Influences on participation in a programme addressing loneliness among people with depression and anxiety: findings from the Community Navigator Study

Abstract

Background Loneliness is common among people with mental health problems and is associated with depression, anxiety and poorer recovery. In the absence of an existing evidence-based intervention, the Community Navigator programme was developed to help reduce loneliness among people with severe depression and/or anxiety using secondary mental health services. This paper presents a co-produced qualitative analysis of the factors that appear to influence participation in this programme. Methods The programme consisted of up to ten meetings with a Community Navigator and three optional group sessions. It was assessed using a feasibility trial. Semi-structured interviews were carried out with participants (N = 19) shortly after programme completion, by a researcher with experience of depression and anxiety. A two-stage qualitative approach to analysis was undertaken by members of the study’s co-production working group, which included service users, clinicians and researchers, using both a narrative analysis of three interviews to produce case studies as well as a thematic analysis of all nineteen interviews. Results From our case study analysis, it was clear how hard it was for participants to work with their feelings of loneliness. Six themes from the thematic analysis were identified to explain both motivation to and barriers towards participation in the programme, which relate to individual and structural factors: desire to connect with others or not; finding meaningful things to do; individual’s social confidence, particularly in group settings; accessibility of resources locally both in terms of practical considerations and financial cost; timing of the programme including in relation to people’s mental health; and, relationship with the Community Navigator. Conclusions We found that people with severe depression and/or anxiety supported by secondary mental health services may want to address feelings of loneliness but are aware of the emotional effort this entails. Interventions to address loneliness should be developed that consider the factors that enable and hinder participation and seek to build into their programmes the necessary support structures to address what may be a major personal challenge.