Young adults with psychosis find recovery through everyday communities
A new PhD thesis from the University of Southern Denmark (SDU) shows that young adults find more hope and empowerment in friendships and creative environments than in psychiatry.
Young adults living with psychosis often experience that recovery rarely gains momentum within psychiatry. Instead, they begin to find their footing through everyday communities, friendships and creative spaces. These settings allow them to be more than their diagnosis and to explore new ways of belonging. That’s the conclusion of a new PhD thesis from the University of Southern Denmark.
Ida Storm, PhD in psychiatric nursing and researcher at Region Zealand’s Psychiatric Research Unit and at the Department of Regional Health Research at SDU, has explored how young adults themselves describe their paths to recovery – and their accounts clearly show that community and identity matter at least as much as treatment and symptom relief.
An earthquake in young lives
When mental illness strikes during youth, it disrupts a fragile phase of life when identity and belonging are still being formed.
– For young adults, recovery is also about figuring out who they are, where they belong, and what they can dare to hope for in the future. As one participant put it: When adults become mentally ill, they need a push to get back on track – but young people are still learning how to walk, so to speak, and that makes it harder for them to understand why life is even worth living, says Ida Storm.
– That’s why mental illness can feel like an earthquake when it hits during youth. It creates fundamental doubt about who you are, who you can become, and whether life will ever be good again – not least because young people have relatively little life experience to draw on.
Isolation worsens – community heals
Mental illness can lead to social isolation, both because of low energy and the fear of stigma. The resulting loneliness often worsens mental distress.
– Young adults become socially isolated because mental illness depletes their social energy, and because many withdraw out of fear of being stigmatised. The problem is that the loneliness this isolation leads to often worsens the condition and can even trigger suicidal thoughts, explains Ida Storm.
Meet the researcher
Ida Storm completed her PhD dissertation at the Department of Regional Health Research, where she continues as a visiting researcher. She works in Psychiatry Region Zealand
Three recommendations for strengthening the recovery opportunities of young people living with mental illness:
- Include friends – both in treatment and as a resource in their own right
- Support access to meaningful everyday contexts where young people can participate at their own pace and on their own terms
- Collaborate with young people – both in treatment and in the development of future mental health services
Recovery grows in meaningful everyday life
Young adults describe recovery as something that often gains momentum outside the mental health system – in relationships and everyday communities.
– According to their stories, it’s rarely within psychiatry that they have their most meaningful experiences of recovery. These are more likely to happen in friendships or interest-based communities, where they feel safe and accepted. These settings give them space to try out new roles and feel that what they contribute matters. And I believe that’s something we all need, says Ida Storm.
– Positive experiences like these foster renewed hope for the future, and that hope is crucial for young adults’ recovery. In psychiatry, we can work to support them in finding these paths to a good everyday life.
Friendships as a key to adolescent recovery
The young adults’ stories highlight that friendships play a crucial role in their recovery:
– Friendships can support recovery in different ways. Some find safety and understanding in close, long-term relationships with friends who have been by their side for years. Others find belonging and shape their identity within groups of friends who share the same hobbies.
– Sometimes these two types of friendships overlap, and both are important for recovery – because young people develop through relationships with others, says Ida Storm.
At the same time, unequal expectations in friendships or past experiences of rejection can intensify feelings of isolation and worthlessness in adolescents with mental illness.
Some young adults find it easier to form and maintain friendships online, where rejection feels less personal. Yet despite the importance of friendships, they are rarely included in psychiatric care:
– Involving friends and supporting friendships is an untapped and promising area for mental health services. But we still face challenges in involving friends in ways that truly support the young person. To do that well, we need to collaborate with young people themselves, says Ida Storm.
Imagined spaces enable real progress
Most of the young adults in the project found support and strength in creative communities – especially in spaces where the pressure to perform was paused and they could experiment with new identities.
– The participants spoke of recovery experiences in what could be called ‘imagined realities’ – for instance, through role-playing, theatre or online gaming. It’s a bit like learning to drive on a skid pad: a safe place to practice before you’re thrown into real-life traffic. In these imagined realities, you can test yourself, build relationships, develop skills and gain experience – without the harsh consequences of failing an exam, dropping out of education or being rejected by peers.
– These spaces allow adolescents to build positive experiences that prepare them for adult life. That can make it easier to find a meaningful path as a young adult – even while living with mental illness, concludes Ida Storm.
Method: Centring the voices of young people
The thesis is based on three qualitative studies: an international literature review (a meta-ethnography) and two interview-based studies with six adolescents aged 23-32 years who have previously received treatment through OPUS – a nationwide psychiatric program for adolescents with psychosis.
The research takes its starting point in the participants’ lived experiences. This approach opens up new understandings of what recovery means – not as something that happens solely within the individual, but especially through relationships, communities and everyday life.
The thesis combines health science and youth sociology – a rare but fruitful approach, as it takes into account the specific challenges and conditions faced by adolescents. The concept of belonging – the feeling of being part of something – is a central theme in the analysis.