To befriend or to be a friend: a systematic review of the meaning and practice of “befriending” in mental health care

Abstract

Background: “Befriending” involves pairing a volunteer with a person with a mental illness in the community to spend social time together. The term can have very different connotations.

Aims: To review how “befriending” was used in mental health care.

Method: A systematic review with a narrative synthesis was used to explore how befriending is conceptualised and practiced. We extracted descriptions of “befriending” from efficacy studies, befriending manuals, and reports from the gray literature and explored the practical implications of the different concepts of “befriending”.

Results: The lay understanding of the phrase “to befriend” is “to be a friend to”. This contrasts to codes of practice used by befriending organisations, which describes a relationship distinct from friendship. The literature (12 relevant papers total) suggests a spectrum of practices; at one end is a relationship that is professional or therapeutic in nature, while at the other end, the relationship is conceptualised as much closer to a naturally occurring friendship.

Conclusion: The different concepts determine distinct practices, which may lead to confusion when the term befriending is used. The term “befriending”, may be understood to concern friendship, which may be inappropriate where the organisation offers a professional style relationship.

• befriending
• friendship
• mental illness
• social isolation

Acknowledgements

We thank the research team at the Unit for Community and Social Psychiatry for their continued contributions in discussing the content of this article. This work was conducted at the WHO Collaborating Centre for Mental Health Services.

Declaration of interest

This paper/article/abstract/presentation/poster presents independent research funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research programme (Grant Reference Number RP-PG-0611-20002). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.