After I began my PhD research, earlier than the Covid pandemic, I’d get requested why I used to be taking a look at 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heard from a few of my individuals, peer supporters had been struggling to be accepted, the NHS relied on paper and outdated applied sciences, and voluntary sector organisations noticed face-to-face conversations as the guts of their supply.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 occasions have modified.
Peer supporters at the moment are established inside the psychological well being workforce throughout England (NHSE, 2020) and a latest systematic umbrella evaluate of peer assist, beforehand featured in these woodlands, has described its effectiveness in addition to limitations 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 fast 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 latest 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 staff?
Strategies
The authors of this evaluate searched educational databases for trials of digital peer assist to deal with questions in regards to the results of: totally different sources of the peer assist together with casual and formal; options of digital peer assist akin to dosage and platforms; and elements associated to people and international locations. They had been particularly within the impacts on wholesome individuals, 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 can we join digitally with different individuals 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 embrace casual, naturally occurring peer assist could also be more practical than extra formal choices for wholesome individuals. Effectiveness appeared to lower with longer durations, with ideas that this is likely to be as a result of “prolonged intervals of intervention end in destructive interactions with friends” (p.6). For each bodily and psychological well being, extra interactive platforms had been more practical: apps, social networks and video conferencing had been more practical than boards and dialogue boards, web sites and others (emails, texts and cellphone).
The influence 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 situations. As a result of there weren’t sufficient research to match 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 elements; that different probably necessary moderators (akin to 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 research:
advances understanding of efficient digital peer assist for wholesome populations past earlier opinions and meta-analyses that centered on people already recognized with scientific situations (p.7).
How can 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 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 “dwell or automated providers delivered via know-how media” (Fortuna et al., 2020, p.2). Except for 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 taking a look at, 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 individuals with lived expertise to assist different individuals 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 look assist values and rules.
Inside this present evaluate, I used to be confused by the inclusion of a number of the main 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, but it surely didn’t really feel central to their research. One other instance was a research in regards to the influence 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 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 individuals, in phrases like “peer victimisation” (p.899) and “peer battle” (p.902). These are just some 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 individuals and individuals with scientific situations within the preliminary search. The evaluate meant to check if digital peer assist is likely to be more practical for wholesome individuals, so I may admire the necessity for a comparability with individuals who weren’t wholesome. However an exclusion within the search phrases of “people with scientific situations” led to me questioning the inclusion of research the place individuals had been clearly at present or lately utilizing providers akin to inpatient psychiatric providers and most cancers providers. Definitions and an evidence are necessary to grasp the populations who would possibly 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 carried out 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 in recent times, in order that the research had been throughout totally different contexts. I query if they’d all be thought-about related to as we speak’s observe.
All these questions (and extra) left me with severe doubts about this research and what it would add to present observe and understanding. I acknowledge that a few of my doubts could stem from cultural variations for a world research, and that the language and understandings of peer assist itself would possibly fluctuate throughout international locations (for instance, see Ma, 2025).
With out a clear and agreed definition of digital peer assist, it’s not doable 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 individuals 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 person teams and mutual support. It is just lately that providers are adopting it by using paid peer assist staff 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 danger 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 staff 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). Nevertheless, if peer assist is about lived expertise, then we have to 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 suppose once more in regards to the influence of analysis strategies on the event of peer assist, and there may be revealed recommendation for journal editors and reviewers with helpful inquiries to be requested about participation (Colder Carras et al, 2022).
All in, there isn’t a purpose for journals to publish research about peer assist that aren’t specific about together with a lived expertise perspective.
There are sufficient considerations in regards to the professionalisation of peer assist because it will get absorbed into methods 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 will not be 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 vital harms. With tales together with the excessive profile and rising considerations round 7 cups, the Nationwide Consuming Problems Affiliation’s elimination 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 presents little to reassure or to affect observe. 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 situations and demographic traits. There’s unlikely to be one answer 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 individuals, particularly individuals with lived experience. We’d need to use digital platforms, or we would not. However we should always definitely 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 gives coaching and consultancy associated to look assist, and the Survivor Researcher Community CIC, which gives 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 signify 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 research of using digital applied sciences by peer supporters’.
Hyperlinks
Major paper
Yeo, G., Fortuna, Ok. L., Lansford, J. E., & Rudolph, Ok. 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, 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 Stop 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 Drugs, 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 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 ordinary 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 longer term: 10 yr well being plan for England. https://www.england.nhs.uk/long-term-plan/
NHSE. (2020) Workforce, coaching and schooling: 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 enhancing 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 expertise, 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
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