Abstract
Social support is a well-recognised protective factor for children's mental health. Whilst many interventions exist that seek to mobilise social support to improve children's mental health, not much is known about how to best do this. We sought to generate knowledge about the ways in which social support can be mobilised to improve children's mental health. We conducted a systematic review, which followed the principles of a realist synthesis. The following databases were searched: PubMed, CINAHL, Ovid MEDLINE, PsychINFO, EMBASE, Child and Adolescent Studies, EconLit and SocINDEX. Studies were included if the age of participants was between 0 and 18 years and they evaluated or described programme theories of interventions that sought to improve children's mental health by mobilising social support. Relevance and quality of studies were assessed, and data were extracted and analysed narratively. Thirty-three articles were included. Studies varied substantially with regard to the detail in which they described the processes of mobilising social support and expected mechanisms to improve children's mental health. Those that provided this detail showed the following: Intervention components included explaining the benefits of social support and relationships to families and modelling friendly relationships to improve social skills. Pathways to improved outcomes reflected bi-directional and dynamic relationships between social support and mental health, and complex and long-term processes of establishing relationship qualities such as trust and reciprocity. Parents' ability to mobilise social support for themselves and on behalf of children was assumed to impact on their children's mental health, and (future) ability to mobilise social support. Although interventions were considered affordable, some required substantial human and financial resources from existing systems. Mobilising social support for vulnerable children can be a complex process that requires careful planning, and theory-informed evaluations can have an important role in increasing knowledge about how to best address social support and loneliness in children.
Highlights
Social support refers to the extent to which an individual has access to, or perceives they have access to, assistance and resources provided by people in their social network [1]
Interventions most commonly mobilised the social support of parents, followed by those studies that were about mobilising social support of children
A few were about increasing social support of the family as a whole
Summary
Social support refers to the extent to which an individual has access to, or perceives they have access to, assistance and resources provided by people in their social network [1] It is concerned with the function of social relationships rather than their structural constellation, which makes it, to some extent, distinguishable from other concepts such as social capital or social connectedness, the terms are overlapping and sometimes used interchangeably [2]. Whilst potential adverse effects of social support have been established, too, social support is generally regarded as an important protective factor for positive mental health at all ages, including during childhood and adolescence [2,3,4]. Findings from the youth literature suggest that sources and types or characteristics of social support might influence the magnitude of the protective (or sometimes adverse) effects of social support on mental health, but that important evidence gaps remain [14,15,16]
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