Henderson, Gregor

MacBeth, Angus

Rogers, Tim

Thomson, Meigan

Vines, John

English

With the high prevalence of mental health problems, particularly for young people, there is an urgent need to increase scalable access to effective mental health support and treatment at population level. Digital mental health (DMH) can play an important role in the mental health ecosystem, offering opportunities to improve access to evidence-based, psychologically informed treatments and support mechanisms. Best practice in digital mental health can also ensure safety and vibrancy of online support environments, alongside clear protocols for risk management. Digital peer support is a common element of DMH products and services, involving people sharing knowledge, experiences, advice, or practical help with each other, and provides benefits that ‘traditional’ face-to-face therapeutic approaches do not. However, further research into the effectiveness, utility, and acceptability of DMH platforms is needed.Our collaborative project worked with Togetherall, a DMH provider, to develop a model of how a DMH peer-support platform works in practice. In doing so we sought to identify stakeholder’s perspectives on commissioning and/or using the platform to develop a model of how the use of DMH peer-support operates in practice, and the benefits it can bring. We developed a Theory of Change (ToC) for DMH peer support to understand the lived experience of how these platforms work for different stakeholders.Findings highlight 3 distinct pathways through the platform for Togetherall staff, members using the platform, and commissioners who signpost to the platform. The platform was felt to fill a service provision gap and increase service-user choice and accessibility. Functionality within the platform to maintain a safe and vibrant community was highlighted as important. Provision of a safe online environment for all members was felt to lead to longer-term improvements in symptoms and wellbeing, whilst also enabling management of individuals in crisis using escalation procedures.DMH peer support was felt to inhabit part of a wider ecosystem of support either imbedded within a care pathway or as an additional component of in-person mental health services. It was also felt to alleviate demand on mental health services, whilst also empowering people to access resources and manage their mental health independently from formal services. We highlight that successful platforms have clear guidance for commissioners and users, have a clear user interface and architecture, and well-designed procedures for risk management and escalation of concerns. Further work is required to better calibrate outcome measurement, understanding what causes members using peer support to disengage, how members perceive and react to supports, and how online social networks work in DMH environments. There are also opportunities to better understand risk management and to develop more responsive legal and regulatory frameworks in the field. Additionally, we highlight the importance of co-production and collaboration between users, DMH providers, commissioners, policy makers and the research community.<br/

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Towards a better understanding of peer support platforms for digital mental health:Learning from stakeholder engagement and mapping a Theory of Change

https://www.research.ed.ac.uk/files/341872572/Policy_BriefDMHPeerSupportFinal2023.pdf

Towards a better understanding of peer support platforms for digital mental health:Learning from stakeholder engagement and mapping a Theory of Change

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