How do people with long-term mental health problems negotiate relationships with network members at times of crisis?

Abstract

A network perspective offers the opportunity to address the latent assets and resources which may be available to people in need of condition management and support1. Support from social networks has been shown to make a contribution to improved health outcomes for people with Long Term Conditions (LTC) and in the genesis of Mental Health (MH) problems and utilisation of services 2,3 . Exploring the role and function of social ties is relevant for understanding the support and resources that are leveraged in the
trajectories of those experiencing MH problems in everyday life recovery and in times of crises. Previous research suggests that one response to crisis is to identify those most able to provide support from a larger
group (selective activation) with the consequence that those able to secure ‘adequate’ network resources
seemingly report better outcomes than those who ‘injudiciously’ select network ties2. A ‘social safety net’, comprising community organisations and health-related network ties has the potential to reduce the
utilisation of MH services4 by providing emotional and direct alternative support for self-management activity. People, animals and material objects are key to providing support and linking people to needed resources in a person’s personal network. For example, online peer support has been found to provide
benefits through social connectedness, feelings of group belonging and the sharing of strategies and narrative for coping with the challenges of living life with a MH problem5. Diverse networks (including
strong and weak ties) may be better placed (compared to more restricted network types) to support LTC management, because of the availability of increased opportunities for negotiating relationships with
network members and resources1. Connections to and interaction with objects, places, pets and activities are also likely to be relevant to understanding the crises and recovery ‘work’ of those with a MH problem6.
However, relatively little is understood about the way in which network members provide support and resources for management and the difference in network support requirements at different times (eg in times of crisis versus recovery). Here, we utilise network mapping as an heuristic device to explore
people’s personal networks to examine the support available to manage MH and explore relationships with different network members at times of crisis.
Crisis represents a negative event in life. However it can also be an opportunity for growth7. For the purposes of this study, crisis is defined as the point at which mental distress becomes overwhelming or unmanageable
to the extent that the experience of it disrupts everyday life. It is a multifaceted process which can be understood as a trajectory that can be recognisable but is not necessarily linear

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Identifiers

ORCID for Sandra Walker: orcid.org/0000-0003-1826-1201

ORCID for Anne Kennedy: orcid.org/0000-0003-4570-9104

ORCID for Ivaylo Vassilev: orcid.org/0000-0002-2206-8247

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