Friendship theory for public health research and practice: a critical realist review

Abstract

Aims: To critically analyse theories of friendship through privileging research on the experience of friendship among those who have experienced mental ill-health. To inform public health approaches that aim to facilitate friendship and assist those experiencing mental ill-health. Method: A selective, iterative, purposive review of theoretical and empirical studies, within a critical realist epistemology, is undertaken to provide an analysis. Results: Existing theories – exchange and equity, capital, identity, and attachment – all provide some insight into friendship when encountering mental ill-health. However, recognition theory is found to best capture and explain the experience. Conclusion: Recognition theory forms a substantial theoretical foundation for public health initiatives that address friendship and mental ill-health. Friendship can contribute to public mental health, and suggestions are made to give friendship itself recognition within public health frameworks.