Loneliness epidemic speaks to need for behavioral healthcare

Photo: Basak Gurbuz Derman/Getty Images

Loneliness: It was a widespread problem in the U.S. before the pandemic, but COVID-19 made it worse, forcing people into isolation and social distancing protocols. It's been one of the biggest motivators behind the push for increased access to mental health services, and a new poll from Morning Consult and Cigna shows more than half of U.S adults still consider themselves lonely.

Today, about 58% of U.S. adults consider themselves lonely, a seven percentage point increase from 2018, the poll found. The data shows adults with mental health issues are more than twice as likely to experience loneliness as those with strong mental health.

Of course, as in most aspects of health and wellbeing, personal factors such as race, age, gender and income all play a role in how people experience loneliness, and some people are more impacted than others.

Those from underrepresented racial groups, for example, are more likely to be lonely, including 75% of Hispanic adults and 68% of Black adults – at least 10 percentage points higher than the total adult population.

Those with lower incomes are also lonelier, the data showed, with about 63% of adults earning less than $50,000 annually classified as such. That's 10 points higher than those earning $50,000 or more, and there's a relation to Medicaid as well: About 72% of Americans who receive health benefits through Medicaid are classified as lonely, which is substantially more than the 55% of adults covered by private or employer- or union-provided health insurance benefits.

Young adults generally appeared to be the loneliest group overall, with 79% of those aged 18 to 24 reporting feelings of loneliness. That's much higher than the 41% of seniors 66 or older who report the same.

Men and women reported loneliness at about the same rates, with 57% of men and 59% of women saying they were lonely.

WHAT'S THE IMPACT?

The data established a connection between feelings of loneliness and poor physical or mental health. While one doesn't cause the other, the links are there.

Adults with physical health issues, for instance, are about 50% more likely to be lonely than those with strong physical health. Seventy-seven percent of adults classified as having fair or poor physical health are experiencing loneliness, while only half of those with excellent or very good physical health are lonely. 

Also, adults classified as lonely are significantly more likely to be diagnosed with or receiving care for a range of health issues including sleep disorders, weight problems and substance use.

Perhaps the strongest link to loneliness was mental health struggles, since those with behavioral health issues are more than twice as likely to be lonely. One in four adults are classified as having fair or poor mental health, and among them 85% are lonely compared to 42% of adults with excellent or very good mental health. One in three lonely adults are currently diagnosed with or receiving medical treatment for a behavioral or mental health condition such as anxiety, depression and bipolar disorder.

The survey claims the private and public sectors will need to come together to drive systemic change, but it focused specifically on actions employers can take, such as prioritizing activities that bring people together both in person and virtually – including team meetings and events, volunteer activities, employee resource groups and even town halls.

It also encouraged employers to prioritize work-life balance, encourage paid time off and provide a spectrum of services and support for mental health concerns.

THE LARGER TREND

A May CVS Health/Morning Consult poll showed mental health concerns keep rising among Americans of all backgrounds, especially those who are Black, young adults, older than 65 or who identify as LGBTQIA+.

The findings indicate both an increase in the prevalence of mental health concerns among certain groups of Americans, and more willingness to seek out options for care. Telehealth has gone a long way toward making people feel more comfortable seeking treatment.

A 2021 study showed that mental health services accounted for the most common use of telehealth during the early days of the pandemic. In the midst of skyrocketing depression rates, the findings show that more patients used telehealth for behavioral rather than physical conditions.

This shift to telehealth, particularly video, was enabled by time-limited, regulatory changes related to reimbursement, privacy standards for telehealth technology, and licensure. Lessons from utilization during this period can inform policy for the post-COVID-19 era.

A report from health insurer Cigna, also released last year, made it clear that businesses have taken notice of this shift to behavioral telehealth: Some 44% of human resources decision-makers and 27% of health plan leaders said that increased access to mental health services will become a long-term solution for their organization. Some 57% of health plan leaders said they had seen the value of mental health services increase more than for most other services and benefits as a result of the coronavirus.

Telehealth is likely the main catalyst for this change, with many patients seeking behavioral care for the first time during the public health crisis thanks in large part to access to technology.

With more than 60% of behavioral health customers now using virtual services, 97% of the people who accessed such services during the initial stay-at-home orders from March to May 2020 didn't have a behavioral telehealth claim prior to lockdown.

Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com