Greensburg resident John Herrmann has a suppertime appointment each Thursday at the city’s Otterbein United Methodist Church.
Helping to hand out meals to those in need during the weekly Feeding the Spirit program there helps him in his ongoing efforts to form and maintain positive connections in the community.
Herrmann, 66, said that when he was diagnosed with bipolar disorder more than three decades ago, it made him feel isolated from others.
“I thought I was the only one with this,” he said. “I was very lonely. I didn’t know where to turn or really understand what was going on.”
A new epidemic of loneliness and isolation has affected many others across the country, with serious implications for their physical and mental health, according to a recent advisory issued by U.S. Surgeon General Dr. Vivek Murthy.
About half of U.S. adults have reported experiencing measurable levels of loneliness, according to Murthy, who issued his report in time for Mental Health Awareness Month, observed in May.
He said the potential consequences of poor or insufficient connection with others include a 29% increased risk of heart disease, a 32% increased risk of stroke and a 50% increased risk of developing dementia for older adults. A lack of social connection also increases the risk of premature death by more than 60%, Murthy reported.
He said the risk of developing depression among adults who report feeling lonely often is more than double that of people who rarely or never feel lonely.
Many who seek assistance for mental health issues are experiencing depression and anxiety, according to clinical psychologist Lisa McCay. She supervises the outpatient therapy department of the Family Counseling Center of Armstrong County, which has offices in Leechburg and Kittanning.
“The more depressed you are, the harder it is to motivate yourself to get out and go places to meet people, the more convinced you are that other people are judging you or are thinking negative things about you,” McCay said. “That makes it all the harder to go out there. It becomes sort of a negative snowball.”
Murthy’s sounding of the alarm about the damaging effects of isolation on health was needed, according to local professionals who stress the connection between mental health and physical health.
Heather McLean, outreach coordinator for Greensburg-based nonprofit Mental Health America of Southwestern PA, leads several support groups for people experiencing various issues, including those recovering from a suicide attempt or those supporting a loved one with mental illness.
Conversations among group participants reveal a common theme. “When their emotional wellness is not good, their physical wellness is not good,” McLean said. “They may have stomach or back issues, feel dizzy or fatigued. There is a huge connection between loneliness and fatigue. It’s like a snowball effect; it just increases it.”
“With depression, you can lose the motivation for taking care of yourself and being more proactive with your health,” said Patti Lewis, director of behavioral health for Westmoreland County-based Excela Health, now part of the Independence Health System. “That can certainly lead to problems.”
Missed doctor’s appointments, she said, could increase the risk of experiencing cardiac issues or developing diabetes.
Mental and behavioral health professionals note isolation and feelings of loneliness have always been among factors that affect their clients. But those issues became more prominent following the arrival of the covid-19 pandemic and its initial restrictions on in-person activities.
“The pandemic really did a doozy on us,” said McLean.
Before the pandemic, being home alone was a potential cause of anxiety for older people, McLean said.
“Now it’s flipped,” she said. “There’s an anxiety about having to go places.”
Despite the easing of the pandemic, she said, “There is a lot of the aging population that never really left their homes. It’s been very hard for them to get reintegrated into the community. Some are still afraid of getting sick.”
A 2019 study published online in the National Library of Medicine indicates patients with severe mental illness die about 10 to 20 years earlier than the general population. That study focused on more than 800 mental health patients in The Netherlands with chronic conditions and functional impairment who were receiving long-term care or were in psychiatric hospitals.
Laurie Barnett Levine, CEO of Mental Health America of Southwestern PA, cited factors that could contribute to such early deaths.
“There may be physical health issues, smoking, other lifestyle factors, medications they might be taking,” she said. “They also experience loneliness and isolation. It’s often difficult for them to maintain social relationships.”
In step with the growing need for mental health services, suicide numbers reached a high of 62 last year in Westmoreland County, according to an annual report by the county coroner. The largest number of those self-inflicted deaths, 15, occurred among people ages 51-60, while the 16-20 and 91-plus age brackets each accounted for one.
Herrmann speaks openly about his mental health experiences and has become an advocate for others with similar challenges. A survivor of multiple suicide attempts and episodes of suicidal thoughts, he noted a growing network of social connections he has developed has given him an extra incentive to overcome such thoughts.
Bipolar disorder, according to the National Institutes of Health, causes unusual shifts in a person’s mood, energy, activity levels and concentration that can make it difficult to carry out day-to-day tasks.
When Herrmann learned about a conference on the topic, he “saw other people around me with the same illness. I wasn’t the only one out there.”
“I thought to myself, ‘How many people would you affect if you did this?’ ” he said. “I know thousands of people in Westmoreland County and across the state. It would have a big ripple effect on so many people. It just pulled me out of it.”
While the need for mental health services has increased, staffing for many of those services has been unable to keep pace.
The Family Counseling Center of Armstrong County has grown over the past 15 years, seeing its outpatient staff expand from about eight therapists to nearly 50, according to McCay.
Still, she said, “Our waiting list is as long as it’s ever been,” with about 200 patients lined up to see a therapist at last count.
“The biggest issue we face is a workforce issue,” said Gretchen Kelly, legislative affairs committee chair for the Conference of Allegheny Providers, an association of nonprofit human service agencies in Allegheny County that offer behavioral health services.
“We just can’t find enough staff to run our programming,” said Kelly, who noted human service organizations haven’t been able to match rising wages offered by major retailers. “That creates waiting lists and gaps in services for children and adults who desperately need these services.”
Many organizations are advocating for an increase in government funding to help bridge that gap.
Pennsylvania Gov. Josh Shapiro has proposed a roughly $20 million increase in Pennsylvania’s 2023-24 budget for safety-net mental health services that are managed at the county level. But, according to the Associated Press, that may not be enough for counties that say they are working with the same amount of state aid as they received in 2012.
Awareness and outreach
Meanwhile, service providers are reaching out to increase awareness of mental health issues and to encourage those who need help to seek it.
According to Lewis, “Two-thirds of people with mental health disorders do not seek treatment. Of the third that does seek treatment, only 75% actually complete treatment.”
“One in four individuals will be impacted by mental illness in any given year,” Levine said. “People think about a stereotype, but it’s not always who you think it is. It could be your friend or neighbor.
“These are people who are going to work every day, but they might have depression or anxiety or bipolar issues, and they’re experiencing loneliness when they’re coming home.”
Communicating with others is key, McLean said.
“We don’t want to reach out and say we need help because we don’t want people to know we’re vulnerable, and so we don’t,” she said. “The more people talk about it, the more it breaks down that stigma. We need to realize that there are a lot of people who are lonely, and we need to start talking about it.”
With the easing of the pandemic, “a lot of energy and time has been spent urging people to get back into the community, what would be attractive to get them back out and relaunch themselves,” said Conference of Allegheny Providers President Sue Coyle. “Finding out how to do that has been a little tricky. It’s become more of a challenge to get people to come out and take on activities that abate loneliness.”
“We’re all social creatures,” said Dillon Stein, director of palliative care for Butler Health System, now part of the Independence Health System. “If people are isolated, it increases their risk of not being well. We’re seeing the downstream effects of what had to be done during the pandemic.”
“It took me at least 15 years to really accept that I have an illness,” said Herrmann, who was placed in an institutional setting for five years as a juvenile and wasn’t diagnosed with bipolar disorder until he was 31.
He likens his disorder to a roller coaster.
Herrmann said he would experience periods of high energy and round-the-clock wakefulness alternating with extreme fatigue and sleepiness, a cycle that sometimes included hospital stays.
“I would do things that were abnormal, and I would think about hurting myself,” he said.
He said finding the right combination of medications to counteract a chemical imbalance in his system has been key for controlling his disorder.
“Then everything started to fall into place,” he said. “Since I’ve been stable, I’ve made a lot of friendships.”
Herrmann shares his story at training sessions provided by a multi-county Crisis Intervention Team. The sessions are meant to better prepare first responders for interacting with those who have mental health issues.
“I’m very outspoken about it,” Herrmann said of his experiences. “What is really important to me is if I can make one change in somebody’s life.”
He is active with other organizations, including the Pennsylvania Mental Health Planning Council and the Ray of Hope Westmoreland County Suicide Awareness and Prevention Task Force.
When taking part in Ray of Hope outreach events, Herrmann said, he is sensitive to others who may be struggling with mental health issues and may want to talk to someone who can empathize.
“I’ve been there and done that,” he said. “The most important thing to know is that you’re not alone. It’s OK not to be OK.”