Cohesion of the primary social network and sustained service use before the first psychiatric hospitalization.

This study analyzed the relationship between social network dynamics and initial help-seeking behaviors. The primary social network was reconstructed for the period beginning with initial observation of unusual behavior and ending with first psychiatric hospitalization. The social network's influence was analyzed based on the concept of social network cohesion, considering both structure and content of social ties. The results demonstrate that networks succeed in referring the family member to services and in maintaining a clinical follow-up to the degree that they are cohesive. When a network lacks cohesiveness, the onset and development of problem behaviors are less easily recognized. These findings confirm the importance of social and interactional contexts in decision-making processes leading to use of psychiatric services and specify the roles they play.