Social network activation: The role of health discussion partners in recovery from mental illness

• Published in: Social science & medicine (1982) Vol. 125; pp. 116 - 128
• Main Authors: Perry, Brea L., Pescosolido, Bernice A.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.01.2015; Pergamon Press Inc
• Subjects: Adolescent; Adult; Aged; Certainty; Egocentric social networks; Female; Habitus; Health Problems; Help-seeking; Humans; Illness; Interpersonal Relations; Longitudinal Studies; Male; Mental disorders; Mental Disorders - psychology; Mental Disorders - rehabilitation; Mental Health; Mental health care; Mental Illness; Middle Aged; Network Episode Model; Patients; Personal Satisfaction; Psychiatric disorder; Quality of Life; Rational Choice; Safety; Social Networks; Social roles; Social Support; Young Adult; Egocentric social networks; Help-seeking; Network Episode Model; Mental illness; Habitus; Social support; Psychiatric disorder
• ISSN: 0277-9536; 1873-5347
• DOI: 10.1016/j.socscimed.2013.12.033

In response to health problems, individuals may strategically activate their social network ties to help manage crisis and uncertainty. While it is well-established that social relationships provide a crucial safety net, little is known about who is chosen to help during an episode of illness. Guided by the Network Episode Model, two aspects of consulting others in the face of mental illness are considered. First, we ask who activates ties, and what kinds of ties and networks they attempt to leverage for discussing health matters. Second, we ask about the utility of activating health-focused network ties. Specifically, we examine the consequences of network activation at time of entry into treatment for individuals' quality of life, social satisfaction, ability to perform social roles, and mental health functioning nearly one year later. Using interview data from the longitudinal Indianapolis Network Mental Health Study (INMHS, N = 171), we focus on a sample of new patients with serious mental illness and a group with less severe disorders who are experiencing their first contact with the mental health treatment system. Three findings stand out. First, our results reveal the nature of agency in illness response. Whether under a rational choice or habitus logic, individuals appear to evaluate support needs, identifying the best possible matches among a larger group of potential health discussants. These include members of the core network and those with prior mental health experiences. Second, selective activation processes have implications for recovery. Those who secure adequate network resources report better outcomes than those who injudiciously activate network ties. Individuals who activate weaker relationships and those who are unsupportive of medical care experience poorer functioning, limited success in fulfilling social roles, and lower social satisfaction and quality of life later on. Third, the evidence suggests that social networks matter above and beyond the influence of any particular individual or relationship. People whose networks can be characterized as having a pro-medical culture report better recovery outcomes. •Provides information about who people turn to for health discussion during an episode of illness.•Examines effects of network activation at time of entry into treatment for recovery outcomes one year later.•Individuals identify the best possible matches to support needs among a larger group of potential health discussants.•Activation of strong ties and those supportive of medical care is associated with better outcomes.•People whose networks can be characterized as having a pro-medical culture report better outcomes.