Exploring the experiences of loneliness in adults with mental health problems: a co-produced participatory qualitative interview study

Background Many mental health conditions are associated with loneliness, which is both a potential trigger and an exacerbating factor in mental health conditions. Richer evidence about how people with mental health problems experience loneliness, and about what exacerbates or alleviates it, is needed to underpin research on strategies to help with loneliness in this context. Methods Our aim was to explore experiences of loneliness, as well as what contributes to or helps address it, among a diverse sample of adults living with mental health problems in the UK. We recruited purposively via online networks and community organisations. Qualitative semi-structured interviews were conducted with 59 consenting participants by video call or telephone. Researchers with relevant lived experience were involved at all stages, including design, data collection, analysis and writing up of results. Findings Analysis led to identification of four overarching themes: 1. What the word lonely meant to participants, 2. Contributory factors to ongoing loneliness, 3. Connections between loneliness & mental health, 4. Ways of reducing loneliness. Central aspects of loneliness were lack of meaningful connections with others and lack of a sense of belonging to valued groups and communities. Some drivers of loneliness, such as losses and transitions, were universal, but specific links were made between living with mental health problems and being lonely. These included direct effects of psychiatric symptoms, the need to withdraw to cope with mental health problems, and impacts of stigma and poverty. Conclusions The multiplicity of contributors to loneliness that we identified, and of potential strategies for reducing it, suggest that a variety of approaches are relevant to reducing loneliness among people with mental health problems, including peer support and supported self-help, psychological and social interventions, and strategies to facilitate change at community and societal levels. The views and experiences of adults living with mental health problems are a rich source for understanding why loneliness is a frequent experience in this context and what may address it. Co-produced approaches to developing and testing interventions have potential to draw on this experiential knowledge in formulating effective approaches to loneliness.