Technology and Opportunity: People with Serious Mental Illness and Social Connection

Background and Purpose. Virtual communities provide unique arenas for individuals to socialize or find information. Although concern has grown that virtual communities may heighten social isolation, research suggests that time spent online has been positively associated with civic engagement. The Internet offers opportunities to communicate in social environments that differ from traditional interpersonal contexts; this may be especially important for marginalized subgroups such as individuals with serious mental illness (SMI). Little research is available, however, on use of technology among this group.  This study explored: 1) how consumers accessed, utilized, and paid for cell phones and the Internet; 2) if and how cell phones and Internet were sources of social connection; 3) the roles of service providers in facilitating access to technology, and its applications to resource development.

 Methods. Semi-structured qualitative interviews were conducted with 50 people with SMI living in supported, community-based housing in New Jersey, and recruited through purposeful sampling. Interviews were comprised of open-ended questions that solicited exploratory information regarding participants’ Internet and cell phone use, connection to online communities, and how they learned to access technology.. Data were audiorecorded, transcribed, and subjected to template analysis by multiple coders using Atlas.ti software. An initial coding hierarchy was created to reflect the study questions. Thematic analysis was used to develop sub-themes within this coding hierarchy; subsequently, comparative cross-case analysis was used to ensure that findings reflected the individual experience of each participant.

 Results. Cell phones were ubiquitous and were typically provided free to consumers through federal, state, or privately funded programs funneled through local mental health programs for individuals with SMI.  Most respondents used cell phones as a primary mode of contact with social networks, including providers, family, friends, and potential employers. Several described cell phones as “lifelines”. Usage, however, frequently became disrupted as pre-paid minutes ran out or phones broke, and contacts with providers and friends were suspended.  About two-thirds of respondents also used the Internet, primarily on computers available through mental health programs, supported housing facilities, or local public libraries; a handful had their own computers and Internet access. Those who were active online established and maintained a variety of connections through social media. Facebook and online chat rooms enabled some to renew old connections and maintain existing long distance relationships. Others used online resources to find, contact, and connect with community organizations, such as local community theaters, peer support groups, and open mike events.

Conclusions and Implications. For these respondents, cell phones and Internet use were key means for connecting with family, friends, providers, and social and economic resources.  Importantly, consumers’ access to this technology was facilitated by social programs that provided free or low cost hardware and provided instruction on use.  Service providers varied in the degree to which they supported creative use of Internet resources, and few addressed issues of program/hardware limitations. The findings suggest areas for research regarding ways to support technology to advance social connections and resource development for those with SMI.