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Cited by 86Mental Health and Patient InvolvementHealth Literacy and Information AccessibilityDigital Mental Health Interventions

Combining online and offline peer support groups in community mental health care settings: a qualitative study of service users’ experiences

Open access
Strand, Monica, Eng, Lillian Sofie, Gammon, Deede·2020·International Journal of Mental Health Systems
DOI 10.1186/s13033-020-00370-xPMC PMC7260836
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Abstract

BACKGROUND: Peer support for people with long-term mental health problems is central to recovery-oriented approaches in mental health care. Peer support has traditionally been conducted offline in face-to-face groups, while online groups on the Internet have increased rapidly. Offline and online peer support groups are shown to have differing strengths and weaknesses. However, little is known about how combining the two formats might be experienced by service users, which this paper aims to illuminate. METHODS: In this exploratory and descriptive study, a recovery-oriented Internet-based portal called ReConnect was used by service users in two mental health communities in Norway for 6-12 months. The portal included an online peer support group which also facilitated participation in local offline peer support groups. Both group formats were moderated by an employed service user consultant. Qualitative data about service users' experiences were collected through focus groups and individual interviews and inductively analyzed thematically. RESULTS: A total of 14 female service users 22-67 years of age with various diagnoses participated in three focus groups and 10 individual interviews. Two main themes were identified: (1) balancing anonymity and openness, and (2) enabling connectedness. These themes are further illustrated with the subthemes: (i) dilemmas of anonymity and confidentiality, (ii) towards self-disclosure and openness, (iii) new friendships, and (iv) networks in the local community. Three of the subthemes mainly describe benefits, while challenges were more implicit and cut across the subthemes. Identified challenges were related to transitions from anonymity online to revealing one's identity offline, confidentiality, and barriers related to participation in offline peer support groups. CONCLUSIONS: This study suggests that online and offline peer support groups complement each other, and that combining them is mainly described as beneficial by service users. Identified benefits appeared to arise from service users' options of one format or the other, or that they could combine formats in ways that suited their individual values and comfort zones. Moderation by a trained service user consultant appeared essential for both formats and can be used systematically to address identified challenges. Combining online and offline peer support groups is a promising concept for facilitating recovery-oriented care and warrants continued research.

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  • In-person support groups are often challenging due to geographical dispersion and time constraints, especially in rare disease communities.

    “In-person support groups are often challenging due to geographical dispersion and time constraints, which are especially relevant in rare disease communities [17].”

    From Social Media Use Among Parents and Caregivers of Children With Rare Genetic Diseases: Scoping Review (2025) · cites this paper as [17]

    The Results (Enabling connectedness; page unavailable) report practical barriers to attending face-to-face groups, including reliance on others for transport. The Background (page unavailable) describes online support as accessible 24/7 regardless of location. The paper does not establish geographical dispersion or time constraints as reasons in-person groups are challenging, and it studies mental health service users rather than rare disease communities. (LLM, conf=0.82)

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  • Online support groups provide a level of anonymity and reduced stigma that make it more likely for people to share personal information.

    “Online support groups also provide a level of anonymity and reduced stigma that make it more likely for people to share personal information [17].”

    From Social Media Use Among Parents and Caregivers of Children With Rare Genetic Diseases: Scoping Review (2025) · cites this paper as [17]

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Authors
Strand, M., Eng, L. S., & Gammon, D.
Affiliations
Oslo University Hospital (NO)
Corresponding author
Strand, Monica
ORCID
Venue
International Journal of Mental Health Systems
Publisher
Springer Science and Business Media LLC
Published
2020-05-29
Volume
14
Issue
1
Pages
39-39
ISSN
1752-4458 (ISSN-L)
DOI
10.1186/s13033-020-00370-x
PMC
PMC7260836
OpenAlex
W3030252671
Cited by
86
References
73
Citations by year
2026: 15 · 2025: 20 · 2024: 23 · 2023: 17 · 2022: 8 · 2021: 3
FWCI
7.31
Type
journal article
Language
en
Open access
Licence
Locations
  • International Journal of Mental Health Systems (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
Norges Forskningsråd (grant # 213014)
Topics
  • Health Sciences › Health Professions › General Health Professions › Mental Health and Patient Involvement
  • Health Sciences › Health Professions › General Health Professions › Health Literacy and Information Accessibility
  • Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
Keywords
peer support groups, online peer support, community mental health services, recovery-oriented care, service user experiences, anonymity and confidentiality, self-disclosure, online-offline integration, long-term mental health problems, social connectedness

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