?
Michelle Lim 16:36
Yes, so you mentioned that I was a psychologist by training. I’ve been in practice for 20 years now, both in the public system and in the private system. And when I was training as a young psychologist, I chose a field where I was really catering to probably one of the more severely disabled community, people who experienced what we call chronic psychotic disorders. So, people, even after we treated them, would still experience hallucinations and delusions, and their level of care is so high to the point that they often live in group homes. They’re often living with elderly parents because they had to be cared for, and services would see them maybe two or three times a day.
But despite the high amount of contact and high amount of care that we do give this vulnerable group, this group of people still complain of loneliness, and it really struck me how our care industry don’t really prioritise social care at all. In fact, we might only think about their social care perhaps if we want to discharge them off our books.
And so, I decided to do a PhD in looking at social relationships and how that can buffer the distress of mental ill health and that kind of led me into the field of loneliness, unexpectedly, it wasn’t something I planned.
I did a bit of training in the US around loneliness and social anxiety. And when I did come back to Australia, you know, I really kind of connected with people with lived experience who said, look, we really need to do something about this issue, and we need to look at the UK and look at other countries in the world that they’re kind of addressing this now. We need something in Australia that makes sense, and can we use the evidence to really inform practice and policy here? And that’s what Ending Loneliness Together does.
Megan Gilmour 18:37
Yeah, fantastic. Thank you so much for sharing that we often get this answer. That’s some kind of circuitous process that people go through in their lives to arrive at their particular thing and while they never intended, you know, never set out to do that, but that’s the discovery along the way.
Michelle Lim 18:57
Absolutely.
Megan Gilmour 18:58
And I think that connection is so important as well. So, if we move a little bit more into the sort of the health people with health conditions space, knowing all that you know, what’s your biggest hope for people experiencing loneliness, their families and loved ones when navigating a health crisis. So, where that loneliness is in the context of that person having a health crisis or a serious illness?
Michelle Lim 19:31
Yes. I think we do know very, very clearly that people with chronic disease as well have about 2.6 times higher chance of being persistently lonely. So, this is an incredibly vulnerable group. Having to attend to your physical care and mental health care will take you away from building the meaningful social connections that you need, and ironically, sometimes what you need to recover – to accelerate your recovery. So, it’s a very difficult time for a lot of families to manage their connections and chronic disease.
One thing that we really need to do and really advocate for is that how do we encourage social care when people are going through a health and medical crisis. Doctors are very good at knowing what to give us in terms of medication, but they don’t know how to better support people as they go through this journey.
And it’s often sent to the social workers, and interventions and solutions may not be varied enough for someone to uptake those solutions or maybe doesn’t work in their context. But how do we better support people so that they can recover, or they can manage their health crisis a little bit more. I do see some interventions out there that have been helpful, but what we need is better evaluation and better scale up. So, when we know that if these programs work, we also need to be able to scale them up pretty quickly when they work.
Megan Gilmour 21:19
Thank you for that. That’s what MissingSchool has been trying to do in terms of school connection for children who are experiencing a medical condition – is how do you do that at scale? How do you maintain that connection? And not just as you’re saying, not just any connection, but the connection that has meaning for the person, the connections that they want.
How do you scale that cost effectively, and, you know, efficiently? So, this is a big question, and I’d like to touch on later about the role of technology, because I think we’re hearing both sides of the story to do with technology, to do with connectedness and to do with loneliness as well. So, I’d like to just tap onto that.
But I also just wanted to pick up the point that you made about people with chronic health conditions being 2.6 times more likely to experience persistent loneliness, and so when you translate that into the percentage of people that we’re talking about just in the general population, but then for a population of people who are experiencing chronic conditions, then it’s, you know, we’re really getting the picture of how important this is.
Michelle Lim 22:46
Yes, and the work that you guys do is really critical, because you’re really targeting a group where social connection is everything to children. It’s everything. It’s so important for them, they will rank it much higher than the parental relationship.
Megan Gilmour 23:03
And that’s true. And I wonder if there’s a sort of a biological reason for that too. You know that that’s hardwired in because it is about learning to be human and survival and all those things.
Michelle Lim 23:17
Yes, and you know, all of us have been young and at that age, and if we can remember, you know, relationships are really critical to children, and then as we grow into adolescence, you know, it shifts from the parental relationship to your peers. We do shift back down the line, of course, but we’re really trying to navigate who we are in the context of that wider world outside the family.
Yes, parents can provide the best support, but sometimes it just doesn’t feel enough for the young person, because they’re just simply the parents, you know, they’re offering something different. But what they want is that peer relationship that they have more friends, to be acknowledged, to be seen by their peers, and you might be the best parent in the world, and sometimes you just can’t give that and so that is a struggle.
Megan Gilmour 24:13
Yes. And I think, when you say that, what I’m reminded of is the fact that we can feel lonely and disconnected from ourselves and our identity, especially in those teenage years where we’re not quite sure where we fit, which group, who are we shaping up to be? And does that match the environment around us?
And can we find that, and this isn’t my area of research, but that sort of mirroring effect in the world that we have, which is, we see who we are by our relationships to others as well, and our interactions with others. There’s something there at the same time. So, it really does sort of put more granularity to the conversation that we have here at MissingSchool about why that peer connection is so important.
You’ve mentioned identity, and a lot of people that we’ve spoken to on Live & Learn talk about identity from the perspective of different health conditions, and that an important thing is for that person not to become their diagnosis and to be able to maintain their whole self and bring their whole self to the world.
Michelle Lim 25:40
Yes, absolutely. And that is healthy, because, you know, we need to have different facets of ourselves to hold us up, you know. And it’s what we call self-complexity, you know, we need to have a strong identity as a sister, as a daughter, as a friend, you know, someone who does music, someone who does dance, not just someone who’s sick, you know. And having multiple parts of you is really important for our health and wellbeing.
Megan Gilmour 26:09
Thanks for raising that, because I suppose that’s one of the things that children who are in a health crisis, or at times in their health journey are in a health crisis, or isolated, and because of that in hospital, or maybe even at home; one fundamental thing I hear there is the representation through social connections of different facets of ourselves, and obviously, if you’re unwell and isolated, then the range of expressions of that is limited, so you’re not getting the range that you would normally have.
Michelle Lim 26:50
Absolutely, and that in itself becomes a lot more compressed, so a lot more simplistic and this is where you know that whole buffering hypothesis, sometimes the more complex we are, the easier we are to buffer stress and to cope. But when you have that very simplistic identity, you know, if one part falls down, it’s very hard to recover.
How do we help children? How do we help people with chronic disease and with health issues to build different parts of themselves in a way that is helpful and to feasibly do that. You know, we have challenges to begin with. How do we rebuild that part, even if it’s within the resources that they have, right, and their abilities and capacity to do those things.
Megan Gilmour 27:46
Yes, I think we have a side effect of missing school, which is, and I won’t get the wording exactly right, but it’s susceptible to, or at risk of shock. And I think that’s what you’re mentioning there, which is where that variety is taken away, and you’re singularly focused, or only have one source or supply of social connection, you’re more – well it’s vulnerability to shock, you know what I mean, and the effects that that has.
Michelle Lim 28:16
Absolutely, yes.
Megan Gilmour 28:17
So, you’ve talked about some of these, and please feel free to add or discuss further, what are some of the common and perhaps frustrating public misconceptions about loneliness, and how have you seen this impact families?
Michelle Lim 28:33
Yes. I think that a lot of people think that it only affects older people, that you need to experience some sort of bereavement, or maybe something negative or loss that you’re therefore more susceptible to get lonely.
But actually, even positive events can make someone feel lonely. So, things like moving to new school might be a good thing. You know, a new start, maybe a better school. You know, a new job, a new state, a new country. For people in their middle age, you know, having a new baby.
All those things that are seemingly positive, can also pose a social challenge, and that’s okay if you feel a little bit lonely during that transitional time, it’s normal for you to be able to revise your social expectations and challenges and contexts. So, to kind of give people, you know, they should give themselves a little bit of allowance to feel that way.
Megan Gilmour 29:32
I love that answer. It’s so important and brings back to mind that it is a natural human thing, but often we would feel even more guilty or uncomfortable that the fact that something positive is going on in our life and here we are sort of feeling a bit ungrateful for it, or like we’re not enjoying it, and then we’re adding all those layers of narrative on top. But of course, because those involve changes in our social interactions and changes of people often, and all of those sorts of things.
Michelle Lim 30:11
Yes, I think a second point – and just to build on your point, we need to remember that relationships change over time. We should not expect them to be stagnant, and for some reason, we always think, oh, it’s this way, so it has to be kept this way all the time. But you know, people change, and you will change, and context – sometimes it’s got nothing to do with the person, but the context changes.
So, it’s okay, if you actually disconnect from someone, at some point you feel less close to someone, like, do not take it as a sign that, ‘Oh, it’s terrible’; actually, that’s normal. It’s almost like a wave, like we need to kind of ride that wave and build different kinds of friendships, you know, so that we again have that diversity. If you have more than one person, then when we actually go through those changes is not going to affect you as much.
Megan Gilmour 31:05
Yes, you’ll be less vulnerable to shock.
Michelle Lim 31:08
I love it [laughter!]
Megan Gilmour 31:09
Yes, it’s such a helpful conversation. I know people are going to get so much out of this. It’s really something that, I guess because it’s feelings that come and go, that we don’t tend to think that we can practice at them.
And I love the fact that you’ve said out loud that relationships change across life. I mean, it’s something that seems so simple, and yet we beat ourselves up about it, and we tell ourselves all sorts of horrible things about it, and even the same relationship can change and then change back again. People can come, they can go, they can come back again. And all of this is possible.
Michelle Lim 31:57
Yes. And it’s funny, because you know, you and I have probably the benefit of hindsight, but for a child, they do not have the benefit of hindsight.
Megan Gilmour 32:07
That’s right, and so I imagine then, and we’ll go into this, but being able to create some architecture for children around this feeling of loneliness and how natural it is and be able to have those discussions quite openly. And I suppose sometimes I’m thinking as a parent that we might also feel affected by our children’s loneliness when they talk to us about other people doing things –
Michelle Lim 32:44
You don’t have the control, and you want to naturally protect them, but know that as they get older, and this is where I fear, because I do have a very young one, that I’m no longer going to be able to provide that refuge.
So how do we build them in a way that they have that social resilience on top – that’s a little bit of a challenge, isn’t it. Like, this is the thing, I’m sure you think the same way too, but nobody likes to be disliked, and everybody wants to be accepted, right? But there will be moments where your child is just not liked, for whatever reason, and not through any fault of their own.
And how do we give them that perspective, the wider perspective, that it’s actually okay, and that it’s okay to not be liked by everyone, and we can say all we want, but sometimes they just have to experience it to be able then to digest it. Because sometimes, you know, parents saying things, they just go in one ear and out the other, or ‘you’re just trying to make me feel better’, or you know, that kind of stuff.
Megan Gilmour 33:55
Yes, I always had to put in a personal kind of note to self. My children are older, but, and believe me, I didn’t get it right all of the time, but when they were telling me, you know, such and such did this, or someone did that, and tried to delay criticising the other person, because the other thing that happens, to your point, is that today, an enemy, tomorrow, a best friend, the next day [laughter], you’ve got to kind of hold those things quite lightly! And I suppose that gives them the space to do it.
But I can see why this work is – and what our young people and children are going through today, and the wellbeing and health crisis out there, be it physical, be it mental health. These kinds of conversations, backed by scientific knowledge, and translated into everyday practice and action, are going to be just so important for parents to have, and for practitioners to have, so that we can frame this up in a in a more beneficial way, in a helpful way, so that you can navigate the ups and downs, the waves, as you say, as a practice, for children.
So, you have given us some incredible stats. I’ll just go back over it so we can capture it in this section.
How many Australian children and youth are living with loneliness right now? Do we have that number?
Michelle Lim 35:43
We will, this year, because we do need to, what we call, establish a criteria. But it is estimated, I will just speak to the young Australian loneliness survey that I did – before COVID was around one in three young Australians that experience loneliness at any given time.
I do not know about persistent loneliness in that group, but we do know for the 18 to 25 year olds, so still considered young people, at least 40% of young people also experience persistent loneliness, but we do not know what the persistent loneliness statistics are for under eighteens, which we will release probably at Loneliness Awareness Week in 2025, but we don’t expect it to be much, much higher or much lower than 18 to 25 year olds.
Megan Gilmour 36:41
And will that data collection also capture whether other demographics, like whether there’s chronic illness in the picture as well?
Michelle Lim 36:56
Yes, in that particular data set that we’re looking at, there are some health variables, but it’s also a lot of educational and social variables, and we want to look at how being persistently lonely, for example, for young children and adolescents, actually lead to maybe poorer health outcomes and educational outcomes down the line. So, when we look at wave data, we want to kind of look at the prediction of what that looks like for the education outcomes further down.
Megan Gilmour 37:26
It’s interesting, because from peer reviewed research, we know that up to 30% of students have a health condition serious enough to affect their wellbeing and education attainment and attendance. And then we’ve got the current school attendance crisis now globally and nationally.
And the Greens party did some phone surveys, and obviously that’s not peer reviewed research, but there was 40% of young people in the category of experiencing anxiety and other things that were causing them to miss school.
So, there’s some interesting – we won’t make the association directly between those data, because we can’t, but I just say that because we’re talking about health conditions and the interaction with loneliness here.
Michelle Lim 38:37
Absolutely. Yeah.
Megan Gilmour 38:41
This is our one of our typical questions, and I’ll be interested in your answer, and whether it applies. Is there a risk of delayed diagnosis? If it is indeed a diagnosis, and we know it’s not a clinical diagnosis, but is there a risk of delayed diagnosis, or are most cases of loneliness, persistent loneliness picked up easily.
Michelle Lim 39:09
So yes, you’re right. We probably shouldn’t call it a diagnosis, because, again, it’s not a pathological condition. But what we do know is that it’s very likely that people are under reporting loneliness and therefore not getting the help that they need early enough to actually work on the prevention end.
As I mentioned before, there is a lot of stigma and shame and concealment, but also if people are not routinely screened, they’re not routinely asked, I mentioned loneliness is one of those things that we only know if we ask someone.
So, if we go to the doctor, they’re not getting screened. They’re getting screened for depression. And sometimes they assume that that is just because they’re lonely, they’re depressed, and so they get sent to psychologists.
And not saying I’m the one to kind of badmouth my own industry, but what I’m saying is that it’s, you know, send someone with depression to a psychologist, but you don’t have to send someone who’s lonely to a psychologist, because that is a waste of resources, and psychologists are expensive and they’re difficult to get to.
So, there’s a lack of identification in our health system or social systems or school systems. People don’t routinely pick that up. We don’t routinely ask because, again, it’s still an issue that’s really misunderstood, like, why should we ask them – they’re living with a family? Why should we ask them they’re living at home?
Megan Gilmour 40:34
Assumptions
Michelle Lim 40:35
Exactly. And so, because of these false assumptions we don’t screen them. We don’t screen them just because they’re living with other people. And now we know different. But you know, it takes about 15 years for practice and policy to really catch up to science.
Megan Gilmour 40:58
Yes, and this is such an important conversation. Anybody thinking about this can see the problematic nature of that, and where people can end up simply because they’re lonely and may not be able to identify that themselves.
And then those they might be engaging with don’t have the criteria or the processes in place to triage through, you know, ‘Have you had a bereavement?’ ‘Have you had…’ – the first principles or the root causes? And so, we’re going straight up to a higher order, complex diagnosis of depression, and then unfortunately, if it is loneliness, you can see how it won’t be resolved by that pathway.
Michelle Lim 41:53
And people who do get screened by their GPs for depression often say, ‘Well, I was just lonely, but then they were asking me all these clinical questions about whether I want to kill myself, and it just feels really wrong. It feels like they’re not really understanding what I’m trying to say, and it just doesn’t feel like the right process for me.’
Megan Gilmour 42:11
Yes, another important point. So just wanting to be able to have that recognised, and then I suppose having things said that are blatantly unhelpful in that circumstance. It’s a wrong pathway, in other words, it’s going down a wrong path.
Michelle Lim 42:34
It’s absolutely a wrong pathway, exactly, yes, yes.
Megan Gilmour 42:38
And I think that could possibly, for some people, based on what you’ve said, then lead to feelings of guilt or shame or catastrophising loneliness, even persistent loneliness as being depression.
Michelle Lim 42:53
Yes, yes, and then when you do feel that maybe some of them are going well, I need a lot to actually manage this when, in fact, that they don’t need that intensity. They really need just something a lot less intense for them to resolve it.
But ignoring it and not knowing where to go, all those things can really make someone just feel lost about how to seek help and when to seek help.
Megan Gilmour 43:18
Yes, and if the amygdala is dialed up, the fear centre, the threat, can that trigger anxiety, as well as where loneliness can trigger anxiety?
Michelle Lim 43:28
Yes, actually the comorbidity of loneliness and social anxiety is pretty high. There’s kind of some debate as well in the scientific literature if that is sometimes the same thing, because what we do see is very similar neural processes like the amygdala being activated, very similar to social anxiety, and the cognition that goes with that is very similar.
In a lot of my studies when I work with young people, you know people who were screened for being lonely, quite highly lonely, about half of them also meet a clinical diagnosis of social anxiety disorder.
So when we think about addressing loneliness, we often also think about screening for social anxiety, because if you don’t treat that, or you don’t address that, it’s really unlikely that whatever program you put for loneliness is really not going to work, because you’re dealing with a comorbidity issue that will stop them from really getting the connections that they need.
When you have as well, on top of that chronic disease or an illness, I think that’s heightened, that anxiety where you fit in, especially when you’re a child, all of that is heightened dramatically.
Megan Gilmour 44:41
Yes, so that’s one of the biggest issues that students we support face, and one of the things that continuing connection is reported to resolve or reduce, is anxiety. So, we’re also seeing that students who are separated from school have increased anxiety. They also having a health condition and trauma, perhaps associated with that.
There’s a lot going on but staying away from school and having to re-enter after long periods and things like that increases anxiety. So, maintaining the connection, whether it’s digital and physical, actually, is reported by parents and teachers to reduce their anxiety. So, I think this is why your work is just going to be so important in this context as well.
Just talking about kids and you’ve mentioned some there, but are there other complications for children in the context of health conditions, who experience loneliness?
Michelle Lim 45:57
I probably would put a call out to two vulnerable groups. You know, if child identifies as LGBTQI, very much, also facing discrimination, bullying, on top of that. It’s a very vulnerable group, and we already know from the literature that that group will be, you know, when we compare that to adults that group’s experiencing more loneliness than not.
And of course, you know, young people with neurodiversity as well, I think that there’s always this assumption that people, or young people with ASD, for example, don’t want friends, but actually they do. They dearly would love friends and dearly would love their group.
And this assumption that just because maybe they might not have maybe social skills to, you know at the same level, that means that it must be their fault. Actually, it’s not, you know, it’s actually they can experience friendships and relationships in a kind of fulfilling way, but they might have fewer opportunities to do that.
And how do we better support children of neurodiversity? Because we do know that that’s becoming incredibly common now, and there must be supports and more assistance for those two vulnerable groups.
Megan Gilmour 47:26
Yes, absolutely. And across our work, of course, we have students in both of these categories who also have chronic health conditions and, of course, what I’ve been saying more recently is it’s not one thing or the other, it’s the fact that it’s a Venn diagram of issues, because some of those people, young people, come from a rural area, and they come from a low socio-economic situation.
So, there’s this Venn diagram of issues and sort of not fitting in necessarily into one specific category, and the bullying as well. So, children with chronic conditions, it’s reported to be bullied at higher levels of bullying than their peers who don’t.
So I think you and I could probably talk about some of this for hours, and I’m trying to stick to my questions, but I’ll just put a note here to say that, there would be probably a whole sort of range of things you could say to us about what happens when somebody experiences loneliness and expresses that in the school setting, and how that then negatively affects how peers might treat them as well – compounding that.
Michelle Lim 49:01
Yes, yes.
Megan Gilmour 49:05
So, next question is the current population of school aged children with loneliness, and do we have that figure? And if so, how accurate is that?
Michelle Lim 49:18
I think my response will be probably very similar to the ones before. I think we will probably know a little bit more this coming year in terms of the proportion of school age children, but I just kind of reflecting on international data again, that they don’t seem to be really differing too much.
Again, the vulnerability that we do see, and the spikes of vulnerability, would be with children with chronic disease or the existing risk factors that might predispose them to being lonely, and you mentioned low income and socio-economic backgrounds. That would absolutely predispose them – if someone’s coming from the lower socio-economic background – predispose them to experiencing higher levels of loneliness.
Or if we look at just the general population with children that do not have those complex issues, what we have seen typically is that the 18 to 25’s tend to have a spike, and that’s because of the transition from high school for the education and vocational training.
Because your typical school age children are leaving the safety of high school and into a world where actually there’s no structure, no social structure, and a new way of navigating a whole different landscape, including making friends with people who are not of your same age. We tend to see those typical spikes in the 18 to 25 years in international data and national data.
Megan Gilmour 50:53
And noting that you’re mentioning this, in 2025 you’ll be able to release more data on this, this group.
Michelle Lim 51:03
Yeah, we will absolutely love it when, if people do channel into Loneliness Awareness Week, because we’re hoping that in 2025, we’ll be focusing on young people, so adolescents and young adults.
Megan Gilmour 51:14
Yes, and can you tell us when that is
Michelle Lim 51:18
Loneliness Awareness Week is held the first week of August every year. So, we do have a website that’s Loneliness Awareness week.com.au, that we actually host. And right now, people can actually already get resources, which is like, how do you spot loneliness? How do we talk about it?
Loneliness doesn’t have a face. You know, people of different, diverse cultural backgrounds talk about loneliness. To be able to make sure that we don’t see this as just in a high-income country problem as well. You know, this is a global issue. We really very much want to make sure that we start changing the lingo, changing the language that we use when we talk about loneliness.
Megan Gilmour 52:02
And do kids with loneliness – school age children – if you know, currently miss a lot of school. So, this is a bit of a complex one, I guess, or maybe, maybe it’s not.
Michelle Lim 52:15
I think there might be some data around school refusal and loneliness from my understanding and I think that might be UK Data. I haven’t analysed that within the Australian data set, but I would imagine loneliness would be heightened, especially when there’s a disconnect from their peers.
And as I mentioned before, you know the peer relationship for children and adolescents probably starts to get more and more important. And not being at school is incredibly distressing for some young people, and for some of them it’s not something they can control.
Megan Gilmour 53:00
That’s right, yeah, in those cases. And we have a point of view on the labeling that goes along with school non-attendance, and in many ways, it can be about the actual coding of attendance and the way children’s absences are coded, whether it’s an approved medical reason or it’s unapproved, meaning there’s no diagnosis from a doctor, so there’s no reason, which, of course, is not a straightforward thing, as you pointed out earlier, where sometimes even there’s an invisible illness, or there isn’t a diagnosis yet, or it’s chronic anxiety.
So, you know, the labels that are given to children for being away as well also complicate this conversation, don’t they? And unhelpfully so.
Michelle Lim 54:01
Yes, absolutely.
Megan Gilmour 54:04
Just rounding off, you’ve been so generous in terms of the information and pointing to the data and stats that you’ve shared. Are there any particular times in a child’s life – we’ve talked about adolescence. We’ve talked about illness – is there anything you’d like to add to those critical times and what families should be prepared for at those different times, to do with loneliness?
Michelle Lim 54:38
Look, I think, I think children, regardless of the health status, are all – they all are wired and hard wired to connect, right? So, if they don’t get the peer connections that they have at school, it’s about thinking about how we can help them develop new ones outside school, or in their community with other kind of extended family or friends or friendship groups, that a parent can start to give them options, you know,
And again, we need to teach young children about social resilience, about managing realistic expectations of what relationships look like and how they can change, and how it’s okay to have someone potentially pull away from you, and also that they might be doing it themselves.
And how do we teach young children to do what we call a proper social hygiene? Now, we all know how to do it, but we don’t necessarily practice it ourselves. So what are the kind of skills that will help them nurture meaningful, healthy social relationships, and to be able to also be navigating how do you move away from relationships that don’t work anymore, that might be a bad influence on you, bad for your health, [so] that they can find acceptance and belonging in other groups and friendships in other areas that might be better for them. And how do you navigate and how those pathways are possible?
Because I think that, again, you know, depending on the circumstances and the context, we can build some complexity into the child’s world at some point, or at least offer, or at least show there are other pathways. We can’t control everything as parents, but we can draw lines and draw little pathways that might offer your child different options. And that is not just always black and white. There are all these shades of grey as well.
Megan Gilmour 56:48
That’s so important, and we’ll be able to point to your website and places where people can find things, especially about social hygiene practices and things like that, the really tangible things that people can do to – not end loneliness for themselves, because, as you said, that’s not a goal we even need to aspire to – but just to be able to navigate our relationship with loneliness in a more positive and capable way. And I can’t help but think that your work must go into schools. It just must be taught.
Michelle Lim 57:32
Yes, we’re really hoping it will.
Megan Gilmour 57:36
Yes, I look forward to having further conversations with you about that, because we know that a lot of trauma informed practice work is going on in schools, and that’s necessarily essential and important.
We’d also love to see more of this social resilience, and being able to give a toolkit of how to navigate through what is not only essential to us, but is unavoidable, and that is social relationships. It is just, you know, this is what we need to do. This is what we have to do.
And you know, so I guess that brings me to the next question, which is just before we head to close out, and that is, do you think that these vulnerabilities that children are experiencing, some are natural, and then some are more persistent and in the area of loneliness, do you think that what’s currently happening out there or happening in schools is enough right now to do with this?
Michelle Lim 58:54
It’s probably not enough. Yes, that’s probably a gap, because, you know, parents don’t even know what the word is and how to have those discussions and the awareness of tackling this, this is not just a you problem or an I problem. This is everyone’s problem.
Schools are active participant in this, our communities are, our workplaces are, wherever parents have touch points and teachers. The ecosystem of the young person is not just the young person themselves. We all need to be having a proper conversation about what that looks like, how do we address it? What do you mean when we want to address loneliness? Maybe what we’re talking about is persistent loneliness. How do we build an environment that helps young people and children build meaningful social connections healthily?
They might go through those changes of connecting and disconnecting, but they are still able to be resilient enough to find new friendships and don’t have barriers set up for them, and if they do have those barriers, what can we do to actually remove those barriers?
What kind of policies can we do within schools that means that young people with chronic disease do not miss out, do not actually, that they can still meaningfully engage, even if they’re remote. All those things are so important because, as you know, children and young people they’re so diverse. So how we cater to that diversity is really critical.
Megan Gilmour 1:00:27
Yes, thank you so much. I’m picturing like a course at school that’s called ‘How to be a Human’ and this is 101 [laughter]
Michelle Lim 1:00:36
[Laughter], well, we’re developing something right now, so hopefully!
Megan Gilmour 1:00:42
Yes, but seriously, because these things occur so naturally for us, we think that we should just be born knowing, and that we should just be capable. And then we avoid all of the opportunities that you’re talking about to actually become better at connecting; to find ways to resolve our loneliness, healthy ways to resolve our loneliness, without shame, without blame. And that excites me so much, especially for our work, because it’s so much in alignment with what we’re doing.
And we know that this is a social prescription – school connection and maintaining school connection – is a social prescription for social connection. And what we also know on the other side of it is that peers in the classroom also benefit from a person who’s away rejoining the class, even through two-way digital technology connection.
Because we’re getting close to time now, I won’t go into it, but I would love to, if you will, invite you back so we could have a conversation about the role of technology, and maybe what that might look like, simply because when we talk about using technology to connect children to school, sometimes even from policy makers, we kind of get this knee-jerk reaction that is, technology is bad for young people, it’s causing isolation. And I get it, I get that. There’s a lot of narrative out there about social media and other things.
Michelle Lim 1:02:33
But you know, things are never as simple, and they’re never as black and white, are they really?
Megan Gilmour 1:02:37
No, that’s right. It’s kind of like the era of prohibition to do with alcohol, and then that didn’t stop people consuming alcohol. And of course, there’s a whole gradient of levels of where that works well, and then it doesn’t, and so on. And I tend to look at technology in the same way. It’s not good or bad, it’s the applications and how you use it and what use it’s being put to, and all those sorts of things. So, I look forward to more conversations on that, if you if you’re willing to engage in that,
Michelle Lim 1:03:13
Maybe we could have that during Loneliness Awareness Week.
Megan Gilmour 1:03:16
Yes, yes for sure, because your work is just right at the centerpiece of what we’re doing and why we’re doing it and also bringing the science to it and making sure that evidence is speaking through that translation to practice.
Michelle Lim 1:03:38
Yes, and thank you to you and your team for doing this really important work. I really love your mission, and I love the values that you guys hold, and it seems like you guys are doing fantastic work.
So, I really know that young kids who are vulnerable with illness, really have this opportunity to kind of participate back in school because of you guys.
Megan Gilmour 1:04:00
Well, we really want to take it into the UN now. That is our background. We, myself and our Impact Director, came from the international development space. So, it’s a message that we want to – and data – that we want to share internationally, because this is an issue across developed countries, and as you said, just everywhere.
So we have a lot to say now, and I guess what that leads me to is, through your incredible generosity today, and thank you for the work that you’ve done through your career, that you honoured that urge to move into this area and the value that that’s bringing, at a time in history, where it’s just right at the forefront of everything.
And so, you’re ready. You know, all of the work that you’ve done makes you ready for this moment, and everyone is grateful for that. So, as we close, is there anything else we should be asking or talking about in loneliness that we’ve missed that you want to slip in here?
Michelle Lim 1:05:11
I think, I think for parents who are curious, for teachers who are curious, really start to learn about it, talk about, let’s, let’s develop a healthy language about it. And if people would love to help guide the work, share their experiences around this topic with us, please feel free to reach out to me.
[I’m] really always interested in collaborating and interested in channeling the lived experience and, you know, delivering things that really make sense to people we don’t really want to, to deliver anything that doesn’t make sense. So, if there’s anybody who’s interested in reaching out, feel free to email me. It’s michelle@endingloneliness.com.au.
Megan Gilmour 1:05:57
Thank you so much, and we’ll put that in the notes. Do you have a call to action for loneliness in seven words or less, Michelle?
Michelle Lim 1:06:06
You need a national strategy to address loneliness and social isolation.
Megan Gilmour 1:06:09
Ah, there we go.
Michelle Lim 1:06:13
That’s amazing. A federal, national strategy, because we are falling behind, Australia! We are one of the one of three countries that have the economic costings of loneliness and social isolation that cost at $2.7 billion, but we are also the only country that does not have a strategy.
Megan Gilmour 1:06:31
Well, Michelle, that’s something you and I can work on together! Because, yes, this I was recently awarded the 2025 ACT Australian of the Year for the work, and I really have an agenda, and it sounds like yours and mine have a great alignment [laughter]
Michelle Lim 1:06:57
And so, we are connecting Megan! You and I have shared values and shared interests [laughter]
Megan Gilmour 1:07:04
We are connecting – exactly! And there you go. I think that’s such an amazing place to land, which is the meaningful nature of social connection. There has to be meaning made in the connection for it to be effective.
Michelle Lim 1:07:17
Well, this is the highlight of my day.
Megan Gilmour 1:07:20
Yes, and indeed mine. And look, as I said, our absolute and sincere praise and thanks to you for your work. And maybe we’re making a course about how to be a human 101.
Michelle Lim 1:07:35
I love it. I love I love the title [laughter]
Megan Gilmour 1:07:37
Yes, and a shout out to Ending Loneliness Together, you can find learn that place on the interwebs, www.endingloneliness.com.au [https://www.endingloneliness.com.au]. Thank you for joining me today. Michelle on Live & Learn. It’s been an amazing conversation.
Michelle Lim 1:07:59
Thank you so much for having me, Megan.
Megan Gilmour 1:08:04
Thanks everyone for tuning in. Help us turn up the volume so all kids are seen and heard. Follow along, like, share, comment, or leave us a review, because we love hearing from you. And if you want to donate, head to MissingSchool.org.au, because every dollar makes a difference.
View podcast here.
