Social support may not only have a protective effect on preventing or decreasing the risk of developing mental health problems, but may also be helpful for people who have to cope with the stress of a chronic illness. Much of the interest in social support has stemmed from the hope that research on this topic may yield information that can assist in the development of coping enhancing interventions.
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House (1981) has defined social support as the interactive process in which emotional concern, instrumental aid, information, and appraisal are obtained from one’s social network. According to House (1981), emotional support involves the provision of care, empathy, love and trust. Instrumental support is defined as the provision of tangible goods and services and is described as concrete assistance - for example giving financial assistance or performing assigned work. Informational support is defined as the provision of specific information to another during a time of stress. Appraisal support involves helping an individual to better understand stress as well as what resources and coping strategies might be mustered to deal with the stress (House, 1981). Each of these four defining attributes of social support is helpful, protects the person receiving the support, and enables an exchange of reciprocal supportive actions (Hinson Langford, Bowsher, Maloney, & Lillis 1997).
Closely related to the concept of social support is that of social networks. A social network is defined as a web of identified social relationships that surround an individual and the characteristics of those linkages. Each individual is viewed as a node in a network of individuals, and each exchange between them is a link. A social network is a group of people with whom contact is maintained. It contains some form of social bond and is defined in terms of its size, frequency of contact, density or integration of the network, existence of a confidant, the network composition, and perceived support (Bowling, 2001). Social networks are important to individuals and families to the extent that they fulfill members’ needs. Through the interpersonal exchanges within a social network, individuals are influenced and supported in their health behaviour choices. It would be wrong to assume that one particular type of network will always be the most supportive in times of crisis; rather different network members are likely to provide differing types and amounts of support. Social support as a coping resource
The benefit of social support assumes to be that significant others can participate in stress management efforts in a number of ways, such as helping to alter a stressful situation, changing its meaning, or modifying the emotional reactions that are elicited. Thus, a wide variety of behaviours qualify as coping assistance. Social network members can also assist in the process of assimilating and reinterpreting stressful life events in order to minimize their more harmful elements, thus helping the stressed individual to deal with the resulting negative emotions.
It is of decisive value to involve the family and the closest friends, where appropriate, in the acutely depressive phase by giving them information and support. Attention should be paid to depressed patients’ self-critical attitudes and their partners’ understanding of depression, as both may contribute to the course of the recovery process.
To involve and support the patient’s closest social network is also a part of the recovery process for the patient. It is of decisive value that healthcare professionals support the family, not least the children, of how to handle the situation and to allow them to participate in the care planning together with the patient. A family with a mentally ill member might also have difficulty supporting each other, while a friend who lives with another family may have both respite and support that is unavailable to the family member of the PMI (Dahlqvist Jönsson, Skärsäter, Wijk & Danielson 2011; Ewertzon, Cronqvist, Lutzen. & Andershed 2012). It might be easier for a person to use an existing broad network and find different ways of getting support and help through different management strategies, such as taking action while taking care to protect themselves and to step aside when feeling burdened (Östman 2002; Moore & McArthur 2007; Ali, Ahlström, Krevers & Skärsäter 2012).
There needs to be a clinical approach that supports people in articulating their wishes, making choices about treatment, and evaluating the quality and relevance of the services they receive. It is of decisive value that the goal setting should involve a holistic view of the patient and the patient’s world. The patient’s participation in setting these goals can be a significant first step in regaining mastery over his or her life.
Take a look on this video, recently published on Youtube. It is about “What must families know about how to support their loved one with a mental illness?” In his talk on YouTube, Dr. Lloyd Sederer discusses the four things we all must know to help those who may be struggling around us (15 minutes long).
Lloyd I. Sederer, M.D., is Medical Director of the New York State Office of Mental Health (OMH), the nation’s largest state mental health system. Dr. Sederer is an Adjunct Professor at the Columbia/Mailman School of Public Health.
Learning lessons: How can a family member support the service user.
You are more on a Marathon than a sprint
Support requires a lot of time and it means keeping hope alive!
Ali L., Hedman Ahlström, B. Krevers B., Skärsäter I. 2012. Daily life for young adults who care for a person with mental illness: a qualitative study. Journal of Psychiatric and Mental Health Nursing, doi: 10.1111/j.1365-2850.2011.01829.
Bowling A. 2001. Measuring Disease. A Review of Disease-specific Quality of Life Instruments. Second Edition. Open University press, Buckingham, Philadelphia.
Ewertzon, M., Cronqvist, A., Lutzen, K. & Andershed, B. 2012. A lonely life journey bordered with struggle: Being a sibling of an individual with psychosis. Issues in Mental Health Nursing, 33(3),157-64.
Dahlqvist Jönsson, P., Skärsäter, I., Wijk, H. & Danielson, E. 2011. Experience of living with a family member with bipolar disorder. International Journal of Mental Health Nursing 20, 29-37.
Moore, T. & McArthur, M. 2007. We’re all in it together: supporting young carers and their families in Australia Health and Social Care in the Community 15, 561-568.
Östman, M. & Kjellin L. 2002. Stigma by association - Psychological factors in relatives of persons with mental illness. British Journal of Psychiatry, 181, 494-498.
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