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Impacts of Using Peer Online Forums in Mental Health: Realist Evaluation Using Mixed Methods.
Fiona Lobban1, Neil Caton1, Anna Lindroos Cermakova1
1Spectrum Centre, Department of Health Research, Lancaster University, Lancaster, United Kingdom.
Journal of Medical Internet Research
|October 1, 2025
Summary
Peer online mental health forums provide accessible support, largely benefiting users through increased self-efficacy and well-being. Positive impacts depend on user-friendly design and effective moderation for safe, supportive online interactions.
Area of Science:
- Mental Health Research
- Online Support Systems
- Digital Health
Background:
- Peer online forums offer accessible, anonymous mental health support.
- Understanding the mechanisms and beneficiaries of these forums is limited.
Purpose of the Study:
- Develop a program theory for peer online mental health forums.
- Inform users, professionals, and commissioners on forum selection and utilization.
Main Methods:
- Realist evaluation with a mixed-methods case series design.
- Triangulated analysis of web surveys (n=791) and interviews (n=52).
- In-situ analysis of consented forum posts, guided by a patient and public involvement group.
Main Results:
- Largely positive impacts include feeling understood, accepted, increasing self-efficacy, reducing self-stigma, and enhancing mental well-being.
- Positive outcomes are linked to easy navigation, safe posting environments, and responsive moderation.
- Negative impacts arise from poor navigation or inadequate moderation, leading to feelings of being unheard or overburdened.
Conclusions:
- Peer online forums are effective, accessible, and inclusive mental health support tools for many.
- Careful design and well-trained moderators are crucial for maximizing positive impacts.
- Findings inform the development of a moderator toolkit and design guidelines.
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