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Published in: BMC Psychiatry 1/2020

Open Access 01-12-2020 | Research article

Negotiating support from relationships and resources: a longitudinal study examining the role of personal support networks in the management of severe and enduring mental health problems

Authors: Helen Louise Brooks, Penny Bee, Karina Lovell, Anne Rogers

Published in: BMC Psychiatry | Issue 1/2020

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Abstract

Background

Personal communities or personal support networks comprise a variety of social ties considered important to individuals in their everyday lives. This set of active and significant ties influence the capacity to manage mental health problems because of the potential to access social support. However, little is known in the context of people’s everyday management of mental health about how relationships with people, places, objects and activities are navigated and negotiated. This study aimed to explore the nature and negotiation of support from personal communities in the everyday management of severe and enduring mental health problems.

Methods

A longitudinal qualitative study undertaken in the UK incorporating 79 interviews with 29 participants based on personal network mapping. 29 users of mental health services with a diagnosis of severe and enduring mental illness were interviewed at three time points. Data was analysed using an inductive thematic approach underpinned by the Network Episode Model.

Results

The presence and maintenance of interpersonal trust was a fundamental condition of the relational work required to develop, undertake and sustain relationships with others. Whilst relationships with spouses, family members and friends were generally viewed positively, the work required to engage human others was contingent, vicarious and overlain with felt and enacted stigma. Developing relationships with others was hindered by a lack of confidence fuelled by the experience of mental illness and a fear of rejection or failure. By contrast, weaker ties and inanimate objects and places offered and provided a sense of reliability and security. Strategies employed by participants in order to garner sufficient support for condition management in the light of these particular challenges are illuminated by the discussion of who and what is relevant and valued in personal support networks.

Conclusions

Access to valued activities, hobbies and things should be considered alongside human relationships in providing a means of ongoing support and resource for the everyday management of life for those experiencing severe and enduring mental health problems.
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Literature
1.
go back to reference Brooks HL, Lovell K, Bee P, Sanders C, Rogers A. Is it time to abandon care planning in mental health services? A qualitative study exploring the views of professionals, service users and carers. Health Expect. 2017;21(3):597–605.CrossRef Brooks HL, Lovell K, Bee P, Sanders C, Rogers A. Is it time to abandon care planning in mental health services? A qualitative study exploring the views of professionals, service users and carers. Health Expect. 2017;21(3):597–605.CrossRef
2.
go back to reference Brooks H, Lovell K, Bee P, Fraser C, Molloy C, Rogers A. Implementing an intervention designed to enhance service user involvement in mental health care planning: a qualitative process evaluation. Soc Psychiatry Psychiatr Epidemiol. 2018;54:221–33.CrossRef Brooks H, Lovell K, Bee P, Fraser C, Molloy C, Rogers A. Implementing an intervention designed to enhance service user involvement in mental health care planning: a qualitative process evaluation. Soc Psychiatry Psychiatr Epidemiol. 2018;54:221–33.CrossRef
3.
go back to reference Salehi A, Ehrlich C, Kendall E, Sav A. Bonding and bridging social capital in the recovery of severe mental illness: a synthesis of qualitative research. J Ment Health. 2018:1–9. Salehi A, Ehrlich C, Kendall E, Sav A. Bonding and bridging social capital in the recovery of severe mental illness: a synthesis of qualitative research. J Ment Health. 2018:1–9.
4.
go back to reference Webber M, Fendt-Newlin M. A review of social participation interventions for people with mental health problems. Soc Psych Psych Epid. 2017;52(4):369–80.CrossRef Webber M, Fendt-Newlin M. A review of social participation interventions for people with mental health problems. Soc Psych Psych Epid. 2017;52(4):369–80.CrossRef
5.
go back to reference Anderson K, Laxhman N, Priebe S. Can mental health interventions change social networks? A systematic review. Bmc Psychiatry. 2015;15:297.CrossRef Anderson K, Laxhman N, Priebe S. Can mental health interventions change social networks? A systematic review. Bmc Psychiatry. 2015;15:297.CrossRef
6.
go back to reference Oberlin KC, Pizmony-Levy O. Beyond access: social safety nets and the use of free health care services. Sociol Perspect. 2016;59(3):640–67.CrossRef Oberlin KC, Pizmony-Levy O. Beyond access: social safety nets and the use of free health care services. Sociol Perspect. 2016;59(3):640–67.CrossRef
7.
go back to reference Becker T, Thornicroft G, Leese M, McCrone P, Johnson S, Albert M, et al. Social networks and service use among representative cases of psychosis in South London. Br J Psychiatry. 1997;171:15–9.CrossRef Becker T, Thornicroft G, Leese M, McCrone P, Johnson S, Albert M, et al. Social networks and service use among representative cases of psychosis in South London. Br J Psychiatry. 1997;171:15–9.CrossRef
8.
go back to reference Miller AB, Esposito-Smythers C, Leichtweis RN. Role of social support in adolescent suicidal ideation and suicide attempts. J Adolescent Health. 2015;56(3):286–92.CrossRef Miller AB, Esposito-Smythers C, Leichtweis RN. Role of social support in adolescent suicidal ideation and suicide attempts. J Adolescent Health. 2015;56(3):286–92.CrossRef
9.
go back to reference Pescosolido BA. Illness careers and network ties: a conceptual model of utilization and compliance. Adv Med Sociol. 1991;2:161–84. Pescosolido BA. Illness careers and network ties: a conceptual model of utilization and compliance. Adv Med Sociol. 1991;2:161–84.
10.
go back to reference Pescosolido BA. Beyond rational choice: the social dynamics of how people seek help. Am J Sociol. 1991;94(4):1096–138.CrossRef Pescosolido BA. Beyond rational choice: the social dynamics of how people seek help. Am J Sociol. 1991;94(4):1096–138.CrossRef
11.
go back to reference Pescosolido BA. Organizing the sociological landscape for the next decades of health and health care research: the network episode model III-R as cartographic subfield guide. Handb Sociol Soc Res. 2011:39–66. Pescosolido BA. Organizing the sociological landscape for the next decades of health and health care research: the network episode model III-R as cartographic subfield guide. Handb Sociol Soc Res. 2011:39–66.
12.
go back to reference Pescosolido BA, Gardner CB, Lubell KM. How people get into mental health services: stories of choice, coercion and "muddling through" from "first-timers". Soc Sci Med. 1998;46(2):275–86.CrossRef Pescosolido BA, Gardner CB, Lubell KM. How people get into mental health services: stories of choice, coercion and "muddling through" from "first-timers". Soc Sci Med. 1998;46(2):275–86.CrossRef
13.
go back to reference Carpentier N, Lesage A, White D. Family influence on the first stages of the trajectory of patients diagnosed with severe psychiatric disorders. Fam Relat. 1999;48(4):397–403.CrossRef Carpentier N, Lesage A, White D. Family influence on the first stages of the trajectory of patients diagnosed with severe psychiatric disorders. Fam Relat. 1999;48(4):397–403.CrossRef
14.
go back to reference Crotty MM, Henderson J, Ward PR, Fuller J, Rogers A, Kralik D, et al. Analysis of social networks supporting the self-management of type 2 diabetes for people with mental illness. BMC Health Serv Res. 2015;15:257.CrossRef Crotty MM, Henderson J, Ward PR, Fuller J, Rogers A, Kralik D, et al. Analysis of social networks supporting the self-management of type 2 diabetes for people with mental illness. BMC Health Serv Res. 2015;15:257.CrossRef
15.
go back to reference Bordieu P. The genesis of the concepts of habitus and of field. Sociocriticism. 1985;2:11–24. Bordieu P. The genesis of the concepts of habitus and of field. Sociocriticism. 1985;2:11–24.
16.
go back to reference Franklin M, Lewis S, Willis K, Rogers A, Venville A, Smith L. Goals for living with a chronic condition: the relevance of temporalities, dispositions, and resources. Soc Sci Med. 2019;233:13–20.CrossRef Franklin M, Lewis S, Willis K, Rogers A, Venville A, Smith L. Goals for living with a chronic condition: the relevance of temporalities, dispositions, and resources. Soc Sci Med. 2019;233:13–20.CrossRef
17.
18.
go back to reference Perry BL, Pescosolido BA. Social network activation: the role of health discussion partners in recovery from mental illness. Soc Sci Med. 2015;125:116–28.CrossRef Perry BL, Pescosolido BA. Social network activation: the role of health discussion partners in recovery from mental illness. Soc Sci Med. 2015;125:116–28.CrossRef
19.
go back to reference Macdonald EM, Hayes RL, Baglioni AJ. The quantity and quality of the social networks of young people with early psychosis compared with closely matched controls. Schizophr Res. 2000;46(1):25–30.CrossRef Macdonald EM, Hayes RL, Baglioni AJ. The quantity and quality of the social networks of young people with early psychosis compared with closely matched controls. Schizophr Res. 2000;46(1):25–30.CrossRef
20.
go back to reference De Silva MJ, McKenzie K, Harpham T, Huttly SR. Social capital and mental illness: a systematic review. J Epidemiol Community Health. 2005;59(8):619–27.CrossRef De Silva MJ, McKenzie K, Harpham T, Huttly SR. Social capital and mental illness: a systematic review. J Epidemiol Community Health. 2005;59(8):619–27.CrossRef
21.
go back to reference Perry BL, Pescosolido BA. Social network dynamics and biographical disruption: the case of "first-timers" with mental illness. Am J Sociol. 2012;118(1):134–75.CrossRef Perry BL, Pescosolido BA. Social network dynamics and biographical disruption: the case of "first-timers" with mental illness. Am J Sociol. 2012;118(1):134–75.CrossRef
22.
go back to reference Johnson TP. Mental-health, social-relations, and social selection - a longitudinal analysis. J Health Soc Behav. 1991;32(4):408–23.CrossRef Johnson TP. Mental-health, social-relations, and social selection - a longitudinal analysis. J Health Soc Behav. 1991;32(4):408–23.CrossRef
23.
go back to reference Perry BL. The labeling paradox: stigma, the sick role, and social networks in mental illness. J Health Soc Behav. 2011;52(4):460–77.CrossRef Perry BL. The labeling paradox: stigma, the sick role, and social networks in mental illness. J Health Soc Behav. 2011;52(4):460–77.CrossRef
24.
go back to reference Hokanson JE, Rubert MP, Welker RA, Hollander GR, Hedeen C. Interpersonal concomitants and antecedents of depression among college-students. J Abnorm Psychol. 1989;98(3):209–17.CrossRef Hokanson JE, Rubert MP, Welker RA, Hollander GR, Hedeen C. Interpersonal concomitants and antecedents of depression among college-students. J Abnorm Psychol. 1989;98(3):209–17.CrossRef
25.
go back to reference Link BG, Struening E, Cullen FT, Shrout PE, Dohrenwend BP. A modified labeling theory approach to mental-disorders - an empirical-assessment. Am Sociol Rev. 1989;54(3):400–23.CrossRef Link BG, Struening E, Cullen FT, Shrout PE, Dohrenwend BP. A modified labeling theory approach to mental-disorders - an empirical-assessment. Am Sociol Rev. 1989;54(3):400–23.CrossRef
26.
go back to reference Scrambler G. Stigma and disease: changing paradigms. Lancet. 1998;352:1054–5.CrossRef Scrambler G. Stigma and disease: changing paradigms. Lancet. 1998;352:1054–5.CrossRef
27.
go back to reference Pescosolido BA, Martin JK, Long JS, Medina TR, Phelan JC, Link BG. "a disease like any other"? A decade of change in public reactions to schizophrenia, depression, and alcohol dependence. Am J Psychiat. 2010;167(11):1321–30.CrossRef Pescosolido BA, Martin JK, Long JS, Medina TR, Phelan JC, Link BG. "a disease like any other"? A decade of change in public reactions to schizophrenia, depression, and alcohol dependence. Am J Psychiat. 2010;167(11):1321–30.CrossRef
28.
go back to reference Cree L, Brooks HL, Berzins K, Fraser C, Lovell K, Bee P. Carers' experiences of involvement in care planning: a qualitative exploration of the facilitators and barriers to engagement with mental health services. Bmc Psychiatry. 2015;15:208.CrossRef Cree L, Brooks HL, Berzins K, Fraser C, Lovell K, Bee P. Carers' experiences of involvement in care planning: a qualitative exploration of the facilitators and barriers to engagement with mental health services. Bmc Psychiatry. 2015;15:208.CrossRef
29.
go back to reference Walker S, Kennedy A, Vassilev I, Rogers A. How do people with long-term mental health problems negotiate relationships with network members at times of crisis? Health Expect. 2018;21(1):336–46.CrossRef Walker S, Kennedy A, Vassilev I, Rogers A. How do people with long-term mental health problems negotiate relationships with network members at times of crisis? Health Expect. 2018;21(1):336–46.CrossRef
30.
go back to reference Perry BL. Coming untied? Narrative accounts of social network dynamics from first-time mental health clients. Sociol Health Ill. 2012;34(8):1125–39.CrossRef Perry BL. Coming untied? Narrative accounts of social network dynamics from first-time mental health clients. Sociol Health Ill. 2012;34(8):1125–39.CrossRef
31.
go back to reference Vassilev I, Rogers A, Kennedy A, Wensing M, Koetsenruijter J, Orlando R, et al. Social Network Type and Long-Term Condition Management Support: A Cross-Sectional Study in Six European Countries. Plos One. 2016;11(8):e0161027.CrossRef Vassilev I, Rogers A, Kennedy A, Wensing M, Koetsenruijter J, Orlando R, et al. Social Network Type and Long-Term Condition Management Support: A Cross-Sectional Study in Six European Countries. Plos One. 2016;11(8):e0161027.CrossRef
32.
go back to reference Sweet D, Byng R, Webber M, Enki DG, Porter I, Larsen J, et al. Personal well-being networks, social capital and severe mental illness: exploratory study. Br J Psychiatry. 2017;8(4):e59723. Sweet D, Byng R, Webber M, Enki DG, Porter I, Larsen J, et al. Personal well-being networks, social capital and severe mental illness: exploratory study. Br J Psychiatry. 2017;8(4):e59723.
33.
go back to reference Vassilev I, Rogers A, Blickem C, Brooks H, Kapadia D, Kennedy A, et al. Social Networks, the 'Work' and Work Force of Chronic Illness Self-Management: A Survey Analysis of Personal Communities. Plos One. 2013;8(4):e59723.CrossRef Vassilev I, Rogers A, Blickem C, Brooks H, Kapadia D, Kennedy A, et al. Social Networks, the 'Work' and Work Force of Chronic Illness Self-Management: A Survey Analysis of Personal Communities. Plos One. 2013;8(4):e59723.CrossRef
34.
go back to reference Parker VA. Connecting relational work and workgroup context in caregiving organizations. Journal of Applied Behaviour Science. 2002;38(3):276–97.CrossRef Parker VA. Connecting relational work and workgroup context in caregiving organizations. Journal of Applied Behaviour Science. 2002;38(3):276–97.CrossRef
35.
go back to reference Vassilev I, Rogers A, Kennedy A, Koetsenruijter J. The influence of social networks on self-management support: a metasynthesis. BMC Public Health. 2014;14. Vassilev I, Rogers A, Kennedy A, Koetsenruijter J. The influence of social networks on self-management support: a metasynthesis. BMC Public Health. 2014;14.
36.
go back to reference Lovell K, Bee P, Brooks H, Cahoon P, Callaghan P, Carter L, et al. Embedding shared decision-making in the care of patients with severe and enduring mental health problems: the EQUIP pragmatic cluster randomised trial. PLoS One. 2018;13(8):e0201533.CrossRef Lovell K, Bee P, Brooks H, Cahoon P, Callaghan P, Carter L, et al. Embedding shared decision-making in the care of patients with severe and enduring mental health problems: the EQUIP pragmatic cluster randomised trial. PLoS One. 2018;13(8):e0201533.CrossRef
37.
go back to reference Morris R, Kirk S, Kennedy A, Vassilev I, Mathieson A, Jeffries M, et al. Connecting local support: a qualitative study exploring the role of voluntary organisations in long-term condition management. Chronic Illn. 2015;11(2):140–55.CrossRef Morris R, Kirk S, Kennedy A, Vassilev I, Mathieson A, Jeffries M, et al. Connecting local support: a qualitative study exploring the role of voluntary organisations in long-term condition management. Chronic Illn. 2015;11(2):140–55.CrossRef
38.
go back to reference Rogers A, Brooks H, Vassilev I, Kennedy A, Blickem C, Reeves D. Why less may be more: a mixed methods study of the work and relatedness of 'weak ties' in supporting long-term condition self-management. Implement Sci. 2014;9:19.CrossRef Rogers A, Brooks H, Vassilev I, Kennedy A, Blickem C, Reeves D. Why less may be more: a mixed methods study of the work and relatedness of 'weak ties' in supporting long-term condition self-management. Implement Sci. 2014;9:19.CrossRef
39.
go back to reference Rogers A, Vassilev I, Brooks H, Kennedy A, Blickem C. Brief encounters: what do primary care professionals contribute to peoples' self-care support network for long-term conditions? A mixed methods study. BMC Fam Pract. 2016;17. Rogers A, Vassilev I, Brooks H, Kennedy A, Blickem C. Brief encounters: what do primary care professionals contribute to peoples' self-care support network for long-term conditions? A mixed methods study. BMC Fam Pract. 2016;17.
40.
go back to reference Braun V, Clarke V. Using thematic analysis in psychology. qualitative Research in Psychology. 2006;3(2):77–101.CrossRef Braun V, Clarke V. Using thematic analysis in psychology. qualitative Research in Psychology. 2006;3(2):77–101.CrossRef
41.
go back to reference Giddens A. Modernity and self-identity: self and Society in the Late Modern age. Stanford: Stanford University Press; 1991. Giddens A. Modernity and self-identity: self and Society in the Late Modern age. Stanford: Stanford University Press; 1991.
42.
go back to reference Grundy AC, Bee P, Meade O, Callaghan P, Beatty S, Olleveant N, et al. Bringing meaning to user involvement in mental health care planning: a qualitative exploration of service user perspectives. J Psychiatr Ment Health Nurs. 2016;23(1):12–21.CrossRef Grundy AC, Bee P, Meade O, Callaghan P, Beatty S, Olleveant N, et al. Bringing meaning to user involvement in mental health care planning: a qualitative exploration of service user perspectives. J Psychiatr Ment Health Nurs. 2016;23(1):12–21.CrossRef
43.
go back to reference Care Quality Commission. Survey of Mental Health Inpatient Services: Care Quality Commission; 2009 [. Care Quality Commission. Survey of Mental Health Inpatient Services: Care Quality Commission; 2009 [.
44.
go back to reference Commission H. Community mental health service users' survey: Healthcare Commission; 2008 [. Commission H. Community mental health service users' survey: Healthcare Commission; 2008 [.
48.
go back to reference Sen A. Development as freedom. New York: Alfred Knopf; 1999. Sen A. Development as freedom. New York: Alfred Knopf; 1999.
49.
go back to reference Pinfold V, Sweet D, Porter I, Quinn C, Byng R, Griffiths C, et al. Improving community health networks for people with severe mental illness: a case study investigation. Southampton: Health Services and Delivery Research; 2015. Pinfold V, Sweet D, Porter I, Quinn C, Byng R, Griffiths C, et al. Improving community health networks for people with severe mental illness: a case study investigation. Southampton: Health Services and Delivery Research; 2015.
Metadata
Title
Negotiating support from relationships and resources: a longitudinal study examining the role of personal support networks in the management of severe and enduring mental health problems
Authors
Helen Louise Brooks
Penny Bee
Karina Lovell
Anne Rogers
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2020
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-020-2458-z

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