After I began my PhD research, earlier than the Covid pandemic, I’d get requested why I used to be how peer supporters use digital applied sciences. Again then, as I later heard from a few of my individuals, peer supporters had been struggling to be accepted, the NHS relied on paper and outdated applied sciences, and voluntary sector organisations noticed face-to-face conversations as the guts of their supply. Why would I select this subject? However how instances have modified.
Peer supporters are actually established inside the psychological well being workforce throughout England (NHSE, 2020) and a current systematic umbrella evaluate of peer assist, beforehand featured in these woodlands, has described its effectiveness in addition to obstacles and enablers to implementation (Cooper et al, 2024). In relation to digital, the newest NHS 10-year plan guarantees a shift from analogue to digital, “from bricks to clicks” (NHS, 2025).
However with the speedy pace of developments related to digital, I query how this shift would possibly really feel from a lived expertise perspective, and if psychological well being care dangers substituting a medical mannequin with a digital mannequin. So, I used to be to have a look at a current evaluate from Yeo and colleagues which mixes the 2 matters of digital and peer assist.
What does a shift ‘from bricks to clicks’ imply for peer assist employees?
Strategies
The authors of this evaluate searched tutorial databases for trials of digital peer assist to deal with questions concerning the results of: totally different sources of the peer assist together with casual and formal; options of digital peer assist reminiscent of dosage and platforms; and elements associated to people and international locations. They had been particularly within the impacts on wholesome folks, for both psychological well being or bodily well being.
They narrowed their search down from over 60,000 distinctive information to 120 research after which turned to analyse the quantitative knowledge. Their meta-analysis mixed the outcomes throughout the research to measure the impacts that addressed their questions.
How can we join digitally with different folks in peer assist?
Outcomes
The outcomes recommend that digital peer assist had stronger optimistic results on psychological well being than on bodily well being, and that digital interventions which embody casual, naturally occurring peer assist could also be simpler than extra formal choices for wholesome folks. Effectiveness appeared to lower with longer durations, with recommendations that this is likely to be as a result of “prolonged intervals of intervention lead to detrimental interactions with friends” (p.6). For each bodily and psychological well being, extra interactive platforms had been simpler: apps, social networks and video conferencing had been simpler than boards and dialogue boards, web sites and others (emails, texts and cellphone).
The impression of digital peer assist was not affected by the age of the individuals, and the impact didn’t cut back with rising severity of current bodily or psychological well being circumstances. As a result of there weren’t sufficient research to check particular person international locations, the authors in contrast Western (e.g. Australia, Canada, Germany, United States) and Japanese (e.g. China, Pakistan, Singapore, Taiwan) international locations. Digital peer assist interventions had higher results on rising psychological well being in Japanese international locations, and on enhancing bodily well being in Western international locations.
Three limitations had been recognized: that the research within the evaluate mixed peer assist with totally different therapy parts; that different doubtlessly necessary moderators (reminiscent of particular settings) weren’t thought of; and that the included research had been primarily Western and didn’t report on ethnicity.
Conclusion
The authors conclude that their research:
advances understanding of efficient digital peer assist for wholesome populations past earlier critiques and meta-analyses that centered on people already recognized with medical circumstances (p.7).
How can we outline ‘digital peer assist’?
Strengths and limitations
I’ve a long-standing frustration concerning the lack of a definition of ‘digital peer assist’ – it’s not confined to this evaluate. An early commentary about peer assist in digital psychiatry advised that peer assist is more and more provided in synchronous and asynchronous applied sciences and “artificially by way of avatars and chatbots” (Venegas et al., 2019, p.222). A later systematic evaluate outlined digital peer assist as “stay or automated providers delivered by means of expertise media” (Fortuna et al., 2020, p.2). Apart from essentially questioning the peer-ness of synthetic or automated assist, once I searched the literature for my PhD, I concluded that almost all research had been , what I generously time period, peer-supported digital interventions. This implies the main target of the researchers was on creating digital interventions, they usually concerned folks with lived expertise to assist different folks to make use of them. Their publications gave particulars concerning the digital interventions, however not often described how, or if, lived experience was utilized in assist, or questioned the expertise required to be thought of a peer. This didn’t really feel true to see assist values and ideas.
Inside this present evaluate, I used to be confused by the inclusion of a few of the major research. For instance, I had by no means understood the Enrich research (Gillard et al, 2022) as being about digital peer assist. Their peer assist intervention included an choice of cellphone calls, nevertheless it didn’t really feel central to their research. One other instance was a research concerning the impression of peer assist coaching delivered on-line in June 2020 through the preliminary pandemic precautions (Pavarini et al, 2023). The first outcomes had been associated to the flexibility to supply assist, and secondary outcomes had been associated to wellbeing, however outcomes had been associated to receiving coaching not peer assist. A 3rd instance was a research of an interactive story-telling app with no human interplay (O’Dea et al, 2020), the place the phrase peer was solely talked about as a problem for younger folks, in phrases like “peer victimisation” (p.899) and “peer battle” (p.902). These are only a few examples of a broad and unhelpful lack of specificity about what constitutes digital peer assist.
I used to be additionally confused about definitions associated to wholesome folks and folks with medical circumstances within the preliminary search. The evaluate meant to check if digital peer assist is likely to be simpler for wholesome folks, so I might admire the necessity for a comparability with individuals who weren’t wholesome. However an exclusion within the search phrases of “people with medical circumstances” led to me questioning the inclusion of research the place individuals had been clearly presently or just lately utilizing providers reminiscent of inpatient psychiatric providers and most cancers providers. Definitions and a proof are necessary to grasp the populations who would possibly profit from digital peer assist.
One other concern concerning the search was the dearth of clear boundaries for publication date. Searches had been performed in December 2023 and Could 2024, however twenty-three of the psychological well being research had been from earlier than 2014, together with one from 1990. Digital platforms, the implementation of peer assist, and, to some extent, our views on psychological well being, have all modified in recent times, in order that the research had been throughout totally different contexts. I query if they might all be thought of related to as we speak’s follow.
All these questions (and extra) left me with critical doubts about this research and what it would add to present follow and understanding. I acknowledge that a few of my doubts could stem from cultural variations for a global research, and that the language and understandings of peer assist itself would possibly range throughout international locations (for instance, see Ma, 2025).
With no clear and agreed definition of digital peer assist, it’s not attainable to conclude from this evaluate what options of the digital interventions would possibly make them efficient.
Lived expertise involvement
Peer assist is essentially about lived expertise: about folks of equal standing offering assist to one another (Mead et al., 2001). In relation to psychological well being, peer assist has an extended, activist historical past with roots in consumer teams and mutual support. It is just just lately that providers are adopting it by using paid peer assist employees or recognising the worth of the mutual support we would present informally to one another, together with in on-line boards. However as providers, and researchers, transfer into our areas, there’s a threat that the essence of peer assist is misplaced, diluted into simply one other intervention.
There was no assertion of positionality inside this evaluate to recommend if any of the workforce had been working from a lived expertise perspective. Admittedly, the researchers could not have wished to reveal their very own experiences (Baldawi et al, 2025). Nonetheless, if peer assist is about lived expertise, then we must be seen and central to research about it, not simply as individuals, however as lively researchers, advisors, and as a part of the peer evaluate groups for funders and journals. Gillard (2019) factors to the necessity to assume once more concerning the impression of analysis strategies on the event of peer assist, and there may be printed recommendation for journal editors and reviewers with helpful inquiries to be requested about participation (Colder Carras et al, 2022).
All in, there isn’t any purpose for journals to publish research about peer assist that aren’t express about together with a lived expertise perspective.
There are sufficient issues concerning the professionalisation of peer assist because it will get absorbed into techniques with out the misappropriation of the phrase right into a digital mannequin. Shifting forwards, as we’re pushed ‘from bricks to clicks’ and builders rush in, all of us have a accountability to make sure that the unconventional roots of peer assist are usually not misplaced within the course of.
Is ‘digital peer assist’ being outlined with out involving us?
Implications for follow
With my curiosity in digital and peer assist, I’ve turn out to be more and more alarmed on the potential for a digital mannequin to trigger important harms. With tales together with the excessive profile and rising issues round 7 cups, the Nationwide Consuming Problems Affiliation’s removing of its chatbot, Tessa, and fears over harms from ChatGPT with its stigma and sycophancy, I’m cautious of a tradition of digital options which concentrate on competitors and monetary pursuits versus public profit and social justice.
This evaluate gives little to reassure or to affect follow. It’s the unstated gaps which can be necessary. We don’t know what sort of peer assist, formal or casual, digital or in particular person, would possibly work for various circumstances, international locations, well being circumstances and demographic traits. There’s unlikely to be one resolution for all, and there are lots of gaps to curiosity researchers.
However first, maybe we have to “ask what sort of future we wish to create, collectively” (Bender & Hanna, 2025, p. 196). Peer assist is essentially not about bricks or clicks, however about folks, particularly folks with lived experience. We’d wish to use digital platforms, or we would not. However we must always actually be concerned in questioning and creating our future selections.
What sort of future are we creating, collectively?
Assertion of pursuits
I’m a co-director of each With-you Consultancy Ltd, which supplies coaching and consultancy associated to see assist, and the Survivor Researcher Community CIC, which supplies assist for researchers working from a lived expertise perspective. I additionally work freelance for numerous Universities and organisations. The views expressed on this weblog are private and don’t characterize the views of any organisation I’m linked with.
I used to be a co-author on two papers which I’ve cited: these led by Cooper and by Colder Carras.
My PhD thesis is titled ‘Navigating the digital world: a grounded concept research of the usage of digital applied sciences by peer supporters’.
Hyperlinks
Major paper
Yeo, G., Fortuna, Okay. L., Lansford, J. E., & Rudolph, Okay. D. (2025). The consequences of digital peer assist interventions on bodily and psychological well being: A evaluate and meta-analysis. Epidemiology and Psychiatric Sciences, 34, e9.
Different references
Baidawi, S., Avery, S., Ball, R., & Newitt, R. (2025). Dwelling with Expertise within the Academy: Pressures to Disclose in Routine Analysis Actions. Australian Social Work, 78(2), 226–235. https://doi.org/10.1080/0312407X.2023.2237490
Bender, E.M. & Hanna, A. (2025) The AI Con. Penguin Random Home
Colder Carras, M., Machin, Okay., Brown, M., Marttinen, T.-L., Maxwell, C., Frampton, B., Jackman, M., & Jones, N. (2022). Strengthening Evaluate and Publication of Participatory Psychological Well being Analysis to Promote Empowerment and Stop Co-optation. Psychiatric Companies, appi.ps.20220085. https://doi.org/10.1176/appi.ps.20220085
Cooper, R. E., Saunders, Okay. R. Okay., Greenburgh, A., Shah, P., Appleton, R., Machin, Okay., Jeynes, T., Barnett, P., Allan, S. M., Griffiths, J., Stuart, R., Mitchell, L., Chipp, B., Jeffreys, S., Lloyd-Evans, B., Simpson, A., & Johnson, S. (2024). The effectiveness, implementation, and experiences of peer assist approaches for psychological well being: A scientific umbrella evaluate. BMC Medication, 22(1), 72. https://doi.org/10.1186/s12916-024-03260-y
Gillard, S. (2019). Peer assist in psychological well being providers: The place is the analysis taking us, and can we wish to go there? Journal of Psychological Well being, 28(4), 341–344. https://doi.org/10.1080/09638237.2019.1608935
Gillard, S., Bremner, S., Patel, A., Goldsmith, L., Marks, J., Foster, R., Morshead, R., White, S., Gibson, S. L., Healey, A., Lucock, M., Patel, S., Repper, J., Rinaldi, M., Simpson, A., Ussher, M., Worner, J., & Priebe, S. (2022). Peer assist for discharge from inpatient psychological well being care versus care as regular in England (ENRICH): A parallel, two-group, individually randomised managed trial. The Lancet Psychiatry, 9(2), 125–136. https://doi.org/10.1016/S2215-0366(21)00398-9
Ma, Z. (2025). Survivors, customers, or friends? Translating identities and decolonizing psychological well being in China. Transcultural Psychiatry. https://doi.org/10.1177/13634615251359756
Mead, S., Hilton, D., & Curtis, L. (2001). Peer assist: A theoretical perspective. Psychiatric Rehabilitation Journal, 25(2), 134–141.
NHS. (2025). Match for the long run: 10 yr well being plan for England. https://www.england.nhs.uk/long-term-plan/
NHSE. (2020) Workforce, coaching and schooling: Peer assist employees. https://www.hee.nhs.uk/our-work/mental-health/new-roles-mental-health/peer-support-workers
O’Dea, B., Han, J., Batterham, P. J., Achilles, M. R., Calear, A. L., Werner-Seidler, A., Parker, B., Shand, F., & Christensen, H. (2020). A randomised managed trial of a relationship-focussed cell phone software for enhancing adolescents’ psychological well being. Journal of Little one Psychology and Psychiatry, 61(8), 899–913. https://doi.org/10.1111/jcpp.13294
Pavarini, G., Reardon, T., Hollowell, A., Bennett, V., Lawrance, E., Brooks-Corridor, E., Foster-Estwick, A., Juma, D. O., Lewis, P., Energy, L., Rogers, M., Pinfold, V., Singh, I., & Peer Help Younger Individuals’s Advisory Group. (2023). On-line peer assist coaching to advertise adolescents’ emotional assist expertise, psychological well being and company throughout COVID-19: Randomised managed trial and qualitative analysis. European Little one & Adolescent Psychiatry, 32(6), 1119–1130. https://doi.org/10.1007/s00787-021-01933-0
