Support Systems

A support system is the network of people and resources you turn to for help. It offers comfort, practical aid, and useful information in hard times and good ones.¹

Most advice about building one asks you to count something. The counts are familiar: how many people you could name, how near they live, how often you see them.

Those counts have been tested against how people actually fare. They fail in one direction. They mark people as well supported when they are not. The opposite mistake is rare.

On this page

• What a support system is, and what gets counted
• The forms support takes
• The help you get and the help you believe is there
• What the standard measure misses
• What support is for besides rescue
• Taking stock of your own
• When to bring in professional support

What a support system is, and what gets counted

Social support is the giving of assistance or comfort to others. It usually helps them cope with biological, psychological and social stressors.¹ Stressors are the pressures that come from the body, the mind and a person's circumstances.

Support can arise from any relationship in a person's network. That includes family members, friends, neighbours, religious institutions, colleagues, caregivers or support groups.¹

Some of that is informal: the ongoing relationships with immediate family, relatives, friends and work associates.² Some is formal. That covers the therapist, the doctor and the social worker.

Researchers measure two different things here. The difference runs through everything below.

The structural side is the existence and size of a network. That means the number of social ties and how often people interact.⁴ The functional side is the person's own appraisal of the support they experience. That is the quality or depth of those relationships.⁴

A network can be large on the first measure and poor on the second. Almost everything that is easy to count belongs to the first.

The forms support takes

Support is not one thing. The forms are not interchangeable. One account has social support reducing the adverse effects of mental stress in five ways: emotional attention, helping, information, assessment of others' feedback about the quality of performance, and sociability.⁵

Most people need several of these. Most are better covered on some than on others.

• Emotional support. Comfort and empathy that let you feel valued, accepted and understood.¹
• Practical support. Hands-on help with tasks, money, or family and work responsibilities.²
• Informational support. Facts, advice and guidance when you face a decision.⁶
• Appraisal support. Honest feedback that helps you judge how you are doing.⁵
• Companionship. Shared time and sociability.⁵
• Spiritual support. Comfort and meaning drawn from a shared community of belief.⁶

The help you get and the help you believe is there

Researchers separate two things. One is the help a person actually receives. The other is the help they believe is available.⁴

Received support is specific support, such as advice, actually provided to the person when it is needed.⁴ Perceived support is that person's own judgement that someone would help if the need arose.⁴ The two sound alike. They do not behave alike.

Only perceived support is consistently linked to better mental health. Received support and social integration have not been found to relate to health in the same way.⁴ One review puts it plainly: the only aspect of social support linked to health outcomes is the belief that help is available if needed, rather than the help actually received.⁴

That is a strong claim. It does not come from one body of research. A meta-analysis pools the results of many separate studies into a single finding. One such analysis, covering 64 studies conducted in Iran, states the same point: social support alone is not important, what is important is the belief in the existence of social support.⁵

This does not fit the usual advice. That advice treats a support system as something to accumulate, and counts contacts to see how you are doing.

The measure that tracks with health is harder to count. It is not how many people are in your life. It is whether you would know who to call.

Two models explain how support does its work. Both have evidence behind them.⁴

The first is the buffering model. On this model, support is beneficial mainly under high stress. People with a high level of perceived support show fewer negative health effects after stressful events than people with a low level.⁴

The second is the main effect model. On this model, support is good for physical and mental health regardless of how much stress a person is under.⁴ Which of the two is operating is not fixed. It can vary among situations, persons and populations.⁴

This is not only a research distinction. Among people living with depression, substantial evidence comes from prospective studies. These follow the same people forward in time rather than asking them to look back. Those who perceive their social support as poorer have worse outcomes in depressive symptoms, recovery and social functioning.⁴

The belief is not a stand-in for something else. On this evidence, the outcomes are linked to the belief itself.

What the standard measure misses

Researchers do not treat support as one long scale running from weak to strong. They sort networks into types.

The scheme used most often with older people is Wenger's typology. A typology is a set of categories rather than a score. It identifies five types from responses to eight questions on the availability of local kin, the frequency of face-to-face interaction with family, friends and neighbours, and community integration.⁸

• Local family-dependent. The person relies on relatives living in the same community. Community involvement is low and networks tend to be small.⁸
• Locally integrated. Helping relationships with local family, friends and neighbours, usually alongside active involvement in religious or community groups. Average network size is larger than the other types.⁸
• Local self-contained. A more private, household-centred life, with neighbours relied on only when there is real need. Community involvement is rare or low key and the network is smaller than most others.⁸
• Wider community-focused. No local kin, a focus on friends and community groups, and a likely long-distance relationship with family. These networks are large.⁸
• Private restricted. No local kin, and low levels of contact with neighbours and the community. These networks are small.⁸

Type does predict how people fare. The pattern holds in different places.

One survey covered eight low and middle income countries: India, China, Cuba, the Dominican Republic, Venezuela, Mexico, Peru and Puerto Rico. It reached 17,031 people aged 65 and over. Loneliness, depression, less happiness, poor health, disability and need for care were all significantly associated with the non-integrated network types.⁹

New Zealand gives the same answer. A study of 872 older adults confirmed the five types. Māori participants were more likely to report integrated network types, and there was no difference between Māori and non-Māori in how the types themselves were configured.¹⁰

The eight questions are the weak point. These typologies were built in Western, individualistic settings, and may not be sensitive to differences within and between cultures.⁸ They rest heavily on whether relatives live close by and how often the person sees them. Where three generations share one home, those questions are all but answered in advance.

The consequence shows up in the numbers. Earlier research applied the standard typology to South Asian elders.

More than three-quarters of all respondents were categorised as having either family-dependent or locally integrated support networks. Those two types provide the highest levels of informal care in Western populations.⁸ That classification was likely to have been unduly influenced by the proximity and frequency of contact of family members within multigenerational households.⁸

Living with family is not the same as being supported by family. Intergenerational co-residence cannot be assumed to equate to the provision of support. Older people in multigenerational households may themselves be providing it, undertaking household tasks for others or caring for younger generations. Or their own support needs may be given a lower priority than those of others in the household.⁸

So the researchers built a typology from that population instead. They drew on 590 Gujarati, Punjabi and Sylheti elders living in the United Kingdom and South Asia. Four types emerged rather than five. The people with non-kin restricted networks were more likely to be lonely and isolated than the others.⁸

Their conclusion matters most. Using network typologies developed with individualistically oriented cultures skews distributions towards the more robust network types. It could underestimate the support needs of older people from familistic cultures. Those people may be isolated and lonely, with limited informal sources of help.⁸

Set that beside the eight-country validation and the two results conflict. That study supported the construct validity of the typology, meaning it does appear to measure what it claims to. It also found the family-dependent and locally integrated types to be the most prevalent of the five.⁹ Those are the same two types identified as taking in people whose closeness to family may have been read as support.⁸

Neither study settles it. Whether the typology detects genuine support in those households, or only the appearance of it, stays open. The eight-country authors note that criterion validity still needs testing with longitudinal data.⁹ Longitudinal data follows the same people over years, so it can show what came first.

This is not only an academic problem. Multigenerational households are a residency pattern distinct from the normative one that may be used to marginalise groups. Co-residency and assumed levels of social support are provided as a justification for reduced access to appropriate formal care services.⁸

What this evidence does not cover. Nearly all of it concerns older people.

Work with young adults in the United States found six network types rather than five, and moved the useful question from type to type-by-function. Family-focused networks were the most beneficial confidant and companionship networks. Relying on peers-focused networks for advice-seeking and practical support was associated with lower psychological well-being than family-focused networks.¹¹

The New Zealand authors add a caution that applies to all of it. How far people endorse family accessibility, frequency of interactions and community engagement is itself influenced by sample and contextual characteristics. That is why they argue the types should be derived empirically rather than scored from a predefined key.¹⁰

What support is for besides rescue

The counting goes wrong in a third place. This time it is in the research itself.

Work on relationships and health has focused almost exclusively on supportive relationships in the context of stress or adversity. It has all but ignored the other life context in which relationships protect and enhance well-being. That context is enabling a person to participate fully in opportunities for growth and development when nothing is wrong.⁷

The same relationship is meant to do both jobs. One model of thriving through relationships sets out those two life contexts: coping successfully with adversity, and actively pursuing opportunities for growth. It proposes two relational support functions, one fundamental to each: a safe haven to come back to when things are hard, and a secure base to go out from.⁷ A relationship judged only on the first can look adequate while doing none of the second.

None of this makes a support system easy. Support systems are not infallible. Relationship stress can have a negative impact on people, patient and caregiver alike, behaviourally, psychosocially and physiologically.³ Support involves a reciprocal exchange rather than one-way rescue, which means the people who help you have their own difficulties to manage.⁶

The risk runs the other way too. Individuals with the lowest level of involvement in social relationships face a greater mortality risk.³

Taking stock of your own

If perceived support is the part that tracks with health, counting people is the wrong measure.⁴ One short questionnaire is used often in general population surveys.

That questionnaire is the OSS-3, from the WHO Regional Office for Europe. It asks about three things only: the number of close people, the interest shown by others, and the help available from neighbours. Responses are grouped as weak, medium or good support.⁴

Two of those three are about what other people do, not how many of them there are.

The second correction is that support arrives function by function. Confiding, advice-seeking, practical support and companionship are separate networks. The same person can be well covered on one and have almost nobody on another.¹¹

So a useful stocktake takes each function in turn and asks who is actually there for it. That is a harder question than how many people you could list.

Two things are worth doing with the answer. The first is to keep a mix of ties.

Bonding capital comes from socialising with people who are like you, of a similar age or religion. Bridging capital comes from people who are not, between generations for instance. The two kinds strengthen each other.⁴

The second is to match the function to the relationship rather than asking one person for everything. That is the direction the young-adult findings on confiding, advice and practical help point in.¹¹

If a function comes up empty, that is information rather than a verdict on you. Naming the empty one is the point of doing it this way.

When to bring in professional support

Sometimes the people around you are not enough. That is not a failure of theirs or of yours.

A therapist or counsellor adds trained, confidential support alongside your own network rather than in place of it. That can also be the one relationship where you are not also looking after the other person. If you are unsure where to start, this guide on finding the right therapist can help.

Related terms

• Mental Health Support: professional and informal help for mental health.
• Social Support: support focused on social connection.
• Peer Support: support from people with shared experience.

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This information is for educational purposes and is not a substitute for professional mental health care. Strong support systems help, and professional help may still be needed.

References

This article is for general information and is not a substitute for professional assessment or care. If this is affecting your life, consider reaching out to a qualified mental health professional.

Show references

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