The climate and culture of treatment for clients with serious mental illness (SMI) are complex. In this study, we aim to cultivate a deeper understanding of the treatment environment using a network typological approach to measure the local treatment context and assess its implications on the perceived quality of clients’ relationships with their care providers. We use in-depth egocentric network data from clients with SMI in community mental health centers and state psychiatric hospitals from the Indiana Mental Health Services and HIV Risk Study (N = 417). Clustering analysis identifies five unique and distinct network types: supportive, sparse, diverse, clinical, and treatment-focused. Weighted least squares regressions reveal clients in networks with high amounts of support predict a more trusting working alliance, whereas care-oriented networks predict a less trusting alliance. Our findings underscore the need to consider the local network context in studies of the quality of care provided to people with SMI.

患有严重精神疾病（SMI）的患者的治疗气候和文化很复杂。在本研究中，我们旨在使用网络类型学方法来对治疗环境进行更深入的了解，以测量局部治疗环境并评估其对服务对象与服务提供者关系的感知质量的影响。我们使用印第安纳州心理健康服务和HIV风险研究（N= 417）。聚类分析确定了五种独特的网络类型：支持性网络，稀疏网络，多样化网络，临床网络和以治疗为重点的网络。加权最小二乘回归显示，在具有大量支持的网络中，客户预测一个更可信赖的工作联盟，而面向护理的网络则预测一个较不信任的联盟。我们的发现强调了在研究向SMI患者提供的护理质量时需要考虑本地网络环境。