loneliness prevention – From volunteer trash cleanups in Charlotte to “Valentines” delivered with meals in rural western Kentucky, efforts aimed at social connection are emerging as a practical, policy-backed path to suicide prevention.
Every Tuesday for a decade, Steve Siple went to bar trivia night in Birmingham, Alabama. After he moved to North Carolina, he traded that ritual for another—joining other Charlotte locals on Saturdays to pick up trash along the city’s light rail.
For Siple, these aren’t just ways to pass time. They’re protection.
Siple has battled suicidal thoughts in the past. He lost his father to suicide, and one of his sons has struggled with thoughts of hurting himself. Those losses made him vigilant about protecting himself and his family—regular counseling. open conversations about mental health. and a deliberate priority on social connection.
“Loneliness was, over my lifetime, one of the greatest risk factors” for suicide, Siple said. He is a former board chair for the American Foundation for Suicide Prevention.
To many people, that connection may sound obvious. Yet in the broader approach to suicide prevention, treating serious mental illness—such as major depressive disorder—often centers on medication and talk therapy, with little or no attention to factors like social isolation or financial duress.
In recent years, that omission has started to crack, as clinicians, researchers, and advocates increasingly push loneliness into the foreground—not as a personal failing, but as something communities and policymakers can help address.
The evidence behind the focus is broad. Loneliness is described as a particularly strong predictor for older adults. who have the highest rates of suicide. and for youths. for whom suicide is the second-leading cause of death. One oft-cited study concluded that being socially disconnected is as harmful to one’s health as smoking up to 15 cigarettes a day.
And the trend, according to mental health researchers and clinicians, is getting worse. They point to multiple drivers of increased loneliness in America. including the rapid growth of technology such as smartphones and artificial intelligence; increased political polarization; the shift to remote work since the COVID pandemic; and decreased participation in religious institutions.
With suicide rates remaining stubbornly high—often ranking among the top 10 causes of death in America—advocates and people who have lost loved ones say expanding pathways to social connection may be a next frontier.
“If we want to reduce suicide rates in our country, which is absolutely essential, then a key part of that has to be fostering social connection,” Vivek Murthy said. Murthy served as surgeon general under Presidents Barack Obama and Joe Biden.
In 2023, Murthy released the first U.S. Surgeon General’s Advisory on loneliness as a public health issue, with more than 300 supporting citations. He has also written a book on the topic and has toured the country discussing the value of social connection.
“To help someone else feel less alone, to help them feel seen and understood and valued,” he told KFF Health News, “that can be one of the most powerful interventions that we make.”
The idea of elected officials playing a role doesn’t sit neatly with the instinct that families and neighbors should handle loneliness on their own. But Murthy argues that local leaders have tools too.
They can use their bully pulpits to make social connection a mainstream concern, he said. They can create microgrants to support grassroots ideas from community entrepreneurs and invest in “social infrastructure,” he added. In Murthy’s framing. social infrastructure includes physical spaces like libraries and parks and also policies and programs. including building public transportation and fostering volunteer groups.
“These all matter and impact whether people gather,” Murthy said.
Yet for cash-strapped local governments, investing in public institutions and infrastructure can feel out of reach. Officials may be trying to balance budgets without increasing tax burdens.
Some of the responses show how communities are trying to get creative without waiting for large-scale changes.
In Charlotte. a health system and a museum have teamed up to provide “prescriptions” for people to attend art classes or live performances together. In Tennessee. the city of Chattanooga is funding community ideas to increase connection and time in nature. including benches where people can speak with volunteer listeners. Across the country. men’s sheds have popped up as places where men can work on projects side by side and discuss their mental health.
A theme runs through those examples: connection can be designed into everyday life.
The smallest shifts can reach people most exposed to isolation. In rural Pennyrile, a nine-county region of western Kentucky, Marcie O’Neal led suicide prevention efforts starting in 2024 after local leaders saw a rise in suicides among the elderly.
O’Neal’s grant was about $280,000—less than $3 per person in the region. Still, she saw strengths already present there, including dedicated meal delivery programs and high school clubs.
Drivers who drop off prepared meals to homebound residents can be the only person that an older adult sees in the week, O’Neal said. The state had already been training some of those drivers to recognize warning signs of suicide among older people and alert county agencies to follow up with them.
O’Neal wanted to add another layer—cards delivered with meals, written by students.
She reached out to high school Beta clubs, which focus on fostering leadership skills and volunteerism, across all nine counties and asked them to write cards that could be distributed to older residents along with meals. The response was swift.
About 1,200 cards were delivered last May. O’Neal said the gesture was repeated in February for Valentine’s Day and again this May.
She recalled one older resident telling her, “I don’t remember the last time I got a Valentine’s card.”
For the students, the program also mattered. O’Neal said they enjoyed feeling as if they made a difference. She’s helping one school set up an ongoing pen pal program with a nearby retirement community.
Locals affectionately call O’Neal “the suicide lady,” a term she considers “a badge of honor.”
Suicide prevention “doesn’t have to be sweeping huge things,” O’Neal said. “It’s a little thing you can do that can kind of snowball into more things.”
She is also navigating grief; more on suicide: her daughter’s suicide shocked the community, and she is raising awareness.
Siple described a different kind of isolation—one that can happen even when life is orderly on paper. He said the loneliness hit hardest when he transitioned from a job at a commercial bank to working at home.
He spent most of his day analyzing Excel sheets, drafting grant proposals, and compiling recommendations for clients. He felt the work was important, but isolating, Siple said.
“If my wife or kids were around during the evening, I was safe,” he said. Holding meetings at coffee shops helped too.
But when he was alone at his desk, “that’s where I got the darkest lonely feelings,” he said, including thoughts of suicide.
Breaking out of it meant finding new connections—some spiritual, some social, and some tied to shared interests.
Siple said church was a great anchor for him and his wife, not just on Sundays but throughout the week at Bible studies and potlucks. They also go to see a variety of live music, including bluegrass and alternative rock.
“Being with folks that are into the same type of music that we’re into for a concert feels like connection,” he said.
Research suggests sports can play a similar role in some instances. At least two studies have found major sporting events are associated with lower suicide rates. The authors posit it’s because people coming together to support their team or to enjoy the event creates a sense of belonging. which is protective.
That concept resonates with Sarah Brummett, who has worked 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 of those initiatives, she said.
“We can’t eliminate hard stuff in our lives,” Brummett said. She lost five friends to suicide, starting in middle school.
“Belonging is really the secret sauce,” Brummett said, “for how we, as humans, can navigate really hard things.”
The through-line—from public advisories to meal deliveries, from light rail cleanups to benches staffed by volunteer listeners—is that preventing suicide doesn’t only mean responding to crisis. It also means making sure people have reasons to stay connected, before the darkest moments arrive.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—the independent source for health policy research, polling and journalism.
suicide prevention loneliness social connection U.S. Surgeon General advisory mental health community programs KFF Health News rural Kentucky loneliness policy