A comparison of formal and informal help in the context of mental health recovery

BACKGROUND: People in recovery from anxiety, depressive or bipolar disorders can receive both formal (from practitioners) and informal help (from family and friends). These two types of helping relationships have often been studied separately as either therapeutic relationships or social support. Yet, the mechanisms of these two forms of help have not been empirically compared in the context of mental health recovery. AIMS: The purpose of this study is to compare the mechanisms of informal help and formal help in recovery by combining the perspectives of individuals in recovery, their informal helper and their practitioner. METHOD: Individual interviews were conducted with 15 triads (N = 45 participants) comprising a person in recovery, their most significant informal helper and their most significant practitioner to compare the two forms of help through a mixed method approach. Based on the paradigm of critical realism, the research puts the emphasis on the triangulation of data sources and types. RESULTS: The informal and formal helping relationships serve multiple functions some can be found in both, often in different ways (communication, presence and availability). Informal helpers tend to serve a broader array of functions than practitioners do. Regarding differences, formal help is characterised by scheduling, time limitations and professional competencies. Informal help is characterised by emotional closeness, companionship and reciprocity. Also, people in recovery are active when it comes to determining the role that their helpers play (agency). CONCLUSIONS: Social support from family members and friends, as well as help from professionals can contribute to recovery in different ways. Attesting to the agency of people in recovery, the two forms of help are not only perceived as complementary, they are deliberately kept so.