The Association between Loneliness with Increased Mental Health Problems and Substance Use During the COVID-19 Pandemic in Richmond, Virginia

Background. The COVID-19 pandemic caused significant psychological distress among U.S. adults leading to increased rates of adverse mental health symptoms and substance use. This study aims to evaluate the consistency of the association between loneliness and increased mental health problems and substance use in Richmond, VA during the COVID-19 pandemic. Methods. Data were collected in two phases: 1) internet-based surveys from August 2020 to March 2021 (N=327) and 2) paper-pencil surveys from May to October 2021 (N=225). Logistic regression was used to test the association between loneliness and increased mental health and substance use, while adjusting for sociodemographic factors and pre-existing mental health conditions. Results. Both survey populations reported a high prevalence of increased loneliness (46.7% - 68.8%), mental health problems (50.2% - 67.3%), and substance use (22.2% - 29.4%) since the COVID-19 pandemic. Increased loneliness since the pandemic was significantly associated with increased mental health problems (Online survey: AOR=5.00, 95% CI=2.56 - 9.97; Paper-pencil survey: AOR=10.48, 95% CI=4.18 - 28.59) and increased substance use (Online survey: AOR=3.14, 95% CI=1.58 - 6.60; Paper-pencil survey: AOR=5.89, 95% CI=1.97 - 19.71). Conclusions. The association between increased loneliness and increased mental health problems and substance use during COVID-19 in Richmond, Virginia was consistent across the two survey populations and similar to the rest of the U.S