Loneliness is on the rise in Germany - why this is dangerous for democracy and health

Loneliness on the Rise: A Ticking Time Bomb for German Democracy and Health

Governing bodies leaping into action with research, local initiatives, and diverse alliances to tackle pressing health and societal concerns - it's becoming a familiar pattern. This time, the focus is on the escalating issue of loneliness, a matter of grave importance for both democratic stability and public well-being.

Germany's cabinet has recently rolled out a "loneliness strategy" boasting over 100 initiatives, from dedicated loneliness research chairs at universities to a "Coalition Against Loneliness" comprised of various players in society. To its credit, this list includes innovative ideas such as model projects designed to engage the 28-59 age group which, unfortunately, suffers from loneliness as much as the elderly population.

Loneliness's harmful effects on health and society

As Hannah Arendt pointed out in her seminal work "Elements and Origins of Totalitarianism," loneliness is a dangerous force that promotes depression, diabetes, and cardiovascular diseases. Moreover, the later stages of chronic loneliness can have devastating consequences, including early deaths and increased instances of heart attacks and strokes. On top of these physical health side effects, loneliness has been shown to erode democratic trust and encourage the proliferation of conspiracy theories - traits that pose a significant threat to our society.

This crisis was even more acute during the pandemic, when teenagers and young adults were especially affected by feelings of isolation. According to a recent survey, almost one in seven of them in North Rhine-Westphalia describe themselves as "very lonely."

Insufficient support for existing initiatives

The hospitality shown towards the 100-measure loneliness strategy is not without merit; nevertheless, its main drawback is the absence of binding financial commitments. As a result, the strategy risks becoming a mere pipedream. Regrettably, Germany has a unique advantage in its well-developed civil society sector, but the funds needed to support these initiatives consistently elude them.

Despite the abundance of anti-loneliness initiatives and clubs, a majority of these institutions frequently witness financial struggles and ultimately grind to a halt. Rather than perpetuating a never-ending string of pilot projects, what truly matters is the long-term endowment of established associations and programs.

The British example: Social prescriptions

The United Kingdom, grappling with the aftermath of Thatcherism's welfare state dismantling, has devised an intriguing alternative in the form of "social prescriptions." By enlisting GPs as allies in our fight against loneliness, they cast the medical profession as a tireless advocate on behalf of the socially isolated. Doctors with an inkling that their patient's core struggle lies in isolation, can jot down their concerns with the click of a button: a simple form will subtly suggest "loneliness" as a potential issue.

Once submitted, responsibilities shift to the local authority's "link workers" who facilitate referrals to various clubs, classes, or therapeutic sessions. Additional encouragement comes in the form of human companionship, as the lonely often find comfort in knowing that they are not alone and accompanying others in small steps back into society.

Pursuing social prescriptions in Germany would entail tackling the country's thicket of legal regulations, most notably the Social Code. However, a round of legal expert input is necessary to adhere social prescriptions to the German medical system with a proper billing provision for loneliness, an issue not yet officially recognized as an illness.

In the Berlin-Lichtenberg district, a local GP practice has embraced this approach, providing a space for social counseling and bolstering the invisible work of Germany's community organizations threatened by a lack of funding. The hope remains that the German government will recognize that mere words of support are insufficient, and that effective action requires sustainable funding and a comprehensive rethinking of national policies aimed at overcoming this lurking threat to health and democracy.

1. In order to combat loneliness successfully and in line with the British example, it is crucial to provide long-term funding for established initiatives, associations, and programs to address loneliness sustainably.
2. To implement "social prescribing" in Germany, changes in the legal framework and the development of a code for billing mental health care are necessary.
3. To integrate loneliness programs into established medical practices, collaboration between GPs and community resources can be a powerful starting point.
4. Long-term funding and substantial support for community organizations enable widespread impact on tackling loneliness in high-risk groups, such as low-income earners and older adults.
5. Educational efforts and raising public awareness regarding the detrimental consequences of loneliness promotes empathy and supports collective action against social isolation.

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Combating loneliness effectively requires a comprehensive approach involving the provision of long-term funding for initiatives and associations, legal framework changes, and collaboration between healthcare professionals and community resources. Some key considerations for implementing these strategies include:

1. Comprehensive funding support is essential for successful, sustainable programs aimed at addressing loneliness across the population, particularly targeting high-risk groups.
2. Legislation changes are vital to establish a legal framework that supports the integration of social care into routine medical assessments and care plans. This includes designing a proper billing code for loneliness and legal protections for individuals experiencing loneliness.
3. Integrating social care into established medical practice by fostering collaboration with community resources enables more consistent, effective care for the socially isolated and tackles underlying factors contributing to loneliness.
4. Scaling up and sustaining loneliness efforts is critical, particularly in developing digital infrastructure and technologies, to ensure positive outcomes in communities with varying degrees of connectivity and socioeconomic disparities.
5. Incorporating public awareness campaigns to challenge societal attitudes and stigmas surrounding loneliness increases understanding and empathy, ultimately fostering a supportive culture for the socially isolated.

By adopting a comprehensive and evidence-based approach to combating loneliness, governments can make meaningful strides in promoting positive mental health and overall wellness.