A longitudinal examination of factors predicting the social networks and mental health services of Black and Latinx Individuals with serious mental illnesses - Project Summary/Abstract: Social networks (SNs), and the supports derived from them, are established determinants of health and mortality for the general population and are especially important for individuals with serious mental illnesses (SMIs; e.g., schizophrenia, bipolar, depression). Individuals with SMIs die approximately 10-30 years before their peers without SMIs, in part due to a lack of necessary supports and resources. These inequalities are even more profound for Black and Latinx individuals with SMIs, whose networks are known to be limited by systemic racism, stigma, and discrimination. Yet existing research has focused primarily on White individuals. Most prior research focused on how social-cognitive deficits due to SMIs can erode SNs and lead to social isolation. However, there is growing evidence that non-clinical (e.g., race and mental illness stigma) and systemic factors (e.g., incarceration, housing) are equally powerful predictors of SNs. It is critical to understand how risk and protective factors affect trajectories of SN size, composition, function, and experiences because these ultimately influence mental health services outcomes (e.g., mental health services engagement). The proposed longitudinal, mixed-method study (N=600) comprehensively investigates the SNs of Black and Latinx individuals with SMIs. It assesses how their SNs change over an 18-month period due to clinical (i.e., social cognition, self-efficacy, social motivation, and substance use); non-clinical (i.e., stigma); and systemic (i.e., incarceration and hospitalization) risk and protective factors. We hypothesize that systemic factors will have stronger associations (as compared to clinical or non-clinical factors) with SN elements and consequently, mental health services outcomes both at baseline and over time. The proposed study builds on the PIs’ previously developed, stakeholder-defined theoretical SN framework encompassing SN structure (size, compositional stability); function (social support, social resources); and derived experiences (sense of belonging, social isolation). We use an innovative ego- centric SN mapping methodology to conceptualize and measure SN elements at 3 time points (baseline, 9, and 18 months) and test if these relationships are moderated by race/ethnicity over time. In addition to structured assessments and SN maps, the study utilizes in-depth semi-structured interviews with Black and Latinx individuals with SMIs (N=50; 25 per group) at baseline and 18 months. To be conducted in collaboration with community partners and key stakeholders, these interviews will help further demystify the relationships between different risk and protective factors and SN elements. We will compare and contrast the qualitative findings with the quantitative results to provide critical mechanistic information about intervention targets to enhance SNs and increase mental health service engagement and satisfaction among Black and Latinx individuals with SMIs. These individuals are highly vulnerable to SN deterioration, have an increased burden of illness, and remain overwhelmingly under-represented in SN research.
