The Structure of Social Support: A Multilevel Analysis of the Personal Networks of People with Severe Mental Disorders

Abstract Background. For psychiatric service users suffering from severe mental disorders, the social support provided by personal social networks is essential for living a meaningful life within the community. However, the importance of the support received depend on the relations between the providers of social support. Yet this hasn’t been addressed in the literature so far for people with severe mental disorders. This article seeks to investigate how characteristics of service users with severe mental disorders, their social contacts, and the pattern of relationships between those contacts influence the distribution and provision of social support to people with severe mental disorders. Methods. We collected personal network data relating to 380 psychiatric service users from a random sample of health care providers in Belgium. We computed various measures of the structure of those neworks and of the position of support persons within those networks. We conducted a multilevel analysis of the importance of the support provided by each support persons.Results. The results show that the more central a support person was in the network of a service user, the more important his or her support was considered to be by the service user. Also, the denser the network in which a support person was embedded, the less important was the support he or she offers, but only for hospitalised service users. Conclusions. These finding highlight the collective dimension of social support. We discuss the implications for the organisation of mental health care.