Considerations in Designing Digital Peer Support for Mental Health: Interview Study Among Users of a Digital Support System (Buddy Project)

Abstract

Background Peer support is an approach to cope with mental illness, and technology provides a way to facilitate peer support. However, there are barriers to seeking support in offline and technology-mediated contexts. Objective This study aims to uncover potential ways to design digital mental health peer support systems and to outline a set of principles for future designers to consider as they embark on designing these systems. By learning how existing systems are used by people in daily life and by centering their experiences, we can better understand how to design mental health peer support technologies that foreground people’s needs. One existing digital peer support system is Buddy Project, the case study in this paper. Methods This paper reports on an interview study with Buddy Project users (N=13). Data were analyzed using the constant comparative approach. Results Individuals matched through Buddy Project developed supportive friendships with one another, leading them to become each other’s peer supporters in their respective journeys. It was not only the mental health peer support that was important to participants but also being able to connect over other parts of their lives and identities. The design of Buddy Project provided a sense of anonymity and separation from pre-existing ties, making it easier for participants to disclose struggles; moreover, the pairs appreciated being able to browse each other’s social media pages before connecting. Buddy Project has an explicit mission to prevent suicide and demonstrates this mission across its online platforms, which helps reduce the stigma around mental health within the peer support space. Pairs were matched based on shared interests and identities. This choice aided the pairs in developing meaningful, compatible, and supportive relationships with each other, where they felt seen and understood. However, the pairs were concerned that matching based on a shared mental health diagnosis may lead to sharing unhealthy coping mechanisms or comparing themselves and the severity of their experiences with their peers. Conclusions The results of this study shed light on desirable features of a digital mental health peer support system: matching peers based on interests and identities that they self-identify with; having an explicit mental health–related mission coupled with social media and other web-based presences to signal that discussing mental health is safe within the peer support ecosystem; and not matching peers based on a broad mental health diagnosis. However, if the diagnosis is important, this matching should account for illness severity and educate peers on how to provide support while avoiding suggesting unhelpful coping mechanisms; allowing for some degree of anonymity and control over how peers present themselves to each other; and providing relevant information and tools to potential peers to help them decide if they would like to embark on a relationship with their matched peer before connecting with them.

Understanding University Students’ Experiences, Perceptions, and Attitudes Toward Peers Displaying Mental Health–Related Problems on Social Networking Sites: Online Survey and Interview Study

“…Social media helps college students, in general [22], and those who are suffering to attain improved mental well-being, in particular [9,10]. Thus, researchers have identified numerous factors that drive online social support [23] and have proposed computing platforms that would promote online mental health support from peers [17,24]. Despite the demonstrated importance of online social support, researchers have yet to empirically study the motives and challenges behind such support from the perspective of the peers who are expected to provide it.…”

Effective Strategies for Crowd-Powered Cognitive Reappraisal Systems: A Field Deployment of the Flip*Doubt Web Application for Mental Health

“…However, this heuristic approach is not personalized to the user or context. A substantial body of work has highlighted the need for such personalization as an area for future research in the study of mental health BITs (e.g., [59,71,72,93]), as well as the vital need to incorporate peer supporters [4,24,44,67,68]. Crowdsourcing is thus a second approach that can help to leverage peer support, provide users with personalized reframes, and scale BITs outside of the supervision of professional therapists.…”

“…Other papers focus matching chat partners. For example, Andalibi & Flood interviewed users of Buddy Project, which connects anonymous youths struggling with mental health [4]. Unlike physical illnesses such as cancer [32,51,89] or rare diseases [52], where research has established that matching based on condition is a crucial goal, [4] found that users should be paired based on shared interests or identity, rather than mental health diagnoses, since over-exposure to the same mental illness can lead to unhealthy comparisons or disordered coping mechanisms.…”

“…Therefore, it has become vitally important to consider new ways to expand models of delivery for therapeutic interventions beyond individual or group therapy with clinical, licensed psychotherapists [44]. In particular, the psychology [44,77] and social computing [4,24,67,68] literature strongly advocate for a need to involve well-intentioned peers (e.g., friends, family, community volunteers, or other strangers online) in mental health interventions, even without professional training or knowledge, both because peers are particularly well-positioned to provide support, and because peer support is often crucial or necessary for recovery.…”

Towards a Design Space for Emotion Recognition

“…In automotive industry, emotion recognition coupled with behavioral interventions can help drivers to reduce their stress levels as well as the risk of car accidents [24,25,32]. Emotion recognition has a large range of applicability, being also studied for healthcare delivery [3,19], mental health [26], assistive technologies [33], and games [15].…”