The rise of digital peer support across the world

COVID-19 is impacting the mental health of people on a global scale that has never been seen before in modern history. In both resource-rich nations like the United States and resource-poor nations like Bangladesh, we see an unprecedented increase in the number of children and adults with new or worsening mental health as a result of the pandemic.

Telehealth has expanded across the globe to address these rising rates and the mobilization of digital peer support has been a valuable/critical/key part of this effort. 
While some healthcare providers have had decades of training in telehealth and an established infrastructure to deliver these services—many have not—including peer support specialists. Peer support specialists are people with a mental health condition and/or substance use challenge, trained and accredited by their respective state to provide peer support services. Peer support services are considered by the World Health Organization to be an essential mental health service and peer support has shown promise in terms of improving mental health symptoms and quality of life as well as decreasing burden on the mental health system.           

Since 2001, in-person Medicaid reimbursable peer support services have markedly augmented services offered by the traditional healthcare system by providing community-based peer support services (i.e., outside of clinical settings) in 46 states. Right now, our only option is telehealth services in the community–yet, peer support specialists have been one of the last workforces to offer telehealth services. This is despite the finding from a survey of 267 peer specialists across 38 states showing that 95% own a smartphone and express interest in using this technology to enhance peer support services 

Following the expansion of telehealth benefits on March 17, 2020, peer support specialists mobilized and began delivering telehealth backed by current scientific evidence on the feasibility, acceptability and potential benefits of digital peer support.  This mobilization of peer support specialists across the globe was a leap into uncertainty—and this leap was bold and courageous—all in the effort to help other people with similar experiences during this crisis. This dramatic shift from in-person peer support services to digital peer support services has the potential to help people maintain their health and wellness and deliver on our commitment to service users and their families. 

Let us learn from the rise of all healthcare workers, including peer support specialists that may be struggling themselves —to take on new challenges, to be bold, to be courageous. The past several months have been devastating, but it has shown us opportunities where we can rise together and change our practices to make a positive global impact on population health.

Karen Fortuna, PhD 
Assistant Professor of Psychiatry, Dartmouth College 

Robert Walker, MS, COAP
Exteernal Consumer Engagement Liaison, MA Dept. of Mental Health

Karen Fortuna and Rob Walker work together to advance digital peer support at