The impact of social connections on recovery in community mental health services.

Eva VELTHORST1, Anne-Kathrin FETT2

1GGZ Noord-Holland-Noord, Heerhugowaard, Netherlands
2City, University of London, London, United Kingdom

Introduction:

Feelings of loneliness and poor relationship satisfaction have been associated with a large range of negative physical and mental health outcomes. The wide-ranging implications of the various facets of social connections for public health are increasingly recognized, yet, there is limited research on how these factors affect recovery in real-world mental health services.

 

Methods:

A retrospective observational cohort study was conducted using data from 15,512 individuals aged 18 to 99 who sought in-, or outpatient help at GGZ Noord-Holland-Noord in the Netherlands between February 2010 and August 2023. The study examined demographic characteristics, perceived loneliness, social relationship satisfaction, symptom distress, role functioning satisfaction (using the Outcome Questionnaire-45), time to discharge, and mortality. Data were stratified by diagnosis, sex, and age, and univariate regression analyses were used to explore the association between social connections and mental health outcomes.

 

Results:

Both poor social relationship satisfaction and loneliness were independently linked to symptomatic distress at initial assessment and follow-up (p<.001), with slightly weaker associations for role functioning satisfaction. The impact of social factors on symptomatic distress was stronger in individuals diagnosed with psychotic or bipolar disorders than in those with other disorders (SRS baseline: R2=.004, p<.001; follow-up: R2=.08, p<.001, Loneliness baseline: R2=.002, p=.002; follow-up: R2=.05, p<.001)). Interestingly, older individuals reported lower levels of social relationship satisfaction and loneliness, yet, the negative impact of poor social connections on outcomes was similar across all age groups. No significant sex differences were found in these associations.

 

Conclusion:

Despite certain diagnostic groups and older individuals experiencing less loneliness and poor relationship satisfaction in our mental health service, the negative impact of these factors on mental health outcomes is profound across all age groups, highlighting the need for attention to the social network in mental health care.