West Virginia University Future of Mental Health Care Report Revising 3 projects: annotated bibliography, evaluation, and research proposal and write a ref

West Virginia University Future of Mental Health Care Report Revising 3 projects: annotated bibliography, evaluation, and research proposal and write a reflection (2-3 double spaced pages). Will include some comments on each project to help you when you revise down below. I don’t have any comments for the proposal so just do your best. Highlight revisions please. The article for the evaluation project is attached.Annotated bibliography (Project #1): I also like your title; it’s a great way to let your readers know what the sources are focused on (and whether they’re applicable to the readers’ interests). When revising, you might focus on bringing the main idea into the first line. While summaries can sometimes build up to the main point, you want to get there quickly with an annotated bibliography. Remember, your audience is often reading this to find literature to read and ‘enter the conversation,’ so beginning with the point helps. You did this well in the Lofton entry. You started out with the main point (what the authors are trying to say) and followed up with supporting evidence. I think if you employ this method with some of the other entries (like the Health Information National Trends Survey and the Miller entry), you’ll have an excellent annotated bibliography.Evaluation (Project #2): While you’ve got a great grasp on the concept of evaluation, the assignment calls for the evaluation of a specific text. The definition of a text is fairly broad–it can be anything from a tweet to a documentary–but it has to be something that humans created. You could argue that social media and mental health was created by humans as a concept, but it doesn’t qualify as a text. Try to find something within the topic (like one of the sources you referenced) and evaluate that based on criteria.I will need the 3 project revised with Highlighted revisions back. So, you can revise the projects first then write a 2-3 pages of reflection on them. What you can include in the reflection could be how hard or easy they were to write and revise, what are some problems or trouble spots that came up during writing them and how you revised theme or what you did when revising them, etc. HHS Public Access
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Epidemiol Psychiatr Sci. Author manuscript; available in PMC 2016 April 13.
Published in final edited form as:
Epidemiol Psychiatr Sci. 2016 April ; 25(2): 113–122. doi:10.1017/S2045796015001067.
The future of mental health care: peer-to-peer support and social
media
J. A. Naslund1,2,*, K. A. Aschbrenner1,2,3, L. A. Marsch3,4, and S. J. Bartels1,2,3,5
1Health
Promotion Research Center at Dartmouth, Lebanon, New Hampshire, USA
2The
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Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Lebanon,
New Hampshire, USA
3Department
of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire,
USA
4The
Center for Technology and Behavioral Health, Dartmouth College, Lebanon, New
Hampshire, USA
5Department
of Community and Family Medicine, Geisel School of Medicine at Dartmouth,
Lebanon, New Hampshire, USA
Abstract
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Aims—People with serious mental illness are increasingly turning to popular social media,
including Facebook, Twitter or YouTube, to share their illness experiences or seek advice from
others with similar health conditions. This emerging form of unsolicited communication among
self-forming online communities of patients and individuals with diverse health concerns is
referred to as peer-to-peer support. We offer a perspective on how online peer-to-peer connections
among people with serious mental illness could advance efforts to promote mental and physical
wellbeing in this group.
Methods—In this commentary, we take the perspective that when an individual with serious
mental illness decides to connect with similar others online it represents a critical point in their
illness experience. We propose a conceptual model to illustrate how online peer-to-peer
connections may afford opportunities for individuals with serious mental illness to challenge
stigma, increase consumer activation and access online interventions for mental and physical wellbeing.
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Results—People with serious mental illness report benefits from interacting with peers online
from greater social connectedness, feelings of group belonging and by sharing personal stories and
strategies for coping with day-to-day challenges of living with a mental illness. Within online
communities, individuals with serious mental illness could challenge stigma through personal
empowerment and providing hope. By learning from peers online, these individuals may gain
*
Address for correspondence: J. A. Naslund, Health Promotion Research Center at Dartmouth, Lebanon, 46 Centerra Parkway,
Lebanon, New Hampshire 03766, USA. (john.a.naslund@gmail.com).
The authors report no competing interests.
Conflict of Interest
None.
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insight about important health care decisions, which could promote mental health care seeking
behaviours. These individuals could also access interventions for mental and physical wellbeing
delivered through social media that could incorporate mutual support between peers, help promote
treatment engagement and reach a wider demographic. Unforeseen risks may include exposure to
misleading information, facing hostile or derogatory comments from others, or feeling more
uncertain about one’s health condition. However, given the evidence to date, the benefits of online
peer-to-peer support appear to outweigh the potential risks.
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Conclusion—Future research must explore these opportunities to support and empower people
with serious mental illness through online peer networks while carefully considering potential
risks that may arise from online peer-to-peer interactions. Efforts will also need to address
methodological challenges in the form of evaluating interventions delivered through social media
and collecting objective mental and physical health outcome measures online. A key challenge
will be to determine whether skills learned from peers in online networks translate into tangible
and meaningful improvements in recovery, employment, or mental and physical wellbeing in the
offline world.
Keywords
Internet; mental health; mental illness stigma; peer support; social network
‘I don’t know what led me to find your videos, but by some sort of luck I found
your videos a month before I was diagnosed with schizophrenia. It’s been a very
hard and trying few months but you have given me a lot of hope. So thank you,
keep up the good work.’
(Individual with schizophrenia commenting on YouTube)
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‘I comment on many of these posts because if I give one person hope it is more
than worth it to do so. Depression nearly cost me my life a couple of times when I
was in my 20s. It was really very rough at times, I know there are many, many out
there who want to give up but don’t!!! THERE IS HELP OUT THERE! There are
people who care!!!’
(Individual with bipolar disorder commenting on Facebook)
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Posts like these on popular social media such as Facebook or YouTube convey acceptance,
hope, validation and illustrate the give-and-take nature of connecting with peers online.
Increasingly, individuals with serious mental illnesses like schizophrenia, schizoaffective
disorder, or bipolar disorder are turning to social media to talk about their illness
experiences, seek advice and learn from and support each other (Gowen et al. 2012; Naslund
et al. 2014; Miller et al. 2015). This unsolicited communication occurs naturally and
involves self-forming online communities of individuals who share an understanding of
living with mental illness. Referred to as online peer-to-peer support, this emerging form of
social interaction has been described as one of the most transformational features of the
Internet (Ziebland & Wyke, 2012) and may present new opportunities to promote recovery,
self-esteem and mental and physical wellbeing among individuals with serious mental
illness.
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Worldwide, serious mental illness is a leading cause of disability (Murray & Lopez, 1997)
and is associated with debilitating symptoms of anxiety, depression and low motivation
(Kessler et al. 2003). Being labelled mentally ill, and the ensuing societal stigma and
prejudice, can have devastating effects on quality of life, self-efficacy and ability to pursue
meaningful life goals (Corrigan, 1998). For people with serious mental illness the effects of
stigma, feelings of hopelessness and helplessness, and resulting social marginalisation and
withdrawal lead to increased risk of substance use, poverty, homelessness, unemployment,
hospitalisation and suicide (Dixon, 1995; Corrigan, 2004; Folsom et al. 2005; Pompili et al.
2008). There are also numerous challenges to addressing these concerns from a clinical
perspective. For example, to reach individuals with serious mental illness, it is necessary to
overcome barriers such as social isolation, reluctance to use formal health care services and
challenging social circumstances such as traumatic life events or disruptive home
environments (RachBeisel et al. 1999; Hert et al. 2011). Online peer networks may offer
novel approaches for supporting and engaging this high-risk group in treatment efforts.
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By early 2015, over 2 billion people globally had active social media accounts (Kemp,
2015). Social media refers to interactive web and mobile platforms through which
individuals and communities share, co-create, or exchange information, ideas, photos, or
videos within a virtual network. Online social networking represents a prominent form of
communication in many people’s lives. For individuals with stigmatised illnesses, such as
serious mental illness, social media may make it possible to connect with others who share
similar health conditions and to seek or disclose health information without having to reveal
one’s personal identity (Berger et al. 2005). Additionally, many people with serious mental
illness experience symptoms that interfere with socialising in face-to-face encounters
(Dickerson et al. 2001). Therefore social media may help to facilitate social connections
among this group by overcoming obstacles such as stigma and mental health symptoms
(Highton-Williamson et al. 2015).
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Research suggests that people with serious mental illness are interested and willing to form
connections with others through social media. A survey of young adults found that those
with mental illness were more likely to express personal views through blogging, build
friendships on social media and connect with people online who have shared interests
compared with those without mental illness (Gowen et al. 2012). Similarly, another survey
found that adults with schizophrenia were as likely as adults without mental illness to form
social connections online despite having fewer offline relationships, lower income and less
Internet access (Spinzy et al. 2012). In a qualitative study, popular social media appeared
useful for allowing people with serious mental illness to feel less alone and to find hope and
to support each other, and to share personal stories and strategies for coping with day-to-day
challenges of living with a mental illness (Naslund et al. 2014). Other studies have found
that online support groups, forums and chat rooms serve as important venues for discussing
sensitive mental health conditions (Kummervold et al. 2002), and for disclosing personal
experiences of living with schizophrenia or seeking and sharing information related to
symptoms and medications (Haker et al. 2005).
Despite this mounting evidence, limited attention has been directed at utilising these online
networks to disseminate materials for mental health education or support, or to widen access
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to evidence-based services among these high-risk individuals. In this paper we present our
perspective on how interactions among people with serious mental illness over social media,
referred to as online peer-to-peer support, may afford important opportunities to advance
treatment efforts aimed at promoting mental and physical well-being in this group. First, we
consider the importance of forming social connections and the role of social media among
people with serious mental illness. Then, we propose three areas where online peer-to-peer
connections may have a profound impact for these individuals. These include challenging
stigma, increasing consumer activation, and accessing interventions for mental and physical
wellbeing. We carefully consider the potential risks associated with interacting with peers
online. To conclude, we discuss important challenges ahead and recommend future research
directions.
Online peer-to-peer support and mental illness
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Prior studies have emphasised the importance of individuals feeling connected to others and
sharing a sense of belonging to a group (Brewer, 1991). Identifying with a social group is
believed to increase self-esteem and self-efficacy, and reduce uncertainty about oneself
(McKenna & Bargh, 1998). Among people with serious mental illness, connecting with
similar others may contribute to better recovery, personal wellbeing and social integration
(Davidson et al. 1999). Yet, for these individuals, identifying and reaching out to others
poses numerous risks in the form of disclosure and potential disapproval, rejection, or
negative attitudes (Link et al. 1997). Many people with serious mental illness also
experience challenges with face-to-face communication due to impairments in cognitive and
social functioning (Dickerson et al. 2001). For someone with serious mental illness, the
decision to reach out and connect with others to discuss personal health issues typically
occurs at a time of increased instability and when facing significant life challenges (Perry &
Pescosolido, 2015). Seeking support and social connection is therefore a critical point in the
lives of people with serious mental illness, and the decision of who to reach out to may be
detrimental in determining their path to successful recovery and wellbeing.
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Through social media, people with serious mental illness can potentially identify similar
others and experience benefits of group participation at their own convenience, while
remaining anonymous and avoiding challenges associated with interpersonal deficits such as
interpreting social cues or non-verbal communication (Mittal et al. 2007; HightonWilliamson et al. 2015). Social media overcomes geographic boundaries and time
constraints, and allows users to choose whether or not to actively create content, disclose
personal health information, post comments, or passively view content posted by others.
Research suggests that within an online network, both individuals who choose to share
content or connect with different users, as well as those who choose to seek health
information without interacting with others can experience important benefits (van UdenKraan et al. 2008; Mo & Coulson, 2010; Chung, 2014). Compared with spontaneous face-toface encounters, social media users maintain greater control meaning that they can choose
their own level of engagement and the extent to which they interact with others. This may be
especially important for people with serious mental illness because social media may help
them overcome debilitating effects of their illness such as information processing
challenges, increased social anxiety, or difficulties with social interaction (Schrank et al.
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2010). On social media individuals with serious mental illness can choose whether to post
content and how quickly to respond to comments, and can revisit conversations or seek
greater clarity at their own pace. For someone experiencing mental health symptoms
combined with fear of stigma and rejection, this added control through online
communication may be empowering.
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Social media also represents a user-driven environment, where individuals with Internet
access through their mobile device or computer can have a voice and the opportunity to
express themselves and connect to a larger online community. Online peer-to-peer networks
represent a significant contrast to traditional biomedical or psychiatric approaches to mental
health care. Many people with serious mental illness have had to fight against discrimination
and injustice, and advocate for basic human rights and mental health care reform (Tomes,
2006). For this group, social media may serve as a platform through which many of these
individuals can continue to challenge prejudiced societal views, question authoritarian
medical practices and share positive attitudes and beliefs.
New opportunities through online peer-to-peer support
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We take the perspective that when an individual with serious mental illness decides to
connect with similar others online, it represents a critical point in their illness experience.
These individuals are likely facing significant personal challenges, social isolation, or fears
about how others will view them, which may prompt them to seek information or support
online. In Fig. 1, we propose a conceptual model to illustrate how online peer-to-peer
connections may afford individuals with serious mental illness opportunities to challenge
stigma, increase consumer activation and access online interventions. Our conceptual model
is informed by existing literature including studies of online communities and online support
groups for mental illness as well as other patient groups with diverse health conditions, and
suggests how individuals with serious mental illness may benefit from peer-to-peer
interactions following the initial decision to visit an online community. As depicted in Fig.
1, the proposed opportunities do not necessarily occur in a sequential order.
Challenge stigma
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When individuals with serious mental illness visit an online community they may be
experiencing shame, uncertainty and feeling alone with their symptoms or illness diagnosis.
These individuals may have fears about reaching out to others, driven by concerns about
what other people will say or think and the possibility of rejection because of their illness
(Link et al. 1997). When individuals with mental illness internalise discriminatory societal
views and stereotypes, it often leads to negative consequences including diminished selfesteem and self-efficacy, and greater depressive symptoms (Corrigan, 1998). Stigma impacts
an individual’s ability to carry out daily activities such as work or school, to pursue life
goals and to seek necessary mental health care (Link et al. 1997; Corrigan, 1998).
Online communities may serve as powerful venues where individuals with serious mental
illness can challenge stigma through personal empowerment and providing hope (Lawlor &
Kirakowski, 2014). Studies have shown that knowing that there are others facing similar
concerns, frustrations and illness symptoms can be highly reassuring and can create a sense
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of belonging to a group (Harvey et al. 2007). Young adults with mental illness report that
one of the primary reasons for connecting with others online is to feel less alone (Burns et
al. 2009), and popular social media allows people with serious mental illness to feel
connected while gaining a sense of relief from knowing that others share similar experiences
and challenges (Naslund et al. 2014). Research also suggests that true self can be expressed
more easily within online networks because the anonymity of the Internet can shield from
disapproval or fear of making mistakes (Bargh et al. 2002). This is also important because
self-expression may help protect against harmful effects of stigma (Bargh & McKenna,
2004; Whitley & Campbell, 2014). Therefore, individuals with serious mental illness may
benefit from interacting with others through social media because they can be themselves
without letting the challenges of their illness get in the way.
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Coming out and disclosing one’s illness to others is also an important approach for
addressing stigma (Corrigan et al. 2010; Corrigan et al. 2013). Through online peer-to-peer
communities, individuals with serious mental illness can connect with others with lived
experience and openly disclose their own diagnosis while choosing to share positive stories
of recovery and facts to challenge stigma and directly address widespread myths and
misperceptions about living with a mental illness. Research suggests that marginalised
individuals may benefit from feelings of empowerment, greater personal identity and pride
by connecting with similar others online (van Uden-Kraan et al. 2009). The increase in
confidence and sense of belonging gained through selectively disclosing to others online
may even make individuals feel more comfortable disclosing their illness in face-to-face
encounters (McKenna & Bargh, 1998). As the number of online forums, blogs, or Facebook
groups dedicated to empowering and supporting people living with serious mental illness
continues to grow, it is clear that online communities will serve as valuable outlets for these
individuals. Future research must establish whether online peer-to-peer support effectively
challenges stigma and helps overcome social isolation among individuals with serious
mental illness.
Increase consumer activation
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Engaging wi…
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