what is the primary risk of peer-to-peer support in social media?

Epidemiol Psychiatr Sci. 2016 Apr; 25(2): 113–122.

The future of mental wellness intendance: peer-to-peer support and social media

J. A. Naslund

^oneWellness Promotion Research Middle at Dartmouth, Lebanese republic, New Hampshire, United states of america

²The Dartmouth Institute for Wellness Policy and Clinical Practice, Dartmouth College, Lebanon, New Hampshire, USA

G. A. Aschbrenner

ⁱHealth Promotion Enquiry Center at Dartmouth, Lebanon, New Hampshire, USA

^twoThe Dartmouth Institute for Wellness Policy and Clinical Practice, Dartmouth College, Lebanese republic, New Hampshire, USA

³Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, U.s.a.

L. A. Marsch

³Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, United states of america

⁴The Heart for Engineering and Behavioral Health, Dartmouth Higher, Lebanon, New Hampshire, USA

S. J. Bartels

¹Health Promotion Research Center at Dartmouth, Lebanon, New Hampshire, USA

²The Dartmouth Plant for Health Policy and Clinical Do, Dartmouth Higher, Lebanon, New Hampshire, U.s.a.

ⁱⁱⁱDepartment of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA

⁵Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA

Received 2015 October 8; Accepted 2015 Nov xxx.

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 communication from others with similar health conditions. This emerging form of unsolicited communication among cocky-forming online communities of patients and individuals with diverse health concerns is referred to as peer-to-peer support. We offering a perspective on how online peer-to-peer connections among people with serious mental disease could advance efforts to promote mental and physical wellbeing in this grouping.

Methods:

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

Results:

People with serious mental illness study benefits from interacting with peers online from greater social connection, 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 disease could challenge stigma through personal empowerment and providing hope. Past learning from peers online, these individuals may gain insight well-nigh important health intendance decisions, which could promote mental wellness care seeking behaviours. These individuals could also access interventions for mental and concrete wellbeing delivered through social media that could incorporate mutual back up betwixt peers, assist promote handling engagement and reach a wider demographic. Unforeseen risks may include exposure to misleading data, facing hostile or derogatory comments from others, or feeling more uncertain about one's health condition. Nonetheless, given the evidence to appointment, the benefits of online peer-to-peer back up appear to outweigh the potential risks.

Conclusion:

Future research must explore these opportunities to back up and empower people with serious mental affliction through online peer networks while carefully because potential risks that may arise from online peer-to-peer interactions. Efforts will too demand to address methodological challenges in the form of evaluating interventions delivered through social media and collecting objective mental and concrete health outcome measures online. A central challenge will be to determine whether skills learned from peers in online networks interpret into tangible and meaningful improvements in recovery, employment, or mental and physical wellbeing in the offline globe.

Key words: Net, mental wellness, mental illness stigma, peer support, social network

'I don't know what led me to observe your videos, simply by some sort of luck I establish your videos a month before I was diagnosed with schizophrenia. Information technology's been a very hard and trying few months but you have given me a lot of hope. So thank you, keep up the good piece of work.'

(Individual with schizophrenia commenting on YouTube)

'I annotate on many of these posts because if I give i person hope it is more than worth it to practise so. Depression nearly cost me my life a couple of times when I was in my 20s. It was really very rough at times, I know there are many, many out there who want to surrender but don't!!! There IS HELP OUT THERE! There are people who care!!!'

(Individual with bipolar disorder commenting on Facebook)

Posts like these on popular social media such as Facebook or YouTube convey acceptance, hope, validation and illustrate the give-and-have nature of connecting with peers online. Increasingly, individuals with serious mental illnesses similar schizophrenia, schizoaffective disorder, or bipolar disorder are turning to social media to talk near their affliction experiences, seek advice and learn from and support each other (Gowen et al. 2012; Naslund et al. 2014; Miller et al. 2015). This unsolicited communication occurs naturally and involves cocky-forming online communities of individuals who share an understanding of living with mental disease. Referred to as online peer-to-peer support, this emerging grade of social interaction has been described as one of the most transformational features of the Internet (Ziebland & Wyke, 2012) and may present new opportunities to promote recovery, cocky-esteem and mental and physical wellbeing among individuals with serious mental illness.

Worldwide, serious mental illness is a leading cause of disability (Murray & Lopez, 1997) and is associated with debilitating symptoms of anxiety, depression and low motivation (Kessler et al. 2003). Being labelled mentally ill, and the ensuing societal stigma and prejudice, can have devastating effects on quality of life, self-efficacy and ability to pursue meaningful life goals (Corrigan, 1998). For people with serious mental affliction the effects of stigma, feelings of hopelessness and helplessness, and resulting social marginalisation and withdrawal pb to increased take chances of substance utilise, poverty, homelessness, unemployment, hospitalisation and suicide (Dixon, 1995; Corrigan, 2004; Folsom et al. 2005; Pompili et al. 2008). There are also numerous challenges to addressing these concerns from a clinical perspective. For case, to reach individuals with serious mental illness, it is necessary to overcome barriers such as social isolation, reluctance to use formal health care services and challenging social circumstances such as traumatic life events or disruptive domicile environments (RachBeisel et al. 1999; Hert et al. 2011). Online peer networks may offer novel approaches for supporting and engaging this high-gamble group in handling efforts.

By early 2015, over ii billion people globally had active social media accounts (Kemp, 2015). Social media refers to interactive web and mobile platforms through which individuals and communities share, co-create, or exchange information, ideas, photos, or videos within a virtual network. Online social networking represents a prominent form of communication in many people's lives. For individuals with stigmatised illnesses, such as serious mental illness, social media may brand information technology possible to connect with others who share similar health conditions and to seek or disclose health information without having to reveal one'due south personal identity (Berger et al. 2005). Additionally, many people with serious mental disease experience symptoms that interfere with socialising in face-to-face encounters (Dickerson et al. 2001). Therefore social media may help to facilitate social connections among this group by overcoming obstacles such every bit stigma and mental health symptoms (Highton-Williamson et al. 2015).

Research suggests that people with serious mental affliction are interested and willing to form connections with others through social media. A survey of immature adults plant that those with mental affliction were more likely to express personal views through blogging, build friendships on social media and connect with people online who have shared interests compared with those without mental illness (Gowen et al. 2012). Similarly, another survey found that adults with schizophrenia were as likely as adults without mental illness to course social connections online despite having fewer offline relationships, lower income and less Cyberspace access (Spinzy et al. 2012). In a qualitative study, popular social media appeared useful for allowing people with serious mental illness to experience less alone and to find hope and to back up each other, and to share personal stories and strategies for coping with day-to-day challenges of living with a mental illness (Naslund et al. 2014). Other studies have found that online support groups, forums and chat rooms serve every bit important venues for discussing sensitive mental wellness weather condition (Kummervold et al. 2002), and for disclosing personal experiences of living with schizophrenia or seeking and sharing information related to symptoms and medications (Haker et al. 2005).

Despite this mounting show, limited attending has been directed at utilising these online networks to disseminate materials for mental health instruction or back up, or to widen access to testify-based services among these high-take a chance individuals. In this newspaper we present our perspective on how interactions among people with serious mental illness over social media, referred to as online peer-to-peer support, may afford important opportunities to advance treatment efforts aimed at promoting mental and concrete wellbeing in this grouping. Offset, we consider the importance of forming social connections and the part of social media among people with serious mental illness. So, we propose three areas where online peer-to-peer connections may have a profound touch for these individuals. These include challenging stigma, increasing consumer activation, and accessing interventions for mental and physical wellbeing. We carefully consider the potential risks associated with interacting with peers online. To conclude, nosotros discuss important challenges ahead and recommend hereafter research directions.

Online peer-to-peer support and mental affliction

Prior studies have emphasised the importance of individuals feeling connected to others and sharing a sense of belonging to a group (Brewer, 1991). Identifying with a social group is believed to increase self-esteem and self-efficacy, and reduce dubiety virtually oneself (McKenna & Bargh, 1998). Amongst people with serious mental illness, connecting with similar others may contribute to improve recovery, personal wellbeing and social integration (Davidson et al. 1999). Yet, for these individuals, identifying and reaching out to others poses numerous risks in the form of disclosure and potential disapproval, rejection, or negative attitudes (Link et al. 1997). Many people with serious mental illness also experience challenges with face-to-face communication due to impairments in cerebral and social functioning (Dickerson et al. 2001). For someone with serious mental illness, the decision to attain out and connect with others to talk over personal wellness issues typically occurs at a time of increased instability and when facing significant life challenges (Perry & Pescosolido, 2015). Seeking support and social connection is therefore a critical signal in the lives of people with serious mental illness, and the decision of who to reach out to may be detrimental in determining their path to successful recovery and wellbeing.

Through social media, people with serious mental affliction can potentially identify similar others and experience benefits of grouping participation at their own convenience, while remaining bearding and avoiding challenges associated with interpersonal deficits such every bit interpreting social cues or non-exact communication (Mittal et al. 2007; Highton-Williamson et al. 2015). Social media overcomes geographic boundaries and time constraints, and allows users to choose whether or non to actively create content, disembalm personal health information, mail service comments, or passively view content posted by others. Enquiry suggests that within an online network, both individuals who choose to share content or connect with different users, too as those who choose to seek health data without interacting with others tin can experience important benefits (van Uden-Kraan et al. 2008; Mo & Coulson, 2010; Chung, 2014). Compared with spontaneous face-to-face encounters, social media users maintain greater control meaning that they tin choose their ain level of engagement and the extent to which they interact with others. This may be especially of import for people with serious mental illness because social media may aid them overcome debilitating effects of their illness such equally information processing challenges, increased social anxiety, or difficulties with social interaction (Schrank et al. 2010). On social media individuals with serious mental illness can cull whether to mail service content and how chop-chop to respond to comments, and tin can revisit conversations or seek greater clarity at their ain footstep. For someone experiencing mental health symptoms combined with fear of stigma and rejection, this added control through online communication may be empowering.

Social media also represents a user-driven environment, where individuals with Net admission through their mobile device or computer can take a voice and the opportunity to express themselves and connect to a larger online community. Online peer-to-peer networks represent a significant contrast to traditional biomedical or psychiatric approaches to mental health care. Many people with serious mental disease have had to fight against discrimination and injustice, and advocate for basic human rights and mental health care reform (Tomes, 2006). For this group, social media may serve as a platform through which many of these individuals can continue to claiming prejudiced societal views, question disciplinarian medical practices and share positive attitudes and behavior.

New opportunities through online peer-to-peer back up

We take the perspective that when an private with serious mental illness decides to connect with similar others online, information technology represents a critical bespeak in their illness experience. These individuals are likely facing significant personal challenges, social isolation, or fears about how others will view them, which may prompt them to seek information or support online. In Fig. 1, we advise a conceptual model to illustrate how online peer-to-peer connections may afford individuals with serious mental affliction opportunities to challenge stigma, increase consumer activation and admission online interventions. Our conceptual model is informed by existing literature including studies of online communities and online support groups for mental affliction as well as other patient groups with various wellness conditions, and suggests how individuals with serious mental disease may benefit from peer-to-peer interactions following the initial decision to visit an online customs. As depicted in Fig. 1, the proposed opportunities do non necessarily occur in a sequential lodge.

An external file that holds a picture, illustration, etc. Object name is S2045796015001067_fig1.jpg

Conceptual model illustrating potential opportunities that may be available to individuals with serious mental illness subsequently visiting an online community of peers.

Challenge stigma

When individuals with serious mental illness visit an online community they may be experiencing shame, uncertainty and feeling alone with their symptoms or illness diagnosis. These individuals may accept fears most reaching out to others, driven past concerns about what other people will say or call back and the possibility of rejection because of their illness (Link et al. 1997). When individuals with mental illness internalise discriminatory societal views and stereotypes, information technology often leads to negative consequences including diminished self-esteem and self-efficacy, and greater depressive symptoms (Corrigan, 1998). Stigma impacts an individual's ability to behave out daily activities such every bit work or school, to pursue life goals and to seek necessary mental health care (Link et al. 1997; Corrigan, 1998).

Online communities may serve as powerful venues where individuals with serious mental illness tin claiming stigma through personal empowerment and providing hope (Lawlor & Kirakowski, 2014). Studies take shown that knowing that there are others facing similar concerns, frustrations and affliction symptoms tin be highly reassuring and can create a sense of belonging to a grouping (Harvey et al. 2007). Young adults with mental disease report that one of the primary reasons for connecting with others online is to experience less solitary (Burns et al. 2009), and pop social media allows people with serious mental illness to feel connected while gaining a sense of relief from knowing that others share similar experiences and challenges (Naslund et al. 2014). Research also suggests that truthful cocky tin be expressed more than easily within online networks because the anonymity of the Internet can shield from disapproval or fear of making mistakes (Bargh et al. 2002). This is likewise important because cocky-expression may assist protect against harmful effects of stigma (Bargh & McKenna, 2004; Whitley & Campbell, 2014). Therefore, individuals with serious mental illness may benefit from interacting with others through social media considering they can exist themselves without letting the challenges of their illness go in the mode.

Coming out and disclosing i'south illness to others is as well an important approach for addressing stigma (Corrigan et al. 2010; Corrigan et al. 2013). Through online peer-to-peer communities, individuals with serious mental illness tin connect with others with lived feel and openly disclose their own diagnosis while choosing to share positive stories of recovery and facts to challenge stigma and directly address widespread myths and misperceptions about living with a mental affliction. Research suggests that marginalised individuals may benefit from feelings of empowerment, greater personal identity and pride by connecting with like others online (van Uden-Kraan et al. 2009). The increment in confidence and sense of belonging gained through selectively disclosing to others online may even make individuals feel more than comfortable disclosing their illness in face-to-face encounters (McKenna & Bargh, 1998). Every bit the number of online forums, blogs, or Facebook groups defended to empowering and supporting people living with serious mental illness continues to grow, information technology is clear that online communities volition serve as valuable outlets for these individuals. Hereafter research must institute whether online peer-to-peer support effectively challenges stigma and helps overcome social isolation amid individuals with serious mental illness.

Increase consumer activation

Engaging with like others online may prompt further interest in learning what to look, how to cope and how to arroyo important health care decisions. As individuals with serious mental illness increasingly use popular social media to share experiences navigating the health care system, discuss the utilize of different medications and communicate near the importance of finding the right doctor (Naslund et al. 2014); these online networks may promote consumer activation and mental health intendance seeking behaviours. A contempo study found that many people with mental illness were motivated to seek formal mental wellness intendance afterward first searching or discussing concerns with peers online (Lawlor & Kirakowski, 2014). It is possible that connecting with like others through online networks may human activity as a goad for prompting individuals to seek formal intendance (Powell et al. 2003).

Learning about the experiences of others may help individuals feel at ease, know what questions to inquire and know what to look during a medical visit or hospitalisation (Lowe et al. 2009). Prior studies have shown that when someone learns about other people's personal experiences facing illness, they feel more than confident and empowered in making their own health care decisions (Entwistle et al. 2011). Research also suggests that many people will seek wellness information online following a medical visit where they felt dissatisfied or disagreed with the advice they received from their medical provider (Raupach & Hiller, 2002).

Among people with serious mental illness who have access to medical care, research consistently shows that it is substandard (Wang et al. 2002). Peer-facilitated approaches to finding ways to meliorate communicate with medical providers, to navigate unfamiliar wellness care environments and to take an agile role during primary care visits may exist important strategies for improving the quality of health care encounters (Bartels et al. 2013). Therefore, learning from peers through online networks may aid individuals with serious mental illness realise that they can make their ain health care decisions, and may help them become more empowered consumers by being better prepared for medical visits and being more proactive and assertive in their communication with health intendance providers. Farther enquiry is needed to determine whether seeking health information and learning tips and strategies from peers online can help individuals with serious mental disease feel more confident in their interactions with medical and mental wellness care providers.

Access to interventions for mental and physical wellbeing

Equally people with serious mental illness feel comfy visiting online networks, there may be opportunities for these individuals to access interventions aimed at supporting mental and physical wellbeing. Interventions delivered through online communities could leverage common back up among peers, and assistance promote handling engagement and preclude written report compunction (Alvarez-Jimenez et al. 2014), and reach a wider demographic including individuals who may exist reluctant to seek formal services (Naslund et al. 2015b). At that place may be opportunities to deliver flexible interventions that allow personalisation by catering to the dissimilar needs and preferences of members of the online community (Alvarez-Jimenez et al. 2014). Interventions could be adaptive, by integrating feedback from peers within the network and making improvements to intervention design and commitment in real time. For instance, an intervention could iteratively incorporate new strategies or content suggested past customs members based on the number of likes or positive feedback from others.

To date, the majority of studies of online networks among people with serious mental illness have involved survey methods, qualitative interviews, or content analyses of online discussions (Lawlor & Kirakowski, 2014). Few studies have collected objective mental or physical health outcomes over time, and only a handful of interventions accept been delivered to individuals with serious mental illness using social media (Alvarez-Jimenez et al. 2014; Naslund et al. 2015c). For example, the HORYZONS social networking intervention for beginning episode psychosis involves the delivery of show-based online psychoeducation enhanced by chastened peer-to-peer support within an online forum (Alvarez-Jimenez et al. 2013, Lederman et al. 2014). Preliminary findings show that young participants were highly engaged in the HORYZONS system, and found it safe to use and empowering, and reported that it helped them feel more socially connected (Alvarez-Jimenez et al. 2013). Recent studies of online psychoeducation interventions for bipolar disorder have also included chastened discussion forums to facilitate peer-to-peer support (Simon et al. 2011; Smith et al. 2011; Todd et al. 2014; Lauder et al. 2015).

While these studies have been highly promising, there have also been mixed results. A randomised controlled trial of online peer support yielded inconclusive results regarding the benefits of online interactions among individuals with serious mental illness (Kaplan et al. 2011). However, these interventions have all been delivered through online environments adult specifically for the research studies. Using artificially created online networks may non be generalisable because these networks may lack the norms, dynamics and atmosphere of naturally occurring online communities (Lawlor & Kirakowski, 2014). Therefore, future studies should attempt to employ naturally occurring peer-to-peer networks equally observed on pop social media. It volition be of import to consider how formal interventions may modify peer dynamics within naturally occurring networks, and whether providing show-based services in this manner might bear on how individuals choose to interact with each other online.

Given the high prevalence of co-occurring mental and concrete health concerns among people with serious mental illness (Sokal et al. 2004), interventions delivered through social media should exist aimed at promoting both mental and physical wellbeing. Efforts could support individual empowerment, social connection, skill building, psychoeducation and mental illness recovery, while simultaneously promoting healthy lifestyle such as quitting smoking, eating healthy, establishing a regular sleep schedule and getting exercise. Efforts in the general population include interventions on Facebook for weight loss (Napolitano et al. 2013) and smoking cessation (Ramo et al. 2015) among young adults, while emerging wearable technologies could afford opportunities for peers with serious mental illness to share exercise or personal wellness goals over social media (Naslund et al. 2015a). Delivering interventions for mental and physical wellbeing through social media appears highly promising, all the same the success of future interventions will depend on whether skills learned in online networks tin exist applied to real earth contexts (Alvarez-Jimenez et al. 2014).

Risks of online peer-to-peer support

Online peer-to-peer connections are influencing the mode people with serious mental illness experience their symptoms, discover ways to cope and seek mental wellness care; all the same, risks and concerns surrounding this emerging form of online communication must be advisedly considered. For instance, there are risks inherent in obtaining advice from peers with unknown credentials. Information technology is not ever possible to confirm the reliability of what peers say to each other in an online network, and it is not clear how different content is perceived as trustworthy (Entwistle et al. 2011). It is also possible that learning from the experiences of others online may lead to unrealistic expectations and greater anxiety or confusion virtually ane's own condition (Ziebland & Wyke, 2012). Yet, research shows that many people who visit online networks are aware of the need to evaluate the suggestions and communication provided by others with caution, and also to appraise whether the information posted by others is applicable to their own health concerns (Armstrong & Powell, 2009, Schrank et al. 2010).

Social media also provides opportunities to form meaningful relationships with others, which tin can be beneficial, but also poses risks. Prior studies have shown that individuals can develop a dependency for online relationships (Caplan, 2003; Chung, 2013), resulting in further challenges communicating in offline environments (Crabtree et al. 2010). Online networks may besides contribute to greater social withdrawal and avoidance (Lawlor & Kirakowski, 2014). Withal, many individuals with serious mental illness may already be highly socially isolated earlier seeking connections with others online, suggesting that online networks may at least provide some form of interaction or group belonging. It is also possible that online peer networks may be the only potential way to reach the most socially isolated individuals.

Online interactions with peers can more often than not accept a positive influence, though it is possible to discover online forums that support or promote cocky-harm and other unhealthy or destructive behaviours (Ziebland & Wyke, 2012). Additional risks may include exposure to hostile or derogatory comments posted past others, as well as online harassment. A recent review of online social networking amid people with mental illness plant limited evidence of such risks (Highton-Williamson et al. 2015), though research must explore whether individuals with serious mental illness are able to retain a sense of control over negative social encounters online, or whether negative encounters further exacerbate their mental health symptoms or contribute to reduced self-esteem. These risks are not unique to online environments, and it is important to acknowledge that individuals with serious mental affliction remain at elevated risk of being victims of discrimination, abuse and violent crimes in face-to-face encounters in real world settings (Goodman et al. 1997, Lam & Rosenheck, 1998; Hiday et al. 1999; Corrigan et al. 2003). Therefore, the risks of connecting with similar others through social media should ever exist considered in light of existing susceptibility to risks posed past offline encounters. Overall, benefits of online peer-to-peer support appear to outweigh potential concerns, though sources of risk must be explored further to inform time to come inquiry efforts.

Challenges ahead and next steps

When people with serious mental illness connect with online communities of similar others to acquire, share and give and receive support, it challenges dominant societal views that this alienated group lacks the technical proficiency and ability to engage in meaningful social relationships through contemporary technological platforms (Parr, 2008). Online peer networks challenge pervasive societal stigma and discrimination by giving various patient groups their ain vox and opportunity for self-expression. As the use of popular social media continues to proliferate rapidly (Duggan, 2015), peer-to-peer interactions volition increasingly become an of import function of how people with serious mental affliction communicate with each other.

Future research must carefully consider the mechanisms involved in online peer-to-peer connections that may be fundamental in supporting and promoting mental and physical wellbeing, as these potential behavioural mechanisms may be applicable beyond apace changing social media platforms. Future efforts must besides explore whether potential benefits of online peer-to-peer support are accrued every bit beyond income and indigenous groups. Despite promising trends of increasing social media apply (Duggan, 2015) and admission to mobile devices (Smith, 2015) beyond all demographic groups, focused efforts volition be necessary to reach the near isolated and low-income individuals with serious mental illness who may accept greater symptom severity, lower education and who may remain disconnected or unable to access online networks. Mobile devices have become the master method for accessing social media (Kemp, 2015), which facilitates access among low-income individuals who rely on their mobile devices for Internet access (McGrane, 2013).

Increasing mobile connectivity and use of social media are occurring even more than rapidly throughout the developing world (Pew Research Heart, 2014). As pop social media becomes an integral form of communication and social connection across low-income regions, in that location is similar potential to leverage the lesser-up and user-driven nature of these online peer networks to support mental health recovery, empowerment and to combat stigma. This may be specially important in fragmented wellness intendance systems in depression and heart income countries where admission to mental wellness services is limited and even non-existent (Patel et al. 2007). It is possible that the greatest gains in peer-to-peer connections among people with serious mental illness will be realised across low-resource settings.

We are at the get-go of what will probable be a significant shift in the mode that people with serious mental illness tin can challenge stigma, seek wellness information and access interventions aimed at providing back up and promoting mental and physical wellbeing. Every bit this research area advances, it is essential to closely involve individuals with serious mental disease who are active members of online communities to inform efforts aimed at harnessing the apply of online peer networks. At that place are also methodological challenges to surmount, such equally determining the platonic approaches for evaluating multicomponent interventions delivered through online peer networks, and identifying strategies for collecting objective mental and physical health consequence measures to determine effectiveness and bear upon. As Parr (2008) points out, people with serious mental affliction may experience greater social connectedness, feelings of grouping belonging and instrumental and emotional support from online peer-to-peer support, however these individuals yet live in an offline world. Therefore, the true challenge that lies ahead will exist to determine whether benefits of feeling less alone, learning from similar others and gaining confidence from interacting with peers online translate into tangible and meaningful improvements in recovery, employment, or mental and physical wellbeing that volition be realised in the offline globe.

Acknowledgements

This work was supported by a grant from the National Institute of Mental Wellness (Grant number: NIMH R01 MH104555) and by the United States Centers for Disease Control and Prevention Wellness Promotion Enquiry Center at Dartmouth (Cooperative Agreement Number U48 DP005018). The funders had no role in the grooming of the manuscript or decision to publish. The authors written report no competing interests.

Disharmonize of Interest

None.

References

Alvarez-Jimenez Thousand, Bendall S, Lederman R, Wadley K, 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 Enquiry 143, 143–149. [PubMed] [Google Scholar]
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, 96–106. [PubMed] [Google Scholar]
Armstrong N, Powell J (2009). Patient perspectives on health advice posted on Internet discussion boards: a qualitative study. Health Expectations 12, 313–320. [PMC gratuitous article] [PubMed] [Google Scholar]
Bargh JA, McKenna KY, Fitzsimons GM (2002). Can you see the real me? Activation and expression of the "true cocky" on the Net. Journal of Social Issues 58, 33–48. [Google Scholar]
Bargh JA, McKenna KYA (2004). The Internet and social life. Annual Review of Psychology 55, 573–590. [PubMed] [Google Scholar]
Bartels SJ, Aschbrenner KA, Rolin SA, Hendrick DC, Naslund JA, Faber MJ (2013). Activating older adults with serious mental illness for collaborative main care visits. Psychiatric Rehabilitation Journal 36, 278–288. [PMC complimentary article] [PubMed] [Google Scholar]
Berger M, Wagner TH, Baker LC (2005). Internet use and stigmatized affliction. Social Science & Medicine 61, 1821–1827. [PubMed] [Google Scholar]
Brewer MB (1991). The social self: on beingness the same and dissimilar at the same fourth dimension. Personality and Social Psychology Bulletin 17, 475–482. [Google Scholar]
Burns JM, Durkin LA, Nicholas J (2009). Mental wellness of young people in the United States: what role can the cyberspace play in reducing stigma and promoting help seeking? Journal of Adolescent Wellness 45, 95–97. [PubMed] [Google Scholar]
Caplan SE (2003). Preference for online social interaction a theory of problematic Net utilize and psychosocial well-being. Advice Inquiry 30, 625–648. [Google Scholar]
Chung JE (2013). Social interaction in online back up groups: preference for online social interaction over offline social interaction. Computers in Human Behavior 29, 1408–1414. [Google Scholar]
Chung JE (2014). Social networking in online support groups for wellness: how online social networking benefits patients. Journal of Wellness Communication 19, 639–659. [PubMed] [Google Scholar]
Corrigan Prisoner of war (1998). The touch of stigma on severe mental illness. Cognitive and Behavioral Do five, 201–222. [Google Scholar]
Corrigan PW (2004). How stigma interferes with mental health care. American Psychologist 59, 614–625. [PubMed] [Google Scholar]
Corrigan PW, Kosyluk KA, Rüsch N (2013). Reducing self-stigma by coming out proud. American Journal of Public Health 103, 794–800. [PMC free article] [PubMed] [Google Scholar]
Corrigan PW, Morris Southward, Larson J, Rafacz J, Wassel A, Michaels P, Wilkniss S, Batia One thousand, Rüsch North (2010). Self-stigma and coming out about ane'southward mental illness. Journal of Community Psychology 38, 259–275. [PMC free article] [PubMed] [Google Scholar]
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, 1105–1110. [PubMed] [Google Scholar]
Crabtree JW, Haslam SA, Postmes T, Haslam C (2010). Mental health support groups, stigma, and self-esteem: positive and negative implications of grouping identification. Periodical of Social Bug 66, 553–569. [Google Scholar]
Davidson L, Chinman M, Kloos B, Weingarten R, Stayner D, Tebes JK (1999). Peer support among individuals with severe mental affliction: a review of the evidence. Clinical Psychology: Scientific discipline and Practice 6, 165–187. [Google Scholar]
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 performance? Psychiatry Research 102, 21–27. [PubMed] [Google Scholar]
Dixon L (1995). Furnishings of homelessness on the quality of life of persons with astringent mental affliction. Psychiatric Services 46, 922–926. [PubMed] [Google Scholar]
Duggan Thousand (2015). Mobile Messaging and Social Media 2015. Pew Research Middle: http://www.pewinternet.org/2015/08/19/mobile-messaging-and-social-media-2015/
Entwistle VA, France EF, Wyke S, Jepson R, Hunt K, Ziebland South, Thompson A (2011). How information about other people'due south personal experiences tin help with healthcare controlling: a qualitative study. Patient Education and Counseling 85, e291–e298. [PubMed] [Google Scholar]
Folsom DP, Hawthorne W, Lindamer L, Gilmer T, Bailey A, Golshan S, Garcia P, Unützer J, Hough R, Jeste DV (2005). Prevalence and adventure factors for homelessness and utilization of mental health services among 10 340 patients with serious mental affliction in a big public mental health system. American Periodical of Psychiatry 162, 370–376. [PubMed] [Google Scholar]
Goodman LA, Rosenberg SD, Mueser KT, Drake RE (1997). Physical and sexual assault history in women with serious mental illness: prevalence, correlates, handling, and hereafter research directions. Schizophrenia Bulletin 23, 685–696. [PubMed] [Google Scholar]
Gowen Yard, Deschaine M, Gruttadara D, Markey D (2012). Young adults with mental wellness conditions and social networking websites: seeking tools to build community. Psychiatric Rehabilitation Journal 35, 245–250. [PubMed] [Google Scholar]
Haker H, Lauber C, Rössler W (2005). Net forums: a self-aid arroyo for individuals with schizophrenia? Acta Psychiatrica Scandinavica 112, 474–477. [PubMed] [Google Scholar]
Harvey KJ, Brown B, Crawford P, Macfarlane A, McPherson A (2007). 'Am I normal?' Teenagers, sexual health and the internet. Social Science & Medicine 65, 771–781. [PubMed] [Google Scholar]
Hert M, Cohen D, Bobes J, Cetkovich-Bakmas M, Leucht S, Ndetei DM, Newcomer JW, Uwakwe R, Asai I, Moller H-J (2011). Physical affliction in patients with astringent mental disorders. 2. Barriers to care, monitoring and treatment guidelines, plus recommendations at the system and individual level. Earth Psychiatry 10, 138–151. [PMC gratuitous article] [PubMed] [Google Scholar]
Hiday VA, Swartz MS, Swanson JW, Borum R, Wagner Hour (1999). Criminal victimization of persons with severe mental illness. Psychiatric Services 50, 62–68. [PubMed] [Google Scholar]
Highton-Williamson E, Priebe S, Giacco D (2015). Online social networking in people with psychosis: a systematic review. International Journal of Social Psychiatry 61, 92–101. [PubMed] [Google Scholar]
Kaplan 1000, Salzer MS, Solomon P, Brusilovskiy Eastward, Cousounis P (2011). Internet peer support for individuals with psychiatric disabilities: a randomized controlled trial. Social Science & Medicine 72, 54–62. [PubMed] [Google Scholar]
Kemp Southward (2015). Digital, social and mobile worldwide in 2015. We Are Social: http://wearesocial.internet/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 disease in the general population. Athenaeum of Full general Psychiatry 60, 184–189. [PubMed] [Google Scholar]
Kummervold PE, Gammon D, Bergvik S, Johnsen J-AK, Hasvold T, Rosenvinge JH (2002). Social support in a wired world: apply of online mental health forums in Norway. Nordic Periodical of Psychiatry 56, 59–65. [PubMed] [Google Scholar]
Lam JA, Rosenheck R (1998). The effect of victimization on clinical outcomes of homeless persons with serious mental affliction. Psychiatric Services 49, 678–683. [PubMed] [Google Scholar]
Lauder S, Chester A, Castle D, Dodd Due south, Gliddon E, Berk L, Chamberlain J, Klein B, Gilbert M, Austin DW (2015). A randomized head to head trial of MoodSwings.cyberspace.au: an internet based self-help program for bipolar disorder. Journal of Affective Disorders 171, thirteen–21. [PubMed] [Google Scholar]
Lawlor A, Kirakowski J (2014). Online back up groups for mental health: a infinite for challenging self-stigma or a means of social abstention? Computers in Human being Behavior 32, 152–161. [Google Scholar]
Lederman R, Wadley 1000, Gleeson J, Bendall S, Álvarez-Jiménez K (2014). Moderated online social therapy: designing and evaluating technology for mental health. ACM Transactions on Computer-Human Interaction (TOCHI) 21, 1–32. [Google Scholar]
Link BG, Struening EL, Rahav Chiliad, Phelan JC, Nuttbrock 50 (1997). On stigma and its consequences: prove from a longitudinal study of men with dual diagnoses of mental affliction and substance abuse. Journal of Health and Social Behavior 177–190. [PubMed] [Google Scholar]
Lowe P, Powell J, Griffiths F, Thorogood M, Locock L (2009). "Making information technology all normal": the function of the net in problematic pregnancy. Qualitative Wellness Research 19, 1476–1484. [PubMed] [Google Scholar]
McGrane K (2013). The rise of the mobile-only user. Harvard Business Review: https://hbr.org/2013/05/the-rise-of-the-mobile-but-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, 681–694. [Google Scholar]
Miller BJ, Stewart A, Schrimsher J, Peeples D, Buckley PF (2015). How connected are people with schizophrenia? Cell phone, reckoner, email, and social media use. Psychiatry Enquiry 225, 458–463. [PubMed] [Google Scholar]
Mittal VA, Tessner KD, Walker EF (2007). Elevated social Net use and schizotypal personality disorder in adolescents. Schizophrenia Inquiry 94, 50–57. [PMC free article] [PubMed] [Google Scholar]
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 being Behavior 26, 1183–1193. [Google Scholar]
Murray CJ, Lopez Advertising (1997). Culling projections of bloodshed and inability by cause 1990–2020: global brunt of disease written report. The Lancet 349, 1498–1504. [PubMed] [Google Scholar]
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, 25–31. [PubMed] [Google Scholar]
Naslund JA, Grande SW, Aschbrenner KA, Elwyn G (2014). Naturally occurring peer back up through social media: the experiences of individuals with severe mental illness using YouTube. PloS One nine, e110171. [PMC complimentary article] [PubMed] [Google Scholar]
Naslund JA, Aschbrenner KA, Barre LK, Bartels SJ (2015a). Feasibility of pop one thousand-Wellness technologies for activity tracking among individuals with serious mental illness. Telemedicine and e-Health 21, 213–216. [PMC free article] [PubMed] [Google Scholar]
Naslund JA, Aschbrenner KA, Marsch LA, McHugo GJ, Bartels SJ (2015b). Crowdsourcing for conducting randomized trials of Cyberspace delivered interventions in people with serious mental illness: a systematic review. Contemporary Clinical Trials 44, 77–88. [PMC costless commodity] [PubMed] [Google Scholar]
Naslund JA, Marsch LA, McHugo GJ, Bartels SJ (2015c). Emerging mHealth and eHealth interventions for serious mental affliction: a review of the literature. Journal of Mental Health 24, 321–332. [PMC free commodity] [PubMed] [Google Scholar]
Parr H (2008). Mental Health and Social Infinite: Towards Inclusionary Geographies? Blackwell Publishing: Malden, MA. [Google Scholar]
Patel Five, Araya R, Chatterjee S, Chisholm D, Cohen A, De Silva G, Hosman C, McGuire H, Rojas G, van Ommeren M (2007). Treatment and prevention of mental disorders in low-income and center-income countries. The Lancet 370, 991–1005. [PubMed] [Google Scholar]
Perry BL, Pescosolido BA (2015). Social network activation: the office of wellness discussion partners in recovery from mental illness. Social Science & Medicine 125, 116–128. [PMC free commodity] [PubMed] [Google Scholar]
Pew Enquiry Centre (2014). Emerging Nations Embrace Internet, Mobile Engineering. Pew Enquiry Center: http://www.pewglobal.org/2014/02/13/emerging-nations-encompass-internet-mobile-technology/
Pompili M, Lester D, Innamorati K, Tatarelli R, Girardi P (2008). Assessment and treatment of suicide risk in schizophrenia. Skilful Review of Neurotherapeutics 8, 51–74. [PubMed] [Google Scholar]
Powell J, McCarthy North, Eysenbach G (2003). Cross-sectional survey of users of Internet low communities. BMC Psychiatry three, nineteen. [PMC free article] [PubMed] [Google Scholar]
RachBeisel J, Scott J, Dixon L (1999). Co-occurring severe mental affliction and substance apply disorders: a review of recent research. Psychiatric Services 50, 1427–1434. [PubMed] [Google Scholar]
Ramo DE, Thrul J, Delucchi KL, Ling PM, Hall SM, Prochaska JJ (2015). The Tobacco Status Project (TSP): report protocol for a randomized controlled trial of a Facebook smoking cessation intervention for young adults. BMC Public Wellness 15, 897. [PMC free article] [PubMed] [Google Scholar]
Raupach JC, Hiller JE (2002). Information and back up for women post-obit the main treatment of breast cancer. Health Expectations 5, 289–301. [PMC complimentary article] [PubMed] [Google Scholar]
Schrank B, Sibitz I, Unger A, Amering M (2010). How patients with schizophrenia utilize the Internet: qualitative report. Journal of Medical Internet Enquiry 12, e70. [PMC complimentary article] [PubMed] [Google Scholar]
Simon GE, Ludman EJ, Goodale LC, Dykstra DM, Stone E, Cutsogeorge D, Operskalski B, Savarino J, Pabiniak C (2011). An online recovery program program: tin can peer coaching increase participation? Psychiatric Services 62, 666–669. [PMC free article] [PubMed] [Google Scholar]
Smith A (2015). U.South. smartphone utilize in 2015. Pew Research Center: http://world wide web.pewinternet.org/2015/04/01/us-smartphone-apply-in-2015/
Smith DJ, Griffiths E, Poole R, Di Florio A, Barnes Eastward, Kelly MJ, Craddock N, Hood K, Simpson South (2011). Beating bipolar: exploratory trial of a novel internet-based psychoeducational treatment for bipolar disorder. Bipolar Disorders 13, 571–577. [PubMed] [Google Scholar]
Sokal J, Messias East, 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 Periodical of Nervous and Mental Affliction 192, 421–427. [PubMed] [Google Scholar]
Spinzy Y, Nitzan U, Becker G, Bloch Y, Fennig Southward (2012). Does the Internet offering social opportunities for individuals with schizophrenia? A cross-sectional pilot study. Psychiatry Research 198, 319–320. [PubMed] [Google Scholar]
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 Melancholia Disorders 169, 21–29. [PubMed] [Google Scholar]
Tomes N (2006). The patient as a policy factor: a historical case study of the consumer/survivor movement in mental wellness. Health Affairs 25, 720–729. [PubMed] [Google Scholar]
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. Periodical of Medical Internet Research 10, e18. [PMC free article] [PubMed] [Google Scholar]
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 Instruction and Counseling 74, 61–69. [PubMed] [Google Scholar]
Wang PS, Demler O, Kessler RC (2002). Adequacy of handling for serious mental illness in the United States. American Journal of Public Health 92, 92–98. [PMC free commodity] [PubMed] [Google Scholar]
Whitley R, Campbell RD (2014). Stigma, agency and recovery amongst people with severe mental illness. Social Scientific discipline & Medicine 107, 1–8. [PubMed] [Google Scholar]
Ziebland S, Wyke Southward (2012). Health and illness in a connected world: how might sharing experiences on the internet affect people's health? Milbank Quarterly ninety, 219–249. [PMC free commodity] [PubMed] [Google Scholar]

Articles from Epidemiology and Psychiatric Sciences are provided here courtesy of Cambridge Academy Press

bestlictur.blogspot.com

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4830464/