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For People with Serious Mental Illness, Dissatisfaction with Housing May Contribute to Loneliness

A study funded by the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR).

According to the American Psychiatric Association, a serious mental illness is a behavioral, mental, or emotional disorder that seriously impairs a person’s ability to function and interferes with or limits one or more major life activities.  People with serious mental illness may struggle with understanding or relating to other people and being withdrawn from family and friends. They also report higher levels of depressive symptoms, suicidal ideation, and loneliness than the general population. Loneliness, or the feeling of being alone, has been linked to poorer health outcomes and higher rates of psychiatric hospitalizations. Previous studies have found that for people with serious mental illness, dissatisfaction with social relationships as well as experiencing lack of social support and participation in community activities can lead to feelings of loneliness. Previous research has also shown that certain environmental factors can contribute to building and strengthening social relationships such as factors related to housing. However, few studies have examined the impact of housing on loneliness for people with serious mental illness.

A recent NIDILRR-funded study looked at whether housing was associated with loneliness in people with serious mental illness. Specifically, researchers wanted to know whether living alone or with others, being satisfied with housing, and the duration of time spent in one’s residence, contributed to greater feelings of loneliness.

Researchers at the project on Increasing Community Participation in Adults with Schizophrenia and the Rehabilitation Research and Training Center on Community Living and Participation of People with Serious Mental Illness analyzed data collected from 188 individuals who participated in previous studies. All participants had a serious mental illness, were between 18 and 64 years old, and lived in or around Philadelphia, Pennsylvania. Participants provided their demographic information and answered questions on whether they lived alone, with others such as family or friends, or with strangers in mental health residential housing. Participants answered how long they lived in their current location and whether or not they were satisfied with their housing in terms of location, cost, living arrangements, and living conditions. To measure feelings of loneliness, participants answered a questionnaire about how often they felt left out or isolated from others, and whether they had people who understood them and whom they could talk to.

Forty-four percent of participants lived alone; 30% lived with family, roommates, or friends; and 26% lived in mental health residential housing. Overall, the participants stayed at their residence on average for 5.2 years, with some staying as little as one day and others up to 40 years. Over two-thirds (68%) of participants were satisfied with their current housing, while 32% were dissatisfied or neutral.

Related to factors contributing to the feeling of loneliness, the researchers found that:

  • Satisfaction with housing was the strongest predictor of loneliness. Participants who were unsatisfied with their housing conditions had high levels of loneliness, regardless of other factors.
  • Housing duration was the second strongest predictor of loneliness: in general, the longer participants lived in a residence the less lonely they were.
  • Whether or not participants lived alone was not related to loneliness.

The authors noted that while housing satisfaction and loneliness may seem unrelated on the surface, they may be linked through social connections— which have been shown to be predictive of loneliness. Physical features of a home, like size and location, may impact satisfaction, but so may the social aspects such as being able to invite friends over or getting to know one’s neighbors. The authors also noted that good housing can help people feel a sense of belonging, and previous studies have shown a connection between belonging, housing satisfaction, and loneliness. Related to housing duration being predictive of loneliness, the authors noted that people who move often may have fewer social connections in their new location. Moving may make it challenging to learn about a neighborhood or form social relationships in the community resulting in greater feelings of loneliness. These findings also support previous findings showing the link between social relationships and community engagement with loneliness.

The authors suggested that more support may be needed to help people with serious mental illness find housing that better meets their needs. Service providers may want to help people with serious mental illness learn more about their community and encourage them to increase their engagement and participation with neighbors and local resources. Support programs may want to focus on assisting people with serious mental illness to stay longer in their homes so long as it is to their satisfaction, or to move within the same community. If a move is required, then programs may want to encourage people with serious mental illness to use coping strategies to deal with any feelings of loneliness that may arise during the transition to new housing. Finally, the authors recommended that policy makers press for more comprehensive funding not only for housing for people with serious mental illness, but also programs that foster community engagement.

To learn more:

The Rehabilitation Research and Training Center on Participation and Community Living for People with Psychiatric Disabilities offers a large collection of resources to support participation of people with serious mental illness, including guides, programs, calendars, and other tools for individuals and practitioners.

NARIC’s Research In Focus series has looked at the connection between community participation and mental health:

To learn more about this study:

Nagata, S., Brusilovskiy, E., Townley, G, McCormick, B., Thomas, E.C, Snethen, G., Salzer, M.S. (2023). Housing and loneliness among individuals with serious mental illness. International Journal of Social Psychiatry. 69(3):559-566. This article is available from the NARIC collection under Accession Number J92022.

Research In Focus is a publication of the National Rehabilitation Information Center (NARIC), a library and information center focusing on disability and rehabilitation research, with a special focus on the research funded by NIDILRR. NARIC provides information, referral, and document delivery on a wide range of disability and rehabilitation topics. To learn more about this study and the work of the greater NIDILRR grantee community, visit NARIC at http://www.naric.com or call 800/346-2742 to speak to an information specialist.