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Social support network and continuity of care: an ego-network study of psychiatric service users

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Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Purpose

For severely mentally ill (SMI) users, continuity of care requires consistency between the supports provided by the members of their social support network. However, we know little about their network cohesion and its association with continuity of care. We set out to investigate this association and hypothesised that it would depend on the severity of the user’s situation and on his/her living arrangements.

Methods

We conducted face-to-face interviews with 380 SMI users recruited in outpatient and inpatient mental health services in three areas in Belgium. Data regarding users’ social networks were collected using an ego-network mapping technique and analysed with social network analysis. The cohesion indicators were density (frequency of connections between network members), centralisation (having a small number of central people), and egobetweenness (the user’s centrality in his/her own network). Participants’ perception of continuity of care was measured by the Alberta Continuity of Services Scale.

Results

Results show that cohesion indicators were associated with continuity of care only for users with high-severity problems, regardless of their living arrangements. The numbers of network members, professionals, and services in the network were all negatively associated with continuity of care for all the users.

Conclusions

Satisfactory continuity of care requires fewer professionals or services in a user’s network and a dense network for users with the most severe problems. This implies that those providing care must not only be able to increase cohesion within a network, but also to adapt their interventions to support the transition to a different, individualised network structure when severity decreases.

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Acknowledgements

We thank for their support: the Fonds National pour la Recherche Scientifique; Psychiatric Hospital of Beau Vallon, Namur; Brothers of Charity and Saint-Bernard Psychiatric Centre, Manage; Jean Titeca Hospital, Brussels; Saint-Luc University Hospital, Brussels; and Epsylon, Network of Psychiatric Services, Brussels.

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Authors and Affiliations

  1. Institute of Health and Society, Université catholique de Louvain, Clos Chapelle-aux-Champs, B1.30.15, 1200, Brussels, Belgium

    François Wyngaerden, Pablo Nicaise, Vincent Dubois & Vincent Lorant

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  1. François Wyngaerden
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  2. Pablo Nicaise
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  3. Vincent Dubois
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  4. Vincent Lorant
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Correspondence to François Wyngaerden.

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Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest. This study was approved by the “Commission d’Ethique Biomédicale Hospitalo-facultaire” of the Université catholique de Louvain on 18 June 2012. Belgian registration No.: B40320121407.

Appendix

Appendix

See Table 5.

Table 5 Agreement between users and their main clinician on the presence of different types of services in a user’s network, Morpheus Study, Belgium 2014–2015
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Wyngaerden, F., Nicaise, P., Dubois, V. et al. Social support network and continuity of care: an ego-network study of psychiatric service users. Soc Psychiatry Psychiatr Epidemiol 54, 725–735 (2019). https://doi.org/10.1007/s00127-019-01660-7

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  • DOI: https://doi.org/10.1007/s00127-019-01660-7

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