Loneliness and care in mental health
There are words and emotions that emerge whenever mental health is discussed: distress, distance, fear. Something perceived as far away, unusual, sometimes even to be avoided. “It doesn’t matter, there are specialists for that anyway.” A reassuring phrase, yet one that oversimplifies a far more complex reality. In Italy, more than 854,000 psychiatric patients receive assistance (Italian Ministry of Health Report 2024). A figure that reminds us how widespread this issue is, and yet how little it is still understood.
This is not only about perceptions: as Sue Abderholden of the National Alliance on Mental Illness (NAMI) observes, “perhaps it is time to use the word stigma more sparingly, or not use it at all in this context. In reality, what people with mental illnesses face is not stigma, but discrimination. The word stigma does not accurately reflect the discrimination people experience in housing, education, employment, and healthcare. It was not stigma that left many people stuck in emergency rooms. It was not stigma that caused public and private healthcare systems not to cover the treatments and services necessary for mental health. It was not stigma that led so many people with mental health conditions into the criminal justice system. It was not stigma that caused so many people to become unemployed. It is discrimination.”
It is within this space that loneliness emerges. Not only for the person living with the illness, but also for families, who often find themselves unprepared. The onset of a disorder arrives like a bolt from the blue: people begin navigating storms without a map, facing daily struggles, delayed diagnoses, changing therapies, complex medications that leave them dazed, and countless unanswered questions. Step by step, loneliness grows. The caregiver — mother, father, sibling — becomes a constant point of reference, a director trying to hold everything together with fragile threads, often without adequate tools or certainty. “Del doman non v’è certezza,” wrote Lorenzo de' Medici. It sounds poetic, yet in everyday caregiving it weighs like a constant uncertainty.
Even the healthcare system, despite the dedication of many professionals, struggles to sustain this complexity: brief meetings with specialists, limited spaces for listening, little relational continuity. Competence is not always lacking; sometimes what is missing is the time needed to build a true alliance. And so the question becomes inevitable: how much does the social context contribute to loneliness? How heavy is the feeling of being observed, judged, or simply misunderstood?
Families react in different ways: some withdraw, out of exhaustion or shame; others continue searching for answers for as long as their energy allows, often eventually finding mutual support groups that become essential spaces for sharing experiences and receiving guidance. Trying to change perspective may help. If we break a limb, everyone around us is ready to help and support us. When people see us with crutches, the first emotions are not discomfort, fear, or avoidance, but rather a willingness to help us with everyday tasks, such as climbing stairs or carrying heavy bags. Imagine a world in which people living with mental health conditions were accepted and supported in the same way. A world where healthcare facilities are welcoming, and where care is not only clinical, but also rooted in relationships, community, and networks of support.
Because care cannot be left to a single actor. The healthcare system, society, and families must be able to communicate and support one another. Only in this way can real change be built. Loneliness is beautiful only when it is chosen as a form of self-care. It becomes a burden when it is imposed by society and by context. Caring for others is not simple: it requires time, patience, and the ability to reinvent oneself every day. But how much more sustainable would this world be if it were not experienced in solitude?