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

Main factors associated with mental disorders 1.Adverse childhood conditions 2.Poverty 3.War experience and torture 4.Social isolation 5.Social inequality

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

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

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

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

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

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

Resource-oriented themes Social relation ships Decision- making ability Know ledge Individual strengths Recreation al activities Self- actualising Befriending Client-centred therapy Creative music therapy Open dialogue Peer support workers Positive psychotherapy Self-help groups Solution-focused therapy Systemic family therapy Therapeutic communities

Types of social relationships ProfessionalsPeersFriends Family Befriending Client-centred therapy Creative music therapy Open dialogue Peer support workers Positive psychotherapy Self-help groups Solution-focused therapy Systemic family therapy Therapeutic communities

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