Mental health and loneliness: the relationship across life stages

The Department for Digital, Culture, Media and Sport (DCMS) commissioned NatCen to explore the relationship between loneliness and mental health across four key life stages.

Previous research has demonstrated an association between experiences of loneliness and poor mental health, however, the nature of this relationship is less well understood, particularly among groups at greater risk of loneliness. Through qualitative research, this project sought to explore this relationship among those who were experiencing loneliness and who had pre-existing mental health conditions. For this study, the research focused on people at key life stages – young adulthood; parents of young children; middle-age; and retirement – when it is known people may be at greater risk of experiencing loneliness.

The study aimed to explore:

• how those with diagnosed mental health problems experience loneliness;
• the extent to which social stigma associated with mental health conditions plays a role in experience of loneliness; and,
• how experiences of loneliness among those who have experienced mental health conditions vary by life stage.

Findings

This qualitative study found that:

• The relationship between loneliness and mental health was bi-directional and cyclical. There were a range of ways in which mental health issues could lead to greater feelings of loneliness and in which loneliness could lead to a decline in mental health. For example, loneliness could lead to mental health issues where people lost confidence in socialising and where loneliness led to negative thought patterns, low mood and less motivation. Mental health issues could lead to loneliness where people had low self-esteem, did not want to be a burden on others or had to mask their true feelings from those around them.
• Loneliness was experienced in a variety of ways and across a spectrum. Loneliness was not about the quantity of social connections but the quality of these relationships. Those who were most lonely described feeling isolated, with no close friends or supportive others. At the other end of the spectrum, the least lonely people were those with a wider social network, including close connections who provided emotional support. For this group, periods of loneliness correlated with poor mental health. In between these groups were people with a few close connections, and a small number of supportive others. However, these social connections were not always able to provide the level of support participants needed.
• Stigma was experienced as feelings of loneliness and poor mental health being dismissed and trivialised by others, resulting in participants feeling judgement and shame.  This affected their ability to be open about their feelings and seek help, further reinforcing feelings of loneliness. The stigma attached to loneliness was evident in the way that participants did not always use the word lonely and some wanted to avoid the term altogether.
• There were a number of key events across the different life stages that were associated with periods of loneliness or a decline in mental health. In addition, some factors such as relationship difficulties including domestic violence; limited financial resources or neighbourhoods that lack transport or amenities could exacerbate loneliness across all life stages.
  • Adverse events in childhood or adolescence such as experiences of abuse, neglect, losing a parent or having parents with mental health issues were linked by participants to effects on their mental health in later life.
  • In early adulthood, leaving the family home and the transition to living independently was associated with a risk of loneliness or poor mental health.
  • For parents with young children, the increased stress associated with new caring responsibilities, weight of social expectations, and experiences of fertility issues or pregnancy loss fed into feelings of loneliness.
  • For those in the middle-aged life stage, the events and experiences that led to loneliness included a decline in physical health, managing difficult family situations, difficulties finding and sustaining intimate relationships and changes to work routines such as redundancy or the move to working from home in the pandemic.
  • For those who were retired, key events such as retiring and leaving the workplace, bereavements or a decline in physical health led to feelings of loneliness.
  • There were few examples of participants accessing specific support to tackle loneliness, despite having accessed mental health support. Instead, participants proactively sought out social support to tackle feelings of isolation themselves, through group activities and online interaction. A number of suggestions were made about the way in which support could be improved. This included the provision of more local and tailored mental health support, support group activities in communities around shared interests and the establishment of community-based caseworkers.

Methodology

This qualitative research consisted of two phases: interviews with professional expert stakeholders and depth interviews and diaries with people who were experiencing loneliness and had pre-existing mental health conditions.

Researchers did not use the word ‘loneliness’ unless it was used by a participant first. This was because people have different understandings of loneliness and some people may be reluctant to use the word. Instead, participants were asked about their feelings of connection to people in their social network.

Participants were recruited from one of the following four life stages: young adulthood (18–30 years old); parents of young children (with children aged 5 or under); middle aged (40–60 years old); or retired. Across the sample there were a range of mental health conditions experienced including depression, anxiety, post-traumatic stress disorder, schizophrenia, bi-polar disorder and borderline personality disorder, among others.