Managing loneliness among lone workers and those on sick leave

Loneliness is a well-known risk factor for mental health conditions including anxiety and depression, and lone working and long periods of sickness absence can increase the level of risk. Kate Field explores how occupational health can help address this.

It’s perhaps unsurprising that the UK’s 2021 Census, completed in the midst of the Covid-19 pandemic, found that feelings of loneliness increased.

We are social animals who want to feel connection with other human beings, and the restrictions we faced robbed us of this for extended periods. Social connection is recognised as a critical aspect to our wellbeing, while loneliness can increase the likelihood of mental ill-health.

Employers should consider where loneliness or working alone may increase physical and mental health and safety risks.

Lone working does not mean that the person has to be working in complete isolation all the time. For example, a cleaner may enter a building while it is still very busy but may be left alone to finish their shift, or an occupational health practitioner may work in a department which is busy at certain times of day, but quiet and isolated at other times – both can be considered lone workers. In addition, there are those working in the community or across multiple locations for whom lone working has become normal.

And for large parts of the working population, home working has become the norm. While there are undoubtedly advantages to remote or hybrid working, it has also been an isolating experience for some. It is important for organisations to explore why. Is it lack of direct interaction with people, or is it because workers feel unsupported, unclear about what was expected of them, or unsafe?

Risks of lone working

There are also other risks for lone and home workers, such as medical emergencies where a person becomes incapacitated and can’t call for help. Often, lone workers are seen as ‘out of sight and out of mind’. Therefore, regular contact should be established between worker and manager to ensure they are supported. Other processes such as such as signing in and out of work using a whiteboard and having a database of emergency contacts could be useful.

A ‘buddy system’ is an effective way of staying in contact with someone who is working alone, particularly those working in the community or across multiple locations. The buddy is usually a nominated person (co-workers, family or friend) who the lone worker can contact at any time while working, but it can also be an automated system that workers use simply to check in and out of their work activities.

Suitability for lone working

An occupational health practitioner’s role is vital in understanding if a person is medically fit and suitable to work alone. Of course, pre-placement screening can’t be used to exclude candidates, but understanding if there are underlying medical conditions that may require adaptations is an area that can be explored. Fit for role assessments can be used for a more detailed risk assessment and need to consider both routine work and foreseeable emergencies which may impose additional physical and mental burdens on the worker.

An often-missed reason for feeling of isolation is sickness absence. This in turn can create stress and mental ill-health. Evidence shows that the longer a person is away from work, the less likely they are to return. For example, after six months’ absence with back pain, there’s only a 50% chance of a worker returning, according to the British Society for Rehabilitation Medicine.

It is important to begin the process of rehabilitation early, so that workers can:

• Return to work in a suitable role
• Regain confidence and motivation
• Maintain good relationships with their managers and colleagues
• Avoid financial hardship and having to retire from work because of ill health.

There’s also a misperception that workers who have issues with their physical or mental health should not return to work until they’re fully fit. However, evidence shows that, provided the right adjustments are made and support is provided, managing an injury or health condition at work is often better than prolonged absence. Good rehabilitation practice requires effective collaboration between employers, managers, workers and a range of other professionals, including occupational health.

Risk factor for mental health conditions

Loneliness is a recognised risk factor for work-related stress, anxiety and depression. When considering mental health, it is essential that employers identify and proactively manage this and other risk factors.

HSE data shows that work-related stress, depression or anxiety account for 51% of all work-related ill health cases and 55% of all working days lost due to work-related ill health. To combat this, employers must manage psychological health and safety as effectively as they do physical health and safety

There is now guidance on how to do this. Published in summer 2021, the new international standard, ISO 45003 on psychological health and safety management, provides a practical ‘how to’ guide. As with other areas of health and safety, employers need to be able to identify the hazards, assess risks and know what organisational-level changes are needed to manage them.

Prioritising employee mental health and wellbeing is key to ensuring an organisation’s long-term success, and part of this exercise will involve an awareness of the risks posed by loneliness and lone working.