Community Support Systems and Their Influence on Mental Health Outcomes Among Adults

Zuraifa Hamidu

Abstract

The level of mental health challenges among adults has not been as high as it is worldwide, and thus, there is a need to have a broad insight into protective factors other than clinical interventions. This research examined the links among dimensions of the community support system and mental health outcomes among adults, with social isolation and loneliness as mediators. Researchers gathered data from 487 adults aged 18–84 living in urban, suburban, and rural settings using validated measures of community support (structural, functional, perceived support, and community engagement), social isolation and loneliness, and mental health outcomes, including psychological distress, depression, anxiety, and well-being. Findings showed a high level of negative correlations between mental health symptoms and all of the dimensions of community support (r = -.35 to -.56, p < .001), and perceived support became the strongest predictor. The regression models used in this study were hierarchical and explained 43.5% of the variance in psychological distress. Community support, along with demographics and physical health, explained 21.4% of the variance in psychological distress. Loneliness mediated 63.8% of the effect of perceived support on psychological distress. Age also had a significant moderating effect, with young adults (18-30 years) showing the greatest effect, reporting the highest symptom levels despite having larger networks. The results indicate the robust links between community support and mental health impacts, which implies that the interventions that can improve community ties can be effective and can assist the population with high rates of loneliness and social isolation.




Keywords


community support systems; mental health; social isolation; loneli-ness; adult well-being; social determinants of health; community en-gagement

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References


1. Thoits, P. A. (2011). Mechanisms linking social ties and support to physical and mental health. Journal of Health and Social Behaviour, 52(2), 145–161. doi: 10.1177/0022146510395592

2. Santini, Z. I., Jose, P. E., Cornwell, E. Y., Koyanagi, A., Nielsen, L., Hinrichsen, C., Meilstrup, C., Madsen, K. R., & Koushede, V. (2020). Social disconnectedness, perceived isolation, and symptoms of depression and anxiety among older Americans (NSHAP): a longitudinal mediation analysis. The Lancet Public Health, 5(1), 62–70. doi: 10.1016/s2468-2667(19)30230-0

3. Majer, J. M., Jason, L. A., North, C. S., Ferrari, J. R., Porter, N. S., Olson, B., Davis, M., Aase, D., & Molloy, J. P. (2008). A Longitudinal Analysis of Psychiatric Severity upon Outcomes Among Substance Abusers Residing in Self‐Help Settings. American Journal of Community Psychology, 42(1–2), 145–153. doi: 10.1007/s10464-008-9190-z

4. Garcia, M. A., Homan, P. A., García, C., & Brown, T. H. (2020). The colour of COVID-19: Structural racism and the disproportionate impact of the pandemic on older Black and Latinx adults. The Journals of Gerontology Series B, 76(3), e75–e80. doi: 10.1093/geronb/gbaa114

5. Philippe, T. J., Sikder, N., Jackson, A., Koblanski, M. E., Liow, E., Pilarinos, A., & Vasarhelyi, K. (2022). Digital Health Interventions for Delivery of Mental Health Care: Systematic and Comprehensive Meta-Review. JMIR Mental Health, 9(5), 35159. doi: 10.2196/35159

6. WHO. (2024). WHO Results Report 2023 shows notable health achievements and calls for a concerted drive toward Sustainable Development Goals. Retrieved from https://www.who.int/news/item/07-05-2024-who-results-report-2023-shows-notable-health-achievements-and-calls-for-concerted-drive-toward-sustainable-development-goals

7. Swarts, B. (2023). The Relationship between Public Mental Health Policy and the Practice of Community Psychology through Family Support Groups. New Voices in Psychology. doi: 10.25159/2958-3918/14816

8. Rekha, T., Kumar, N., Hegde, K., Unnikrishnan, B., Mithra, P., Holla, R., & Bhagawan, D. (2023). The COVID-19 pandemic and mental health outcomes – A cross-sectional study among health care workers in Coastal South India. F1000Research, 11, 676. doi: 10.12688/f1000research.111193.4

9. Acoba, E. F. (2024). Social support and mental health: the mediating role of perceived stress. Frontiers in Psychology, 15, 1330720. doi: 10.3389/fpsyg.2024.1330720

10. Kirkbride, J. B., Anglin, D. M., Colman, I., Dykxhoorn, J., Jones, P. B., Patalay, P., Pitman, A., Soneson, E., Steare, T., Wright, T., & Griffiths, S. L. (2024). The social determinants of mental health and disorder: evidence, prevention and recommendations. World Psychiatry, 23(1), 58–90. doi: 10.1002/wps.21160

11. Hassan, S. M., Giebel, C., Morasae, E. K., Rotheram, C., Mathieson, V., Ward, D., Reynolds, V., Price, A., Bristow, K., & Kullu, C. (2020). Social prescribing for people with mental health needs living in disadvantaged communities: the Life Rooms model. BMC Health Services Research, 20(1), 19. doi: 10.1186/s12913-019-4882-7

12. Smikowski, J., Dewane, S., Johnson, M. E., Brems, C., Bruss, C., & Roberts, L. W. (2009). Community-Based Participatory Research for Improved Mental Health. Ethics & Behaviour, 19(6), 461–478. doi: 10.1080/10508420903274971

13. Lewis, C. C., Boyd, M. R., Walsh-Bailey, C., Lyon, A. R., Beidas, R., Mittman, B., Aarons, G. A., Weiner, B. J., & Chambers, D. A. (2020). A systematic review of empirical studies examining mechanisms of implementation in health. Implementation Science, 15(1), 21. doi: 10.1186/s13012-020-00983-3

14. Keyes, C. L. M. (2013). Mental health as a complete state: How the salutogenic perspective completes the picture. In G. F. Bauer & O. Hämmig, Bridging occupational, organisational and public health (pp. 179-192). Springer.

15. Ferrari, A., Santomauro, D., Herrera, A., Shadid, J., Ashbaugh, C., Erskine, H., Charlson, F., Degenhardt, L., Scott, J., McGrath, J., Allebeck, P., Benjet, C., Breitborde, N., Brugha, T., Dai, X., Dandona, L., Dandona, R., Fischer, F., Haagsma, J., & Whiteford, H. (2022).Global, Regional, and National Burden of 12 Mental Disorders in 204 Countries and Territories, 1990–2019: a Systematic Analysis for the Global Burden of Disease Study 2019. (2022). The Lancet Psychiatry, 9(2), 137–150. doi: 10.1016/s2215-0366(21)00395-3

16. Tanarsuwongkul, S., Liu, J., Spaulding, M., Perea-Schmittle, K., Lohman, M., & Wang, Q. (2025). Associations between social determinants of health and mental health disorders among the U.S. population: a cross-sectional study. Epidemiology and Psychiatric Sciences, 34, 4. doi: 10.1017/s2045796024000866

17. Cohen, S., & Janicki‐deverts, D. (2012). Who's Stressed? Distributions of Psychological Stress in the United States in Probability Samples from 1983, 2006, and 20091. Journal of Applied Social Psychology, 42(6), 1320–1334. doi: 10.1111/j.1559-1816.2012.00900.x

18. Ellison, N. B., Vitak, J., Grey, R., & Lampe, C. (2014). Cultivating social resources on social network sites: Facebook relationship maintenance behaviours and their role in social capital processes. Journal of Computer-Mediated Communication, 19(4), 855–870. doi: 10.1111/jcc4.12078

19. Primack, B. A., Shensa, A., Sidani, J. E., Whaite, E. O., Lin, L. Y., Rosen, D., Colditz, J. B., Radovic, A., & Miller, E. (2017). Social media use and perceived social isolation among young adults in the U.S. American Journal of Preventive Medicine, 53(1), 1–8. doi: 10.1016/j.amepre.2017.01.010

20. Taylor, R. J., Chatters, L. M., & Taylor, H. O. (2018). Race and objective social isolation: older African Americans, Black Caribbeans, and Non-Hispanic Whites. The Journals of Gerontology Series B, 74(8), 1429–1440. doi: 10.1093/geronb/gby114

21. Surkalim, D. L., Luo, M., Eres, R., Gebel, K., Van Buskirk, J., Bauman, A., & Ding, D. (2022). The prevalence of loneliness across 113 countries: systematic review and meta-analysis. BMJ, 376, 067068. doi: 10.1136/bmj-2021-067068

22. Bzdok, D., & Dunbar, R. I. (2020). The Neurobiology of Social Distance. Trends in Cognitive Sciences, 24(9), 717–733. doi: 10.1016/j.tics.2020.05.016

23. Donovan, N. J., & Blazer, D. (2020). Social isolation and loneliness in older adults: Review and commentary of a National Academies report. American Journal of Geriatric Psychiatry, 28(12), 1233–1244. doi: 10.1016/j.jagp.2020.08.005

24. Fakoya, O. A., McCorry, N. K., & Donnelly, M. (2020). Loneliness and social isolation interventions for older adults: a scoping review of reviews. BMC Public Health, 20(1), 129. doi: 10.1186/s12889-020-8251-6

25. Hall, C. E., Wehling, H., Stansfield, J., South, J., Brooks, S. K., Greenberg, N., Amlôt, R., & Weston, D. (2023). Examining the role of community resilience and social capital on mental health in public health emergency and disaster response: a scoping review. BMC Public Health, 23(1), 2482. doi: 10.1186/s12889-023-17242-x

26. Ehsan, A., Klaas, H. S., Bastianen, A., & Spini, D. (2019). Social capital and health: A systematic review of systematic reviews. SSM - Population Health, 8, 100425. doi: 10.1016/j.ssmph.2019.100425

27. Jenkinson, C. E., Dickens, A. P., Jones, K., Thompson-Coon, J., Taylor, R. S., Rogers, M., Bambra, C. L., Lang, I., & Richards, S. H. (2013). Is volunteering a public health intervention? A systematic review and meta-analysis of the health and survival of volunteers. BMC Public Health, 13(1), 773. doi: 10.1186/1471-2458-13-773

28. Bunn, C., Kalinga, C., Mtema, O., Abdulla, S., Dillip, A., Lwanda, J., Mtenga, S. M., Sharp, J., Strachan, Z., & Grey, C. M. (2020). Arts-based approaches to promoting health in sub-Saharan Africa: a scoping review. BMJ Global Health, 5(5), 001987. doi: 10.1136/bmjgh-2019-001987

29. Parker, C., Scott, S., & Geddes, A. (2020). Snowball sampling. SAGE Research Methods Foundations. doi: 10.4135/9781526421036831710

30. Daikeler, J., Bošnjak, M., & Manfreda, K. L. (2019). Web versus Other Survey Modes: An updated and extended Meta-Analysis comparing response rates. Journal of Survey Statistics and Methodology, 8(3), 513–539. doi: 10.1093/jssam/smz008

31. Kuiper, J. S., Zuidersma, M., Voshaar, R. C. O., Zuidema, S. U., Van Den Heuvel, E. R., Stolk, R. P., & Smidt, N. (2015). Social relationships and risk of dementia: A systematic review and meta-analysis of longitudinal cohort studies. Ageing Research Reviews, 22, 39–57. doi: 10.1016/j.arr.2015.04.006

32. Liu, H., Zhang, M., Yang, Q., & Yu, B. (2019). Gender differences in the influence of social isolation and loneliness on depressive symptoms in college students: a longitudinal study. Social Psychiatry and Psychiatric Epidemiology, 55(2), 251–257. doi: 10.1007/s00127-019-01726-6

33. Batterham, P. J., Sunderland, M., Slade, T., Calear, A. L., & Carragher, N. (2017). Assessing distress in the community: psychometric properties and crosswalk comparison of eight measures of psychological distress. Psychological Medicine, 48(8), 1316–1324. doi: 10.1017/s0033291717002835

34. Zhang, W., O'Brien, N., Forrest, J. I., Salters, K. A., Patterson, T. L., Montaner, J. S. G., Hogg, R. S., & Lima, V. D. (2012). Validating a Shortened Depression Scale (10 Item CES-D) among HIV-Positive People in British Columbia, Canada. PLoS ONE, 7(7), 40793. doi: 10.1371/journal.pone.0040793

35. Mossman, S. A., Luft, M. J., Schroeder, H. K., Varney, S. T., Fleck, D. E., Barzman, D. H., Gilman, R., DelBello, M. P., & Strawn, J. R. (2017). The Generalised Anxiety Disorder 7-item scale in adolescents with generalised anxiety disorder: Signal detection and validation. Ann Clin Psychiatry, 29(4), 227-234

36. Michalec, B., Diefenbeck, C., & Mahoney, M. (2013). The calm before the storm? Burnout and compassion fatigue among undergraduate nursing students. Nurse Education Today, 33(4), 314–320. doi: 10.1016/j.nedt.2013.01.026

37. Field, A. (2018). Discovering statistics using IBM SPSS Statistics (5th ed.). SAGE Edge

38. Hayes, A. F. (2022). Introduction to Mediation, Moderation, and Conditional Process Analysis: A Regression-Based Approach. Guilford Publications

39. Eisenberger, N. I. (2014). Social Pain and the Brain: Controversies, Questions, and Where to Go from Here. Annual Review of Psychology, 66(1), 601–629. doi: 10.1146/annurev-psych-010213-115146

40. Cacioppo, J. T., & Cacioppo, S. (2018). Loneliness in the Modern Age: An Evolutionary Theory of Loneliness (ETL). In Advances in experimental social psychology (pp. 127–197). doi: 10.1016/bs.aesp.2018.03.003

41. Henderson, C., Evans-Lacko, S., & Thornicroft, G. (2013). Mental Illness Stigma, Help Seeking, and Public Health Programs. American Journal of Public Health, 103(5), 777–780. doi: 10.2105/ajph.2012.301056

42. Masi, C. M., Chen, H., Hawkley, L. C., & Cacioppo, J. T. (2010). A Meta-Analysis of Interventions to Reduce Loneliness. Personality and Social Psychology Review, 15(3), 219–266. doi: 10.1177/1088868310377394

43. Mousavizadeh, S. N., & Bidgoli, M. A. J. (2023). Recovery-Oriented Practices in Community-based Mental Health Services: A Systematic Review. Iranian Journal of Psychiatry, 18(3), 332–351. doi: 10.18502/ijps.v18i3.13013

44. Arcaya, M. C., Tucker-Seeley, R. D., Kim, R., Schnake-Mahl, A., So, M., & Subramanian, S. (2016). Research on neighbourhood effects on health in the United States: A systematic review of study characteristics. Social Science & Medicine, 168, 16–29. doi: 10.1016/j.socscimed.2016.08.047

45. Wang, J., Mann, F., Lloyd-Evans, B., Ma, R., & Johnson, S. (2018). Associations between loneliness and perceived social support and outcomes of mental health problems: a systematic review. BMC Psychiatry, 18(1), 156. doi: 10.1186/s12888-018-1736-5

46. Bailey, Z. D., Feldman, J. M., & Bassett, M. T. (2020). How structural racism works — Racist policies as a root cause of U.S. racial health inequities. New England Journal of Medicine, 384(8), 768–773. doi: 10.1056/nejmms2025396


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