Community Mental Health Journal

, Volume 55, Issue 5, pp 768–776 | Cite as

Social Support Networks and Symptom Severity Among Patients with Co-occurring Mental Health and Substance Use Disorders

  • Marie C. HaverfieldEmail author
  • Mark Ilgen
  • Eric Schmidt
  • Alexandra Shelley
  • Christine Timko
Original Paper


Patients entering an inpatient psychiatry program (N = 406) with co-occurring mental health and substance use disorders reported on their social support networks (source, type) at treatment intake, and completed symptom measures at baseline and 3-, 9-, and 15-month follow-ups (77%). Longitudinal growth models found aspects of participants’ support networks were associated with specific symptoms over time. Less family support (i.e., more conflict) was the most consistent predictor of mental health and substance use outcomes and was associated with greater psychiatric, depression, Post Traumatic Stress Disorder (PTSD), and drug use severity. More peer support (via mutual-help involvement) was associated with greater initial improvement in alcohol use severity. Findings suggest that to facilitate the benefits of social support for patients with a dual diagnosis returning to the community, specific components of support should be assessed and considered in the treatment plan, rather than viewing support as a general and undifferentiated factor affecting recovery.


Co-occurring disorders Social support networks Symptom severity Recovery 



This research was supported by the Department of Veterans Affairs, Health Services Research and Development (HSR&D) Service (SRCS 00-001 to Dr. Timko; and IAC 09-055 to Dr. Timko and Dr. Ilgen). Dr. Haverfield was funded by the VA Office of Academic Affiliations, Advanced Fellowship Program in Health Services Research and Development. The views expressed are the authors’ and do not necessarily reflect those of the VA.

Compliance with Ethical Standards

Conflict of interest

No conflicts of interest are reported by any of the authors listed on this manuscript.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Veterans Affairs Health Care SystemCenter for Innovation to ImplementationPalo AltoUSA
  2. 2.Center for Health Policy/Center on Primary Care and Outcomes ResearchStanford University School of MedicineStanfordUSA
  3. 3.Department of PsychiatryUniversity of Michigan School of MedicineAnn ArborUSA
  4. 4.Center for Clinical Management Research (CCMR)VA Ann Arbor Healthcare SystemAnn ArborUSA
  5. 5.Program Evaluation Resource CenterVA Office of Mental Health and Suicide PreventionMenlo ParkUSA
  6. 6.Department of Psychiatry and Behavioral SciencesStanford University School of MedicineStanfordUSA

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