Good friends are hard to find? The social networks of people with mental illness 12 years after deinstitutionalisation

Forrester‐Jones, Rachel; Carpenter, John; Coolen‐Schrijner, Pauline; Cambridge, Paul; Tate, Alison; Hallam, Angela; Beecham, Jennifer; Knapp, Martín; Wooff, David

doi:10.3109/09638237.2011.608743

Cited by 34 publications

(26 citation statements)

References 33 publications

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“…However, a study on people who had been in a mental institution found a larger social network size of 23. 82 Our data also suggest it was the type of relationship (close relationships) rather than the number which was most important for resource exchange and this was supported by other work. 221 …”

Section: Data Limitationssupporting

confidence: 85%

“…This finding has been replicated in studies which had also reported a lack of social support, and unmet needs around social interaction and community belonging. 82,83 Studies which examined composition of social networks of individuals with psychosis had found them to contain fewer friends 46 and more service practitioners 84 than the general population, and the onset of psychosis can involve changes in social networks and the loss of friends. 85 It is the multifaceted and dynamic nature of social networks that this study explores, looking beneath a map of connections to understand the negotiated meaning, sets of choices, capacity for growth and qualities such as reciprocity.…”

Section: The Recovery Approachmentioning

confidence: 99%

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Improving community health networks for people with severe mental illness: a case study investigation

Pinfold

Sweet

Porter³

et al. 2015

Health Services and Delivery Research

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IntroductionPolicy drivers in mental health to address personal recovery, stigma and poor physical health indicate that new service solutions are required. This study aimed to understand how connections to people, places and activities were utilised by individuals with severe mental illness (SMI) to benefit health and wellbeing.MethodsA five-module mixed-methods design was undertaken in two study sites. Data were collected from 150 network-mapping interviews and 41 in-depth follow-up interviews with people with SMI; in-depth interviews with 30 organisation stakeholders and 12 organisation leaders; and 44 telephone interviews with practitioners. We undertook a three-stage synthesis process including independent lived experience feedback, and a patient and public involvement team participated in tool design, data collection, analysis and write-up.ResultsThree personal network types were found in our study using the community health network approach: diverse and active; family and stable; formal and sparse. Controlled for other factors we found only four variables significantly associated with which network type a participant had: living alone or not; housing status; formal education; long-term sickness or disability. Diagnosis was not a factor. These variables are challenging to address but they do point to potential for network change. The qualitative interviews with people with SMI provided further understanding of connection-building and resource utilisation. We explored individual agency across each network type, and identified recognition of the importance and value of social support and active connection management alongside the risks of isolation, even for those most affected by mental illness. We identified tensions in personal networks, be that relationships with practitioners or families, dealing with the impact of stigma, or frustrations of not being in employment, which all impact on network resources and well-being. The value of connectedness within personal networks of people, place and activity for supporting recovery was evident in shaping identity, providing meaning to life and sense of belonging, gaining access to new resources, structuring routines and helping individuals ‘move on’ in their recovery journey.Health-care practitioners recognised that social factors were important in recovery but reported system-level barriers (workload, administrative bureaucracy, limited contact time with clients) in addressing these issues fully. Even practitioners working in third-sector services whose remit involved increasing clients’ social connection faced restrictions due to being evaluated by outcome criteria that limited holistic recovery-focused practices. Service providers were keen to promote recovery-focused approaches. We found contrasts between recovery ideology within mental health policy and recovery practice on the ground. In particular, the social aspects of supporting people with SMI are often underprioritised in the health-care system. In a demanding and changing context, strategic multiagency working was seen as crucial but we found few examples of embedded multisector organisation partnerships.ConclusionWhile our exploratory study has limitations, findings suggest potential for people with SMI to be supported to become more active managers of their personal networks to support well-being regardless of current network type. The health and social care system does not currently deliver multiagency integrated solutions to support SMI and social recovery.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

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Section: Data Limitationssupporting

confidence: 85%

Section: The Recovery Approachmentioning

confidence: 99%

Improving community health networks for people with severe mental illness: a case study investigation

Pinfold

Sweet

Porter³

et al. 2015

Health Services and Delivery Research

Self Cite

View full text Add to dashboard Cite

show abstract

“…This finding is in line with Norman et al's [1] study and is also consistent with Winefield and colleagues' [31] original data which showed that higher satisfaction with supportive relationships was inversely related to depression. It is likely that many people with psychosis do in fact have social support in place [39], but this may not be beneficial for their mental-health if the social support is seen as poor and inadequate.…”

Section: Perceived Social Supportmentioning

confidence: 99%

Social networks and support in first-episode psychosis: exploring the role of loneliness and anxiety

Sündermann

Onwumere

Kane

et al. 2013

Soc Psychiatry Psychiatr Epidemiol

152

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PURPOSE-To investigate social support and network features in people with first episode psychosis, and to examine anxiety as a possible mediator between loneliness and a rating of paranoia.METHOD-Thirty eight people with first-episode psychosis were recruited for a cross-sectional study. Self report questionnaires and structured interviews assessed symptoms, functioning, and qualitative social network and support features. A mood-induction task involved watching anxiety-inducing pictures on a computer screen. Visual analogue scales assessed changes in paranoia, anxiety and loneliness and a mediation analysis was conducted.RESULTS-One third of the sample (34%) had no confidant (95% CI 18.4%, 50.0%). The average number of weekly contacts was 3.9, with 2.6 lonely days. Poor perceived social support, loneliness and the absence of a confidant were strongly associated with psychosis and depressive symptoms (.35

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“…Many people using mental health services do not access the normal experiences of citizenship. For example, impoverished social networks remain the norm (Forrester-Jones et al 2012). One solution is the development of peer support worker services in health services.…”

Section: 'Hope Is Necessary For Recovery'mentioning

confidence: 99%

Recovery grows up

Slade¹,

Williams²,

Bird³

et al. 2012

Journal of Mental Health

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Good friends are hard to find? The social networks of people with mental illness 12 years after deinstitutionalisation

Abstract: Appropriate activities and social contexts are still needed to facilitate the social networks of people with mental illness, in particular, for those aged under 65 years.

Cited by 34 publications

References 33 publications

Improving community health networks for people with severe mental illness: a case study investigation

Improving community health networks for people with severe mental illness: a case study investigation

Social networks and support in first-episode psychosis: exploring the role of loneliness and anxiety

Recovery grows up

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