An evaluation of an online peer support forum for university students with depressive symptoms
Open accessAbstract
Background Depression is the most common mental health problem among young people, particularly university students, with prevalence rates as high as 48% reported. This population however, is reluctant to seek professional help. Online interventions may be particularly appealing to students, with evidence suggesting that they use the Internet for mental health support. While there are many mental health resources on the Internet few focus specifically on the needs of young people and few have been evaluated. This research aimed to develop and pilot test an online peer support intervention for students experiencing depressive symptoms.Methods A depression support Web site (www.losetheblues.ie) was designed specifically for 18-24 year old students. The study used a mixed method, involving quantitative descriptive, pre- and post-test and qualitative descriptive designs. Data were collected using the Centre for Epidemiological Studies Depression Scale (CES-D), a background questionnaire and online forum posts.Results The sample consisted of 117 university students with self-reported depressive symptoms. Results from participants in the pre- and post-test element of the study, showed no statistical significance. The forum posts revealed that the participants' main difficulties were loneliness and perceived lack of socialization skills. The Web site provided a place for sharing, offering and receiving emotional and informational support.Conclusion Developing health care interventions in an online environment presents unique challenges to the research process, however they have the potential to provide mental health care that is accessible and affordable.
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In one study of an online peer-support website, anonymity allowed participants to share details that they had never shared before.
“In one study of an online peer-support website, anonymity allowed participants to share details that they had never shared before, and in fact had “put a lot of effort into hiding” (48, p. 87).”
From What Works and What Doesn’t Work? A Systematic Review of Digital Mental Health Interventions for Depression and Anxiety in Young People (2019) · cites this paper as [48]
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Dewa, L. H., Lawrance, E., Roberts, L. F., Brooks-Hall, E., Ashrafian, H., Fontana, G., & Aylin, P. P. (2021) · Journal of Medical Internet Research · doi:10.2196/26584 · Cited by 30 · see citing works
“…P =.003), with high heterogeneity (I 2 = 83.1%; Figure 3) [29,31,56-58]. social connectedness [22,28,29,31,52,57,58], loneliness (reduced) [30,31,40,54,59], relatedness [56], sense of belonging [22,31], being able to share [21,52,54], less alone in one’s feelings [25,54], feeling normalized…”
InfluentialThe effect of counselling-based training on online peer support
Lekka, F., Efstathiou, G., & Kalantzi-Azizi, A. (2014) · British Journal of Guidance and Counselling · doi:10.1080/03069885.2014.959472 · Cited by 24 · see citing works
Moskowitz, J. T., Addington, E. L., Shiu, E. W., Bassett, S. M., Schuette, S., Kwok, I., Freedman, M. E., Leykin, Y., Saslow, L. R., Cohn, M., et al. (2021) · Journal of Medical Internet Research · doi:10.2196/25922 · Cited by 21 · see citing works
“Social enhancements such as discussion boards that encourage users to generate and share content with each other can improve engagement [11-14].”
Choi, I., Mestroni, G., Hunt, C. J., & Glozier, N. (2022) · JMIR Formative Research · doi:10.2196/35659 · Cited by 23 · see citing works
“The uptake of digital interventions for the treatment of mental health conditions such as stress and depressive symptoms among university populations was reported to mostly range from 1% to 8% [54-59], with one study reporting 16.”
Parmar, J. S., Thapa, P., Micheal, S., Dune, T. M., LIM, D. J., Alford, S., Mistry, S. K., & Arora, A. (2025) · Education Sciences · doi:10.3390/educsci15030273 · Cited by 35 · see citing works
Bautista, C. L., Ralston, A. L., Brock, R. L., & Hope, D. A. (2022) · Cogent Psychology · doi:10.1080/23311908.2022.2040160 · Cited by 17 · see citing works
“Community-based lay workers can enhance treatment gains without the need for heavy reliance on mental healthcare professionals (Abas et al., 2016; Horgan et al., 2013; Rhodes et al., 2009).”
BackgroundDevelopment, Evaluation, and Evolution of a Peer Support Program in Veterinary Medical Education
Spielman, S., Hughes, K., & Rhind, S. M. (2015) · Journal of Veterinary Medical Education · doi:10.3138/jvme.1114-115r · Cited by 16 · see citing works
Psychological Interventions for Higher Education Students in Europe: A Systematic Literature Review
Franzoi, I. G., Sauta, M. D., Barbagli, F., Avalle, C., & Granieri, A. (2022) · Youth · doi:10.3390/youth2030017 · Cited by 22 · see citing works
“Contrarily, Horgan and colleagues’ [114] exploration of an online peer support intervention for students experiencing depressive symptoms showed no statistically significant differences between pre and post-intervention.”
BackgroundWoodgate, R. L., Sigurdson, C. M., Demczuk, L., Tennent, P., Wallis, B., & Wener, P. F. (2017) · The JBI Database of Systematic Reviews and Implementation Reports · doi:10.11124/jbisrir-2016003283 · Cited by 15 · see citing works
Social media use for supporting mental health (SMILE)
Brown, G., Rathbone, A. L., & Prescott, J. (2021) · Mental Health Review Journal · doi:10.1108/mhrj-10-2020-0079 · Cited by 14 · see citing works
Storman, D., Jemioło, P., Świerz, M. J., Sawiec, Z., Antonowicz, E., Prokop‐Dorner, A., Gotfryd-Burzyńska, M., & Bała, M. M. (2022) · JMIR Mental Health · doi:10.2196/36056 · Cited by 14 · see citing works
“A total of 44 studies were included in the final analysis and 8 were labeled as ongoing (Multimedia Appendix 4 [63-105] and Multimedia Appendix 5 [104-111]).”
BackgroundCherba, M., Thoër, C., Turbide, O., Denault, V., Rénaud, L., Valderrama, A., Courcy, I., Cordelier, B., Laquerre, M.-E., Cyr, C., et al. (2019) · Santé Publique · doi:10.3917/spub.191.0083 · Cited by 14 · see citing works
“…expliquer les diff é rents niveaux d’engagement sont cit é s dans les articles, tels que le sexe (les femmes participant plus activement) [24, 32, 50, 54, 55], l’origine ethnoculturelle [16, 17], le niveau de litté - ratie [43], l’exp é rience pr é alable des r é seaux sociaux [13, 41, 43], les…”
BackgroundStafford, E., Hides, L. M., & Kavanagh, D. J. (2015) · Internet Interventions · doi:10.1016/j.invent.2015.05.004 · Cited by 13 · see citing works
“The addition of a moderated peer support forum to the program, could be another strategy to increase its impact (Horgan et al., 2013).”
BackgroundNasier, B., Gibson, K. L., & Trnka, S. H. (2021) · Computers in Human Behavior · doi:10.1016/j.chb.2021.106933 · Cited by 13 · see citing works
Amanvermez, Y., Karyotaki, E., Cuijpers, P. J., Čihařová, M., Donker, M. H., Hurks, P. P. M., Salemink, E., Spinhoven, P., Struijs, S. Y., & de Wit, L. M. (2023) · JMIR Formative Research · doi:10.2196/45725 · Cited by 14 · see citing works
Long-term telemental health prevention interventions for youth: A rapid review.
Abuwalla, Z., Clark, M. D., Burke, B. J., Tannenbaum, V., Patel, S., Mitacek, R., Gladstone, T. R. G., & Voorhees, B. W. V. (2017) · Internet Interventions · doi:10.1016/j.invent.2017.11.006 · Cited by 12 · see citing works
“University students with depressive symptoms reported that using an online peer forum helped them with loneliness, and created a space for giving and receiving support (Horgan et al., 2013).”
BackgroundOnline mental health peer support: a systematic scoping review of theoretical mechanisms of effect
Yuan, S., Davidson, G., & Best, P. (2025) · BMC Digital Health · doi:10.1186/s44247-025-00205-0 · Cited by 11 · see citing works
“…support, from general mental health problems [18, 31, 32] [42, 45–50] to specific mental health problems such as anxiety [51], depression [9, 36, 37, 44, 51–53], emotional abuse and neglect [43], self-harm [8, 14, 54, 55], suicide [54], schizophrenia disorders [12] as well as eating disorders…”
InfluentialBickerstaff, J. M., Karim, S., Whitman, R. K., Cypher, A., Wiener, S. J., & Radović, A. (2021) · Journal of Technology in Behavioral Science · doi:10.1007/s41347-021-00210-w · Cited by 11 · see citing works
Social Media Use by Transplant Recipients for Support and Healing
Grumme, V. S., & Gordon, S. C. (2016) · CIN Computers Informatics Nursing · doi:10.1097/cin.0000000000000276 · Cited by 12 · see citing works
Using technology to support the social and emotional well‐being of nurses: A scoping review protocol
Webster, N., Oyebode, J. R., Jenkins, C., & Smythe, A. (2018) · Journal of Advanced Nursing · doi:10.1111/jan.13942 · Cited by 11 · see citing works
Experiences of Chinese international students living in Australia: Wellbeing from "we" to "me"
Huang, L., Kern, M. L., & Oades, L. G. (2022) · International Journal of Wellbeing · doi:10.5502/ijw.v12i3.1915 · Cited by 10 · see citing works
Integrated learning communities as a peer support initiative for first year university students
Spiridon, E., Kaye, L. K., Nicolson, R. I., Ransom, H. J., Tan, A. J. Y., & Tang, B. W. X. (2020) · Journal of Applied Social Psychology · doi:10.1111/jasp.12668 · Cited by 11 · see citing works
Reitegger, F., Peras, I., Wright, M., & Gasteiger‐Klicpera, B. (2024) · Adolescent Research Review · doi:10.1007/s40894-024-00237-z · Cited by 13 · see citing works
Ferizaj, D., Lalk, C., Lahmann, N., Strube‐Lahmann, S., & Rubel, J. A. (2025) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1503427 · Cited by 9 · see citing works
“This may reduce isolation (11) and stress (12) and even improve symptoms of depression (11) and self-harm (13).”
Fulford, H., McSwiggan, L. C., Kroll, T., & MacGillivray, S. A. (2016) · JMIR Mental Health · doi:10.2196/mental.5966 · Cited by 9 · see citing works
“ICTs appeared to be being used for help-seeking through the acquirement of self-help information, the development of skills, and also as a means to seek help through online support groups and forums [38,40,45,57,58].”
InfluentialDefining Symptom Concepts in Chronic Subjective Tinnitus: Web-Based Discussion Forum Study
Hibbert, A., Vesala, M., Kerr, M., Fackrell, K., Harrison, S., Smith, H. L., & Hall, D. A. (2019) · Interactive Journal of Medical Research · doi:10.2196/14446 · Cited by 9 · see citing works
“Unsurprisingly, an increasing number of investigators are designing Web discussion forums to collect qualitative research data from patients and using thematic analysis to evaluate forum posts [38-40].”
A web-based adolescent depression support system: feedback and implications for the future
Anttila, K., Anttila, M., & Valimaki, M. A. (2019) · Informatics for Health and Social Care · doi:10.1080/17538157.2019.1656206 · Cited by 8 · see citing works
“As seen in other studies, we found the need for confidentiality and privacy regarding highly sensitive issues.(26,29,44) In our study, the adolescents expressed thoughts and feelings via a support system, yet they were still worried that somebody might find out about their personal writings.”
BackgroundResultInfluentialSouth African psychologists’ use of the Internet in their practices
Evans, D. J. (2014) · South African Journal of Psychology · doi:10.1177/0081246314527874 · Cited by 8 · see citing works
Dunn, L. C., Alexander, S., & Howard, A. L. (2022) · Infant and Child Development · doi:10.1002/icd.2349 · Cited by 9 · see citing works
Tian, E., Ho, M. K., Chou, O. H. I., Chong, S. Y. C., Kwan, C. T., Lam, A. H.-Y., & Chan, K. (2025) · Clinical Child Psychology and Psychiatry · doi:10.1177/13591045251338475 · Cited by 7 · see citing works
“The study observed a high attrition rate of over 80%, with users ’ frequency of visiting the site and posting gradually reducing over time (Horgan et al., 2013).”
Banwell, E., Hanley, T., García, S. D. O., Mindel, C., Kayll, T., & Sefi, A. (2022) · JMIR Formative Research · doi:10.2196/36432 · Cited by 8 · see citing works
“Mental health discussion forums are particularly valued by young people who perceive themselves as lacking social skills [16].”
BackgroundEvaluating user experiences of SHaRON: an online CBT-based peer support platform
Browne, N. L., Carragher, N. O., O’Toole, A., Pimm, J., Ryder, J., & Thew, G. R. (2022) · The Cognitive Behaviour Therapist · doi:10.1017/s1754470x22000150 · Cited by 7 · see citing works
“Horgan et al .”
Golz, C., Richter, D., Sprecher, N., & Gurtner, C. (2022) · BMC Psychiatry · doi:10.1186/s12888-022-04080-1 · Cited by 7 · see citing works
“In this context, exchanges with peers (i.e. persons with a comparable health-related problem) are particularly supportive in improving mental health [13], although only a few users are active in this way, with the majority only reading the shared experiences [14].”
BackgroundPeer Support Programs for Youth Mental Health
Boucher, J., Subramonian, A., Hill, S., Gates, M., Brundisini, F. K., Severn, M., Kaunelis, D., Smith, A. L., & Helis, E. (2022) · Canadian Journal of Health Technologies · doi:10.51731/cjht.2022.495 · Cited by 8 · see citing works
Davila, C., Chan, S. H., Gosline, A., Arenas, Z., Kavanagh, J. E., Feltz, B., McCarthy, E., Pitts, T., & Ritchie, C. S. (2023) · Journal of Medical Internet Research · doi:10.2196/48550 · Cited by 6 · see citing works
Confidentiality, anonymity and amnesty for midwives in distress seeking online support – Ethical?
Pezaro, S., Clyne, W., & Gerada, C. (2016) · Nursing Ethics · doi:10.1177/0969733016654315 · Cited by 6 · see citing works
“As confidentiality and anonymity have been cited as two of the most important features of an online peer support forum, these two principles may be key features in online interventions to support midwives in work-related psychological distress.(95) In order to mitigate risk, users may require ethical guidance in relat…”
Giovenco, D., Shook‐Sa, B. E., Hutson, B., Buchanan, L., Fisher, E. B., & Pettifor, A. E. (2022) · medRxiv · doi:10.1101/2021.12.31.21268596 · Cited by 6 · see citing works
Meter, A. V., & Agrawal, N. (2022) · Journal of Child and Adolescent Mental Health · doi:10.2989/17280583.2023.2283030 · Cited by 5 · see citing works
“This study is among the first to evaluate the mental health benefits of an online support community for youth – extending the peer support model, which is popular and effective among adults, to adolescents (Hanley et al ., 2019; Horgan et al ., 2013; Prescott et al ., 2017; Stevens et al ., 2022) .”
BackgroundPrescott, J. (2022) · Mental Health and Social Inclusion · doi:10.1108/mhsi-02-2022-0010 · Cited by 5 · see citing works
Mindel, C., Mainstone-Cotton, L., García, S. D. O., Sefi, A., Sugarman, G., Salhi, L., Brick, H., Jackson, K., & Hanley, T. (2022) · Frontiers in Digital Health · doi:10.3389/fdgth.2022.872404 · Cited by 5 · see citing works
“Horgan and colleagues (25) used thematic analysis on forum posts, alongside standardised outcomes for depression and anxiety.”
BackgroundRivera, E., Barahona-Aguilar, C., Cuevas, G., Orellana-Moreno, F., Corrales, I., Mejía-Sánchez, R., Paz-Maldonado, E., & Landa–Blanco, M. (2025) · Frontiers in Psychology · doi:10.3389/fpsyg.2025.1565943 · Cited by 4 · see citing works
Typology of online mental health peer support for young people: a systematic scoping review
Yuan, S., Davidson, G., & Best, P. (2025) · Children and Youth Services Review · doi:10.1016/j.childyouth.2025.108662 · Cited by 4 · see citing works
da Costa, M. P., Foster, R., Gillard, S., & Priebe, S. (2019) · Springer eBooks · doi:10.1007/978-3-319-70134-9_72-1 · Cited by 4 · see citing works
da Costa, M. P., Foster, R., Gillard, S., & Priebe, S. (2021) · Springer eBooks · doi:10.1007/978-3-030-57296-9_72 · Cited by 4 · see citing works
Darker, C. D., Moore, E., Flynn, E., O’Neill, M., Doherty, L., McMahon, J., McLoughlin, O., Rouine, E., Ivers, J., Allwright, S., et al. (2021) · Health Promotion International · doi:10.1093/heapro/daab071 · Cited by 4 · see citing works
Homer, S. R., Milne‐Ives, M., Cornford, E., Richardson, R., Rogers, A., Relf, O., Andrade, J., Meinert, E., & May, J. (2026) · npj Mental Health Research · doi:10.1038/s44184-026-00191-9 · Cited by 4 · see citing works
“Yet,only fi veinterventionsweredelivereddigitally:a depression support forum 29 ; facilitated online chat 30,31 ; an online journal 30 ; and one app, Nod 26 , which delivers mindfulness activities and sociability tips.”
Rathbun‐Grubb, S. (2019) · The International Journal of Information Diversity & Inclusion (IJIDI) · doi:10.33137/ijidi.v3i4.33011 · Cited by 3 · see citing works
“A mental health support forum created as a therapeutic intervention for students with depression also showed that sharing in the online environment can provide sufferers with coping strategies, social support, and general information about the illness (Horgan et al., 2013).”
BackgroundYeo, G., Chang, W. C., Lee, L. N., Oon, M., & Ho, D. (2022) · JMIR Research Protocols · doi:10.2196/34602 · Cited by 3 · see citing works
“Before the pandemic, the administration of digital peer support to a college student population mediated the impact of various psychological and health outcomes [25,26].”
Wade-Bohleber, L., Crameri, A., & von Wyl, A. (2018) · Springer eBooks · doi:10.1007/978-3-662-55733-4_3 · Cited by 3 · see citing works
Psychotherapeutic potential of online self-help groups
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‘Giving a piece of you’: the lecturer experience of aiding student wellbeing
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“Research indicates that young people as “digital natives” frequently use the internet to seek mental health support and report high levels of satisfaction with online resources [21,24,25].”
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Cognitive Theories of Depression in Online Peer Support Forums: Exploring the Cognitive Triad
Pierce, N. E., & Hoelterhoff, M. (2017) · Journal of European Psychology Students · doi:10.5334/jeps.405 · Cited by 2 · see citing works
“Horgan, McCarthy, and Sweeney (2013) found indication that an online environment allows users to receive emotional and social support through identifying with others experiencing the same symptoms.”
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Interventions Addressing Loneliness Among University Students: A Systematic ReviewPreprint
Ellard, O. B., Dennison, C., & Tuomainen, H. (2021) · Research Square · doi:10.21203/rs.3.rs-234688/v1 · Cited by 2 · see citing works
“Two studies recruited medical students (45, 46), one recruited black, male students (47) and one recruited students scoring highly on the C-DES scale of depressive symptoms (48).”
BackgroundMethodInfluentialLoneliness: Coping and Flourishing
Rokach, A., & Patel, K. (2025) · Springer eBooks · doi:10.1007/978-3-032-02959-1_21 · Cited by 1 · see citing works
Kashihara, J., & Sakamoto, S. (2021) · Japanese Psychological Research · doi:10.1111/jpr.12371 · Cited by 1 · see citing works
- Authors
- Horgan, A., McCarthy, G., & Sweeney, J.
- Affiliations
- University College Cork (IE)
- Corresponding author
- Horgan, Aine
- McCarthy, Geraldine
- Sweeney, John
- Venue
- Archives of Psychiatric Nursing
- Publisher
- Elsevier BV
- Published
- 2013-04
- Volume
- 27
- Issue
- 2
- Pages
- 84-89
- ISSN
- 0883-9417 (ISSN-L)
- OpenAlex
- W2040831923
- Cited by
- 127
- References
- 50
- Citations by year
- 2026: 3 · 2025: 9 · 2024: 9 · 2023: 8 · 2022: 22 · 2021: 19 · 2020: 11 · 2019: 15 · 2018: 4 · 2017: 5 · 2016: 9 · 2015: 7 · 2014: 5 · 2013: 1
- FWCI
- 11.21
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- Locations
- Archives of Psychiatric Nursing (publishedVersion)
- PubMed (publishedVersion)
- Cork Open Research Archive (University College Cork, Ireland) (acceptedVersion, cc-by-nc-nd)
- Arrow@dit (Dublin Institute of Technology) (submittedVersion, cc-by-nc-nd)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Health Sciences › Health Professions › General Health Professions › Health Literacy and Information Accessibility
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- online peer support, university students, depressive symptoms, depression, online intervention, online forums, loneliness, socialization skills, help-seeking, youth
- MeSH terms
- Adolescent, Depression, Female, Humans, Loneliness, Male, Peer Group, Self-Help Groups, Students, Universities, Program Evaluation, Internet, Young Adult
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