Coming untied? Narrative accounts of social network dynamics from first-time mental health clients.

Existing research demonstrates a relationship between mental illness and social network attrition over time - a pattern attributed to dysfunctional psychosocial and interpersonal processes and rejection. Yet, according to the social network perspective, personal network dynamics naturally accompany important biographical transitions or events, suggesting that our current understanding of mechanisms underlying network instability in mental illness may be incomplete. This research uses data from the Indianapolis Network Mental Health Study, a longitudinal study of social network dynamics spanning five years. It focuses on in-depth interviews with 135 individuals making their first major contact with the mental health treatment system. First, levels of tie attrition and replacement in the core discussion networks of individuals with mental illness are compared to a sample with no self-reported history of mental illness. Second, using open-ended responses describing why specific individuals mentioned in previous waves were not listed again, respondents' explanations of attrition are analysed qualitatively. In addition to providing support for existing perspectives, the themes suggest a need to also consider: (i) interaction strategies that maximise the supportiveness of social networks and minimise burden and (ii) changing life circumstances external to social networks that influence opportunities for social interaction.