In a groundbreaking study conducted at the University of Gondar Comprehensive Specialized Hospital in Ethiopia, researchers have uncovered critical insights into the prevalence and determinants of low perceived social support among individuals grappling with mental illness. This comprehensive investigation sheds new light on how social support systems—or the lack thereof—play a pivotal role in the mental health trajectories of outpatient clinic attendees. As mental health gains prominence on global health agendas, understanding the nuances behind social support structures is essential not only for enhancing patient care but also for informing public health policies in low-resource settings.
Social support, a multifaceted concept encompassing emotional, instrumental, and informational assistance, is well-documented in psychiatric literature as a buffer against psychological distress and a catalyst for recovery. The recently published findings reveal that approximately 12.1% of the mental health patients surveyed in Gondar reported experiencing low levels of perceived social support from their closest relational networks consisting of family, friends, and significant others. This statistic reverberates alarmingly against the backdrop of Ethiopia’s evolving mental health infrastructure, calling for urgent attention to social determinants as integral components of psychiatric care.
Delving into the study’s methodology, the research team employed a systematic random sampling technique to recruit 636 participants from the psychiatric outpatient clinics over a six-month period spanning from October 2022 to March 2023. The robustness of this sampling framework lends credence to the representativeness of the findings. Participants’ perceived social support was rigorously quantified using the Multidimensional Perceived Social Support Scale (MPSS-12)—a validated tool that precisely captures the subjective appraisal of support from different social domains. Additionally, psychometric evaluations incorporated measures of self-esteem, medication adherence, substance use, and clinical severity to draw intricate correlations across psychosocial variables.
The analytical backbone of the study, anchored in SPSS version 28, employed both bivariate and multivariate logistic regression models to parse out independent predictors of low social support within the cohort. The multivariate approach is particularly salient, enabling the isolation of variables that exert statistically significant influences while adjusting for potential confounders. The threshold for significance was prudently set at a p-value less than 0.05, ensuring that findings meet stringent inferential criteria. Adjusted odds ratios (AORs) with accompanying 95% confidence intervals provide nuanced estimates of risk factors associated with diminished social support.
Key revelations emerged from these analyses, illuminating the complex social fabric that shapes mental health outcomes. Patients who lived alone exhibited more than double the odds of perceiving inadequate social support compared to those residing with others (AOR=2.40). This finding underscores the detrimental impact of social isolation on psychological well-being, a factor often exacerbated by stigmatization of mental illness in Ethiopian society. Similarly, clinical variables such as having experienced a relapse heightened the risk of low support, suggesting that recurrent symptom exacerbations may erode patients’ relational ties or individuals may withdraw socially due to illness severity.
Family engagement—or the conspicuous absence thereof—surfaced as a formidable determinant. Those whose families were not involved in patient care faced an odds ratio of 4.67 for low perceived support, signaling that familial participation is not merely beneficial but potentially essential for fostering protective social environments. This aligns with broader cultural contexts where extended family networks traditionally provide scaffolding for healthcare support. Moreover, severity of illness, categorized objectively into moderate and severe grades, correlated significantly with low social support, revealing an interplay between clinical progression and social marginalization.
Psychosocial factors intrinsic to the patient’s self-concept also influenced support perceptions. Low self-esteem emerged as a significant predictor (AOR=2.36), accentuating the bidirectional relationship between internal psychological states and external social interactions. Poor medication adherence further compounded vulnerability, with affected individuals nearly twice as likely to report insufficient support. This nexus implies that social neglect may hinder adherence, or conversely, that non-adherence exacerbates social alienation—a critical insight for targeted interventions aimed at improving both medication compliance and relational engagement.
The implications of this study transcend clinical settings, compelling mental health practitioners, policymakers, and community stakeholders to recalibrate approaches. Enhancing social support mechanisms should form an integral component of therapeutic regimens. Tailored psychosocial interventions that prioritize reconnecting isolated individuals, fostering family involvement, and addressing self-esteem deficits could substantially ameliorate patient outcomes. Such holistic strategies resonate with the global mental health movement’s push towards recovery-oriented care that transcends symptom management, recognizing the indispensable role of social environments.
Furthermore, the research amplifies calls for culturally informed programs that mitigate stigma and promote community inclusivity. In the context of Ethiopia’s limited mental health resources, leveraging existing social networks and community health workers might offer sustainable avenues to bolster support systems. The study’s findings serve as an empirical foundation advocating for integrated models where clinical treatment dovetails with social rehabilitation efforts, ensuring patients are not just clinically stable but socially resilient.
In conclusion, the investigation spearheaded by Alemu and colleagues provides a vital lens on the intersection of social support and mental health in a low-income country setting. The identification of living alone, relapse occurrences, family disengagement, illness severity, low self-esteem, and suboptimal medication adherence as pivotal factors delineates clear targets for intervention. As mental health burden intensifies globally, replicating such rigorous research across diverse contexts promises to unravel the complex social determinants that either facilitate or hinder recovery. This study undeniably charts a path forward for embedding social support within comprehensive mental health care frameworks, particularly within underserved populations.
Ongoing research should now explore interventional strategies tailored to these determinants. Longitudinal designs could elucidate causal pathways and assess the efficacy of targeted psychosocial programs. Additionally, qualitative inquiries might deepen understanding of lived experiences behind quantitative metrics, enriching mental health services with patient-centered perspectives. Collectively, these efforts will catalyze transformative changes, enhancing not only clinical outcomes but also quality of life for individuals navigating the challenges of mental illness.
The significance of social support as a buffer in mental health cannot be overstated. This research accentuates the urgent necessity to operationalize social support enhancement as a clinical imperative. For stakeholders invested in mental health reform, these findings propel a reevaluation of care paradigms, spotlighting social support as an indispensable pillar of psychiatric treatment. Ultimately, addressing this often-overlooked dimension may significantly attenuate the pervasive morbidity associated with mental illnesses.
Subject of Research: Prevalence and associated factors of low perceived social support among people with mental illness attending psychiatric outpatient clinics in Gondar, Ethiopia.
Article Title: Prevalence and factors influencing low social support from family, friends, and significant others among people with mental illness attending psychiatric outpatient clinics in Gondar, Ethiopia.
Article References:
Alemu, W.G., Mwanri, L., Due, C. et al. Prevalence and factors influencing low social support from family, friends, and significant others among people with mental illness attending psychiatric outpatient clinics in Gondar, Ethiopia. BMC Psychiatry 25, 429 (2025). https://doi.org/10.1186/s12888-025-06889-y
Image Credits: AI Generated
