The Revolving Door: Patient Needs and Network Turnover during Mental Health Treatment

• In Event: 480 - Section on Medical Sociology Refereed Roundtable Session and Business Meeting
  In Refereed Roundtable 60min: Table 10. Illness Experience

Abstract

While much research examines the consequences of deinstitutionalization for caregivers, few studies address support mobilization strategies used by patients themselves. We examine the relationship between mental health patients’ needs, their activation of network ties for health discussion, and network dynamics during the course of treatment. We hypothesize that patients strategically activate their network ties for support that matches their needs. Linking activation to network dynamics, we also propose that patients with greater needs exhaust their supportive relationships and experience more network turnover. We draw on a dataset of new mental health patients (N=173) and their associated network members (N=4144) observed over 3 years. Random-intercept regression models test the relationship between patients’ needs and (1) network tie activation for health discussion, and (2) network turnover. Although overall level of need does not predict network tie activation, mental health patients are more likely to activate network ties who provide support that matches their expressed needs for discussion, emotional, and financial support. In addition, patients with elevated needs experience increased network turnover. Strategic activation and its unintended consequence together suggest a “revolving door” of support for patients in crisis. In the post-deinstitutionalization era, patients’ informal social safety nets must compensate for needs that are left unmet by deficits in the formal treatment system. We find that patients seek out network members who are well-equipped to help them cope with the onset of illness. At the same time, network activation may lead to instability as high-need patients churn through supportive relationships.

Authors

• William R McConnell, Indiana University - Bloomington

• Brea Louise Perry, Indiana University