This study builds upon previous research examining the role of online peer support communities for persons living with mental health conditions [19, 20]. The dramatic shift to virtual care necessitated by the COVID-19 pandemic has substantially altered the delivery of mental health services  and has prompted us to inquire how we can better meet the needs of persons living with mental health conditions. As part of this inquiry, we examined the patterns of use evident within online communities during the pandemic and explored whether there may be interest among persons living with mental health conditions to access evidence-based resources or interventions through these digital spaces.
Importantly, our findings highlight that some persons living with mental health conditions appear interested in accessing additional evidence-based programs, such as psychoeducational resources and other interventions via online peer support communities. This could lead to innovative collaborations between online peer support communities and conventional care, as these persons tend to be most interested in evidence-based interventions and services related to enhancing coping mechanisms and skills, enabling overall wellbeing, and supporting access to therapy. Encouragingly, a recent systematic review of digital peer support interventions for persons with a lived experience of a serious mental illness found that peer-to-peer networks combined with evidence-based practice interventions reported statistically significant improvements in psychiatric symptoms . Taken together, these findings suggest that online peer support communities should be explored further as a potential avenue for collaboration, particularly for delivery of effective, evidence-based programs, and as a tool that might help bridge gaps in service delivery.
This is especially important to research further as the expansion of teletherapy alone, as necessitated by the COVID-19 pandemic, has not brought an influx of new patients into the care delivery system. According to data from recent TIME/Harris Poll national surveys, only 5% of 3,214 respondents indicated they received mental health services for the first time during the height of the COVID-19 crisis . This suggests that despite the growth in digital methods of care delivery, issues in accessing support services and evidence-based interventions persist. A recent RAND Corporation report found that only 45% of people with a mental illness in the US received any mental health treatment in 2019 . The gap in access is more pronounced among particular segments of the population. Despite similar levels of mental health care need, racial/ethnic minorities in the United States are half as likely to use mental health care as non-Hispanic Whites . As such, researchers and healthcare providers need to continue exploring a range of mechanisms for facilitating access. In this context, the potential of online peer support communities as avenues for collaboration, complementary support, and delivery of evidence-based services should be further investigated.
Peer support is seen as an essential recovery service for people with mental health conditions globally  and is currently being implemented in some primary care settings as a patient-centered approach . In the United States, the recently passed PEERS Act provides Medicare coverage of peer support services for individuals with mental illness and/or substance use disorders who are receiving integrated behavioral health services . This legislation ensures peer support specialists are recognized and compensated, incentivizing the development of novel methods that deliver formal peer services online. Such peer support, whether in-person/digital or formal/informal, may encourage persons to initially seek out care and continue with care . The growing recognition of the potential benefits of peer support – and the digital communities built to encourage such interactions – could help scholars and practitioners develop mental healthcare delivery models that align conventional care and online support on a larger scale. Moreover, collaborations between existing digital peer support communities and formal mental health services could potentially mitigate some barriers to access and streamline interventions, as many patients already complement traditional health care trajectories by exchanging information about conditions and guidance in treatments via online peer support communities .
Further research is required to determine best practices in developing collaborative care delivery models that align digital peer support communities with formal mental health services. This study suggests that persons living with mental health conditions may be interested in the evolution of such models and any further research should closely involve target audiences across the development, testing, and implementation stages.
More research is needed to determine the often invisible and unrecognized ways in which online peer support communities are already part of the care system and could further complement formal care. Future studies are needed that investigate this topic longitudinally and across a wide range of online peer support communities, especially given the differences in reach and target audiences across the diversity of online platforms. Investigating this topic across other online peer support communities is vital as our study contained a sample who tended to be female, non-Hispanic white, older, and highly educated. As such, it is critical to expand the reach of this exploratory research to investigate how interest in evidence-based interventions through these communities differs by gender, race, age, education, and socioeconomic demographics.
More research is also needed to explore the specific types and mediums of evidence-based interventions and resources that may be of interest and how they should be distributed in these communities according to persons living with mental health conditions. This study did not aim to explore these specifics but rather set the stage for future investigations into the development and dissemination of such resources, particularly for those at the earliest stages of intervention. An important area of future research also involves examining how evidence-based interventions offered through online peer support communities can offer safe virtual environments for diverse population groups and democratize access to care for underserved racial and ethnic minority groups.
Our study found that respondents who use online peer support communities at least once a day or at least once a week are more likely to self-report that these communities contributed to benefits to their mental health. This finding is vulnerable to selection bias as respondents who see benefits in the use of online peer support platforms are more likely to use the platform more frequently. This can be addressed in future research by engaging a larger sample of online peer support community members who exhibit diverse patterns of community use. If the finding is replicated among this larger and more diverse group, it would offer further evidence supporting an association between frequency of online peer support community use and self-reported benefits to mental health.