Social Networks Among Unstably Housed Adults with Co-Occurring Serious Mental Illness and Substance Use

Background and Purpose: Social networks determine social capital: one’s ability to access tangible (e.g., job opportunities, housing) and intangible (e.g., social support) resources. The number and diversity of people within a person’s social network determines their social capital.

The social networks of people with co-occurring SMI and substance use (COD), and those of unhoused people, are strained and small, focused on treatment and services, and characterized by unequal helping relationships. People with COD, and unhoused people, tend to have more bonding (i.e., strong ties with similar individuals) compared to bridging (i.e., weak ties with more diverse groups) social capital. This is problematic because bridging capital facilitates access to new opportunities, information, and resources.

Despite these bodies of literature, there is little research examining the social networks of people with COD who are also unstably housed, which could exacerbate the challenges they already face in building social networks.

Methods: We explored between group differences in social networks by housing status (stable vs. unstable in the last 30 days) among a sample of adults with COD. In our sample of 34 individuals, 21 reported stable housing and 13 reported unstable housing.

Results: Unstably housed participants had significantly smaller social networks than those with stable housing (M=13.08, SD=7.60 vs. M=25.14, SD=19.60), t(28.13)=2.53, p=.017. They reported a significantly greater proportion of network members who had ever used drugs (M=79.84%, SD=30.66) relative to those with stable housing (M=53.21%, SD=35.67), t(26.16)=−2.21, p=.036. When accounting for differences in overall network size, participants experiencing unstable housing had a significantly smaller effective number of high-closeness ties (M=5.15, SD=3.00) compared to those with stable housing (M=11.81, SD=8.76), t(18.19)=3.19, p=.004 and a significantly smaller effective number of high-contact ties (M=7.77, SD=4.02) compared to those with stable housing (M=13.81, SD=8.83), t(30.04)=2.71, p=.011. Participants with stable housing reported a significantly higher proportion of relationships lasting at least 12 months (M=84.97%, SD=16.63) compared to those with unstable housing (M=65.23%, SD=25.53), t(32)=2.74, p=.010. Similarly, while the proportion of ties established prior to substance use treatment did not differ significantly between groups (p=.095), participants with stable housing had a significantly greater number of such ties (M=14.14 vs. 5.77), t(27.53)=2.62, p=.014. Unstably housed participants reported significantly higher levels of positive psychotic symptoms compared to those stably housed (M=11.14, SD=4.60 vs. M=7.79, SD=1.63), t(19)=−2.49, p=.022; there were no significant differences in substance use.

Conclusions and Implications: Unstably housed participants had social networks that were structurally similar in composition but smaller than those of housed participants, resulting in fewer close, frequent, long-standing social ties. This suggests that while the types of relationships and perceived support may be comparable, the overall availability of social capital for unstably housed individuals is reduced. Unstable housing was also associated with greater symptom severity and higher lifetime substance use exposure within networks, despite few differences in diagnoses, current substance use, or broader functioning. These findings indicate that housing instability may not fundamentally alter the structure of social networks, but instead constrains their scale, depth, and potential to provide meaningful support.