The Ripple Effect: Social Network Dynamics, Social Location, and Strategies of Interaction in Mental Illness Careers

Abstract

Social networks are dynamic in nature, characterized by ebbs and flows in the level and quality of interaction that correspond to important changes in the lives of individuals. Disruptive events and transitions have been theorized to restrict access to existing network ties and provide opportunities for new associations and alter network structure, altering network structure, function, and content in meaningful ways. The main objective of this research is to capture the interplay between the dramatically changing circumstances in individuals' lives, the activation of social resources, and the evolution of networks. Plainly, the central question is 'how and why do social networks evolve in response to disruption and uncertainty?' This research is fundamentally about how crisis requires people to rethink and respond to changes in their social interaction patterns, and reorganize personal social networks challenged by escalating needs, changes in social location, and the stigma attached to mental illness. Using the Indianapolis Network Mental Health Study (INMHS), I follow the social network experiences of 171 "first-timers," that is, individuals making their first major contact with the largest public and private treatment centers in the city.

Data reveal that crisis reverberates through the social network, initiating significant changes in network size, functionality, and level of membership turnover. When we experience crisis, support needs increase, in turn shaping interactions in ways that have important implications for the stability of social networks. Moreover, crisis in one life domain tends to lead to disruptive transitions in other domains, as well. Seldom considered, but of great consequence for "first-timers," are changes in social structural location, including residential and relationship instability, jeopardize existing ties and exacerbate the level of disruption in social ties. Network disruption then affects how networks function, as new social ties do not easily replace longstanding friends and family. In short, traumatic events, like illness, in the lives of individuals set into motion a ripple effect that has pervasive consequences for social life.

In sum, this research addresses the classic sociological tension between structure and agency. That is, it illustrates that individuals are not unobtrusive observers of social network instability or passive recipients of network resources. Rather, individuals early in their experiences with mental health treatment are often active and occasionally strategic agents who shape and maintain their social networks in ways that help them meet their needs and cope with uncertainty and crisis. However, people's ability to construct their networks and mobilize resources is constrained by structural factors, often out of their control, including disruptive events that force transitions into and out of the different social roles, statuses, and group memberships that accompany mental illness.