Abstract
Impact and Implications The Received Social Support Scale for Persons with Serious Mental Illness (rSSS-SMI) is the first service-user-driven SMI-specific measure of social support that assesses received support, an orientation that is critical to a full determination of social support conditions. The rSSS-SMI provides researchers with a preliminary tool for developing and validating interventions that extend beyond generic social network enhancements to target and enhance SMI-specific types of support. The rSSS-SMI also provides a vehicle for identifying the interactions between specific types of support and SMI stressors (e.g., homelessness, unemployment, isolation, poverty, stigma, illness management)-information that will have significant impact on improving quality of life, wellness, and recovery among persons with SMI. Existing population-specific support measures for communities with health conditions are being used to establish and assess national health care performance standards. The rSSS- SMI exerts a parallel impact on mental health care policy.
Purpose/Objective: This study investigated the psychometric properties of a newly developed Received Social Support Scale for Persons with Serious Mental Illness (rSSS-SMI). The rSSS-SMI measures three support domains: Day-to-Day Living support, Mental Health Support, and Adherence Support. Research Method/Design: (a) to examine the item quality of the rSSS-SMI, (b) to investigate the construct validity and verify the dimensionality of the rSSS-SMI, and (c) to investigate the reliability and validity of the rSSS-SMI scores. A sample of 267 community-based case management service recipients with SMI completed the rSSS-SMI and three additional scales (Interpersonal Support Evaluation List-Short Form [ISEL-12]; Symptom Checklist-6 [SCL-6]; Satisfaction with Life Scale [SWLS]). Results: Three items were dropped from the scale resulting in a 21-item scale. Confirmatory factor analysis and Item Response Theory analyses revealed our proposed three-factor model fit the data best, with average loadings at .74 (SD = .09). The three-factor model had higher item discrimination and item difficulty parameters than the one-factor model. The rSSS-SMI achieved strong internal consistency with estimates of .94 (full scale), .83 (Day-to-Day Living Support), .84 (Mental Health Support) and .76 (Adherence Support). The three-week interval test-retest reliability coefficient was .59. Convergent and discriminant validity evidence revealed a small, positive correlation between the rSSS-SMI and perceived support (ISEL-12) and symptom distress (SCL-6) and a small, negative, nonsignificant relationship with life satisfaction (SWLS). Conclusion: This study provides preliminary reliability and validity evidence for the rSSS-SMI and confirms our proposed three-factor structure (Day-to-Day Living Support, Mental Health Support, Adherence Support).