Host: Kate Mulligan is an associate professor at the Dalla Lana School of Public Health, and the founding scientific director of the Canadian Institute for Social Prescribing. Kate, great to have you on the program. How are you doing?

Kate Mulligan: Thanks so much, Dan. I'm doing really well. How are you?

Host: I'm doing great. Let's talk about the data that talks about loneliness. What does it show here in Canada?

Kate Mulligan: Well, at least 1 in 5 Canadians is experiencing loneliness and 1 in 4 is is experiencing mental illness or mental health challenges. And sometimes those can be really correlated. For young people, the rates are higher than average. And we know that that's partly because they're at a really formative time in their lives, with much change going on, but also a formative and changing time in the world right now, with a lot of precarity and a lot of uncertainty about what their roles are now and what they might be in the future.

Host: I want to dig a little bit deeper into the demographics of it. We hear a lot about loneliness epidemic affecting young men specifically, are we more likely to be lonely men?

Kate Mulligan: No. The reality is that young women and young men are both experiencing social isolation and loneliness. And in fact, many more young women are experiencing anxiety and depression. But the consequences of those experiences are quite different by gender, so young women are still more likely to seek social support or health help from health systems, whereas young men are less likely to do so. And we also know that men are more likely to channel some of these experiences into things like substance use, violence, and even suicide completion, which is at about 75% of suicides in Canada, are from from men.

Host: Let's you alluded to it a little bit in your previous answer. Are there particular causes for their loneliness you had mentioned? I mean, there's a lot of if we look at sort of the last couple of years, we can point to a few things. But yeah, let's break it down.

Kate Mulligan: Yeah. So loneliness is it's not an individual failing. It's a policy problem. And it comes from the structures that we've created for ourselves in this world. It used to be a bit of a tough sell for me to talk about loneliness and social disconnection and lack of social cohesion as health issues prior to Covid and then during the pandemic, we all experienced for ourselves what it is like to really live in more socially isolated circumstances, and we've still never really fully recovered as a society in terms of the level of social participation and interaction that we had prior to that time. And of course, that's only just one of the drivers. We don't have the same levels of community engagement and support that we once had in things like faith communities or service clubs. We have a lot more use of screen time by young people, who are also increasingly turning to things like AI chatbots instead of other humans for help with their mental health and social challenges. So it seems to be accelerating. There are a number of different reasons and causes, but really one of the most important underlying factors beneath all of those is the feeling amongst those young people and many people of other ages as well, that we don't matter. And we see this in Canadian healthcare systems, for example, when we sort of feel like maybe we're imposing when we go for an appointment or we think we might have something of a need because we know how strained and stressed our health system is and that it's something shared between us. But that adds up to a level of sort of bureaucratic indifference that really, really impacts us. And for young people, at that formative time in their lives, they want to feel that they matter. They want to feel that they're making a contribution to the to this society. They want to feel that they have some competence and mastery over their own lives and some independence and some choices that are going to make a difference for themselves. Those are those underlying reasons that we need to change some of our structural supports for these young people, including young men, to give them a place of belonging and mattering. Again.

Host: With that, I want to put the public health lens on here. How are people's failures to maintain close connections, relationships hurting society? What is the trickle down effect look like?

Kate Mulligan: I think there are a few things. I mean, one, there are increased healthcare costs. So we start going to our health care providers because we lack other places to go to express our social needs. We also go because our social needs are being literally expressed in our bodies. So we have higher rates of all cause mortality, all reasons for death that are that because of extended and growing loneliness and social disconnection, we're biological creatures. We are meant to be around other people. We have higher rates of these mental health disorders, as I've mentioned, but also higher rates of physical health challenges, heart attack, stroke. Many kinds of brain disorders, and other challenges that are either caused or exacerbated by this loneliness. So it's showing up in our bodies, it's showing up in our health systems, and we can treat it, and we can prevent it much more effectively in other places. It's also showing up in our lack of sense of agency that we can take care of one another as neighbours, in our own communities, in our own societies, that we don't need to rely on big external institutions for some of those basic supports that used to just be in community.

Host: Well, let's talk about some of those supports. You are the founding scientific director of the Canadian Institute for Social Prescribing. What do you do?

Kate Mulligan: Well, I look for good practices where people are connecting these health care and social issues, and I try to surface them and share them around the country and the world to make them part of our regular health care system and our regular government practice. And so far, it's been amazing to see the growth of social prescribing all across the country. We started with a pilot project in 11 community health centres all across Ontario back in 2018 and 2019. We now have social prescribing happening in every single province across the country, often government funded, but not always so. A big part of what I'm doing is helping to build the evidence base, helping those innovators to find one another and helping to get their story on the record so that we can make this a regular part of our health system.

Host: One of the conversations that we're having, especially on this episode, is sort of the connection from loneliness to radicalization, extremism. I'm curious, could it help prevent radicalization?

Kate Mulligan: Well, I do think so, yes. So some of the things that we focus on in social prescribing are around, again, intervening so that people feel that they matter, and intervening for young people means a lifetime of prevention. Right. We can intervene upstream and help young men stay engaged in their communities, in their employment and in their own sense of health and care, saving millions of dollars in those upstream health costs, but also in increased social and economic participation, being part of everyday life, which is really underlying all of this, what it's really about getting people back engaged into community so we can get to them, you know, younger men feeling that sense of not mattering. They're going to have two options. They can hear from this hopeful, in-person, hands on vision, or they can hear from the algorithm that takes them to a much darker path, but also offers them a sense of agency and a sense of belonging. And many of those same factors that I've been talking about. So we do need to intervene. We can intervene earlier, and there are many good examples of this happening all across the province and the country.

Kate Mulligan: So in Sturgeon Lake, for example, there are programs for young Indigenous men to reconnect with culturally appropriate sense of masculinity and identity and heritage early on to connect with their culture. We've got black focused social prescribing programs across the province that are helping young black men, and other members of the black community use Afrocentric principles to underpin their collective and individual health. Many other examples are happening all across the province, but what we really need to do is knit those together into more of a system, and that's what we're on our way to doing now.

Host: That sounds very hopeful, Kate, I really appreciate your time on the program. Wish you all the best and thank you for your insights.

Kate Mulligan: Thanks so much.