155 Effectiveness of a social network intervention 5 improvements on mental wellbeing (Priebe et al., 2020; Swinkels et al., 2023b). Furthermore, a befriending study including patients with SMI, a population comparable to the forensic population, demonstrated that mental wellbeing only increased in patients with significant improvements on social support (McCorkle et al., 2008). As we found no significant improvements on social network and support outcomes in our study, the null findings on mental wellbeing might be explained by the absence of clear improvements on social network and support outcomes. Another explanation for the findings, including the temporary negative effects on mental wellbeing at 6 months, may be related to the overall low compliance of patients in our trial. Regarding the negative effects, for example, it is possible that patients with low compliance had more severe mental health problems and complex needs (Swinkels et al., 2023a). Furthermore, although speculative, the failure to participate in the intervention and to develop a bond with the volunteer could cause frustrations, disappointment, or self-doubt. Yet, previous studies among general psychiatric populations also faced compliance difficulties but did not find negative effects, which could suggest that effects of informal social network interventions might be different in forensic psychiatric populations (McCorkle et al., 2008; Priebe et al., 2020). Probably, even higher compliance rates and longer timeframes are needed to demonstrate improvements on mental wellbeing among forensic patients (McCorkle et al., 2008; Pettus‐Davis et al., 2017). On the other hand, we cannot rule out the influence of contextual factors, such as the COVID-19 pandemic, relationship problems, financial problems, and unstable housing. These factors may have complicated the contact between patient-coach dyads and prevented them from participating in social activities in the community, impeding the effects (Long et al., 2022; Swinkels et al., 2023a). Additionally, we found positive effects on duration of hospitalization and criminal behavior in patients receiving the informal social network intervention in addition to TAU. Moreover, these findings appeared to be robust, as intention-to-treat and per-protocol analyses generally yielded similar results. This study is the first to demonstrate positive effects of an additive informal social network interventions on hospitalization. Similar results have been demonstrated in other additive peer mentoring interventions that shared the primary aim of providing support to patients with SMI (O'Connell et al., 2018, 2020; Sledge et al., 2011). Based on these studies, we hypothesize that the provision of additional social support by volunteers during treatment might enhance treatment adherence and a sense of self-efficacy of patients, reducing hospitalization and criminal recidivism (O’Connell et al., 2020; Sledge et al., 2011; Tse et al., 2016). Furthermore, the positive findings on criminal behavior found in the current study are consistent with previous meta-analyses and RCTs
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