In May 2024 Rethink Mental Illness used social media to ask what people wanted the world to know about living with mental illness, below are some of the comments they received:
- ‘It’s not a fun quirk or a cute part of my personality that makes me special. It’s not something to use as an adjective, to trivialise or to belittle. It’s an illness, treat it as such.’
- ‘Fighting the triggers and symptoms, all day, every day, takes a kind of strength that most people will never know.’
- ‘At times we could come across as ‘rude’, but actually we’re fighting a battle inside our own heads and find certain situations difficult and may not handle it great.’
(Rethink Mental Illness, 2024
These comments illustrate the complexities of living with long-term mental health challenges. They also reflect the varied and individual nature of people’s experiences.
The World Health Organisation (WHO) define mental disorders as being ‘characterized by a clinically significant disturbance in an individual’s cognition, emotional regulation, or behaviour’. They state mental disorders are often ‘associated with distress or impairment in important areas of functioning’ (WHO, 2025). Mental illness can refer to a range of conditions including bipolar disorder, schizophrenia, depression, post-traumatic stress order (PTSD) and anxiety disorders. The experiences of living with these conditions are very individual however, common challenges can include feelings of isolation sometimes related to fear of leaving areas that feel safe or avoiding others due to fears of judgement. This can lead to a reduction in social interaction and support resulting in feelings of loneliness which can further exacerbate mental health challenges.
Support systems are vital when living with mental health challenges, however, sometimes it has been unclear exactly what is meant by this term. Cohen and Wills (1985) discuss how social support can be organised differently into two categories, structurally and functionally. Considering the structural aspect of social support can include how big an individual’s social network is and how much they are connected within this. The functional aspect is how much an individual perceives the social support network they have, as well as the quality of the relationships.
Gariepy, Honkaniemi and Quesnel-Vallee (2016) discuss social support as a multi-dimensional concept which can be divided into three categories, emotional, instrumental and informational. Emotional support refers to encouragement, understanding and caring that can be gained from another person. Instrumental support includes more practical support such as helping with housework or collecting supplies; and informational support as passing on knowledge that may be helpful or offering advice.
Many studies have suggested that social support has a protective role in mental health challenges (Cobb, 1976; Mohl, Yunus, Hairi, Hairi and Choo, 2019; Weziak-Bialowolska, Bialowolski, Lee, Chen, VanderWeekle and McNeely, 2022; Cohen and Wills, 1985; Bedaso, Adams, Peng and Sibbritt, 2021). Wang, Mann, Lloyd-Evans, Ma, Johnson (2018) completed a systematic review exploring links between loneliness, perceived social support and mental health challenges. They found a link between depression and people’s perceived social support systems, suggesting poorer social support was linked with difficulties in functioning and slower rates of recovery. Wang et al also suggested there was evidence of a similar relationship with bipolar disorder and anxiety disorders. Other research has suggested that lower levels of depression can be related to parental support in children and support from partners, family and friends (Gariepy et al, 2016; Mohd et al., 2019).
More recently researchers have become interested in what it is about social support that has such a positive impact on mental health. Acoba (2024) suggested Lazarus and Folkman’s Stress and Coping Theory could help explain this link. This theory suggests that how an individual views a problem and their ability to cope with the difficulty significantly impacts on their experience of it. Therefore, a situation is more problematic when it is considered as very challenging and that the individual does not have the ability or resources to cope. On the flip side, if an individual considers the difficulty to be manageable and believes they have the resources stress is reduced. Based on this theory social support provides a buffering function to difficulty, helping a situation to feel more manageable but also supporting people in feeling like they can cope with difficulty. Cohen and Wills (1985) agree that social support can serve as a buffer but also suggest that social support can provide an overall benefit to our self-worth and sense of security which has a positive impact on coping with difficulty.
This article has focused on social support as a human-to-human connection, however, the link between human and animal can also provide a bond that is beneficial to those experiencing long term mental health challenges. Irvin (2014) describes the relationship an individual has with their assistant dog as ‘mutually interdependent’ (Irvin, 2014, p.66), a relationship that benefits both human and dog by providing a sense of security and safety for both. The role of an assistant dog can also promote and support social systems, helping individuals feel more confident and secure in engaging in other relationships or networks.
It is evident that support systems are vitally important for people, especially those living with long-term mental health challenges. Social networks can help people meet practical needs, providing information, helping them collect resources and medication as well as tackle daily tasks that can feel problematic. They can help people exercise, access nature, attend appointments and perhaps more importantly, combat loneliness. Consideration of how support systems could be built or accessed is therefore an important step towards supporting individuals to live a meaningful life.
References
Acoba, E. F. (2024). Social support and mental health: the mediating role of perceived stress. Frontiers in Psychology, 21:15:1330720. https://doi.org/10.3389/fpsyg.2024.1330720
Bedaso, A., Adams, J., Peng, W., and Sibbritt, D. (2021). The relationship between social support and mental health problems during pregnancy: a systematic review and meta-analysis. Reproductive Health, 18:162, 1-23. https://doi.org/10.1186/s12978-021-01209-5
Cobb, S. (1976). Social support as a moderator of life stress. Psychosomatic Medicine, 38(5), 300-314.
Cohen, S., and Wills, T.A. (1985). Stress, social support, and the buffering hypothesis. Psychological Bulletin, 98, 310-357.
Gariepy, G., Honkaniemi, H., and Quesnel-Vallee, A. (2016). Social support and protection from depression: A systematic review of current findings in Western countries. British Journal of Psychiatry, 209, 284-293.
Irvin, S. (2014). The healing role of assistance dogs: What these partnerships tell us about the human–animal bond. Animal Frontiers, 4:3, 66-71. http://doi.org/10.2527/af.2014-0024
Lazarus, R. S., and Folkman, S. (1984). Stress, appraisal, and coping. New York, Springer Publishing Company.
Mohd, T. A. M. T., Yunus, R. M., Hairi, F., Hairi, N. N., and Choo, W. Y. (2019). Social support and depression among community dwelling older adults in Asia: A systematic review. BMJ Open 9, https://doi.org/10.1136/bmjopen-2018-026667
Rethink Mental Illness (2024, May 13). What the world needs to know about living with a mental illness. https://www.rethink.org/news-and-stories/news-and-views/2024/what-the-world-needs-to-know-about-living-with-a-mental-illness/
Wang J., Mann F., Lloyd-Evans B., Ma R., and Johnson S. (2018) Associations between loneliness and perceived social support and outcomes of mental health problems: a systematic review. BMC Psychiatry. 18(1):156, 1-17. https://doi.org/10.1186/s12888-018-1736-5
Weziak-Bialowolska, D., Bialowolski, P., Lee, M.T., Chen, Y., VanderWeele, T.J., and McNeely, E. Prospective Associations Between Social Connectedness and Mental Health. Evidence From a Longitudinal Survey and Health Insurance Claims Data. International Journal of Public Health. https://doi.org/10.3389/ijph.2022.1604710
World Health Organisation (2025, September 30). Mental disorders. https://www.who.int/news-room/fact-sheets/detail/mental-disorders
Author: Stephanie Edwards
Stephanie is excited to support the PADs team as a volunteer blog writer using scientific research to raise awareness of mental health challenges and the benefit of psychiatric assistant dogs. Stephanie is an experienced Counselling Psychologist working in private practice. She has worked as a Psychologist for over ten years supporting adults with a variety of mental health difficulties and is particularly interested in working with individuals who have experienced trauma. As a passionate animal lover Stephanie feels most connected to dogs. She is the proud owner of two Labradors, Alfie and Brian, and is happiest in her wellies, over the field on a dog walk.
