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The future of mental health care: peer-to-peer support and social media

  • J. A. Naslund (a1) (a2), K. A. Aschbrenner (a1) (a2) (a3), L. A. Marsch (a3) (a4) and S. J. Bartels (a1) (a2) (a3) (a5)

Abstract

Aims:

People with serious mental illness are increasingly turning to popular social media, including Facebook, Twitter or YouTube, to share their illness experiences or seek advice from others with similar health conditions. This emerging form of unsolicited communication among self-forming online communities of patients and individuals with diverse health concerns is referred to as peer-to-peer support. We offer a perspective on how online peer-to-peer connections among people with serious mental illness could advance efforts to promote mental and physical wellbeing in this group.

Methods:

In this commentary, we take the perspective that when an individual with serious mental illness decides to connect with similar others online it represents a critical point in their illness experience. We propose a conceptual model to illustrate how online peer-to-peer connections may afford opportunities for individuals with serious mental illness to challenge stigma, increase consumer activation and access online interventions for mental and physical wellbeing.

Results:

People with serious mental illness report benefits from interacting with peers online from greater social connectedness, feelings of group belonging and by sharing personal stories and strategies for coping with day-to-day challenges of living with a mental illness. Within online communities, individuals with serious mental illness could challenge stigma through personal empowerment and providing hope. By learning from peers online, these individuals may gain insight about important health care decisions, which could promote mental health care seeking behaviours. These individuals could also access interventions for mental and physical wellbeing delivered through social media that could incorporate mutual support between peers, help promote treatment engagement and reach a wider demographic. Unforeseen risks may include exposure to misleading information, facing hostile or derogatory comments from others, or feeling more uncertain about one's health condition. However, given the evidence to date, the benefits of online peer-to-peer support appear to outweigh the potential risks.

Conclusion:

Future research must explore these opportunities to support and empower people with serious mental illness through online peer networks while carefully considering potential risks that may arise from online peer-to-peer interactions. Efforts will also need to address methodological challenges in the form of evaluating interventions delivered through social media and collecting objective mental and physical health outcome measures online. A key challenge will be to determine whether skills learned from peers in online networks translate into tangible and meaningful improvements in recovery, employment, or mental and physical wellbeing in the offline world.

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Copyright

Corresponding author

*Address for correspondence: J. A. Naslund, Health Promotion Research Center at Dartmouth, Lebanon, 46 Centerra Parkway, Lebanon, New Hampshire 03766, USA. (Email: john.a.naslund@gmail.com)

References

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Alvarez-Jimenez, M, Bendall, S, Lederman, R, Wadley, G, Chinnery, G, Vargas, S, Larkin, M, Killackey, E, McGorry, P, Gleeson, J (2013). On the HORYZON: moderated online social therapy for long-term recovery in first episode psychosis. Schizophrenia Research 143, 143149.
Alvarez-Jimenez, M, Alcazar-Corcoles, M, Gonzalez-Blanch, C, Bendall, S, McGorry, P, Gleeson, J (2014). Online, social media and mobile technologies for psychosis treatment: a systematic review on novel user-led interventions. Schizophrenia Research 156, 96106.
Armstrong, N, Powell, J (2009). Patient perspectives on health advice posted on Internet discussion boards: a qualitative study. Health Expectations 12, 313320.
Bargh, JA, McKenna, KY, Fitzsimons, GM (2002). Can you see the real me? Activation and expression of the “true self” on the Internet. Journal of Social Issues 58, 3348.
Bargh, JA, McKenna, KYA (2004). The Internet and social life. Annual Review of Psychology 55, 573590.
Bartels, SJ, Aschbrenner, KA, Rolin, SA, Hendrick, DC, Naslund, JA, Faber, MJ (2013). Activating older adults with serious mental illness for collaborative primary care visits. Psychiatric Rehabilitation Journal 36, 278288.
Berger, M, Wagner, TH, Baker, LC (2005). Internet use and stigmatized illness. Social Science & Medicine 61, 18211827.
Brewer, MB (1991). The social self: on being the same and different at the same time. Personality and Social Psychology Bulletin 17, 475482.
Burns, JM, Durkin, LA, Nicholas, J (2009). Mental health of young people in the United States: what role can the internet play in reducing stigma and promoting help seeking? Journal of Adolescent Health 45, 9597.
Caplan, SE (2003). Preference for online social interaction a theory of problematic Internet use and psychosocial well-being. Communication Research 30, 625648.
Chung, JE (2013). Social interaction in online support groups: preference for online social interaction over offline social interaction. Computers in Human Behavior 29, 14081414.
Chung, JE (2014). Social networking in online support groups for health: how online social networking benefits patients. Journal of Health Communication 19, 639659.
Corrigan, PW (1998). The impact of stigma on severe mental illness. Cognitive and Behavioral Practice 5, 201222.
Corrigan, PW (2004). How stigma interferes with mental health care. American Psychologist 59, 614625.
Corrigan, PW, Kosyluk, KA, Rüsch, N (2013). Reducing self-stigma by coming out proud. American Journal of Public Health 103, 794800.
Corrigan, PW, Morris, S, Larson, J, Rafacz, J, Wassel, A, Michaels, P, Wilkniss, S, Batia, K, Rüsch, N (2010). Self-stigma and coming out about one's mental illness. Journal of Community Psychology 38, 259275.
Corrigan, PW, Thompson, V, Lambert, D, Sangster, Y, Noel, JG, Campbell, J (2003). Perceptions of discrimination among persons with serious mental illness. Psychiatric Services 54, 11051110.
Crabtree, JW, Haslam, SA, Postmes, T, Haslam, C (2010). Mental health support groups, stigma, and self-esteem: positive and negative implications of group identification. Journal of Social Issues 66, 553569.
Davidson, L, Chinman, M, Kloos, B, Weingarten, R, Stayner, D, Tebes, JK (1999). Peer support among individuals with severe mental illness: a review of the evidence. Clinical Psychology: Science and Practice 6, 165187.
Dickerson, FB, Sommerville, J, Origoni, AE, Ringel, NB, Parente, F (2001). Outpatients with schizophrenia and bipolar I disorder: do they differ in their cognitive and social functioning? Psychiatry Research 102, 2127.
Dixon, L (1995). Effects of homelessness on the quality of life of persons with severe mental illness. Psychiatric Services 46, 922926.
Duggan, M (2015). Mobile Messaging and Social Media 2015. Pew Research Center: http://www.pewinternet.org/2015/08/19/mobile-messaging-and-social-media-2015/
Entwistle, VA, France, EF, Wyke, S, Jepson, R, Hunt, K, Ziebland, S, Thompson, A (2011). How information about other people's personal experiences can help with healthcare decision-making: a qualitative study. Patient Education and Counseling 85, e291e298.
Folsom, DP, Hawthorne, W, Lindamer, L, Gilmer, T, Bailey, A, Golshan, S, Garcia, P, Unützer, J, Hough, R, Jeste, DV (2005). Prevalence and risk factors for homelessness and utilization of mental health services among 10 340 patients with serious mental illness in a large public mental health system. American Journal of Psychiatry 162, 370376.
Goodman, LA, Rosenberg, SD, Mueser, KT, Drake, RE (1997). Physical and sexual assault history in women with serious mental illness: prevalence, correlates, treatment, and future research directions. Schizophrenia Bulletin 23, 685696.
Gowen, K, Deschaine, M, Gruttadara, D, Markey, D (2012). Young adults with mental health conditions and social networking websites: seeking tools to build community. Psychiatric Rehabilitation Journal 35, 245250.
Haker, H, Lauber, C, Rössler, W (2005). Internet forums: a self-help approach for individuals with schizophrenia? Acta Psychiatrica Scandinavica 112, 474477.
Harvey, KJ, Brown, B, Crawford, P, Macfarlane, A, McPherson, A (2007). ‘Am I normal?’ Teenagers, sexual health and the internet. Social Science & Medicine 65, 771781.
Hert, M, Cohen, D, Bobes, J, Cetkovich-Bakmas, M, Leucht, S, Ndetei, DM, Newcomer, JW, Uwakwe, R, Asai, I, Moller, H-J (2011). Physical illness in patients with severe mental disorders. II. Barriers to care, monitoring and treatment guidelines, plus recommendations at the system and individual level. World Psychiatry 10, 138151.
Hiday, VA, Swartz, MS, Swanson, JW, Borum, R, Wagner, HR (1999). Criminal victimization of persons with severe mental illness. Psychiatric Services 50, 6268.
Highton-Williamson, E, Priebe, S, Giacco, D (2015). Online social networking in people with psychosis: a systematic review. International Journal of Social Psychiatry 61, 92101.
Kaplan, K, Salzer, MS, Solomon, P, Brusilovskiy, E, Cousounis, P (2011). Internet peer support for individuals with psychiatric disabilities: a randomized controlled trial. Social Science & Medicine 72, 5462.
Kemp, S (2015). Digital, social and mobile worldwide in 2015. We Are Social: http://wearesocial.net/blog/2015/01/digital-social-mobile-worldwide-2015/
Kessler, RC, Barker, PR, Colpe, LJ, Epstein, JF, Gfroerer, JC, Hiripi, E, Howes, MJ, Normand, S-LT, Manderscheid, RW, Walters, EE (2003). Screening for serious mental illness in the general population. Archives of General Psychiatry 60, 184189.
Kummervold, PE, Gammon, D, Bergvik, S, Johnsen, J-AK, Hasvold, T, Rosenvinge, JH (2002). Social support in a wired world: use of online mental health forums in Norway. Nordic Journal of Psychiatry 56, 5965.
Lam, JA, Rosenheck, R (1998). The effect of victimization on clinical outcomes of homeless persons with serious mental illness. Psychiatric Services 49, 678683.
Lauder, S, Chester, A, Castle, D, Dodd, S, Gliddon, E, Berk, L, Chamberlain, J, Klein, B, Gilbert, M, Austin, DW (2015). A randomized head to head trial of MoodSwings.net.au: an internet based self-help program for bipolar disorder. Journal of Affective Disorders 171, 1321.
Lawlor, A, Kirakowski, J (2014). Online support groups for mental health: a space for challenging self-stigma or a means of social avoidance? Computers in Human Behavior 32, 152161.
Lederman, R, Wadley, G, Gleeson, J, Bendall, S, Álvarez-Jiménez, M (2014). Moderated online social therapy: designing and evaluating technology for mental health. ACM Transactions on Computer-Human Interaction (TOCHI) 21, 132.
Link, BG, Struening, EL, Rahav, M, Phelan, JC, Nuttbrock, L (1997). On stigma and its consequences: evidence from a longitudinal study of men with dual diagnoses of mental illness and substance abuse. Journal of Health and Social Behavior 177190.
Lowe, P, Powell, J, Griffiths, F, Thorogood, M, Locock, L (2009). “Making it all normal”: the role of the internet in problematic pregnancy. Qualitative Health Research 19, 14761484.
McGrane, K (2013). The rise of the mobile-only user. Harvard Business Review: https://hbr.org/2013/05/the-rise-of-the-mobile-only-us/
McKenna, KY, Bargh, JA (1998). Coming out in the age of the Internet: identity “demarginalization” through virtual group participation. Journal of Personality and Social Psychology 75, 681694.
Miller, BJ, Stewart, A, Schrimsher, J, Peeples, D, Buckley, PF (2015). How connected are people with schizophrenia? Cell phone, computer, email, and social media use. Psychiatry Research 225, 458463.
Mittal, VA, Tessner, KD, Walker, EF (2007). Elevated social Internet use and schizotypal personality disorder in adolescents. Schizophrenia Research 94, 5057.
Mo, PK, Coulson, NS (2010). Empowering processes in online support groups among people living with HIV/AIDS: a comparative analysis of ‘lurkers’ and ‘posters’. Computers in Human Behavior 26, 11831193.
Murray, CJ, Lopez, AD (1997). Alternative projections of mortality and disability by cause 1990–2020: global burden of disease study. The Lancet 349, 14981504.
Napolitano, MA, Hayes, S, Bennett, GG, Ives, AK, Foster, GD (2013). Using Facebook and text messaging to deliver a weight loss program to college students. Obesity 21, 2531.
Naslund, JA, Grande, SW, Aschbrenner, KA, Elwyn, G (2014). Naturally occurring peer support through social media: the experiences of individuals with severe mental illness using YouTube. PloS ONE 9, e110171.
Naslund, JA, Aschbrenner, KA, Barre, LK, Bartels, SJ (2015a). Feasibility of popular m-Health technologies for activity tracking among individuals with serious mental illness. Telemedicine and e-Health 21, 213216.
Naslund, JA, Aschbrenner, KA, Marsch, LA, McHugo, GJ, Bartels, SJ (2015b). Crowdsourcing for conducting randomized trials of Internet delivered interventions in people with serious mental illness: a systematic review. Contemporary Clinical Trials 44, 7788.
Naslund, JA, Marsch, LA, McHugo, GJ, Bartels, SJ (2015c). Emerging mHealth and eHealth interventions for serious mental illness: a review of the literature. Journal of Mental Health 24, 321332.
Parr, H (2008). Mental Health and Social Space: Towards Inclusionary Geographies? Blackwell Publishing: Malden, MA.
Patel, V, Araya, R, Chatterjee, S, Chisholm, D, Cohen, A, De Silva, M, Hosman, C, McGuire, H, Rojas, G, van Ommeren, M (2007). Treatment and prevention of mental disorders in low-income and middle-income countries. The Lancet 370, 9911005.
Perry, BL, Pescosolido, BA (2015). Social network activation: the role of health discussion partners in recovery from mental illness. Social Science & Medicine 125, 116128.
Pew Research Center (2014). Emerging Nations Embrace Internet, Mobile Technology. Pew Research Center: http://www.pewglobal.org/2014/02/13/emerging-nations-embrace-internet-mobile-technology/
Pompili, M, Lester, D, Innamorati, M, Tatarelli, R, Girardi, P (2008). Assessment and treatment of suicide risk in schizophrenia. Expert Review of Neurotherapeutics 8, 5174.
Powell, J, McCarthy, N, Eysenbach, G (2003). Cross-sectional survey of users of Internet depression communities. BMC Psychiatry 3, 19.
RachBeisel, J, Scott, J, Dixon, L (1999). Co-occurring severe mental illness and substance use disorders: a review of recent research. Psychiatric Services 50, 14271434.
Ramo, DE, Thrul, J, Delucchi, KL, Ling, PM, Hall, SM, Prochaska, JJ (2015). The Tobacco Status Project (TSP): study protocol for a randomized controlled trial of a Facebook smoking cessation intervention for young adults. BMC Public Health 15, 897.
Raupach, JC, Hiller, JE (2002). Information and support for women following the primary treatment of breast cancer. Health Expectations 5, 289301.
Schrank, B, Sibitz, I, Unger, A, Amering, M (2010). How patients with schizophrenia use the Internet: qualitative study. Journal of Medical Internet Research 12, e70.
Simon, GE, Ludman, EJ, Goodale, LC, Dykstra, DM, Stone, E, Cutsogeorge, D, Operskalski, B, Savarino, J, Pabiniak, C (2011). An online recovery plan program: can peer coaching increase participation? Psychiatric Services 62, 666669.
Smith, A (2015). U.S. smartphone use in 2015. Pew Research Center: http://www.pewinternet.org/2015/04/01/us-smartphone-use-in-2015/
Smith, DJ, Griffiths, E, Poole, R, Di Florio, A, Barnes, E, Kelly, MJ, Craddock, N, Hood, K, Simpson, S (2011). Beating bipolar: exploratory trial of a novel internet-based psychoeducational treatment for bipolar disorder. Bipolar Disorders 13, 571577.
Sokal, J, Messias, E, Dickerson, FB, Kreyenbuhl, J, Brown, CH, Goldberg, RW, Dixon, LB (2004). Comorbidity of medical illnesses among adults with serious mental illness who are receiving community psychiatric services. The Journal of Nervous and Mental Disease 192, 421427.
Spinzy, Y, Nitzan, U, Becker, G, Bloch, Y, Fennig, S (2012). Does the Internet offer social opportunities for individuals with schizophrenia? A cross-sectional pilot study. Psychiatry Research 198, 319320.
Todd, NJ, Jones, SH, Hart, A, Lobban, FA (2014). A web-based self-management intervention for bipolar disorder ‘Living with Bipolar’: a feasibility randomised controlled trial. Journal of Affective Disorders 169, 2129.
Tomes, N (2006). The patient as a policy factor: a historical case study of the consumer/survivor movement in mental health. Health Affairs 25, 720729.
van Uden-Kraan, CF, Drossaert, CH, Taal, E, Seydel, ER, van de Laar, MA (2008). Self-reported differences in empowerment between lurkers and posters in online patient support groups. Journal of Medical Internet Research 10, e18.
van Uden-Kraan, CF, Drossaert, CH, Taal, E, Seydel, ER, van de Laar, MA (2009). Participation in online patient support groups endorses patients’ empowerment. Patient Education and Counseling 74, 6169.
Wang, PS, Demler, O, Kessler, RC (2002). Adequacy of treatment for serious mental illness in the United States. American Journal of Public Health 92, 9298.
Whitley, R, Campbell, RD (2014). Stigma, agency and recovery amongst people with severe mental illness. Social Science & Medicine 107, 18.
Ziebland, S, Wyke, S (2012). Health and illness in a connected world: how might sharing experiences on the internet affect people's health? Milbank Quarterly 90, 219249.

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