Can social support be improved in people with a severe mental illness? A systematic review and meta-analysis

People with a severe mental illness often have less social support than other people, yet these people need social support to face the challenges in their lives. Increasing social support could benefit the person’s recovery, but it is not clear whether interventions that aim to improve social support in people with a severe mental illness are effective. A systematic literature search and review in MEDLINE (PubMed), PsycINFO, CINAHL, Cochrane, JSTOR, IBSS, and Embase was performed. Studies were included if they had a control group and they were aimed at improving social support in people with a severe mental illness who were receiving outpatient treatment. Summary data were extracted from the research papers and compared in a meta-analysis by converting outcomes to effect sizes (Hedges’s g). Eight studies (total n = 1538) that evaluated ten different interventions met the inclusion criteria. All but one of these studies was of sufficient quality to be included in the review. The studies that were included in the meta-analysis had a combined effect size of 0.17 (confidence interval: 0.02 to 0.32), indicating a small or no effect for the interventions that were evaluated. A subgroup analysis of more personalized studies showed a combined effect size of 0.35 (CI = 0.27 to 0.44), indicating a noteworthy effect for these more personalized studies. This evaluation of interventions aimed at improving social support in people with a severe mental illness suggests that these interventions in general have little or no clinical benefit. However, in a subgroup analysis the more personalized interventions have a larger effect on improving social support and merit further research.