Understanding the social costs of psychosis: the experience of adults affected by psychosis identified within the second Australian national survey of psychosis
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BACKGROUND: Social inclusion is a key priority of the Fourth National Mental Health Plan for Australia (2009-2014), with strong evidence for its protective impact on mental health. Social integration has been associated with enhanced well-being for people with mental illnesses such as psychosis. OBJECTIVE: To explore the impact of psychosis on an individual's social and community participation. METHOD: The second Australian national survey of psychosis was conducted across seven Australian sites. Semi-structured interviews with adults living with psychosis assessed mental health status, social and role functioning, life satisfaction and future goals. The cohort comprised 1825 adults with a psychotic illness (59.6% were male; 42.4% were aged 18-34 years; 31.5% had 12 years or more of education) of whom 32.7% had been employed in the past year. RESULTS: Most adults indicated experiencing loneliness (80.1%) and a need for more friends (48.1%). Men were more likely to have never had a long-term relationship (59.4% M, 33.2% F). Even though women were more likely to experience anxiety in social situations [(χ(2)(1) = 8.95, p < 0.01)], they were more likely to have attended a social activity in the past year [χ(2)(2) = 11.84, p < 0.01]. Just over half of the survey participants (56.7%) reported having daily or nearly daily contact with family members. In the past year, 69% had not attended any social activity and 43% described stigma as a barrier. Although 63.2% showed significant impairment in social functioning, only 29.5% had received help for this in the last year. Social isolation and loneliness were rated as major challenges by 37.2% of the cohort. CONCLUSIONS: Social isolation and dysfunction experienced by people with psychosis have not decreased since the last Australian national survey of people with psychosis. Alongside education and employment, social functioning and participation must be addressed to improve social inclusion for people with psychosis. Programs targeting social opportunities (befriending, peer support), social anxiety and social functioning for all stages of psychosis are warranted.
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Fear of being stigmatized and fear of being judged are two of the most frequently reported obstacles to integration by participants.
“Studies report that the fear of being stigmatized and the fear of being judged (the latter often linked to social phobia) are two of the most frequently reported obstacles to integration by participants (4).”
From Mobile intervention for individuals with psychosis, dual disorders, and their common comorbidities: A literature review (2019) · cites this paper as [4]
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- Authors
- Stain, H. J., Galletly, C. A., Clark, S., Wilson, J., Killen, E. A., Anthes, L., Campbell, L. E., Hanlon, M.-C., & Harvey, C.
- Affiliations
- Centre for Rural and Remote Mental Health (AU)
- Ramsay Health Care (Australia) (AU)
- Far West Local Health District (AU)
- University of Newcastle Australia (AU)
- The University of Melbourne (AU)
- Venue
- Australian & New Zealand Journal of Psychiatry
- Publisher
- SAGE Publications
- Published
- 2012-05-29
- Volume
- 46
- Issue
- 9
- Pages
- 879-889
- ISSN
- 0004-8674 (ISSN-L)
- 1440-1614
- OpenAlex
- W1984202485
- Cited by
- 178
- References
- 38
- Citations by year
- 2026: 9 · 2025: 19 · 2024: 14 · 2023: 12 · 2022: 20 · 2021: 25 · 2020: 22 · 2019: 16 · 2018: 8 · 2017: 7 · 2016: 8 · 2015: 8 · 2014: 5 · 2013: 3 · 2012: 2
- FWCI
- 4.11
- Type
- journal article
- Language
- en
- Open access
- Locations
- Australian & New Zealand Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Durham Research Online (Durham University) (acceptedVersion)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
- Durham Research Online (Durham University) (submittedVersion, cc-by)
- NOVA (University of Newcastle Australia) (submittedVersion)
- Funders
- Government of the United Kingdom
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Health Professions › General Health Professions › Mental Health and Patient Involvement
- Keywords
- psychosis, social inclusion, social functioning, social isolation, loneliness, social participation (health and rehabilitation), stigma, social anxiety, social support, peer support, employment, family contact, life satisfaction
- MeSH terms
- Adolescent, Adult, Anxiety, Australia, Female, Health Services Needs and Demand, Health Surveys, Humans, Loneliness, Male, Mental Health Services, Middle Aged, Psychotic Disorders, Social Adjustment, Social Isolation, Friends, Social Stigma
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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