Qualitative Exploration of the Potential for Adverse Events When Using an Online Peer Support Network for Mental Health: Cross-Sectional Survey

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.

A Novel Multimodal Digital Service (Moderated Online Social Therapy+) for Help-Seeking Young People Experiencing Mental Ill-Health: Pilot Evaluation Within a National Youth E-Mental Health Service

“…Against this backdrop, it is essential to develop evidence-based social media–enabled interventions that promote social support while ensuring safety and diminishing harmful consequences. A number of studies from our research lab [ 42 - 44 , 55 ] and others [ 39 ] have shown that carefully designed moderated web-based social media interventions can be safely implemented and are not associated with harmful effects. This study adds to this growing body of evidence by demonstrating that web-based social media interventions can be safely deployed to help-seeking young people via a national web counseling service.…”

“…That said, the type and function of online peer support groups and SNS appear to have a significant effect on their outcomes. For example, unmoderated forums and SNS can lead to increased contagion, distress, and collusion among users [ 39 ]. Conversely, SNS interventions that have been moderated, ideally by professionals, have been found to be safe, engaging, supportive, and useful [ 39 , 41 - 44 ].…”

“…For example, unmoderated forums and SNS can lead to increased contagion, distress, and collusion among users [ 39 ]. Conversely, SNS interventions that have been moderated, ideally by professionals, have been found to be safe, engaging, supportive, and useful [ 39 , 41 - 44 ]. This is in keeping with the findings that young people with mental ill-health have a strong preference for purpose-built, moderated, social media–based interventions enabling peer-to-peer contact as well as clinician support [ 45 ].…”

Examining the Relationship Between the Use of a Mobile Peer-Support App and Self-Injury Outcomes: Longitudinal Mixed Methods Study

“…These elements could be optional and be offered based on the individual’s use patterns. Finally, although the tendency has been to remove graphic, or potentially triggering, content from platforms, there have been discussions about the dangers of overmoderation [ 79 , 81 , 82 ] and the benefits of self-expression [ 83 ]. Our findings suggest a need to consider safe ways of moderating content while also allowing free expression.…”

A Novel Multimodal Digital Service (Moderated Online Social Therapy+) for Help-Seeking Young People Experiencing Mental Ill-Health: Pilot Evaluation Within a National Youth E-Mental Health Service (Preprint)

“…A growing number of online peer support groups and social networking sites (SNS) exist for people with mental health problems. Overall, the extant evidence suggests that online peer support groups can foster a sense of social connectedness, empowerment, and improved quality of life as well as reduce depression and emotional distress [38][39][40]. That said, the type and function of online peer support groups and SNS appear to have a significant effect on their outcomes.…”