Once I began my PhD examine, 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heard from a few of my individuals, peer supporters had been struggling to be accepted, the NHS relied on paper and outdated applied sciences, and voluntary sector organisations noticed face-to-face conversations as the center of their provide. Why would I select this matter? However how occasions have modified.
Peer supporters are actually established throughout 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 boundaries and enablers to implementation (Cooper et al, 2024). In relation to digital, the most recent NHS 10-year plan guarantees a shift from analogue to digital, “from bricks to clicks” (NHS, 2025).
However with the speedy velocity of developments related to digital, I query how this shift may 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 subjects of digital and peer assist.
What does a shift ‘from bricks to clicks’ imply for peer assist staff?
Strategies
The authors of this evaluate searched tutorial databases for trials of digital peer assist to deal with questions in regards to the results of: completely different sources of the peer assist together with casual and formal; options of digital peer assist reminiscent of dosage and platforms; and components associated to people and nations. 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 information. Their meta-analysis mixed the outcomes throughout the research to measure the impacts that addressed their questions.
How will we join digitally with different folks in peer assist?
Outcomes
The outcomes counsel that digital peer assist had stronger constructive results on psychological well being than on bodily well being, and that digital interventions which embrace casual, naturally occurring peer assist could also be simpler than extra formal choices for wholesome folks. Effectiveness appeared to lower with longer durations, with strategies that this could be as a result of “prolonged durations of intervention end in destructive 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 growing severity of current bodily or psychological well being circumstances. As a result of there weren’t sufficient research to check particular person nations, the authors in contrast Western (e.g. Australia, Canada, Germany, United States) and Jap (e.g. China, Pakistan, Singapore, Taiwan) nations. Digital peer assist interventions had better results on growing psychological well being in Jap nations, and on bettering bodily well being in Western nations.
Three limitations had been recognized: that the research within the evaluate mixed peer assist with completely different therapy elements; that different doubtlessly essential moderators (reminiscent of particular settings) weren’t thought-about; and that the included research had been primarily Western and didn’t report on ethnicity.
Conclusion
The authors conclude that their examine:
advances understanding of efficient digital peer assist for wholesome populations past earlier evaluations and meta-analyses that targeted on people already identified with scientific circumstances (p.7).
How will we outline ‘digital peer assist’?
Strengths and limitations
I’ve a long-standing frustration in regards to 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 prompt 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 “reside or automated companies delivered by way of expertise media” (Fortuna et al., 2020, p.2). Other than essentially questioning the peer-ness of synthetic or automated assist, after 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 focus 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 in regards to the digital interventions, however not often described how, or if, lived experience was utilized in assist, or questioned the expertise required to be thought-about a peer. This didn’t really feel true to see assist values and rules.
Inside this present evaluate, I used to be confused by the inclusion of among the major research. For instance, I had by no means understood the Enrich examine (Gillard et al, 2022) as being about digital peer assist. Their peer assist intervention included an choice of cellphone calls, but it surely didn’t really feel central to their examine. One other instance was a examine in regards to 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 power 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 examine 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 scientific circumstances within the preliminary search. The evaluate supposed to check if digital peer assist could be simpler for wholesome folks, so I might respect the necessity for a comparability with individuals who weren’t wholesome. However an exclusion within the search phrases of “people with scientific circumstances” led to me questioning the inclusion of research the place individuals had been clearly presently or not too long ago utilizing companies reminiscent of inpatient psychiatric companies and most cancers companies. Definitions and a proof are essential to know the populations who may profit from digital peer assist.
One other concern in regards to the search was the shortage of clear boundaries for publication date. Searches had been performed in December 2023 and Might 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 lately, in order that the research had been throughout completely different contexts. I query if they might all be thought-about related to at this time’s observe.
All these questions (and extra) left me with critical doubts about this examine and what it’d add to present observe and understanding. I acknowledge that a few of my doubts might stem from cultural variations for a global examine, and that the language and understandings of peer assist itself may range throughout nations (for instance, see Ma, 2025).
And not using a clear and agreed definition of digital peer assist, it’s not potential to conclude from this evaluate what options of the digital interventions may 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 help. It’s only not too long ago that companies are adopting it by using paid peer assist staff or recognising the worth of the mutual help we’d present informally to one another, together with in on-line boards. However as companies, 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 counsel if any of the workforce had been working from a lived expertise perspective. Admittedly, the researchers might not have needed to reveal their very own experiences (Baldawi et al, 2025). Nevertheless, if peer assist is about lived expertise, then we must be seen and central to research about it, not simply as individuals, however as energetic researchers, advisors, and as a part of the peer evaluate groups for funders and journals. Gillard (2019) factors to the necessity to suppose once more in regards to the impression of analysis strategies on the event of peer assist, and there’s 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 cause for journals to publish research about peer assist that aren’t specific about together with a lived expertise perspective.
There are sufficient issues in regards to the professionalisation of peer assist because it will get absorbed into programs 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 should not misplaced within the course of.
Is ‘digital peer assist’ being outlined with out involving us?
Implications for observe
With my curiosity in digital and peer assist, I’ve turn into 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 deal with competitors and monetary pursuits versus public profit and social justice.
This evaluate provides little to reassure or to affect observe. It’s the unstated gaps which are essential. We don’t know what kind of peer assist, formal or casual, digital or in particular person, may work for various circumstances, nations, well being circumstances and demographic traits. There may be unlikely to be one resolution for all, and there are various gaps to curiosity researchers.
However first, maybe we have to “ask what sort of future we need 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 need to use digital platforms, or we’d not. However we should always definitely be concerned in questioning and creating our future decisions.
What sort of future are we creating, collectively?
Assertion of pursuits
I’m a co-director of each With-you Consultancy Ltd, which offers coaching and consultancy associated to see assist, and the Survivor Researcher Community CIC, which offers 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 principle examine of using digital applied sciences by peer supporters’.
Hyperlinks
Main paper
Yeo, G., Fortuna, Ok. L., Lansford, J. E., & Rudolph, Ok. D. (2025). The results 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, Ok., 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 Forestall Co-optation. Psychiatric Providers, appi.ps.20220085. https://doi.org/10.1176/appi.ps.20220085
Cooper, R. E., Saunders, Ok. R. Ok., Greenburgh, A., Shah, P., Appleton, R., Machin, Ok., 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 companies: The place is the analysis taking us, and will we need 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 common 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 training: Peer assist staff. 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 bettering adolescents’ psychological well being. Journal of Youngster 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 Folks’s Advisory Group. (2023). On-line peer assist coaching to advertise adolescents’ emotional assist abilities, psychological well being and company throughout COVID-19: Randomised managed trial and qualitative analysis. European Youngster & Adolescent Psychiatry, 32(6), 1119–1130. https://doi.org/10.1007/s00787-021-01933-0
