We Need a More Nuanced Understanding of Loneliness

Due to increasing trends in the identification of depression, anxiety, and despair among youth internationally, it has been suggested that “loneliness is a problem of epidemic proportions.” However, in a recent article published in Transcultural Psychiatry, authors Janis H. Jenkins, Giselle Sanchez, and Olga Lidia Olivas-Hernández suggest that the scope of research in this realm has been limited, compromised by narrow methodology characterized by quantitative measures and intrapersonal characteristics.

“Recently, there has been a groundswell of attention to the problem of loneliness in association with mental health status. In this article, we make the case that investigations of this problem have thus far been limited by the absence of interdisciplinary approaches.”

The authors propose a broadened conceptualization and approach to the study of trends in loneliness among youth using transdisciplinary techniques emphasizing social networks, relationships, and context. An ethnographic exploration of the lived experiences of adolescents in Tijuana, Mexico, is used to highlight the potential for an embedded approach to understanding loneliness among youth across the globe.

The terms loneliness and social isolation, though often related, have different implications in that loneliness pertains to the subjective experience of a person or persons whose social expectations are discrepant from their day-to-day social realities. Loneliness is not an inherent facet of social isolation; in the same way, poor-quality relationships have the potential to be more distressing than the absence of relationships altogether.

In recent years, loneliness has been identified as a significant public health problem occurring at high rates globally, and with detrimental effects on young people. Some research has indicated that loneliness is a significant social determinant of significant mental distress, both predictive of and reinforced by a variety of “common mental disorders.” Understandings of loneliness vary in important ways across disciplines and cross-culturally. Jenkins, Sanchez, and Olivas-Hernández illustrate the value of applying anthropological techniques and understandings of distress in particular to the field of psychiatry dominated by a medicalized model for loneliness.

The authors sought to enrich the current picture of loneliness painted by psychological survey data and inventories of symptoms. Succinctly put, “[e]thnographic research on loneliness with attention to lived experience can provide a foundation for better understanding of the range and types of loneliness that cannot be ascertained through epidemiological or survey data.”

Recent ethnographic research has highlighted unique mental health challenges among Mexican and limited community resources for addressing these concerns. Many tools available in the US to evaluate mental health lack cultural validity, yet increasing suicide rates among Mexican youth highlight a need for improvements in insights and supports.

Jenkins and colleagues devoted two years to examining the lives and experiences of 35 students at a large high school in Tijuana, primarily serving students from low to low-and-middle-income families. During this time, they employed “sociodemographic forms, semi-structured interviews, focus groups, psychometric assessment scales, and on-site observations” in their investigation, and connected with 71 total community members (students, parents, mental health care providers, and school community members included).

Most student participants engaged in four interviews throughout the project each, whereas single interviews took place with additional participants. Insights were enhanced through ethnographic observations and data from psychometric screening tools.

“An overall aim of the study is to generate an ethnographically informed understanding of contexts and processes that shape the emotional wellbeing and mental health of adolescents. To do so, we are working not only with adolescents, but also their parents, teachers, and mental health providers to gain multiple perspectives on the subjectivity of key stakeholders in relation to cultural meanings and practices surrounding help-seeking for problems perceived in relation to mental health.”

Results indicated that socio-structural insecurities and adversity have a pervasive impact on the everyday lives of students in this particular Tijuana school community. Limited public resources, precarious infrastructure, persistent community violence, a limited police presence, and more together “impact adolescents’ ability to spend time outside, make friends in their neighborhood, or leave their homes during the day as they are prohibited by their parents for their own safety.” Acknowledging these community-level characteristics alone, it is not challenging to imagine the potential barriers to consistent quality relationship maintenance.

Because many adolescents in this particular community belong to families in which all caregivers also work fulltime outside the home, they occupy significant roles caring for their siblings and younger relative and completing household chores. For some student participants, alone time was identified as a treasured opportunity to decompress and process the day’s events. Authors make the critical distinction between loneliness and time alone:

“Critical to those adolescents who experience soledad is the feeling of an absence of emotional connections understood by the adolescents as an absence of love and affection among family and friends. As our data show, soledad emerges within the context of fraught familial and peer relationships, not infrequently exacerbated by the frequent experience of being home alone for the entire day.”

Jenkins and team capture complexities and nuance unlikely to have been detected through the application of quantitative measures or using a cross-sectional technique. Their findings characterize loneliness as a broadly human phenomenon sometimes manifested in experiences of depression, anxiety, and other mental health challenges. They contextualize loneliness as an occurrence with a complex relationship to the community impossible to understand without attention to the social environment.

Their findings suggest that loneliness, in all its intricacy, may be an essential feature of depression in particular among youth in a non-clinical community setting. Multidisciplinary frameworks for understanding experiences of depression may remedy gaps in systems of support currently available to young people struggling in the context of community systems fraught with structural tumult.

“[Ethnographic] methods provide the foundation for seeking insight into the intricacies of personal, cultural, and political dimensions of loneliness, particularly with respect to the well- being of youth living under conditions of structural violence and precarity. Our research […] provides the empirical grounds for proceeding with the specific investigation of loneliness, particularly in relation to depression, as part of the research agenda for the burgeoning field of global mental health. […] loneliness, as a vital, intricate, and intimate emotional realm requires breadth and depth of understanding.”

 

****

Jenkins, J. H., Sanchez, G., & Olivas-Hernández, O. L. (2019). Loneliness, adolescence, and global mental health: Soledad and structural violence in Mexico. Transcultural Psychiatry, 136346151988012. DOI: 10.1177/1363461519880126