Social relationships among persons who have experienced serious mental illness, substance abuse, and homelessness: Implications for recovery

Am J Orthopsychiatry. 2008 Jul;78(3):333-9. doi: 10.1037/a0014155.

Abstract

The new paradigm of recovery has highlighted the importance of positive social relationships, but little is known about their role in recovery among homeless individuals with serious mental illness and comorbid substance abuse. This study used within- and across-case analyses of longitudinal data from qualitative interviews with 41 dually diagnosed individuals entering residential programs to exit homelessness and receive needed services. Thematic findings include (a) "loner talk" and the need for privacy; (b) family ties as "good news, bad news"; (c) when it comes to a partner, other things come first; and (d) in search of positive people. Analyses of change in individual trajectories revealed that stronger social relationships did not coincide exactly with positive outcomes. Although positive life changes were gradual, negative changes could be precipitous. Social relationships were threatened by concentrated disadvantage, that is, a lack of social and economic currency. Findings are discussed with implications for improving services for the most vulnerable individuals who stand to benefit from the era of recovery.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Community Mental Health Services
  • Diagnosis, Dual (Psychiatry)
  • Drug Users
  • Female
  • Humans
  • Ill-Housed Persons / psychology*
  • Interpersonal Relations*
  • Life Change Events
  • Male
  • Mental Disorders / complications
  • Mental Disorders / rehabilitation*
  • Severity of Illness Index
  • Social Environment
  • Social Support
  • Substance-Related Disorders / complications
  • Substance-Related Disorders / rehabilitation*
  • Treatment Outcome