Won't You be My Neighbor?: Neighbors As Distal Support for Individuals with SMI

Objective:

Social networks, providing a range of social support and capital, are regarded as an asset to community integration. While intimate connections among family and friends provide important sources of support, lesser-known acquaintances – or “familiar strangers” – can facilitate support through more anonymous, but still meaningful interactions. Among individuals with serious mental illnesses (SMI), these interactions are significant. They can help to compensate for increased social isolation and smaller networks of peers. They can also help to facilitate a stronger sense of belonging in communities where they live. This study explores relationships between individuals with and without SMIs and their neighbors. We asked whether neighbors, as proxies for familiar strangers, can play a unique role in decreasing loneliness and bolstering a sense of community, particularly for individuals with SMI.

Methods:

Participants in this study were drawn from two samples: 1) 232 individuals with SMI receiving services at outpatient community mental health centers throughout the United States; and 2) 300 adults recruited from the Truven Health Analytics’ PULSE survey. Neighbor relationships were measured using seven items from the Housing Environment Survey. Perceptions of sense of community were assessed using 13 items from the Sense of Community Index-2. A four-item version of the UCLA Loneliness Scale was used to assess perceptions of loneliness and isolation. Independent-samples t-tests were performed to compare neighbor relationships between individuals with and without SMI. Multiple regression analyses were conducted to examine associations between neighbor relationships, sense of community, and loneliness.

Results:

Among participants with SMI, the neighbor relationship scale was significantly associated with sense of community (β = .30, p < .001) though the number of neighbors that participants reported knowing well was not (β = .04, p = .56). Among participants without SMI, both the neighbor relationship scale and the number of neighbors individuals reported knowing well were significantly associated with sense of community (β= .39, p < .001 and β = .11, p < .05, respectively). Among participants with SMI, the neighbor relationship scale was significantly negatively related to loneliness (β = -.37, p < .001), but the number of neighbors participants reported knowing well was not (β = -.08, p = .21). Among participants without SMI, the neighbor relationship scale was significantly associated with loneliness (β = -.37, p < .001), while the number of neighbors participants reported knowing well was not (β = .03, p = .55).

Implications:

Participants with SMI indicated their sense of community and experiences of loneliness were associated with their relationships with their neighbors, no matter the quantity. This finding supports and expands on research indicating ‘diverse and active’ networks are positively associated with mental health wellbeing by identifying neighbors, within a group of wider contacts, as having potential to influence certain outcomes more positively. Providers might capitalize on the utility of neighbors by expanding social and support networks of clients with SMI.