ONLINE peer support groups "hold a way to help scale up care" for people in recovery from mental health difficulties, according to researchers in Glasgow.

Scientists from Glasgow University caution that an increase in people experiencing symptoms of depression and anxiety brought on by the pandemic will be exacerbated by cost of living stresses, warning that "the traditional clinical model of mental health care will not be able to meet the increasing needs and the existing gap has already become worse".

They set about evaluating what is needed to ensure that mental health peer support groups can operate over the internet "in an effective and safe way".

READ MORE: Half of Scots worry for mental health in cost of living crisis

Previous research has found that online groups, rather than face-to-face, can backfire with potentially harmful effects because users have the option to remain anonymous.

This can lead to more hostile environments and in extreme cases can encourage a contagion of negative emotions because the anonymity enables service users to open up more freely, but in doing so to discharge their own negative feelings more easily.

The Glasgow University study is one of the first to look beyond the advantages and disadvantages of online peer support to look instead at how it can be used most effectively.

The Herald: Peer support groups moved online during the Covid lockdownsPeer support groups moved online during the Covid lockdowns (Image: Getty)

Its lead author, Dr Sharon Ding, a senior lecturer in healthcare technologies at the university's School of Computing Science, said: "Physical activities and meeting in person is important to establish trust and connection so that online support can be effective.

"But definitely, there's a space for digital technologies to expand and enhance the capability of peer support because more people can benefit from that."

Dr Ding, who will present the findings at the prestigious Human Factors in Computing Systems conference in Hamburg, Germany this week, recruited 22 participants from groups based in Glasgow, Edinburgh, Motherwell, Levenmouth and South Ayrshire.

Ages ranged from people in their 20s to their 70s.

READ MORE: The GP bringing lifestyle medicine to the banks of Loch Ness

These included service users, volunteers and peer support workers who have been trained to help others following their own recovery from mental health issues.

The ideology of peer support dates back to the 18th Century when the value of hiring recovered patients to help other mentally ill people in hospitals was first recognised, but it grew in popularity from the 1970s onwards and is much more formalised today.

By 2016, there were 80 paid peer support workers, and many more unpaid volunteers, embedded into mental health services in Scotland.

Before the pandemic, most interactions were carried out over the phone or in-person but lockdown resulted in groups moving to online forums such as Teams or Zoom.

The study notes that this "posed more challenges for senior members but made it easier for those with disabilities or living far away to join".

After restrictions lifted, some groups "stayed online or used hybrid forms for groups sessions, while others got back to the more traditional face-to-face meeting".

The Herald: The study was led by a team at Glasgow UniversityThe study was led by a team at Glasgow University (Image: PA)

The study, based on fieldwork observation and analysis, made four key recommendations.

It said online peer support groups should focus on creating "an engaging space for people to simply 'hang out'" and interact in different ways depending on their energy levels.

This could include simply sharing photos, 'liking' other people's posts, or listening to the conversations.

The authors found that it was "just helpful to be part of the group, not necessarily with active chatting or talking", and that offering service users a choice about how to interact is "inherently meaningful for mental health, especially considering the ebbs and flows in symptoms".

READ MORE: Making sense of Scotland's alcohol deaths and suicides 

Secondly, support workers are encouraged to proactively approach those who appear to have low energy and "for whom having someone reaching out to them instead of asking them to reach out to others will be helpful".

Service users could also volunteer to share their stress levels non-verbally using wearable devices like fitness trackers, which could trigger an intervention by a support worker.

Thirdly, they recommend a "bottom up" approach where "recovery members initiate groups based on their own interests, and invite and encourage people with similar interest to join".

This could include shared hobbies such as gaming, crafts or gardening, with people brought together by similar backgrounds - for example, experiences of suicide bereavement or alcohol abuse. 

Dr Ding said: "When they get together they don't just discuss experiences they also do hobbies and activities together, so that it's not just sitting around talking - it's more fun and engaging."

Finally, peer support workers and volunteers should be trained in how to direct participants to "one-on-one counseling or more instrumental or practical help such as applying for social benefits" where their issues are "too sensitive or emotional" to be managed in group sessions.