Abstract
PurposeLoneliness is an important issue for mental health service users. However, it has not been a particularly prominent focus of recent mental health research. This paper aimed to explore the severity of loneliness among people leaving mental health community crisis services, and to identify factors associated with loneliness.MethodsA total of 399 participants experiencing mental health crises recruited for a research trial from community crisis services were included in this cross-sectional study. They completed the eight-item measure of the University of California at Los Angeles Loneliness Scale and a set of instruments assessing socio-demographic, psychosocial, and psychiatric variables.ResultsSeverity of loneliness was high among people leaving community crisis services. Longer years since first contact with mental health services (2–10 years, coefficient = 1.83, 95% CI 0.49–3.16; more than 10 years, coefficient = 1.91, 95% CI 0.46–3.36) and more severe affective symptoms (coefficient = 0.32, 95% CI 0.23–0.40) were associated with greater loneliness, whereas bigger social network size (coefficient = − 0.56, 95% CI − 0.76 to − 0.36) and greater social capital (coefficient = − 0.16, 95% CI − 0.31 to − 0.003) were associated with less severe loneliness.ConclusionsThis paper supports a view that people experiencing mental health crises often report relatively severe loneliness, and that loneliness tends to become more severe during the course of illness. A greater awareness of loneliness among mental health professionals may be beneficial. Loneliness is a potential focus of the development of interventions to improve the lives and outcomes of people with significant mental health problems.
Highlights
Loneliness can be defined as a negative emotional state that occurs when there is a subjective discrepancy between the desired and actual social relationships [1,2,3]
In a comparison between people with psychosis and a general population sample with similar demographic characteristics, the prevalence of loneliness among people with psychosis was 80% compared with 35% in the general population [9]
More than one in four participants had a diagnosis of schizophrenia or psychosis (27.0%), 16.3% were diagnosed with bipolar affective disorder/manic episode, 35.0% suffered from depressive/anxiety disorders, 13.3% from personality disorders, and 8.4% from other disorders
Summary
Loneliness can be defined as a negative emotional state that occurs when there is a subjective discrepancy between the desired and actual social relationships [1,2,3]. Feelings of loneliness have been found to be more prevalent among people with mental health problems than in the general population [5, 6]. Cross-sectional studies have found up to 40% of respondents feeling lonely all or most of the time [7], with an 11-fold increase in the odds of loneliness compared to adults with no mental disorder [8]. In the general population, loneliness is associated with risk factors such as being a victim of domestic violence, lack of employment, not being married/ partnered, being a young or an older adult (compared with middle-aged individuals), and impaired self-reported health [6, 10].
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