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A growing gap has emerged between people with mental illness and health care professionals, which in recent years has been successfully closed through the adoption of peer support services (PSSs). Peer support in mental health has been variously defined in the literature and is simply known as the help and support that people with lived experience of mental illness or a learning disability can give to one another. Although PSSs date back to several centuries, it is only in the last few decades that these services have formally evolved, grown, and become an integral part of the health care system. Debates around peer support in mental health have been raised frequently in the literature. Although many authors have emphasized the utmost importance of incorporating peer support into the health care system to instill hope; to improve engagement, quality of life, self-confidence, and integrity; and to reduce the burden on the health care system, other studies suggest that there are neutral effects from integrating PSSs into health care systems, with a probable waste of resources. In this general review, we aimed to examine the literature, exploring the evolution, growth, types, function, generating tools, evaluation, challenges, and the effect of PSSs in the field of mental health and addiction. In addition, we aimed to describe PSSs in different, nonexhaustive contexts, as shown in the literature, that aims to draw attention to the proposed values of PSSs in such fields. The review was conducted through a general search of the literature on MEDLINE, Google Scholar, EMBASE, Scopus, Chemical Abstracts, and PsycINFO. Search terms included peer support, peer support in mental health, social support, peer, family support, and integrated care. There is abundant literature defining and describing PSSs in different contexts as well as tracking their origins. Two main transformational concepts have been described, namely, intentional peer support and transformation from patients to peer support providers. The effects of PSSs are extensive and integrated into different fields, such as forensic PSSs, addiction, and mental health, and in different age groups and mental health condition severity. Satisfaction of and challenges to PSS integration have been clearly dependent on a number of factors and consequently impact the future prospect of this workforce. There is an internationally growing trend to adopt PSSs within addiction and mental health services, and despite the ongoing challenges, large sections of the current literature support the inclusion of peer support workers in the mental health care workforce. The feasibility and maintenance of a robust PSS in health care would only be possible through collaborative efforts and ongoing support and engagement from all health care practitioners, managers, and other stakeholders.

A high prevalence of psychological distress and unmet mental health needs among youth, combined with a preference for self-reliance and informal support (e.g., peers), poses a major public health challenge. Growing reliance on digital platforms highlights the potential of anonymized online peer support forums as accessible first-line avenues of support. In India, research on peer support interventions remains scarce. This study aimed to identify the concerns for which Indian youth engage in an anonymized, moderated online peer support forum, as well as the purposes for posting. A retrospective qualitative design was employed, analyzing all 137 posts of 124 unique users received between February 2024 and October 2025 on the forum using hybrid thematic analysis. Findings revealed that user posts encompassed diverse concerns across personal, relational, social, and achievement domains. Feeling states emerged as the most prominent theme, frequently co-occurring with other themes, followed by self-related concerns. Several posts explicitly mentioned mental health concerns such as depression and social anxiety, often without mention of professional help-seeking suggestions. Family-related issues, romantic relationship concerns, academic pressures, social comparisons, and unmet needs for approval were some of the other themes that emerged. Shifting from content to motivations for posting, the analysis identified purposes such as venting distress, seeking suggestions, sharing reflections, engaging in meaning-making, and seeking reassurance or validation. Future work needs to examine whether such forums can function not only as spaces for strengthening self-help and peer support processes but also as avenues for improving professional help-seeking through normalization and encouragement of the same when appropriate.

This content analysis of open-ended survey responses compares and contrasts perceptions on supervision from supervisors with experience providing direct peer support services (PS) and supervisors without experience providing direct peer support services (NPS).A 16-item online survey was distributed via the National Association of Peer Supporters (N.A.P.S.) listserv and through peer networks and peer run organizations. Responses from 837 respondents, across 46 US states, were analyzed. Four open ended questions assessed supervisors’ perceptions on differences supervising peer support workers (PSW) as compared to other staff, important qualities of PSW supervisors, roles when supervising a PSW, and concerns about PSWs in the organization. Among NPS and PS, three major differences in themes emerged: the knowledge required of supervisors, understanding of the role of the PSW, and supervisors’ beliefs regarding PSW competencies. PS have a more nuanced understanding of the peer support worker role and the impact of lived experience in the role.

Youth peer support workers (YPSWs) are young adults with lived experience of mental illness during childhood or adolescence who support young people receiving treatment in mental health services. The contributions made by YPSWs are a promising development to facilitate consumer-centered and recovery-oriented care. Although the youth peer support workforce is expanding rapidly, structurally embedding YPSWs in practice is challenging. To overcome these challenges and thereby improve care for young people, insight into YPSW roles, barriers and facilitators for implementing and pursuing youth peer support (YPS) is a necessity. This systematic review examined the published literature to identify existing knowledge on YPSW roles in treatment settings, and the barriers and facilitators for implementing and pursuing YPS in practice. A total of 24 studies from a variety of youth serving contexts were included in this review. Thematic synthesis resulted in six YPSW roles and five themes with barriers and facilitators. The roles included the: engagement role, emotional support role, navigating and planning role, advocacy role, research role and the educational role. The themes explored the needs of YPSWs, experiences of YPSWs, relationships between service users and YPSWs, the collaboration process between YPSWs and non-peer staff, and organizational readiness. This review underlines that YPSWs likely are a valuable addition to numerous youth treatment contexts. Overall, the implementation of YPSWs is a multifaceted operation that requires careful planning. We recommend services to set clear and realistic expectations for YPSWs, to consider potential power imbalances between YPSWs and non-peer staff, to provide adequate resources to pursue YPS, and to approach the implementation of YPSWs with a growth mindset.

The frenzy of postbirth events often takes a toll on mothers' mental well-being, leaving them susceptible to postpartum psychological disorders such as postnatal depression (PND). Social support has been found to be effective in restoring the emotional well-being of new mothers. Therefore, mothers need to be supported during the crucial postpartum period to buffer the negative after effects of childbirth and to promote healthier maternal well-being. This study aimed to evaluate the effectiveness of a technology-based peer-support intervention program (PIP) on maternal outcomes during the early postpartum period. A randomized, parallel-armed controlled trial was conducted. The study recruited 138 mothers (69 in intervention group, 69 in control group) at risk of PND from a tertiary hospital in Singapore. To support these mothers, 20 peer volunteers were recruited by word of mouth and trained by a psychiatrist in social support skills before the intervention commenced. The 4-week-long intervention included a weekly follow-up with a peer volunteer through phone calls or text messages. The intervention group received peer support in addition to the standard care offered by the hospital. The control group only received postnatal standard care. Maternal outcomes (PND, postnatal anxiety [PNA], loneliness, and perceived social support) were measured with reliable and valid instruments. Data were collected immediately postpartum, at 1 month postpartum and at 3 months postpartum. The general linear model was used to compare the groups for postpartum percentage changes in the outcome variables at first and third months, and the linear mixed model was used to compare the trend over the study period. There was a statistically significant difference in Edinburgh Postnatal Depression Scale scores (d=-2.11; 95% CI -4.0 to -0.3; P=.03) between the intervention and control groups at 3 months postpartum after adjusting for covariates. The intervention group had a significant change over time compared with the control group. The technology-based PIP was found to be effective in reducing the risk of PND among new mothers and showed a generally positive trend in reducing PNA and loneliness and increasing perceived social support. This study highlights the importance of training paraprofessionals to provide needed support for new mothers postpartum. A further long-term evaluation of the PIP on maternal and family outcomes and its cost-effectiveness is needed to inform clinical practices. ISRCTN Registry ISRCTN14864807; https://www.isrctn.com/ISRCTN14864807. RR2-10.2196/resprot.9416.

Long COVID is an emerging public health concern. A growing number of individuals are experiencing prolonged, multifaceted health challenges and accompanying social impacts after COVID-19 infections. Support services in the United Kingdom remain insufficient and fraught with complexity. Responding to persistent gaps in care, patients joined forces in online peer support groups. However, little is known about how these groups impact patients with long COVID and their lived experiences of the condition. The aim of this study is to explore the roles that online peer support groups take on and the impact they have on patients experiencing and recovering from long COVID in the United Kingdom. In doing so, this study aims to identify ways to inform future long COVID care, including online peer support and broader long COVID care structures. I conducted 11 semistructured interviews virtually on Zoom in July 2021. Participants had long COVID, were UK-based, and used long COVID online peer support groups. Topics discussed in interviews included what led participants to these groups, experiences within them, and feelings about the roles that the groups took on. I analyzed the results by manually conducting thematic analysis. Long COVID online peer support groups had numerous roles, significantly impacting users. I identified 5 themes and 13 subthemes through thematic analysis. The identified themes were as follows: (1) filling professional care gaps, (2) societal awareness, (3) engagement behavior, (4) diversity, and (5) social connections. Given the void of professional support, those experiencing long COVID gained some benefit from these groups. However, participants emphasized notable concerns about the all-encompassing roles these groups embody and speculated over potential improvements. If used appropriately, online peer support groups could be immensely beneficial for patient well-being, beyond simply filling gaps in long COVID care. However, it appears many groups take on more than they can manage and become potentially harmful. Through prioritizing patient voices, long COVID care could be restructured to maximize peer support's benefits within broader care structures.

Social support is known to reduce risks of postnatal depression (PND) and improve maternal emotional well-being. However, the Asian cultural context is often neglected when appraising maternal needs and mothers' preferences for social support. While many preventive efforts have experimented with technology, professionals, and paraprofessionals in providing social support to mothers in need, most studies determined the effectiveness of their interventions through quantitative measurements of maternal outcomes. Experiences and feedback from both participants and administrators are rarely discussed, especially in an Asian setting. The goal of the research was to evaluate the postnatal experiences of Asian mothers at risk of PND and the perceptions of peer volunteers regarding a technology-based peer-support intervention program (PIP). A qualitative semistructured interview was conducted with 20 Asian mothers at risk of depression (10 from the control group and 10 from the intervention group) and 19 peer volunteers from a randomized controlled trial. The PIP included weekly correspondence between peer volunteers and mothers through any telecommunication means over 4 weeks. All interviews were approximately 30 to 60 minutes long, audiotaped, transcribed verbatim, and analyzed using thematic analysis. Study findings were reported according to the Consolidated Standards of Reporting Trials checklist. Two overarching themes comprising five subthemes were generated: postnatal experience (a bouncy ride, a way forward) and evaluation of the PIP (valuable, flexible, and supportive program; building blocks of a good relationship; and lessons learned and the road ahead). Mothers from both the control and interventions groups were generally satisfied with hospital care and the support received from family. They also shared similar breastfeeding challenges and needs for more informed decisions and follow-up support from the hospital. However, mothers who received the PIP tended to have more positive outlooks of their birth experiences. Overall, peer volunteers and mothers involved in the PIP found the PIP useful and expressed satisfaction with the program's flexibility. They also shared their personal takeaways, the qualities of their friendships, and the need for extended correspondence time and recommended outreach to non-at-risk mothers. The positive endorsement of the PIP by peer volunteers and mothers suggests the success of the PIP in maintaining positive maternal emotional well-being during the postpartum period. With the help of technology, hospitals can easily provide additional peer support to at-risk mothers in addition to existing standard care offered to these mothers. ISRCTN Registry ISRCTN14864807; http://www.isrctn.com/ISRCTN14864807. RR2-10.2196/resprot.9416.

Young- to middle-aged patients with breast cancer face significant psychosocial challenges. Existing interventions often lack comprehensiveness, timely initiation, and tailoring specific to this population's unique needs. This study aimed to evaluate the impact of a peer-led, nurse-involved, blended online and offline peer support intervention program (PNO2PSP) on psychosocial adjustment in young- to middle-aged patients with breast cancer. The effectiveness of PNO2PSP was evaluated through a single-center cluster randomized controlled trial involving 70 newly diagnosed young- to middle-aged patients with breast cancer (35 in each group). The intervention group received an 8-week PNO2PSP in addition to routine care. Psychosocial adjustment, self-efficacy, social support, and coping modes were assessed presurgery and at 4, 8, and 12 weeks post surgery. Generalized estimating equations were used for intention-to-treat analyses. In-depth interviews with 9 participants explored their experiences. Compared to the control group, the intervention group demonstrated significantly lower psychosocial adjustment scores at 8 weeks (T2; Wald χ²1=14.96; P<.001) and 12 weeks (T3; Wald χ²1=7.49; P=.006); social support was higher at 8 weeks (T2; Wald χ²1=7.65; P=.006). Confrontation coping scores were higher at T2 (Wald χ²1=5.46; P=.02), T3 (Wald χ²1=10.04; P=.002), while avoidance coping scores were lower at T1 (Wald χ²1=8.24; P=.004), T2 (Wald χ²1=7.45; P=.006), and T3 (Wald χ²1=5.70; P=.02). Qualitative findings supported these quantitative results, highlighting the program's role in facilitating psychosocial adjustment, providing vital support, boosting treatment confidence, and fostering positive coping. The PNO2PSP effectively improved psychosocial adjustment, social support, and positive coping in young- to middle-aged patients with breast cancer. Its scientifically validated, feasible, and patient-centered design supports its recommendation for wider clinical implementation, with continued training for peer supporters and sustained delivery of peer support.

Although research has found online peer support forums to be helpful for those with mental health conditions, no studies have explored the experiences of those who use forums for support with postpartum psychosis (PP) specifically. This study aimed to understand the lived experiences of using online forums for PP, and how this form of support differs from professional and other informal support. This study used a qualitative approach, including semistructured interviews with 8 participants. Recruitment took place via an online forum run by a charity called Action on Postpartum Psychosis. Transcripts were analyzed using interpretative phenomenological analysis. Four themes were developed in line with participants' experiences (1) from isolation to connection: validation, growth, and hope from shared experiences; (2) complementing not replacing: filling the gaps in support; (3) impacts of privacy, representation, and readiness to share on engagement; and (4) relational experiences within peer support: altruism, boundaries, and comparison. All participants believed forums were helpful to their well-being and recovery; however, some also reported difficulties with engagement, comparison, and regulating their own use. Findings suggest that forums may benefit from being designed in a way that protects users and their identities, for example, via trigger warnings and setting boundaries. Peer online forums offer a unique and potentially effective addition to existing support provided by professionals and personal connections. Professionals should signpost people experiencing PP to forums, but should also understand the support that may be needed in terms of monitoring use and ensuring that appropriate boundaries are put into place.

As the population ages, older adults face an increasing risk of physical inactivity and related health complications, highlighting the need for scalable interventions. Smartphone-based programs have emerged as a promising strategy to support sustained physical activity among older adults. This study aimed to evaluate whether a smartphone lecture program incorporating a digital peer support app would increase physical activity among older adults, compared to a conventional smartphone lecture program. This 2-arm, 1:1 parallel-arm, cluster-randomized trial was conducted in 2 urban regions of Japan (Sumida Ward, Tokyo, and Chiba City, Chiba). Eligible participants were community-dwelling adults aged ≥60 years, able to walk independently, and smartphone users; exclusion criteria included prior use of the peer support app or medical restrictions on walking. Participants were recruited offline during community smartphone lectures (closed-group recruitment). The intervention combined face-to-face lectures with app-based peer support, while outcomes were assessed both objectively (via smartphones) and through self-administered paper questionnaires. All participants received a baseline smartphone lecture. Intervention participants attended 2 additional sessions using a digital peer support app (Minchalle; A10 Lab Inc), which included features such as daily step goals, peer sharing, and group encouragement. Control participants attended 2 standard follow-up smartphone lectures. The primary outcome was the change in weekly average daily step count from baseline to Week 12. Secondary outcomes included total metabolic equivalent of task (MET)-minutes per week (assessed via the International Physical Activity Questionnaire), walking time (≥30 minutes per day), daily smartphone use, and number of smartphone use purposes. A total of 156 community-dwelling older adults were grouped into 40 clusters and randomized (20 intervention clusters, n=80 and 20 control clusters, n=76). In total, 124 participants (79.5%) completed the follow-up, and valid step data were available for 117 participants, with missing data ranging from 5.1% to 29.1%. Baseline daily steps averaged 3951 (SD 1686) in controls versus 4583 (SD 1973) in the intervention arm. An unadjusted mixed model for repeated measures showed significantly higher step changes for intervention participants at Week 12 (difference=579, 95% CI 36-1123; P=.04). No significant differences emerged for total METs (difference=646 MET-min per week, 95% CI -12 to 1303; P=.054) or walking ≥30 minutes per day (odds ratio [OR] 1.56, 95% CI 0.63-3.90; P=.33). However, the intervention arm demonstrated a significant increase in daily smartphone use (OR 4.10, 95% CI 1.15-14.6; P=.03) and in the number of smartphone use purposes (difference=0.58, 95% CI 0.12-1.05; P=.01). A smartphone lecture program integrated with app-based peer support led to modest but meaningful improvements in step counts among older Japanese adults, at Week 12 of the 12-week intervention. Future research should investigate long-term maintenance, additional measures of physical activity, and subpopulation responses to optimize digital health programs for older adults.