Who uses mental health support forums, and why? Triangulating findings from surveys, interviews, and forum posts

Objective: Online forums for mental health, set up by charities, NHS services, and individual volunteers, have increased in popularity. Little is known, however, about who is using them and why. This study aimed to investigate this, using multiple methods to capture different types of users. Methods: A mixed-methods approach was used, with participants recruited from seven UK-based mental health forums as part of the Improving Peer Online Forums (iPOF) project. Forum users (n=791) participated in a survey which was compared to the demographics of NHS Talking Therapies. Twenty interviews with forum users were thematically analysed for reasons for use. Finally, the top keywords in the forums (a corpus of 28 million words) were calculated using the log likelihood test. One keyword was identified consistently across the forums, so its collocation profile was analysed. Results: Surveys showed the forums were predominantly used by white, female, and younger people, though there was a higher proportion of non-binary people compared to NHS Talking Therapies. Thematic analysis of interviews indicated that people used forums because they are easily accessible, overcoming barriers to in-person support, such as the need to speak. The linguistic analysis showed "scared" was a top keyword across all forums, with common collocations being I'm scared because and scared of. Reviewing posts showed users shared fears over mental health symptoms and identity. Conclusion: Forums are important alternative and complementary sources of mental health support, particularly for those facing discrimination or access barriers. Forums provide accessible, anonymous spaces for peer support, to share fears and connect with others.