Inside the town that cured loneliness...

Frome in Somerset isn’t special. It could be any English town. And yet, the people who live there have a story to tell about the simple, ground-shaking power of compassion. If it came in pill form, it would be hailed as a wonder drug. So what makes it so potent? And why hasn’t it been harnessed before?

Wander down the streets of Frome in Somerset and you’ll notice they’re significantly quieter than usual. Walk from the Cheese and Grain building – a 17th century farm produce warehouse-turned-concert hall – down past the Market Place, with all the boutique craft shops and art stores, up towards the steep, cobbled Catherine Hill, and you may only see a handful of people. And yet, you’ll observe a community quietly thriving; strangers smile through their masks and neighbours stop to chat, even if it does involve a fair bit of grumbling about how the much-loved Sunday market, selling everything from kimchi to antique furniture, is still suspended in the name of Covid security.

Frome, population 28,000, prides itself on independence. In 2011, its town council was taken over by independent candidates whose intention was to do what was best for the local people, rather than fight along the traditional political party lines – lending it the moniker ‘the home of flat-pack democracy’. It’s the kind of town where outside-thebox thinking thrives; the kind of town that’s fertile ground for original thought about how to tackle the biggest scourge on modern life (besides the obvious): loneliness. Back in 2013, Frome became the guinea pig for a pioneering initiative that promotes compassion via healthcare, social care and community development, which had a very real impact on the health outcomes of its residents before staying apart became government guidance. Now that loneliness is tipping over from emotional wellbeing issue to public health crisis, could compassion be a local solution to a global problem?

Loneliness has rarely been far from the headlines in recent years. Back in 2018, figures published by the Office for National Statistics revealed that nine million people in the UK considered themselves lonely; that same year, the government appointed its first Minister for Loneliness. In the years since, social isolation has been front and centre of the mental health conversation, and we’ve come to understand it as an affliction as likely to be felt by burned out millennials and harried mothers as care home residents. Of course, that was before. The number of people who reported having felt lonely during the past two weeks jumped from one in 10 to one in four during the first UK lockdown last April, and when we asked you how you were feeling six months later, as part of our Strong Mind survey, you told us that loneliness had the greatest negative impact on your mental health.

So we suspect you’ve felt for yourself the hollowedout pang in the pit of your stomach that we’ve come to recognise as loneliness, and you can probably confirm that it hurts. But a growing body of research is advancing our understanding of the impact of social isolation on health, and the emotional pain is the tip of the iceberg. Multiple studies

The emotional pain loneliness causes is just the tip of the iceberg

have linked loneliness with serious psychiatric issues, like depression, alcoholism and personality disorders, while research has also found that it presents the same risk to your health as smoking and obesity, while increasing your likelihood of developing coronary heart disease, high blood pressure and stroke. In fact, a 2019 Danish study found that women who suffered a heart attack were three times as likely to die within the year if they were lonely. Put simply, it doesn’t matter how well you eat or how hard you work out – you can’t outwit isolation.

SMALL TOWN ENERGY

Dr Helen Kingston has felt lonely. She first experienced the feeling as a junior doctor. After being transferred to busy hospitals in Newcastle, then Birmingham, she came to value the

small acts of kindness that made her feel connected to others in her community. In 1995, she moved to Frome, and as she became embedded in her new community, she began to think of her patients as friends. It was after the 2008 crash that she began to notice people were feeling more isolated. ‘Austerity hit hard and disproportionately impacted those who were already struggling,’ she explains. ‘I’d have people coming into the surgery saying they’d lost hope in finding a way forwards because life was so difficult. We have a close-knit community here, so when you come across someone struggling, it resonates. I’ve lived here so long that I know my patients well – when it’s not an abstract patient but, say, Roger or Claire who you’ve known for years, it becomes more personal and you’re more motivated to help.’

So she did. In 2013, Dr Kingston applied for seed funding to begin a radical new project. After securing the support of the partners in her practice, along with the local council, she set about creating a website featuring all the existing community groups in Frome. The goal was simple: to provide joined-up support for the practical (shopping, looking after pets, cooking, cleaning) as well

as the fun (choir, walking groups, craft clubs and men’s and women’s sheds – spaces for talking while making) that GPS and nurses could point their patients to. Her practice also hired a team of ‘health connectors’ – people who could help the vulnerable via one-to-one support work, as well as training 700 volunteers, from cafe owners to receptionists and librarians, on how to give advice on accessing all the town had to offer. The results were profound. In 2013, Frome experienced a 17% fall in emergency hospital admissions, despite the increase of 29% across the rest of Somerset. Fastforward to 2020 and while the pandemic caused hospital admissions to rise by 8%, this number was significantly lower than the rest of the county, with Frome held up as proof of the power of social connection.

It’s inspiring, sure – but a small, sleepy community in Somerset isn’t necessarily representative of the UK today. And right now, it’s not rural communities but urban settings that are the front line in the fight against social isolation – 2019 Yougov research found that people in cities report a higher incidence of feeling lonely than in the rest of the UK. The reason, according to Dr Gillian Evans, urban anthropologist at the University of

Manchester, isn’t necessarily that city life is lonelier per se. ‘There’s an assumption that, in the city, it’s harder to build and create social networks, while in fact there are pockets across London of longstanding residential history,’ she says. What’s changed, she adds, is how we socialise. ‘Today, people are more likely to build relationships with friends, work colleagues and through social activities than with their neighbours. You’re able to choose who you want to be and where you belong, so there’s less emphasis on your social or geographical roots.’ It’s the reason your top Whatsapp contacts are probably scattered all over the country (and the world). So when Covid kept us from the office, netball practice and big group hangs, levels of urban loneliness soared.

ONLY CONNECT

But if you think what happened in Frome would never work where you live, Dr Julian Abel respectfully disagrees. The former palliative care doctor and director of Compassionate Communities UK has lived just outside Frome for 30 years, and it was both his professional and personal experience that led him to co-author a book on what’s been dubbed ‘The Frome Experiment’. Having spent his life talking to people at the end of theirs, Dr Abel has learned that when people reflect on their lives, it’s the relationships they sustained – not the recognition or success they had in their careers – that count. ‘We tend to think that what’s valuable about ourselves is what we do, our fame or money or achievements, but we value the people around us for who they are, for their love, laughter and friendship.’

Dr Abel believes it’s those relationships that were key to the success of Frome’s experiment. And in The Compassion Project: A Case For Hope & Humankindness From The Town That Beat Loneliness (£16.99, Aster), he argues that what happened in Frome can be replicated elsewhere via a simple concept: compassion (definition: ‘sympathetic pity and concern for the sufferings or misfortunes of others’). ‘The way people gather in cities is different from rural areas, but the basic compassion and communication is the same,’ he explains, citing the example of a volunteer he interviewed for his book, who cooks for a community centre in Hackney, East London. ‘The centre provides meals and a place for people to spend time. Although their circumstances are different to those in rural communities, the same principle applies – when people meet each other, they get on. The core value at the heart of the Frome experiment was compassion, and that’s a universal principle.’ Dr Abel is calling for compassion and connection to be

‘The core value at the heart of the Frome experiment was compassion’

foregrounded at policy-making level. Together with Dr Kingston, he’s taken the Frome initiative to South West Cardiff, and a similar infrastructure has been put in place there. Now, 18 months on, they’re reporting similar effects on hospital admissions to those seen in Frome. If the power you wield is on a more micro level, Dr Abel points to Frome’s Neighbourhood Plan, in which each household checks in on its five nearest neighbours to help offer community-level support, as one example of how everyone can help.

PILLAR OF THE COMMUNITY

Pre-pandemic, you might have written off compassion as being a bit worthy. But in a year when you clapped on your doorstep, called your loved ones just to check in and joined a Whatsapp group for your street, it feels less nice-to-have, more essential for our collective wellbeing. If there’s one thing everyone can take away from the year we all want to forget, it’s this, says Sonia Johnson, professor of social and community psychiatry at UCL and lead for the UK’S cross-disciplinary Loneliness and Social Isolation in Mental Health Network. ‘It’s something that falls by the wayside. People feel too busy, that they have complex demands on them, so they don’t necessarily see being part of groups or maintaining friendships or working to develop new connections as something they should invest time in. But actually, it’s really important for your health and happiness.’ She adds that simply increasing the amount of contact won’t help with loneliness. ‘You need that contact to include positive connection – helping people have both positive expectations of others and a sense of belonging creates that connection, and it all stems from compassion.’ Remember, it’s the little things, too. ‘Buying your neighbour a drink, making tea for a colleague, looking after your parents, cooking a meal for friends – all of these things contain a flavour of compassion within them,’ adds Dr Abel. So make time for them. Remember you’re part of something bigger, and recognise that nurturing, supporting and lifting people in your community – be that the organisation where you work or the area in which you live – is time invested, not wasted. Big life lessons from a small English town.