#VisualAbstract: Layperson-delivered empathy-oriented phone calls reduce loneliness, depression, and anxiety

1. In this randomized clinical trial, empathy-oriented phone calls to older adults during the COVID-19 pandemic were associated with significantly decreased depression, anxiety, and loneliness scores.

2. Layperson-delivered phone calls were an inexpensive and accessible support option for those who experienced barriers to accessing psychiatric care and interventions.

Evidence Rating Level: 1 (Excellent)

Loneliness, depression, and anxiety are well-recognized risk factors for morbidity and mortality which may particularly affect elderly individuals. Lockdowns during the COVID-19 pandemic have been associated with decreased social interaction and accessibility of psychiatric aid. Phone call support programs with layperson volunteers are commonly used for emotional crisis intervention and may represent an effective way to improve mental health outcomes in elderly individuals unable to leave their homes.

This randomized control trial aimed to elucidate the impact of a four-week empathy-based phone support program on improving loneliness, depression, and anxiety. Inclusion criteria were elderly individuals enrolled in Meals on Wheels Central Texas (MOWCTX). Participants who had cognitive impairments or were already enrolled in a social support program were excluded. Study outcomes assessed measures of loneliness, depression, anxiety, and social connection using previously validated questionnaire instruments. Calls were made by 16 postsecondary students aged 17 to 23 who were trained via a one-hour video conference. Follow-up assessments were made at 29 and 35 days after the study began.

A total of 240 participants were included with 120 individuals in both the control and study arm, respectively. Participants in the phone call group scored significantly lower than the control group at follow-up on all measures of loneliness, anxiety, general mental health, and depression. There was no significant difference in score on the De Jong Loneliness Scale. The main limitations of the study included lack of long-term follow-up, controlling for underlying mental health conditions, and difficulty in standardizing empathy-based support calls. Overall, the results of this study suggest that layperson empathy-based support calls improve mental health outcomes in elderly individuals.

Click to read the study in JAMA Psychiatry

Image: PD

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