The Missing Element in Understanding Social Network Influences on Mental Health: Correlates and Consequences of Health Regulation Ties

Social relationships are well-established vectors of both health and illness. Yet, the typical and most often referenced concepts reflect positive aspects of network ties. The effects of social support, social capital, and social resources on health can be conceptualized as testing the integration function of social networks described by Durkheim (1950 [1897]. However, little work (e.g., Umberson’s work on men in marriage) has examined Durkheim’s companion vector of social networks – social regulation, or active attempts by network members to influence their attitudes and behaviors, whether or not this involvement is welcome. We pose two fundamental questions: Which kinds of social network structures (“whole networks”), individual network ties (i.e., alter characteristics), and individuals with mental health problems (i.e., ego characteristics) are more likely to cultivate “hasslers” (i.e., individuals whose interaction with an individual with mental health diagnoses involves regulative aspects). Do regulative efforts in social networks produce salubrious, insalubrious, or no effects on individuals making their first major contact with the mental health system (i.e. “first timers”)? We examine health regulation in the Indianapolis Network Mental Health Study’s sample of individuals with serious mental illness and adjustment disorders. Using a multi-level modeling approach to capture the effects of social ties and social network structures, we find that women, older individuals, family members, those with confidence in medical professionals, and those who have experienced mental health problems are most likely to engage in health regulation. This is especially likely when they are embedded in weaker networks without similar structural characteristics. From a medical perspective, regulative ties are beneficial, increasing ego’s trust in physicians and life satisfaction while decreasing perceived social stress. However, these effects are contingent on tie quality (i.e., large networks characterized by high degrees of closeness) and cultural beliefs (i.e., congruent with medicine) embedded in network ties and structures.