Background: People with serious mental illness (SMI) experience numerous barriers to developing and maintaining friendships.
Aims: To explore the benefits and drawbacks of an intentional friendship programme (Compeer, Inc), which develops new social relationships for people with SMI by matching them in one-to-one relationships with community volunteers for weekly social activities.
Methods: Twenty clients and volunteers, in Compeer friendships for different lengths of time, participated in individual semi-structured qualitative interviews. Several volunteers were themselves current or former consumers of mental health services.
Results: Participants reported numerous benefits to participating in Compeer. Clients and volunteers spoke enthusiastically about the benefits of gaining a friend. Many intentional relationships deepened over several years into mutually beneficial friendships. Most clients became more outgoing, sociable and active, with increased self-esteem, self-worth and self-confidence. Volunteers who had experienced mental illness themselves provided unique added benefits to the relationship. Drawbacks were minimal and financial and other costs to volunteers were low.
Conclusions: Intentional friendships can be a potent yet cost-effective way to help people with SMI develop social skills, expand their social networks, and improve their quality of life. However, because relationships take several years to develop, quantitative evaluations using short follow-up periods may underestimate programme effectiveness.
American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders (4th ed). Washington, DC: American Psychiatric Association.
2.
Armstrong, M., Korba, A.M. & Emard, R. (1995) Of mutual benefit: The reciprocal relationship between consumer volunteers and the clients they serve. Psychiatric Rehabilitation Journal, 19(2), 45-49.
3.
Bengtsson-Tops, A. & Hansson, L. (2001) Quantitative and qualitative aspects of the social network in schizophrenic patients living in the community: Relationship to sociodemographic characteristics and clinical factors and subjective quality of life. International Journal of Social Psychiatry, 47, 67-77.
4.
Boydell, K.M., Gladstone, B.M. & Crawford, E.S. (2002) The dialectic of friendship for people with psychiatric disabilities. Psychiatric Rehabilitation Journal, 26, 123-131.
5.
Bradshaw, T. & Haddock, G. (1998) Is befriending by trained volunteers of value to people suffering from long-term mental illness? Journal of Advanced Nursing, 27, 713-720.
6.
Chinman, M., Kloos, B., O'Connell, M. & Davidson, L. (2002) Service providers' views of psychiatric mutual support groups. Journal of Community Psychology, 30, 349-366.
7.
Corrigan, P.W. (ed) (2005) On the Stigma of Mental Illness: Practical Strategies for Research and Social Change. Washington, DC: American Psychological Association.
8.
Corrigan, P.W., Calabrese, J.D., Diwan, S.E., Keogh, C.B., Keck, L. & Mussey, C. (2002) Some recovery processes in mutual-help groups for persons with mental illness. I: Qualitative analysis of program materials and testimonies. Community Mental Health Journal, 38, 287-301.
9.
Corrigan, P.W. & Penn, D.L. (1999) Lessons from social psychology on discrediting psychiatric stigma. American Psychologist, 54, 765-776.
10.
Cutler, D.L., Bevilacqua, J. & McFarland, B.H. (2003) Four decades of community mental health: A symphony in four movements. Community Mental Health Journal, 39, 381-398.
11.
Davidson, L., Chinman, M., Kloos, B., Weingarten, R., Stayner, D. &Tebes, J.K. (1999) Peer support among individuals with severe mental illness: A review of the evidence. Clinical Psychology: Science & Practice, 6, 165-187.
12.
Davidson, L., Haglund, K.E., Stayner, D.A., Rakfeldt, J., Chinman, M.J. & Kraemer Tebes, J. (2001) `It was just realizing… that life isn't one big horror': A qualitative study of supported socialization . Psychiatric Rehabilitation Journal, 24, 275-292.
13.
Davidson, L., Shahar, G., Stayner, D.A., Chinman, M.J., Rakfeldt, J. & Tebes, J.K. (2004) Supported socialization for people with psychiatric disabilities: Lessons from a randomized controlled trial. Journal of Community Psychology, 32, 453-477.
14.
Drake, R.E., Green, A.I., Mueser, K.T. & Goldman, H.H. (2003) The history of community mental health treatment and rehabilitation for persons with severe mental illness. Community Mental Health Journal, 39, 427-440.
15.
Dunn, E.C., McCorkle, B.H., Wan, Y.M. & Gagne, C. (2006) The making of friendships: Compeers talk about their experiences in the programme. In Compeer: Recovery through the Healing Power of Friends (eds. B.W. Skirboll , L. Bennett & M. Klements) pp. 162-177. Rochester: University of Rochester Press.
16.
Glaser, B.G. (1992) Basics of Grounded Theory Analysis: Emergence vs Forcing. Mill Valley: Sociology Press.
17.
Harris, M. & Bergman, H.C. (1985) Networking with young adult chronic patients. Psychosocial Rehabilitation Journal, 8(3), 28-35.
18.
Hutchinson, D.S., Anthony, W.A., Ashcroft, L., Johnson, E., Dunn, E.C., Lyass, A. & Rogers, E.S. (2006) The personal and vocational impact of training and employing people with psychiatric disabilities as providers. Psychiatric Rehabilitation Journal, 29, 205-213.
19.
Lieberman, A.A., Gowdy, E.A. & Knutson, L.C. (1991) The Mental Health Outreach Project: A case study in selfhelp. Psychosocial Rehabilitation Journal, 14, 100-104.
20.
MacDonald, E.M., Jackson, H.J., Hayes, R.L., Baglioni, A.J. & Madden, C. (1998) Social skill as a determinant of social networks and perceived social support in schizophrenia. Schizophrenia Research, 29, 275-286.
21.
McCorkle, B.H., Rogers, E.S., Dunn, E.C., Lyass, A. & Wan, Y.M. (2008). Increasing social support for individuals with serious mental illness: Evaluating the Compeer model of intentional friendship . Community Mental Health Journal, 44, 359-366.
22.
McCorkle, B.H., Rogers, E.S., Dunn, E.C., Wan, Y.M. & Lyass, A. (2006) A mixed methods study of the benefits of Compeer services. In Compeer: Recovery through the Healing Power of Friends (eds. B.W. Skirboll, L. Bennett & M. Klements ). Rochester: University of Rochester Press.
23.
McGrew, J.H., Bond, G.R., Dietzen, L., McKasson, M. & Miller, L.D. (1995) A multisite study of client outcomes in assertive community treatment. Psychiatric Services, 46, 696-701.
24.
Mowbray, C.T. & Tan, C. (1993) Consumer-operated drop-in centers: Evaluation of operations and impact. Journal of Mental Health Administration , 20, 8-19.
25.
Mueser, K.T. & Tarrier, N. (eds.) (1998) Handbook of Social Functioning in Schizophrenia. Needham Heights: Allyn & Bacon.
26.
Olmstead v. L.C. (98-536) 527 U.S. 581 (1999) 138 F.3d 893.
27.
Patton, M.Q. (2002) Qualitative Research and Evaluation Methods (3rd ed). Thousand Oaks: Sage Publications.
28.
President's New Freedom Commission on Mental Health (2003) Achieving the Promise: Transforming Mental Health Care in America: Final Report. Rockville: President's New Freedom Commission on Mental Health.
29.
Riessman, F. (1965) The `helper' therapy principle. Social Work, 10, 27-32.
30.
Skirboll, B.W. (1994) The Compeer model: Client rehabilitation and economic benefits. Psychosocial Rehabilitation Journal, 18, 89-94.
31.
Skirboll, B.W., Bennett, L. & Klements, M. (eds.) (2006) Compeer: Recovery through the Healing Power of Friends. Rochester: University of Rochester Press.
32.
Skirboll, B.W. & Pavelsky, P.K. (1984) The Compeer Program: Volunteers as friends of the mentally ill. Hospital & Community Psychiatry , 35, 938-939.
33.
Solomon, P. (2004) Peer support/peer-provided services: Underlying processes, benefits and critical ingredients. Psychiatric Rehabilitation Journal, 27, 392-401.
34.
Thornicroft, G. & Breakey, W.R. (1991) The COSTAR Programme. 1: Improving social networks of the long-term mentally ill. British Journal of Psychiatry , 159, 245-249.
35.
Trompenaars, F.J., Masthoff, E.D., van Heck, G.L., De Vries, J. & Hodiamont, P.P. (2007) Relationships between social functioning and quality of life in a population of Dutch adult psychiatric outpatients. International Journal of Social Psychiatry, 53, 36-47.
36.
Wilson, M.E., Flanagan, S. & Rynders, C. (1999) The FRIENDS program: A peer support group model for individuals with a psychiatric disability. Psychiatric Rehabilitation Journal, 22, 239-247.
