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Social Isolation leads to mental illness or Mental Illness leads to Social Isolation?
Point to ponder!

By : Mumtaz Ameen Hamirani

Mental illness has a heavy burden on the globe. Like all other diseases mental illness has put lot of load on health of human beings worldwide. Almost 400 million people are suffering from neurological, mental and psychosocial problems. Out of these 400 million great proportions are from South East Asia .Global Burden of Disease report have highlighted that fifty percent i.e. five out of the ten most disabling disorders in the world are related with psychiatric nature. (WHO Report, 2001). Mental ill person feel odd from others and then it leads to frustration, guilt, and social isolation. According to the Hortulanus, Machielse, & Meeuwesen as cited in Ali & Kohun (2006) Social isolation means lack of purposeful or meaningful relationship. Social isolation means to keep away from other, not socializing with others.

In south Asia most people avoid seeking medical help for psychotic illnesses as they believes that people with mental illness are curse from higher authority [GOD]. People take patients to the traditional healers or faith healers (WHO Report, 2001). In Pakistan burden of mental health is very high. In Pakistani context social isolation is very significant. It is a common saying that a man is a social animal and a person cannot survive without a society. In our culture social isolation is not very significant because of the extended family types, where all people lived together and share their feeling and emotion with each other. In addition people get chance to share their feelings however, this could be overlooked when a person is suffering from an illness especially mental illness. As in physical illness many people comes for condolence because they know that the person is ill because most of the time they are aware of disease and its course. Whereas, most people doesn’t know about mental illness and they are not aware of mental problems. Moreover they don’t even see mental problem as a disease process, they stigmatized mentally ill patient. Mentally people are disregarded, ignored and secluded form the society (WHO Report 2001). This is the main reason why all patients will mental illness suffers with social isolation.

Social Isolation is very complicated to understand. Svensson (n.d) stated “social isolation is not a disease, is not contagious and can be cure.” Anybody can be suffered from social isolation but is usually referred with the mental illness. House (2001) as cited in Ali & Kohum (2006) stated “social isolation as contributing factor for depression means that social isolation can lead to many mental problems.” On the other hand, according to Elisha and Hocking (2005) people with mental illness are more like to suffer from social isolation and loneliness. Means in mental illness patients feels powerless, helpless and guilty and keep them away from others and become socially isolated. Thus, there is a vicious cycle of social isolation and mental illness. In critical analysis of the social isolation, it is very important to understand the main causes behind the social isolation. If we know the exact cause we would be able to the handle it accordingly. Svensson (n.d) suggests some of the major cause responsible for isolation is Illness or disease like when a person is in ill condition, acute or chronic will not be able to maintained social relations and would end up with social isolation Next, Svensson (n.d) stated the loss of significant other like death of a spouse may lead to the social isolation. Third major cause Svensson (n.d) mentioned the transfer or moving, means literature stated that if a person moves to the new community will have no new relationship and will have social isolation. Moreover, Svensson (n.d) pointed out another cause of social isolation is diminished physical capabilities, like in old age person loose senses like loss of sight, loss of hearing will also make person more susceptible to social isolation. After understanding the main factors that leads to social isolation, next important thing is the impacts of social isolation. Holly (2007) stated that “living without social contact and comfort can have serious consequences for patient’s health and life.” Furthermore, Biordi (2002) as cited as Holly (2007) she added that patients who have less social relations are more like to die than the patients with high social bounding. In addition to this social isolation can also leads to low self esteem, and got more prone to many other diseases too

After critical analysis of the issue, next step come i.e. strategies to overcome social isolation. There are many strategies that can be used for the social isolation. Here I have divided the strategies into three level individual level, group level and institutional level. First in individual level we can help the client to identify the causes of social isolation, encourage clients to verbalize their own feeling, perceptions and emotions. Positive feed backs can play a vital role in individuals coping. In addition to this, as mentioned earlier that stigmatization can be one cause of social isolation. Therefore we should try to eradicate stigma attached to the mental illness by providing information and knowledge to clients as well as their family members (WHO Report, 2001). Moreover, several coping strategies can be taught to the patients like communication. Next level is group level. As the patients with social isolation have low self esteem so we should praise and highlight their strengths in group activities. Group activity and group occupational therapies are more effective than individual because it gives a sense to the clients that many other people are also suffering and if someone adopt coping strategies it can be the motivating for others also. In group level community can also play vital role like we can give awareness at the community level and provide information. We can empower community in identifying persons or cases of mental illness and social isolation from the community and in providing appropriate referral to them. Additionally, small campaigns in the school can be form to provide information to the community to improve the understanding and attitude of community people. This will not only decreases the burden on society, but improves the health status of the community (WHO Report, 2001). Last level is the institutional level. At this level, I would like to recommend that the broad approach should be taken like media can play a vital role in spreading awareness about mental illness and consequences of social isolation. Furthermore, organization needs to conduct ongoing sessions for their staff to upgrade their knowledge and competences. Moreover, organizations should make sure that there should be occupational therapist and psychologist in the institute who can assists clients with their coping mechanism.

In conclusion, Social isolation has devastating effects individual’s life. It is very important to understand and to address the issue of social isolation. As we have discussed, mental illness has place high load on the health care system globally and locally, especially in Pakistani context concept of social isolation relation with mental illness is very prominent. There are many factors that lead to social isolation in mentally ill patients and there are significant impacts of social isolation on individual’s health. In addition to this, Social isolation can lead to many mental problems similarly; mental illness itself brings social isolation. Therefore it is important to break the vicious cycle by performing different individual level, group level as well as institutional level. Then only we will be able to make a difference in our society.