title: Naturally occurring peer support through social media: the experiences of individuals with severe mental illness using YouTube.
abstract: Increasingly, people with diverse health conditions turn to social media to share their illness experiences or seek advice from others with similar health concerns. This unstructured medium may represent a platform on which individuals with severe mental illness naturally provide and receive peer support. Peer support includes a system of mutual giving and receiving where individuals with severe mental illness can offer hope, companionship, and encouragement to others facing similar challenges. In this study we explore the phenomenon of individuals with severe mental illness uploading videos to YouTube, and posting and responding to comments as a form of naturally occurring peer support. We also consider the potential risks and benefits of self-disclosure and interacting with others on YouTube. To address these questions, we used qualitative inquiry informed by emerging techniques in online ethnography. We analyzed n = 3,044 comments posted to 19 videos uploaded by individuals who self-identified as having schizophrenia, schizoaffective disorder, or bipolar disorder. We found peer support across four themes: minimizing a sense of isolation and providing hope; finding support through peer exchange and reciprocity; sharing strategies for coping with day-to-day challenges of severe mental illness; and learning from shared experiences of medication use and seeking mental health care. These broad themes are consistent with accepted notions of peer support in severe mental illness as a voluntary process aimed at inclusion and mutual advancement through shared experience and developing a sense of community. Our data suggest that the lack of anonymity and associated risks of being identified as an individual with severe mental illness on YouTube seem to be overlooked by those who posted comments or uploaded videos. Whether or not this platform can provide benefits for a wider community of individuals with severe mental illness remains uncertain.
authors.affiliation: The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Hanover, New Hampshire, United States of America.
authors.forename: John A
authors.initials: JA
authors.lastname: Naslund
authors.affiliation: The Dartmouth Center for Health Care Delivery Science, Dartmouth College, Hanover, New Hampshire, United States of America.
authors.forename: Stuart W
authors.initials: SW
authors.lastname: Grande
authors.affiliation: The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Hanover, New Hampshire, United States of America; Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, United States of America.
authors.forename: Kelly A
authors.initials: KA
authors.lastname: Aschbrenner
authors.affiliation: The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Hanover, New Hampshire, United States of America; The Dartmouth Center for Health Care Delivery Science, Dartmouth College, Hanover, New Hampshire, United States of America.
authors.forename: Glyn
authors.initials: G
authors.lastname: Elwyn
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D020407:Internet; D007858:Learning; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology; D008875:Middle Aged; D010379:Peer Group; D036301:Qualitative Research; D061108:Social Media; D012944:Social Support; D055815:Young Adult