Personal relationships: their role in shaping both cause and cure of mental health disorders

1. Personal relationships: their role in shaping both cause and cure of mental health disorders Stefan Priebe Queen Mary University of London

2. Main factors associated with mental disorders • Adverse childhood conditions • Poverty • War experience and torture • Social isolation • Social inequality

3. Prevention • Safe and supportive upbringing conditions • No social isolation • Strong and weak ties

4. Mental disorders as social phenomena • Defined in social interactions • Occurring in interactions • Related to interactions • Diagnosed in interactions • Treated in interactions

5. Evidence for the benefits of • Various direct social support • Larger social networks • More supportive relationships in networks • Family interventions

6. Therapeutic relationship • Defining element of health care • In patient surveys consistently reported as the most important component of care • Predictor of adherence and outcomes • Along with expectations, most important non-specific factor for outcomes

7. Deficit or resource? • Medical treatment focuses on deficit or dysfunction • There is also some tradition of treatment utilising resources • Independent of diagnostic categories

8. Resource oriented models • Befriending • Client centered therapy • Creative music therapy • Open dialogue • Peer support workers • Positive psychotherapy • Self help groups • Solution focused therapy • Systemic family therapy • Therapeutic communities Priebe et al., Br J Psychiatr, 2014

9. Resource-oriented themes

10. Types of social relationships

11. Personal relationships • Are part of quality of life • Are influenced by and influence experience and skills • Contribute to mental health • Are crucial to overcoming distress • Are facilitated by context factors