Psychiatric/Psychosocial Rehabilitation (PSR) in Relation to Social and Leisure Environments: Friends and Recreation

Introduction: Social isolation and a lack of physical activity are common difficulties experienced by persons with serious mental illnesses living in the community, contributing to high suicide rates and early mortality among this population. Despite the gravity of these concerns, few efforts have been made to target these issues specifically through the development of social and/or psychological interventions to increase the engagement of persons with serious mental illnesses in social, leisure, and recreational activities. Methods: On-line databases were searched for articles addressing the social, leisure, and recreational needs of persons with serious mental illnesses from 1995 to the present. These articles were reviewed and are summarized in the Results section. Results: Despite the advances made in supporting persons with serious mental illness in pursuing other important life domains–such as employment, education, and housing–relatively little progress has been made thus far in increasing socialization and physical activity among this population. Promising models have been developed based on the combination of skills training and the provision of community-based (in vivo) support, and are showing initial promise. Much work remains to be done, however, in offering these opportunities on a broader scale to most individuals who would benefit from them. Conclusions: While a sense of urgency and much activity has been generated by recent findings that adults with serious mental illnesses die on average 25 years earlier than their peers, these efforts have primarily focused on ensuring access to, and improving the quality of, medical care. Few efforts have focused on the role of such mutable lifestyle factors as participation in social and recreational activities, even though these factors are known to play an important role in improving and maintaining the health and wellbeing of the general population. Models are now being developed, however, that promise to extend these benefits to adults with serious mental illnesses as well.