What did we find?
iPOF researchers produced several articles focused on different aspects of online mental health forum use:
Improving Peer Online Forums (iPOF)
The impacts of online mental health forums: Realist synthesis and evaluation
Synthesis
We combined information from 102 published papers and 18 interviews with forum staff to develop initial programme theories about how online forums work. The findings show that people are more likely to keep using online forums if they feel safe there and that the topics are relevant to them. Forums that feel safe, welcoming, and easy to use can help people feel more confident about managing their mental health. In supportive, non-judgmental communities, people can talk about their problems with others who understand, feel less alone, and realise that their mental health struggles are not unusual. They can also encourage and support each other.
Moderators play a key role in making these spaces safe and supportive, encouraging people to join in, and protecting users from harmful content. A key challenge for organisations running these forums is to keep them open and anonymous enough for people to feel comfortable sharing, while also enforcing rules, like limits on what can be posted, to keep everyone safe.
Understanding the Impacts of Online Mental Health Peer Support Forums: Realist Synthesis
Evaluation
We then tested and refined these theories using data collected from people who use forums including a large online survey (n = 791) and in-depth realist interviews (n=52). We also analysed forum posts to identify in situ evidence for our revised theories. This paper is published [add link to the paper]. We found that the impacts of using peer online mental health forums were largely positive. Forums that are easy to navigate, make users feel safe to post, and are supported by well-trained moderators offering timely and sensitive responses can help people find new ways to make sense of their mental health challenges, feel understood, and accepted in the forum. This can lead to an increase in self-efficacy, a reduction in self-stigma, and increased mental wellbeing. Writing about experiences in a forum can itself be cathartic, but when posts have evidently been helpful to other members, posters also benefit from a sense of greater purpose and value. Negative impacts can occur if forums are difficult to navigate or if moderation is unresponsive, insensitive, or inadequate, as users can be left feeling unheard, misunderstood, or overly responsible for the welfare of others.
Impacts of Using Peer Online Forums in Mental Health: Realist Evaluation Using Mixed Methods
Ethics
We only used forum posts from individuals who had freely consented to posts being shared for research because there are a lot of ethical and methodological challenges with using online data to evaluate forums which we discuss in detail here. We are currently using these findings to design a tool to support ethics committees in decision making about use of online data.
Evaluating peer online forums to support health: ethical and practical challenges
Supporting forum moderators: a realist synthesis
This paper aimed to understand how moderators experience their roles and what can be done to better train and support them.
Designing online forums to support health and wellbeing: guidance informed by self-determination theory and stakeholder perspectives
The use of online health forums is growing, yet evidence about their safety and effectiveness remains mixed, partly due to a lack of theory-informed design guidance. This study aimed to draw on the experiences of forum users and staff, alongside research on wellbeing-supportive design and self-determination theory, to develop evidence-based guidelines for creating safe and supportive forums. We conducted 52 interviews with users and staff and held four design workshops, supported by input from a multidisciplinary research team. Using qualitative framework analysis, we adapted an existing wellbeing-supportive technology framework to the context of online health forums. The resulting guidelines are organised around four key principles linked to autonomy, competence, relatedness, and safety, each accompanied by practical design strategies. Findings show substantial room for improving how forums support psychological needs, and the proposed guidelines offer adaptable, evidence-based direction for enhancing forum design across diverse settings.
Who uses forums, and why?: A mixed methods study
A total of 791 forum users across 7 forums filled out a survey, and their information was compared with people who use NHS Talking Therapies. 20 forum users were also interviewed to find out why they use forums. In addition, the researcher team looked at the most common words in 28 million words of forum posts, using a statistical test to find keywords. The surveys showed that most forum users were white, female, and younger. However, compared to NHS Talking Therapies, the forums had more people from different ethnic backgrounds and a higher number of non-binary users. The interviews showed that people use forums because they are easy to access and help them get around barriers to face-to-face support, like having to talk in person. People used the forums for emotional support, advice, and to connect with others who have similar struggles. The word “scared” came up a lot in forum posts. It often appeared in phrases like “I’m scared because...” and “I’m scared of...” When looking at these posts, people often shared fears over identity, including questioning sexuality and gender identity, as well as fears of mental health symptoms.
Understanding safety in mental health forums: realist evaluation
People often turn to online forums for mental health support, but there are concerns these spaces might sometimes cause harm. This study explored how safe people feel using these forums, looking at both risks and whether they feel comfortable sharing. It used interviews with 42 people and survey responses from 504 users across three UK mental health forums, including forums for young people, general mental health, and specific conditions like anxiety, depression, eating disorders, and postpartum psychosis.
More than half of the survey respondents said they felt safe to post because they could stay anonymous (about 60% agreed or strongly agreed). However, around 19% said they had come across upsetting posts, and about a quarter worried that talking about mental health online could sometimes make them feel worse. People valued being able to talk openly without fear of being judged or identified offline. Many said that clear rules and active moderation helped deal with harmful posts quickly, but they also wanted moderators to be sensitive so conversations didn’t feel too controlled. Users often tried to protect themselves by avoiding certain posts or leaving discussions that felt triggering. Overall, the study showed that feeling safe depended not just on stopping harm but also on having a supportive, genuine community where people with similar experiences could connect and help each other.
Understanding Safety in Online Mental Health Forums: Realist Evaluation
Ethnic minority perspectives on forum use
People from ethnic minority backgrounds often use community mental health services less than others in the UK. This study looked at whether online mental health forums might be a better option.
‘In my experience…’ A corpus linguistic analysis
This study explored how people share their own mental health experiences on two online forums and how others respond to them. The researchers used language analysis to look closely at forum posts and worked with people with lived experience to help design the study and understand the results. They focused on how people present their own stories and how these stories shape conversations within the community.
The study found that when people share their experiences, they often give advice or information to help others, most commonly about treatment, medication, or encouraging someone to seek help. When others reply, they usually thank the original poster, share their own similar stories, or say that reading these posts makes them feel less alone. Some negative comments about health professionals did appear, but there was no sign of harmful or false advice. Overall, the findings suggest that sharing personal experiences can help build supportive connections and provide useful guidance in online mental health forums.
‘In my experience …’: The use of the word experience in peer online forums for mental health
Using natural language processing to evaluate mental health forums
This study looked at how artificial intelligence (AI) can help analyse conversations in online mental health forums. It looked directly at text from conversations in mental health forums. The researchers wanted to find out if AI could reliably spot important things in posts, like people feeling connected, sharing personal stories, showing empathy, and saying thank you.
They tested several modern AI tools, especially a type called transformer models, and found that these tools were good at picking out these themes accurately. This is important because it means researchers can quickly look at lots of messages and better understand what makes these forums helpful and supportive. This technology could shape the way that moderators identify and respond to posts.
Access the Natural Language Processing Paper
Superuser's Experiences of Mental Health Forums
Postgraduate researcher Catherine Liberty won Best Poster at the FHM PGR Symposium for her work on superuser's experiences of online mental health forums.
We will add a link to Catherine's paper when it has been published
Using forums for postpartum psychosis
This qualitative study explored how online peer support forums impact individuals experiencing postpartum psychosis—an area previously unexamined. Eight participants recruited via a charity-run forum shared their experiences through semi-structured interviews, analysed using Interpretative Phenomenological Analysis. Four key themes emerged: forums fostered connection and hope, filled gaps in professional support, were shaped by privacy and readiness to share, and involved complex relational dynamics. While forums were broadly seen as beneficial for recovery, challenges around engagement and emotional regulation were noted. The findings suggest forums should be designed with safeguards like trigger warnings and boundaries, and professionals should consider recommending them as a complementary support tool.
You will find a link to Kat William's paper 'Using forums for postpartum psychosis' here, when it is published.