"January 2004" / Includes bibliographical references (leaves 297-313) / x, 313 leaves ; 30 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Thesis (Ph.D.)--University of Adelaide, School of Social Sciences, Discipline of Gender and Labour Studies, 2004

Mental health recovery is a complex phenomenon involving clinical, functional, physical, and social dimensions. The social dimension is understood to involve meaningful relationships and integration with supportive individuals and a wider community. While the recovery model developed from a movement led by consumers and survivors of the mental health system to promote hope, self-determination, and social inclusion, the clinical aspects of recovery have dominated mental health research and practice. The under-investigated area of social recovery calls for psychometrically sound measurement instruments. The purpose of the current study was to develop and validate the Social Recovery Measure (SRM). The study was grounded in disability and mad theories which locate disability at the intersection of the person and the environment. The SRM is a 19-item self-administered instrument scored on a 5-point Likert scale that consists of two domains: Self and Community. Items for the SRM were developed through focus groups and interviews with 41 individuals in recovery from mental health challenges and the preliminary measure was administered to a purposive, nonprobability sample of 228 individuals in recovery. A confirmatory factor analysis (CFA) was conducted and a re-specified model resulted in good model fit. The SRM exhibited excellent internal consistency with a Cronbach's coefficient alpha of .951 and demonstrated excellent test-retest reliability, content validity, and construct validity. Social recovery is highly relevant for social work given the discipline's commitment to disenfranchised populations and investment in creating enabling environments. The SRM has utility for use in evidence based practice and evaluation. The SRM can be used to further research in social recovery, test underlying theory bases, and explore the differential effects of the multiple dimensions of recovery. There is a need to better understand social recovery which this measure can facilitate.

This dissertation aims to explore the relationship between social support and social and psychological wellbeing in the adult population of sexual and gender minorities, or Lesbian, Gay, Bisexual, Transgender (LGBT) adults. We apply Antonucci’s (1987) Convoy Model of Social Relations as a lens through which to conceptualize social support across four dimensions: structure, function, quality, and closeness. Chapter One contains an introduction to the LGBT adult population; a description of the Convoy Model of Social Relations and of technology used to exchange social support; and an outline of the specific aims addressed in this dissertation. Chapter Two is an integrative review of literature about social support networks of LGBT older adults age 50 years and older. Chapter Three is a study designed to investigate relationships between LGBT identity, social support characteristics, the use of online social communication, and psychological and social wellbeing. Chapter Four is a qualitative descriptive study that explores LGBT older adults’ attitudes, perceptions, and uses of technology for social connectedness and support during COVID-19. Chapter Five contains a synthesis of all findings in this dissertation; a discussion of the results as they relate to the Convoy Model of Social Relations; and implications for clinical interventions and future research.

The Community Mental Health Act of 1963 launched the deinstitutionalization movement, whereby individuals with serious mental illnesses were released from psychiatric hospitals and began living and receiving mental health care in the community (Carling, 1995). However, these actions have not necessarily integrated those individuals into all aspects of community life (Dewees, Pulice, & McCormick, 1996). This is unfortunate because people with serious mental illnesses frequently report that community integration is not only important to them, but that it also aids in reducing symptoms and promoting recovery (Townley, 2015). Although past research suggests that receiving mental health care in the community has a positive impact on symptom management, the influence of other community factors (e.g., sense of community, community participation) has yet to be fully explored (Segal, Silverman, & Temkin, 2010). Furthermore, there is lack of understanding as to how these community factors influence other aspects of recovery, such as mental and physical health. As such, the goal of the current study is to better understand the association between community participation and recovery by investigating sense of community as a potential mediating factor between community participation, psychological distress, mental health, and physical health. Data were collected from 300 adults with serious mental illnesses utilizing community mental health services in the United States. Results indicated that sense of community partially mediated the association between community participation and mental health, as well as psychological distress, and fully mediated the association between community participation and physical health. Implications include contributing to the current knowledge base about the role of community factors in recovery and informing future interventions aimed at promoting community integration of adults with serious mental illnesses.

The purpose of this study was to perform an in depth examination of the major factors that increase the reluctance among African Americans to seek mental health treatment.

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As the older population increases, there is a need for increased support for caregivers most of them older themselves. Owning a pet may providesome of this support. This study looked at caregivers age 55 and older of brain-impaired adults and examined whether or not the social support provided by pets during the caregiving time contributes to their well-being.

The present study assessed the relationship between mentally ill homeless and their companion pets and questioned if the pets acted as a barrier for them to receive shelter and other services. The study also sought to find if pets acted as a communication tool between this population and society. themselves because they are mentally vulnerable and victims of a mental disorder.

The primary objective of this research was to explore the impact of possible social factors on non-institutionalized adults 18 years of age or older residing in the United States who exhibited severe mental illness (SMI). A holistic sociological model was developed to explain SMI by incorporating elements of social learning theory, social disorganization theory, and gender socialization theory with social demographic factors. Based on the holistic sociological model, the following factors were investigated: demographic aspects of age, education, income and gender; gender socialization; influence of neighborhood area; social network influence based on communication and interaction among peers and family members; and socially deviant behaviors such as frequently smoking cigarettes, drinking alcohol and using drugs specifically marijuana. The impact of these factors on SMI was examined. A sample of 206 respondents drawn from National Survey on Drug Use and Health, 2003 was assessed. These respondents had answered all the questions related to SMI; social deviant behaviors; neighborhood environment; and communications among peers, family members and friends; and the other studied factors. Ordinary linear regression with interaction terms was employed as a statistical tool to assess the impact of social determinants on SMI. Being female, living a disorganized neighborhood, and frequent and high levels of smoking cigarettes and drinking alcohol had a significant influence on SMI. This reevaluation and reexamination of the role of gender socialization path, socially deviant behaviors like smoking and drinking, and community construction on SMI provided additional insights. This research is one of the first to develop a more holistic sociological model on SMI and explored the previously untested interactive relationships. The limitations of this study suggest the need to test a potential recursive research model and explore additional bi-directional associations.

Humans’ social relationships determine to a large degree their trajectories in life. Despite strong evidence for the impact of interpersonal relations on wellbeing, the causal links between the two are not yet fully understood. This dissertation offers a new perspective on the mechanisms through which social ties influence negative (excessive drinking) and positive (participation in recreational activities) health behaviors. In three studies employing a unique combination of social network, fMRI, and experience-sampling methods, we propose that health decisions are the result of complex computations involving prior social experiences, perceived social norms, social comparison processes, and current feelings of connections. Each chapter of this dissertation discusses one of these three studies. Chapter 1 provides evidence that past social experiences shape valuations of new information by showing that pairs of students that drink often together tend to have more similar neural responses to novel alcohol cues in regions associated with affective self-generated thought. In addition, this Chapter suggests that researchers must consider the intricate interplay between individuals’ personal goals and their communities’ norms to understand the influence of social environments on neural representations. The degree to which students aligned their neural response patterns to alcohol with those of their peers depended on interactions between their individual motives for drinking and their group’s approval of this behavior. Chapter 2 presents novel findings that people spontaneously represent social information from multiple networks (e.g., popularity and leadership) at a neural level in social cognition (right TPJ, dmPFC) and valuation (vmPFC) regions. Importantly, individuals who display higher neural sensitivity to status differences are also more likely to align their drinking behavior with their group norms in daily life. Together, our results provide insight into the neural mechanisms through which social comparison processes shape conformity and suggest social cognition and valuation regions as important hubs orchestrating this process. While Chapter 1 and Chapter 2 focus on the influence of social ties on drinking, Chapter 3 discusses the protective role of close relations during difficult times. We provide evidence that close college friendships, even if afar, helped young adults cope with the stress of the COVID-19 pandemic. Follow-up between- and within-individual analyses reveal that this buffering effect could be explained by differences in the quality of online interactions (e.g., via phone, text messaging), instances of personal disclosure, and participation in enjoyable activities. All in all, this dissertation advances our understanding of why measures of social wellbeing are the best predictor of health trajectories in life, by highlighting the important role social ties play in shaping valuation of new information, guiding behavior to meet social goals, and protecting against stress by allowing people to engage in recreational activities.