Digital peer support interventions for people with mental health conditions in outpatient settings:A systematic review and meta-analysis

Question: What is the effectiveness of digital peer support interventions in improving clinical symptoms, functioning, and treatment engagement among individuals with mental health conditions in outpatient settings? <br/><br/>Study selection and analysis: We conducted a systematic review and random-effects meta-analysis of controlled interventional studies. Five databases (MEDLINE, CENTRAL, Embase, PsycINFO) were searched up to January 2025. Studies evaluated digital peer support via online platforms, mobile apps, or digital communities for people aged ≥16 years with mental health conditions. Outcomes included clinical symptoms (depression, anxiety), functioning (quality of life, social functioning), and treatment engagement. Risk of bias was assessed using Cochrane RoB 2.0 for RCTs and ROBINS-I for non-randomised studies. Certainty of evidence was assessed using GRADE. <br/><br/>Findings: Twenty-nine studies including 5,825 participants were included. Digital peer support was associated with small-to-moderate improvements in symptoms of depression (SMD −0.28; 95% CI −0.42 to −0.14) and anxiety (SMD −0.47; 95% CI −0.68 to −0.27). Functional outcomes improved modestly: social functioning (SMD 0.18; 95% CI 0.07 to 0.29), quality of life (SMD 0.14; 95% CI 0.02 to 0.26), patient activation (SMD 0.39; 95% CI 0.23 to 0.55), and personal recovery (SMD 0.23; 95% CI 0.11 to 0.35). No significant effects were observed for treatment engagement or satisfaction. Preliminary evidence suggested sustained benefits for depression, anxiety, and social functioning. <br/><br/>Conclusions: Digital peer support offers modest improvements in symptoms and functioning for individuals with mental health conditions. Future research should clarify optimal intervention models, examine long-term outcomes, and evaluate scalability and integration into routine outpatient care.