Loneliness, Social Support, and Mental Health Service Use during the Transition to Adulthood

Background and Purpose: Loneliness is recognized as a growing public health epidemic among young adults, and has been increasing in prevalence since before the COVID-19 pandemic. Yet, loneliness research has focused primarily on older adult populations. Additional research is warranted to better understand the social relationships of young adults, particularly the effects of loneliness on young people’s mental health and help-seeking behaviors, especially as they transition into the workforce and explore interpersonal relationships. This study addresses this gap in research by assessing whether loneliness and social support are associated with mental health service use and mental health symptoms (psychological distress and suicidal ideation) among young adults in the general population.

Methods: A subsample of young adults ages 18 to 29 (N = 307) was drawn from the 2017 Survey of Police-Public Encounters, an online, cross-sectional, general population survey administered to residents of New York City and Baltimore. Ordinary least squares and binary logistic regression analyses were performed to model associations between loneliness and mental health symptoms and past year mental health service use outcomes.

Results: Participants identified as mostly female (59.3%), Black or African American (45.6%), heterosexual (84.7%), and U.S.-born (83.4%). Participants’ mean age was 23.6 years (SD = 3.44). Participants with higher levels of loneliness reported significantly higher levels of psychological distress (B = 3.76, p<.001) and over four times the odds of past-year suicidal ideation (OR = 4.61, 95% CI = 2.46–8.63). Participants with lower incomes were significantly associated with elevated levels of psychological distress (B = -.63, p = .01). Participants born in the United States had increased odds (OR = 3.19, 95% CI = 1.20–8.48) of service use compared to first-generation American participants, and those who identified as Black or African American had lower odds (OR = .39, 95% CI = .17–.87) of service use compared to non-Black or African Americans. Mental health service use was more common among young adults reporting increased levels of social support (OR = 2.02, 95% CI = 1.36–2.99), psychological distress (OR = 1.09, 95% CI = 1.03–1.15), and past-year suicidal ideation (OR = 3.53, 95% CI = 1.60–7.84). Approximately 26% of young adults sought mental health treatment within the past year.

Conclusions and Implications: The transition to adulthood is a distinct developmental period to experience loneliness and the COVID-19 pandemic has had a disproportionate impact on young adults. The significant associations of loneliness with mental health symptoms, and social support with mental health service use, highlights the importance of developing interventions to prevent and reduce loneliness and social isolation among young adults.