Hi friends,

Social connection is a major determinant of mental health outcomes.

And yet, we don’t talk about it much.

Every day, we’re becoming lonelier and more isolated, and as we do, our mental health is paying the price.

Unfortunately, things could actually get worse before they get better.

Into the void of social disconnection, AI has entered at top speed.

With its ability to replicate human behaviour, AI agents can be convincing companions, and they are getting adopted at alarming rates. This trend not only has the potential to exacerbate our disconnection, but also to cause real psychological harm if not managed.

Now, you probably already know that social connection is a problem.

It’s popular to talk about our epidemic of loneliness.

But what are we actually doing about it?

Who has tried to tackle this nasty problem, and how has it gone for them? Is anyone making headway?

What role can private organisations play in the solution (if any)? And what ideas do we have for solving it?

That’s what we get into in today’s edition of The Hemingway Report.

Let’s get into it.

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TLDR; The story of social connection and mental health

This topic has been covered in good detail elsewhere on the internet (I’d recommend the US Surgeon General’s 2023 report), so I’ll just give you the quick version of how this story has unfolded.

Here’s what you need to know…

1. Social connection is a measure of the size, function and quality of one’s social network.

What exactly is social connection? It’s not just about how many friends you have. The Surgeon General’s report provides a helpful framework to think about defining and evaluating this factor in one’s life, using three dimensions;

• Structure: The number of relationships, variety of relationships (e.g., co-worker, friend, family, neighbour), and the frequency of interactions with others

• Function: The degree to which others can be relied upon for various needs. •

• Quality: The degree to which relationships and interactions with others are positive, helpful, or satisfying (vs. negative, unhelpful, or unsatisfying).

2. A decline in social connection is associated with greater risk of depression, anxiety and even early mortality

We understand how we define social connection, but does it actually impact mental health? In short, yes. We have strong evidence that low levels of social connection are associated with common mental disorders like Depression and Anxiety:

• “A systematic review of multiple longitudinal studies found that the odds of developing depression in adults is more than double among people who report feeling lonely often, compared to those who rarely or never feel lonely”. Source

• “A review of 63 studies concluded that loneliness and social isolation among children and adolescents increase the risk of depression and anxiety, and that this risk remained high even up to nine years later.” Source

• “Social isolation is arguably the strongest and most reliable predictor of suicidal ideation, attempts, and lethal suicidal behaviour among samples varying in age, nationality, and clinical severity.” Source

3. Social connection influences health outcomes through biology, through psychology, and by influencing our behaviour. 

How does social connection (or a lack of it) actually impact mental health? There are multiple ways that social connection influences mental health outcomes. It can affect our biology directly, but also influences our psychology and, importantly, many of our behaviours.

In addition, strong social connection acts as a safety net for when things go wrong in mental health. When we have people to talk to, they can help us recover or help us engage with the care we need.

4. Social connection has been in severe decline, especially in the US.

There are multiple studies and measures that all confirm that the level of social connection for most people has been in significant decline. People have fewer friends, socialise less, are less likely to be part of a club or religious organisation and spend more time at home.

Here are some of the stats that jumped out at me.

• Almost half of Americans (49%) in 2021 reported having three or fewer close friends, only about a quarter (27%) reported the same in 1990.

• The time spent socially engaging with friends has decreased by 20 hours per month (40 minutes per day).

  

  Source: US Surgeon General Report

• Teens have seen a massive drop-off in face-to-face socialising.

  

• People are spending significantly more time at home, even after the pandemic.

  

• The decline in face-to-face socialising has been largest in 15-24 year olds, black populations, unmarried men and those with no high school degree.

  

5. This decline has been driven by a compounding combination of cultural and technological forces

So what’s caused this decline? It’s complex and multifactorial. But Robert Putnam describes it best in his research Bowling Alone. There’s now a documentary on this research called Join or Die. It’s on Netflix and I’d recommend watching it.

Here’s how Putnam’s work explains the decline in social connectedness.

Since the 1970s, the rise of humanist values has placed greater emphasis on the role of the individual. At the same time, the adoption of two new technologies (the car and the television) led people to start to live more isolated lives, moving to the suburbs and staying at home for entertainment. These factors led to a decline in participation in many social anchors in our communities (churches, unions, clubs, community centres, etc.). As participation in these clubs and organisations dwindled, many closed or became less attractive.

In more recent times, new technology has made it increasingly easy to live an isolated life. We can work, order food, work out and entertain ourselves, all from the comfort of our home. Why would we ever leave?

Like many of the most powerful social trends, these factors compound. Venues are closing, and many people are losing the skills needed to build connection.

Even though we may be able to survive physically in a life of isolation, our bodies and minds were not designed for such a life. 

Our biological need for connection remains. And when it’s not satisfied, we suffer.

The impact is very real and very worrying

Statistics like these are helpful for understanding the size and shape of the problem. But if you want to understand what’s actually going on on the ground, for real humans, you need to look elsewhere.

The rise of r/lonely:

One place you can go to hear people’s stories is Reddit. On the social platform, r/lonely is now a top 1% subreddit by size, with over 438,000 members. Just look at the rate of growth since 2019.

If you read the posts on the subreddit, you can get a sense of what is happening for people. Warning: it’s pretty sad reading (not that this article has been a joyous affair so far…).

Just look at some of these stories.

For example, here is someone who just completed their PhD and had nobody to celebrate with.

And here’s someone watching YouTube just to feel less alone.

Many people's basic needs for connection are not being met. It’s leading to negative consequences for their mental and physical health and at the most extreme end of the spectrum, some people are making the choice to live in complete isolation, entirely removing themselves from society.

Hikikomori: extreme social withdrawal

Hikikomori is the name given to this extreme form of social withdrawal and isolation in Japan. And it’s now becoming a global trend. These people choose to withdraw completely from society, choosing instead to stay at home almost all of the time.

In Japan alone, it’s estimated that 1.5 million people live as hikikomori, with over 600,000 of these aged between forty and sixty-four.

This phenomenon has now been reported in several countries, including France (Chauliac et al., 2017), Brazil (Gondim et al., 2017), China (Wong et al., 2017), Canada, Italy (Stip et al., 2016), India, South Korea and the US (Teo et al., 2015)

The problem of social isolation is not isolated (pardon the pun), to the US or Western world.

What are we doing about it?

We’ve known about this problem for a while. Thankfully, a number of organisations from public to private have tried to tackle it over the last few years, with varying degrees of success. Here’s an overview of some of the approaches that have been taken.

Public Interventions

Many governments have tried to take an active role in addressing this problem.

The UK launched a nationwide loneliness strategy in 2018 and even appointed a Minister for Loneliness. The strategy included a "Let's Talk Loneliness" campaign to try to reduce the stigma of loneliness, as well as millions of pounds to support local community initiatives. To be fair, many of these seem like good ideas; home visits to elderly people or cab services to help people without transport to attend social events. One of these transport services included ‘Happiness Training’ to “help create a positive and welcoming environment”. I;m sure the intent was good but that sounds so freaking dystopian to me…

Anyway, despite these initiatives, there has been little evidence that they are working.

The UK’s 2023 annual report on this program indicates that while awareness has increased, the strategy's impact on actually reducing loneliness has been limited, especially with some of the most affected groups (young adults, disabled people, and LGBTQ communities).

Clinical interventions

In clinical settings, we saw the rise of “social prescribing,” particularly in the UK’s NHS. With this initiative, providers can refer patients to community activities or social clubs. The UK has scaled up this practice with hundreds of dedicated “link workers”. Their role is to understand what is going on for an individual and help introduce them to social activities and build more social habits.

Many patients report short-term boosts from social prescribing – better mood, a sense of belonging, even fewer GP visits – but unfortunately, the existing research has shown little evidence of lasting reductions in loneliness.

Research on these interventions is still emerging, but a 2024 systematic review and meta-analysis by O’Sullivan et al. found that there were no significant improvements in general psychological well-being when results were pooled across studies. There were some benefits for specific niches, but overall, the interventions and outcomes were very heterogeneous, and the overall quality of evidence remains low.

Private and community interventions

A lot of private organisations have been trying to tackle this problem through different approaches.

Some see social isolation as primarily a discovery problem. This includes dating and friend-finding apps. The thesis here is that you just need an easier way to find and “match” with people, the rest will take care of itself. Sure, lots of people have met partners and friends through these apps, but they don’t seem to get to the root of the problem, and many people are pushing back against them. A recent Forbes survey found that 79% of Gen Z report dating app burnout. Many of my own friends are now rebuking this culture of algorithmic dating, deleting their apps and attempting to pursue IRL connections instead. This is a good sign.

Others, like Timeleft, go a step further by actually organising events and dinners where you can meet strangers. These have gained lots of traction in the last 24 months - Timeleft is apparently on track to hit $25M in ARR this year.

Moving further from digital into the real world, other businesses have had success in creating social clubs, often not pitching social connection as their main selling point, but rather as a welcome second-order effect. These have also had commercial success. From gyms to recovery centres to the current wave of longevity and lifestyle clubs, these businesses are getting traction, especially in more affluent communities.

Another play has been to try and create the actual physical infrastructure that facilitates better social connectedness. Businesses like The Commons, Groundfloor Club and more are attempting to build modern-day third spaces.

Belong is one of the coolest organisations I’ve come across, expressly focused on solving loneliness and creating a culture of belonging. They create spaces that serve as modern-day churches – “sanctuaries for human connection, not bound by religion but by the shared experience of being human” and also have an app to support people who want to combat loneliness in their own communities.

Live Near Friends helps people to find buildings that facilitate more communal living (this is actually pretty cool!).

I’ve even come across organisations that have started their own co-housing communities. You can choose to go and live in one of these communities where dozens of other people are committed to living lives more connected to each other and their community. Sunward Co-Housing is one example. Their mission is to “co-create a vibrant multigenerational cohousing community – culturally, economically and racially diverse – which seeks to form regenerative relationships with one another and with Nature.” Is this a cult? I mean, who even draws those lines anymore?

The good thing is that many of these initiatives have merit. Those that tackle the actual infrastructure problems and offer solutions aligned with the reality of the problem of loneliness have the most merit. But their reach is still minuscule, especially compared to the size of the problem. Some of these models may work well in wealthy, urban areas, but would struggle to expand further afield.

So, where does that leave us? In summary, we’ve tried some stuff. A lot of it hasn’t worked. Some have shown promise, but still have very limited reach and impact. We still have a lot of work to do.

So, what should we do?

I spend a lot of my time describing problems. But I always want to offer my thoughts on potential solutions. I have a few opinions on this topic;

1. First, do no harm. We must be very careful not to make this matter worse. Some innovations (like food delivery) have had the unintended consequence of reducing social interaction. Now, I’m not going to blame the founder of DoorDash for our loneliness epidemic, but for any of us building products and services, we should think about how it impacts social connection and, at the very least, ensure it does not enhance the problem.

2. AI with care. The area in which we must be most careful is with AI. AI offers a potentially dangerous antidote to the problem of loneliness and, like technologies that have come before it, could accelerate the trend of isolation. Many lonely people are now using AI agents as a source of companionship. We must realise that this is an attractive alternative for those people. As this Atlantic article highlighted, “These generations may discover that what they want most from their relationships is not a set of people, who might challenge them, but rather a set of feelings – sympathy, humor, validation – that can be more reliably drawn out from silicon than from carbon-based life forms.”
   I believe we need a balanced view on the pros and cons of this behaviour; there may be some benefits for some people, but we must realise there is significant potential for harm. If we are not extremely thoughtful about how these products are developed, regulated and promoted, we could make this problem of social isolation much worse

3. Work with what we’ve got. I saw a good reel on Instagram today, making the point that we shouldn’t use the lack of third spaces as an excuse not to hang out and that it was largely a failure of our imagination. He has a point. It is true that we would benefit from better infrastructure for social connection, but we can also just go and hang out at a coffee shop, in the park, or in each other’s homes. Literally wherever. Yes, let’s try to build new third spaces, but let’s not wait for them.  

4. Give people better options. One of the reasons people are spending more time at home is that there aren’t better alternatives. Being at home can be pretty good. It’s comfortable, we have big TVs, Netflix, PlayStations and our favourite Door-Dash delivery just minutes away. Plus, we don’t have to deal with the inconveniences of the outside world. If we don’t want people to be at home, we need to offer an alternative that is much better. Deep down, people want social connection, so let’s come up with new, engaging, meaningful, enjoyable things for them to do outside of their house and with other people.  

5. Have a horse in the race. Mental health businesses should think deeply about how they can contribute to solutions in this space. Not just because there’s significant potential for impact, because it may make commercial sense too. Finding innovative interventions that improve social connectedness has the potential to improve clinical outcomes. But mental health businesses could also use these initiatives to drive awareness and client acquisition. Consumer brands like Nike, Lululemon, Hoka and more have all realised the growing consumer desire for IRL social connection. They are hosting and sponsoring run clubs, races and meetups all around the world, helping people to gather, get active and to build their brand in the meantime. I’m waiting for a mental health business to be brave and take a big leap into initiatives like this. Self-Space do some really cool stuff with retreats, regular meetups, book clubs and more. Other mental health businesses should follow suit.

6. Be wary of the “loneliness apparatus”. My friend Toby Shorin has some strong opinions on loneliness. To attempt to paraphrase his position, he is concerned that the institutionalisation of the concept may lead to unintended consequences. He has a point. As I’ve mentioned, loneliness is an extremely complex topic and we must try to understand the specificities of its component parts, build solutions for those directly and frame those solutions in positive, additive messaging - focusing on what someone can gain from engaging in them, as opposed to what they could lose from remaining isolated.

7. Play supporting, not leading roles. Making friends and social connections is a deeply personal endeavour. Yes, people want more convenience, but I don’t think anyone likes the idea that this could be manufactured for them. Solutions that try to do this risk failure. People want genuine connection, and the solutions that work best tend to achieve this by approaching the problem side-on, making social connection a welcome secondary outcome to their service. As Toby wrote in his essay, “The most healing social spaces do not even make loneliness or ‘care’ salient; they are intrinsically joyful to be part of, whether their context is religious, sporting, creative, or educational.”

8. Realise that cultural problems require cultural solutions. When we hear the story of how social connection has eroded, we learn that changes in our culture played a major role. And yet, so many of the solutions don’t seem to address these cultural influences. We should try to better understand the cultural trends that are leading people to spend more time alone. Then, we should use culture for the strong tool that it is, to try and turn the tide.

This is far from straightforward. But it’s critical we reverse these trends in social connection. Not only does our mental and physical health depend on it, but perhaps the health and happiness of our society at large.

That’s all for this week.

If you have thoughts on this topic, please reach out. I’m always keen to hear from you.

Keep fighting the good fight!

Steve

Founder of The Hemingway Group

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