Several studies have indicated a co-occurrence between mental problems, a bad economy, and social isolation. Medical treatments focus on reducing the extent of psychiatric problems. Recent research, however, has highlighted the possible effects of social initiatives. The aim of this study was to examine the relation between severe mental illness, economic status, and social relations.

METHOD: a financial contribution per month was granted to 100 individuals with severe mental illnesses for a 9-month period. Assessments of the subjects were made before the start of the intervention and after 7 months' duration. A comparison group including treatment as usual only was followed using the same instruments. Significant improvements were found for depression and anxiety, social networks, and sense of self. No differences in functional level were found. Social initiatives may have treatment and other beneficial effects and should be integrated into working contextually with persons with severe mental illnesses.

During a 9-month period, 100 persons with SMI were given approx. 73 USD per month above their normal income. Sixteen of the subjects were interviewed. The interviews were analysed according to the methods of thematic analysis. The money was used for personal pleasure and to re-establish reciprocal relations to others. The ways in which different individuals used the money at their disposal impacted their sense of self through experiences of mastery, agency, reciprocity, recognition and security. The findings underline the importance of including social circumstances in our understanding of mental health problems, their trajectories and the recovery process.

Objectives: Several studies have pointed at a co-occurrence between severe mental problems and relative poverty. Also users refer to their strained financial situation as one of their main problems. We lack knowledge about how persons ‒ still characterised in diagnostic manuals as having difficulty with their sense of reality and their ability to carry out goal-oriented actions ‒ manage the ‘double trouble’ of having a strained financial situation and mental problems. Method: Sixteen persons diagnosed with severe mental illness were interviewed about how they managed poverty in their everyday life. The interviews were tape-recorded and analysed using the thematic analysis method. Results: The overarching theme that emerged was ‘managing a life on the margin’, with three sub-themes: ‘staying within limits’, ‘widening the boundaries’ and ‘indulging in the unnecessary’. The ways the interviewees coped with their strained financial situation are similar in many respects to those found in poverty research among people who do not have severe mental health problems Conclusions and implication for practice: Professionals should strive to take the individual’s social context into consideration, both when examining each person and in practicing share decision-making. Adopting a contextual approach would help us to see the user as an agent and better understand the onset and development of severe mental problems. Phenomena considered as symptoms might then be better understood as rational coping with the reality of poverty. 

Background: The relationship between severe mental illness, poverty and social isolation has been explored in a number of studies.Aim: The purpose of the study was to explore the relationship between financial strain and social isolation.Methods: Sixteen persons with severe mental illness were interviewed about their experience of having a severe mental illness, living in poverty and the effect these circumstances had on their social relationships. The interviews were analysed according to thematic analysis.Results: The overarching theme was the cost of having friends; it consisted of five categories: the loss of friends; making do without friends; dependence on friends and family; supported socialisation; and money as an aid to recovery. The participants experienced a connection between their financial circumstances, their social relationships and their lack of initiative in maintaining and developing a social network.Conclusions: The results underline the importance of considering the person in his/her social context in order to avoid the risk of interpreting rational strategies for coping as psychiatric symptoms.