Demographics of 59 participants.

BackgroundLoneliness is associated with many mental health conditions, as both a potential causal and an exacerbating factor. Richer evidence about how people with mental health problems experience loneliness, and about what makes it more or less severe, is needed to underpin research on strategies to help address loneliness.MethodsOur aim was to explore experiences of loneliness, as well as what 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, with most interviews conducted during the COVID-19 pandemic. Qualitative semi-structured interviews were conducted with 59 consenting participants face-to-face, 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.FindingsAnalysis led to identification of four overarching themes: 1. What the word “lonely” meant to participants, 2. Connections between loneliness and mental health, 3. Contributory factors to continuing loneliness, 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 also made between living with mental health problems and being lonely. These included direct effects of mental health symptoms, the need to withdraw to cope with mental health problems, and impacts of stigma and poverty.ConclusionsThe 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 frequent in this context and what may address it. Co-produced approaches to developing and testing approaches to loneliness interventions can draw on this experiential knowledge.【研究背景】孤独感与诸多精神健康状况密切相关，既可作为潜在致病因素，也可作为病情加重的诱因。目前亟需更充分的研究证据，阐明精神健康问题群体的孤独感体验及其轻重程度的影响因素，以此为支撑开展针对孤独感的干预策略研究。 【研究方法】本研究旨在探究英国不同群体的精神健康问题成年受试者的孤独感体验，以及缓解孤独感的有效途径。研究采用目的性抽样法，通过线上网络与社区组织招募受试者，多数访谈开展于新冠疫情（COVID-19）大流行期间。本研究对59名知情同意的受试者开展了定性半结构化访谈，访谈形式包括面对面访谈、视频通话访谈与电话访谈。有相关亲身经历的研究者全程参与了研究的各个环节，包括研究设计、数据采集、数据分析以及结果撰写。 【研究结果】通过数据分析，本研究归纳出四大核心主题：1. 受试者对"孤独"一词的认知与内涵；2. 孤独感与精神健康的关联；3. 持续孤独感的促成因素；4. 缓解孤独感的可行路径。孤独感的核心表现为缺乏与他人的有意义联结，以及无法获得所属重要群体与社区的归属感。部分孤独感的诱因（如丧失与人生转折）具有普遍性，但精神健康问题群体的孤独感亦存在其特异性关联，具体包括精神健康症状的直接影响、为应对精神健康问题而产生的社交退缩行为，以及病耻感与贫困带来的负面影响。 【研究结论】本研究识别出多种孤独感促成因素与潜在缓解策略，提示针对精神健康问题群体的孤独感干预需采用多元化方案，包括同伴支持与支持性自助、心理与社会干预，以及推动社区与社会层面变革的相关策略。精神健康问题成年群体的观点与体验，为理解该群体孤独感高发的原因及可行干预方向提供了宝贵的研究素材。在开发与验证孤独感干预方案时，合作式研究方法可充分利用这类来自亲身经历的知识储备。