The Impact of Digital Mental Health Services on Loneliness and Mental Health: Results from a Prospective, Observational Study

Overview

Journal Int J Behav Med

Publisher Informa Healthcare

Date 2023 Jul 24

PMID 37488324

Authors

Kirby Magid

Sara J Sagui-Henson

Cynthia Castro Sweet

Brooke J Smith

Camille E Welcome Chamberlain

Sara M Levens

Affiliations

Soon will be listed here.

Abstract

Background: Loneliness has increased since the COVID-19 pandemic and negatively impacts mental health. This study examined relationships between loneliness and mental health among adults using a digital mental health platform.

Methods: A purposive sample of 919 participants (97% response rate) who were newly enrolled in the platform completed a survey on loneliness, depression, anxiety, well-being, stress, social support, and comorbidities at baseline and 3 months. Platform engagement was tracked during this period. We examined baseline differences between lonely and non-lonely participants; associations between loneliness, mental health symptoms, and comorbidities; and changes in loneliness and mental health through engagement in any form of care.

Results: At baseline, 57.8% of the sample were categorized as lonely. Loneliness was associated with younger age, fewer years of education, and the presence of a comorbidity (p values < .05). Baseline loneliness was associated with greater depression, anxiety, and stress and lower well-being and social support (ps < .001). The percentage of lonely participants decreased at follow-up (57.6% to 52.9%, p = .03). Those who improved in loneliness improved in mental health symptoms, well-being, and social support (ps < .001). Lonely participants who engaged in any form of care reported a greater reduction in loneliness than those who did not engage (p = .04).

Conclusions: This study confirms previous findings of the high prevalence of loneliness among adults and risk factors for increased loneliness. Findings highlight the potential of digital platforms to reach lonely individuals and alleviate loneliness through remote mental health support.

Citing Articles

Utilization, Satisfaction, and Clinical Outcomes of People of Color and White Adults Using an Employer-Sponsored Digital Mental Health Platform.

Sagui Henson S, Welcome Chamberlain C, Smith B, Jackson J, Adusei S, Castro Sweet C Int J Environ Res Public Health. 2025; 21(12).

PMID: 39767499 PMC: 11675968. DOI: 10.3390/ijerph21121660.

Utilization and engagement with an employer-provided digital mental health platform: An international perspective.

Maistrello G, Phillips W, Lee D, Romanelli R Digit Health. 2024; 10:20552076241277180.

PMID: 39257874 PMC: 11384541. DOI: 10.1177/20552076241277180.

References

Cacioppo S, Grippo A, London S, Goossens L, Cacioppo J . Loneliness: clinical import and interventions. Perspect Psychol Sci. 2015; 10(2):238-49. PMC: 4391342. DOI: 10.1177/1745691615570616. View

Cohen S, Kamarck T, Mermelstein R . A global measure of perceived stress. J Health Soc Behav. 1983; 24(4):385-96. View

Rapaport M, Clary C, Fayyad R, Endicott J . Quality-of-life impairment in depressive and anxiety disorders. Am J Psychiatry. 2005; 162(6):1171-8. DOI: 10.1176/appi.ajp.162.6.1171. View

Greenberg P, Fournier A, Sisitsky T, Simes M, Berman R, Koenigsberg S . The Economic Burden of Adults with Major Depressive Disorder in the United States (2010 and 2018). Pharmacoeconomics. 2021; 39(6):653-665. PMC: 8097130. DOI: 10.1007/s40273-021-01019-4. View

Bruehlman-Senecal E, Hook C, Pfeifer J, Fitzgerald C, Davis B, Delucchi K . Smartphone App to Address Loneliness Among College Students: Pilot Randomized Controlled Trial. JMIR Ment Health. 2020; 7(10):e21496. PMC: 7609198. DOI: 10.2196/21496. View

Killgore W, Cloonan S, Taylor E, Dailey N . Loneliness: A signature mental health concern in the era of COVID-19. Psychiatry Res. 2020; 290:113117. PMC: 7255345. DOI: 10.1016/j.psychres.2020.113117. View

Lee C, Cadigan J, Rhew I . Increases in Loneliness Among Young Adults During the COVID-19 Pandemic and Association With Increases in Mental Health Problems. J Adolesc Health. 2020; 67(5):714-717. PMC: 7576375. DOI: 10.1016/j.jadohealth.2020.08.009. View

Spitzer R, Kroenke K, Williams J, Lowe B . A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006; 166(10):1092-7. DOI: 10.1001/archinte.166.10.1092. View

Beutel M, Klein E, Brahler E, Reiner I, Junger C, Michal M . Loneliness in the general population: prevalence, determinants and relations to mental health. BMC Psychiatry. 2017; 17(1):97. PMC: 5359916. DOI: 10.1186/s12888-017-1262-x. View

10.

Philippe T, Sikder N, Jackson A, Koblanski M, Liow E, Pilarinos A . Digital Health Interventions for Delivery of Mental Health Care: Systematic and Comprehensive Meta-Review. JMIR Ment Health. 2022; 9(5):e35159. PMC: 9109782. DOI: 10.2196/35159. View

11.

Mann F, Bone J, Lloyd-Evans B, Frerichs J, Pinfold V, Ma R . A life less lonely: the state of the art in interventions to reduce loneliness in people with mental health problems. Soc Psychiatry Psychiatr Epidemiol. 2017; 52(6):627-638. PMC: 5487590. DOI: 10.1007/s00127-017-1392-y. View

12.

Matthews T, Bryan B, Danese A, Meehan A, Poulton R, Arseneault L . Using a Loneliness Measure to Screen for Risk of Mental Health Problems: A Replication in Two Nationally Representative Cohorts. Int J Environ Res Public Health. 2022; 19(3). PMC: 8834872. DOI: 10.3390/ijerph19031641. View

13.

Park C, Majeed A, Gill H, Tamura J, Ho R, Mansur R . The Effect of Loneliness on Distinct Health Outcomes: A Comprehensive Review and Meta-Analysis. Psychiatry Res. 2020; 294:113514. DOI: 10.1016/j.psychres.2020.113514. View

14.

Hughes M, Waite L, Hawkley L, Cacioppo J . A Short Scale for Measuring Loneliness in Large Surveys: Results From Two Population-Based Studies. Res Aging. 2008; 26(6):655-672. PMC: 2394670. DOI: 10.1177/0164027504268574. View

15.

Masi C, Chen H, Hawkley L, Cacioppo J . A meta-analysis of interventions to reduce loneliness. Pers Soc Psychol Rev. 2010; 15(3):219-66. PMC: 3865701. DOI: 10.1177/1088868310377394. View

16.

Ebert D, Cuijpers P, Munoz R, Baumeister H . Prevention of Mental Health Disorders Using Internet- and Mobile-Based Interventions: A Narrative Review and Recommendations for Future Research. Front Psychiatry. 2017; 8:116. PMC: 5554359. DOI: 10.3389/fpsyt.2017.00116. View

17.

Choi N, Marti C, Bruce M, Hegel M, Wilson N, Kunik M . Six-month postintervention depression and disability outcomes of in-home telehealth problem-solving therapy for depressed, low-income homebound older adults. Depress Anxiety. 2014; 31(8):653-61. PMC: 4122624. DOI: 10.1002/da.22242. View

18.

Lim M, Gleeson J, Rodebaugh T, Eres R, Long K, Casey K . A pilot digital intervention targeting loneliness in young people with psychosis. Soc Psychiatry Psychiatr Epidemiol. 2019; 55(7):877-889. DOI: 10.1007/s00127-019-01681-2. View

19.

Koonin L, Hoots B, Tsang C, Leroy Z, Farris K, Jolly T . Trends in the Use of Telehealth During the Emergence of the COVID-19 Pandemic - United States, January-March 2020. MMWR Morb Mortal Wkly Rep. 2020; 69(43):1595-1599. PMC: 7641006. DOI: 10.15585/mmwr.mm6943a3. View

20.

Steptoe A, Shankar A, Demakakos P, Wardle J . Social isolation, loneliness, and all-cause mortality in older men and women. Proc Natl Acad Sci U S A. 2013; 110(15):5797-801. PMC: 3625264. DOI: 10.1073/pnas.1219686110. View