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Almost every Tuesday for 10 years, Steve Seiple attended bar trivia night with friends in Birmingham, Alabama. After moving to North Carolina, he developed a new habit of picking up trash along the city’s light rail on Saturdays with other Charlotte residents.
These aren’t just fun outings to Siple. They help keep him alive.
Sciple has struggled with suicidal thoughts in the past. He lost his father to suicide and one of his sons struggles with the idea of hurting him.
As a result, Siple became wary of protecting himself and his family. In addition to seeing a counselor regularly and talking openly about his mental health, he prioritizes social connections.
“Throughout my life, loneliness has been one of the biggest risk factors for suicide,” said Seiple, former president of the American Foundation for Suicide Prevention.
To some, this concept may seem obvious. However, this is often overlooked in a holistic approach to suicide prevention. Treatment for serious mental illnesses that can lead to suicide, such as major depressive disorder, often centers on medication and talk therapy, with little or no consideration for factors such as social isolation or financial duress. There is now a growing movement to address loneliness through public policy, not just individual choices.
This research is clear. Among the many complex issues that contribute to suicide, loneliness is a major problem. This is an especially strong predictor for older adults, who have the highest suicide rates, and young people, for whom suicide is the second leading cause of death.
Humans are social animals. When we feel disconnected from each other, our stress levels rise, our immune systems become confused, and we are ultimately more likely to die sooner (from suicide or other causes). A frequently cited study concludes that being cut off from society is as harmful to your health as smoking up to 15 cigarettes a day.
And the situation is getting worse.
Mental health researchers and clinicians say a variety of factors are fueling the increase in loneliness rates in the United States, including the rapid growth of technologies such as smartphones and artificial intelligence. Increased political polarization. The transition to remote work since the coronavirus pandemic. And attendance at religious institutions has declined.
As suicide rates remain high, often ranking among the top 10 causes of death in the United States, some advocates and people who have lost loved ones to suicide say increasing avenues for social connection could be a new frontier.
In this ongoing series, KFF Health News examines new approaches to suicide prevention that shift the focus from stopping harm in moments of crisis to efforts that give people a reason to live well.
“If we want to reduce the suicide rate in our country, which is absolutely essential, a big part of that is promoting social connections,” said Vivek Murthy, who served as surgeon general under Presidents Barack Obama and Joe Biden. “We have enough data to support this as an important area of focus.”
In 2023, Marcy published the first U.S. Surgeon General recommendations on loneliness as a public health issue, with over 300 supporting citations. He has also written a book on the subject and tours the country discussing the value of social connections.
“Helping someone feel less alone and feeling seen, understood, and valued can be one of the most powerful interventions we make,” he told KFF Health News.
Role of elected officials
Curing loneliness may seem like the responsibility of family, neighbors, and those with whom you form one-on-one connections. But Murthy says elected officials also have a job to do.
They can use the bully pulpit to turn this into a mainstream issue, he said. They can support grassroots ideas from local entrepreneurs and create microgrants to invest in “social infrastructure,” he added.
The term refers to things in a community that support the development of social connections, from physical spaces such as libraries and parks to policies and programs such as building public transportation and fostering volunteer groups.
“These are all important and will impact whether people gather or not,” Murthy said.
But investing in public institutions and infrastructure is an expensive endeavor that may seem unreasonable when local officials struggle to balance their budgets without increasing their tax burden.
That’s where the creativity comes from.
Charlotte’s health system and museum are partnering to offer a “prescription” for people to attend art classes and live performances together. The city of Chattanooga, Tennessee, is funding community ideas to increase connection and time in nature, including benches where people can talk with volunteer listeners. And across the country, men’s cabins have sprung up as places where men can work on projects together and discuss mental health.
Meal delivery and Valentine’s Day
Marcy O’Neill knew she didn’t have much money at her disposal. She was hired in 2024 to lead suicide prevention efforts in the rural Pennyrill area of western Kentucky after local leaders noticed an increase in suicides among older adults. Her grant was about $280,000, less than $3 per person in the region.
But she knew the nine-county region had other strengths, including a dedicated meal delivery program and high school clubs.
O’Neill said drivers who deliver prepared meals to homebound residents “may be the only people a senior sees during the week.”
The state had already trained some drivers to recognize warning signs of suicide among seniors and alert county officials to follow up. O’Neill thought there might be another component.
She contacted high school Beta Clubs in nine counties, which focus on developing leadership skills and volunteerism, and asked them to write cards that could be distributed to seniors with meals. Mr O’Neill said the response was swift.
Approximately 1,200 cards were delivered in May last year. They repeated the gesture on Valentine’s Day in February, and again in May of this year.
O’Neill said one elderly resident told her, “I can’t remember the last time I received a Valentine’s Day card.”
O’Neill said the students enjoyed feeling like they were making a difference. She helps a school set up an ongoing pen pal program with a nearby retirement community.
Locals affectionately refer to O’Neill as “Suicide Woman.” She considers the term a “badge of honor.”
Suicide prevention “doesn’t have to be a big deal,” she says. “The little things you can do can snowball into more.”
“Secret sauce”
Sciple, who has prioritized social connections through trivia nights and volunteer cleaning, felt most alone when she transitioned from her job at a commercial bank to working from home.
He spent most of his day analyzing Excel sheets, drafting grant proposals, and compiling recommendations for clients. Although his work felt important, Schipple said he felt alone.
“If my wife and children were with me at night, I was safe,” he says. Holding meetings at coffee shops also helped.
But when he was alone at his desk, “I felt the darkest sense of loneliness there,” he said, and he considered suicide.
To get out of that, I had to look for new connections.
Sciple said the church has been a great haven for him and his wife, not only on Sundays, but also with Bible studies and potlucks. They also go to see a variety of live music, including bluegrass and alternative rock.
“When you’re with people who are into the same type of music that we’re into at a concert, you feel connected,” he said.
Research suggests that sports may play a similar role in some cases. At least two studies have found that major sporting events are associated with lower suicide rates. The authors argue that this is because when people come together to cheer on their team or enjoy an event, it creates a protective sense of belonging.
This concept resonates with Sarah Brummett, who works on suicide prevention efforts at the state and national level and helps run Sources of Strength, an upstream prevention program. Fostering a sense of belonging has played a central role in each initiative, she said.
“You can’t take the hard things out of your life,” said Brummett, who has lost five friends to suicide since middle school.
“A sense of belonging is what gets us through really difficult situations as humans,” she said.
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