Layperson empathy phone calls help reduce loneliness, depression and anxiety during COVD-19

A layperson-delivered, empathy-oriented telephone call programme reduces loneliness, depression and anxiety compared with no calls, and improves general mental health of the participants within 4 weeks, results of a randomized trial have shown.

“The use of lay callers, a deliberate but brief approach on training, and the use of ubiquitous telephones made the approach easily deployable and scalable,” said the authors. [JAMA Psychiatry 2021, doi: 10.1001/jamapsychiatry.2021.0113]

“Future research can determine whether the effects [of a programme of empathetic telephone calls tailored to participants’ preferences] on depression and anxiety can be extended to maximize clinical relevance,” they suggested.

In the study, 240 participants (age ≥65 years, 63 percent; female, 79 percent) who were clients of Meals on Wheels Central Texas (MOWCTX), homebound and expressed a need for food were randomized to receive initially daily calls from one of the 16 callers (age, 17–23 years) who were briefly trained in empathetic conversational techniques (intervention group) for the first 5 days, after which the frequency of calls could be reduced to no less than 2 calls per week over 4 weeks, or no calls (control group) between 6 July 2020 and 24 September 2020.

More than half of the participants (56 percent) were living alone. More than one-third identified themselves as African American and all reported >1 chronic condition.

A significant improvement of 1.1 points on the UCLA Loneliness Scale (p<0.001) was observed among participants in the intervention vs control group. Those in the intervention group also had a numerical improvement of 0.32 points on the De Jong Giervald Loneliness Scale (p=0.06).

Similarly, improvements in depression as measured on the Personal Health Questionnaire For Depression (between-group difference, 1.5; p<0.001) and anxiety as measured on the Generalized Anxiety Disorder (between-group difference, 1.8; p<0.001) were reported in the intervention vs control group.

The programme had a significant impact on mental health of the participants as measured by the Short Form Health Survey Questionnaire (between-group difference, 2.6; p=0.003), but not on general physical health (p=0.98).