Loneliness plays an important role in the development of suicidal ideation, thoughts of ending one’s life, which precedes nearly every suicidal death, according to a study by researchers at Vanderbilt Health.

Their findings, published March 4 in the journal JAMA Network Open, suggest that reducing loneliness could “arrest some of the progression from anxiety and depressive symptoms toward suicidal ideation,” and thus help prevent suicide, which claims more than 48,000 lives in the United States every year.

The study analyzed survey data collected from 633,000 participants in the National Institutes of Health All of Us Research Program, an effort to advance precision medicine by collecting and evaluating health information, including genomic data, from 1 million U.S. residents.

While depressive symptoms held the strongest correlation with suicidal ideation, followed by anxiety symptoms and then loneliness, the researchers discovered that loneliness “mediated,” or was a factor in much of the association between depression, anxiety and suicidal thoughts.

“This study shows us that by treating loneliness we might be able to buffer some of the impacts that anxiety and depression have on suicidal ideation,” said the paper’s first author, Katherine Musacchio Schafer, PhD, MS, MEd, assistant professor of Biomedical Informatics at Vanderbilt Health.

Treating depression and anxiety with cognitive behavioral therapy and medication has for decades been a primary approach to reducing suicidal thoughts and preventing suicide. But for many Americans, access to mental health care is limited.

Because of a nationwide shortage of qualified clinicians, the cost of these interventions, and the social stigma associated with receiving care, mental health treatment is often out of reach. A person-centered approach to reducing loneliness that helps people engage with others might be more feasible.

“There is a nationwide shortage in mental health providers, and because of that, findings from our study have very real relevance for everyday Americans,” said Schafer, who is a clinical psychologist with expertise in the intersection of suicide prevention and informatics.

“People struggling with anxiety and depression might be able to reduce their risk of developing suicidal ideation by reducing loneliness,” she said. “That could look like connecting with the people in their community … (and) their loved ones or finding ways to engage in shared enjoyable experiences and activities.

“People might be able to improve their mental health by reducing loneliness and building connections with the people around them,” Schafer continued. “Even if people cannot access evidence-based mental health care that treats their underlying anxiety and depression, reducing their loneliness may help them feel better.”