Abstract

BackgroundOnline peer support networks are a growing area of mental health support for offering social connection, identity, and support. However, it has been reported that not all individuals have a positive experience on such networks. The potential for adverse events within a moderated online peer support network is a new area of research exploration.ObjectiveThe objective of the study was to determine if use of an online moderated peer networks leads to adverse events for users.MethodsFour biannual online surveys (October 2014 to March 2016) were conducted by a large national UK mental health charity, with users of their online peer support network exploring personal safety, moderation, experiences on the site, and how the site could be improved. Data were analyzed using thematic analysis by 2 independent researchers using a priori themes: negative experiences of moderation, social exclusion, contagion, negative interactions with other users, online relationships, co-rumination and collusion, and other.ResultsIn total, 2353 survey responses were logged with 197 (8.37%) documenting an adverse event of negative experience. A dominant theme of negative experiences of moderation emerged (73/197, 37.1%) with evidence of social exclusion (50/197, 25.4%). Reading user posts was shown to be a cause of worry and distress for a few users, and analysis highlighted several instances of depressogenic and emotional contagion as well as some limited evidence of behavioral contagion (46/197, 23.4%). Very limited evidence of co-rumination (1/197, 0.5%) and no evidence of collusion were identified.ConclusionsEvidence of adverse events was identified at low levels in the sample of respondents, although we have no comparison data to indicate if levels are low compared with comparable platforms. Not all users of online peer support networks find them wholly beneficial. Research must explore what works for whom. The next stage of service development should consider which users may be likely to receive no benefit, or even deteriorate, as a result of using the service.

Highlights

  • Online Peer SupportOnline peer support is an example of a technology-supported mental health self-management approach

  • The approach works on the principles of using mutuality and reciprocity, which in turn facilitate the generation of social capital, known to be associated with well-being and resilience in mental health [2]

  • A total of 8.37% (197/2353) of responses documented an adverse event of negative experience with 1.15% (27/2353) identifying multiple adverse events, which have been listed under multiple themes

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Summary

Introduction

Online Peer SupportOnline peer support is an example of a technology-supported mental health self-management approach. Clinical outcome measures based on a biomedical model to measure effectiveness, online peer support generally appears to have little effect [3,5,6] When outcomes such as social connectedness, personal empowerment, and quality of life are assessed, research demonstrates evidence of benefits to users [4,7,8]. The potential for adverse events within a moderated online peer support network is a new area of research exploration. Methods: Four biannual online surveys (October 2014 to March 2016) were conducted by a large national UK mental health charity, with users of their online peer support network exploring personal safety, moderation, experiences on the site, and how the site could be improved. The stage of service development should consider which users may be likely to receive no benefit, or even deteriorate, as a result of using the service

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