The structure of personal networks of people with severe mental illness and mental health outcomes

Introduction: The personal social support network of individuals with severe mental illness (SMI) is a key feature in recovery-oriented therapeutic models. While it is known that networks of people with SMI are smaller, less diversified, and more fragile than those of the general population, little is known about network structural characteristics and their association with mental health outcomes. In this study, personal support network data was collected during intervention sessions involving clinicians and users. A typology of networks based on network structural characteristics was applied and we analysed how network types were associated with psychosocial functioning and social integration.

Methods: 620 personal support networks of SMI users of Belgian out- and inpatient mental healthcare services were collected. We applied Vacca's strategy, originally developed for classifying personal networks in the general population, to identify network types with similar characteristics in terms of sub-communities, centralisation, and cohesion. Poisson regression was applied to test the association of network types with measurements of psychosocial functioning (HoNOS) and social integration (SIX).

Results: Five network types were identified. The level of fragmentation in networks was high across types and determined membership. Network types having less components were associated with higher psychosocial functioning (=2.78, p<0.01), although more cohesive networks were associated with lower social integration (=-0.57, p<0.01).

Discussion: Overall, the typology was reliable and allowed classifying personal support networks of people with SMI based on their structural characteristics. In addition, network types were associated with significant differences in terms of psychosocial functioning and social integration. However, SMI personal support networks were highly fragmented, making the typology inaccurate. The strategy might need to be further refined. There is an avenue, however, for more research on personal support networks of people with SMI and their association with health and social outcomes.