A typology of moderator practices and community guidelines in online mental health communities to establish a framework for digital safety: A systematised review
Type: article
Study design: Systematic Review
Abstract: BackgroundThe rise of online mental health communities has reshaped the ways individuals seek and receive mental health support. Although online mental health communities (OMHCs) offer a valuable space for peer support, including through experience-sharing, they also present challenges, including moderation practices to cultivate supportive interactions and secure member safety. No comprehensive framework of moderation practices has been established. Developing such an understanding is important, as moderators play a central role in facilitating a sense of community and determining whether online mental health communities function as safe and supportive spaces.ObjectiveTo develop typologies of (a) moderator practices used to support safety and facilitate a sense of community within OMHCs for people with mental health problems and (b) the content of OMHC community guidelines.MethodsA systematised review of empirical research studies focusing on moderation practices and community guidelines in OMHCs was conducted using MedLine, Web of Science, ACM Digital Library, supplemented with a purposive search to identify grey literature on community guidelines for OMHC moderation. Inclusion criteria: online; text-based component; asynchronous or synchronous moderation; mental health-related focus; human moderation. Exclusion criteria: crisis-focussed; audience-based; non-moderated or bot-moderated; profession not peer support; non-English; academic review/thesis. The search period was 2014 to 2024. A bespoke data extraction sheet was piloted then populated, capturing document, OMHC, member and moderator characteristics. Thematic analysis was used to synthesise the findings relating to each objective.ResultsThe systematised search identified 11,347 studies and other documents, from which 80 studies were included, comprising 48 empirical papers and 32 grey literature documents. These related to 52 different OMHCs. Four categories of moderator practices were identified: (1) Pre-moderation and post-moderation processes, (2) Reactive moderation processes, (3) Building the community, and (4) Monitoring members. Pre-moderation and post-moderation processes were used within 41 (79%) of the 52 OMHCs. Three categories of community guideline content were identified: (1) Content of post, (2) Member conduct, and (3) Moderation. The category, content of post, was the most widely used component of community guidelines, used in 35 (67%) of the 52 OMHCs.ConclusionsThe two typologies provide a foundational framework that can be adapted and applied to community guidelines and moderation strategies across a range of contexts. When operationalised, they could provide benefit to people with mental health problems by using them to guide the development of moderator training, digital tools, and governance policies that align with the specific characteristics and objectives of individual OMHCs. Effective translation and application of these typologies require careful, nuanced consideration of each community's goals, membership, and cultural context to ensure their relevance, effectiveness, and impact.
Language: English
Subfield: General Health Professions
Field: Health Professions
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7204678709
Cites:
Cited by:
Related to: