JMIR Publications

ABSTRACT

Background:

The rise of online mental health communities has reshaped the ways individuals seek and receive mental health support. Although online mental health communities 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.

Objective:

To develop typologies of (a) moderator practices used to support safety and facilitate a sense of community within online mental health communities for people with mental health problems and (b) the content of online mental health communities’ community guidelines.

Methods:

A systematised review of empirical research studies focusing on moderation practices and community guidelines with online mental health communities was conducted using MedLine, Web of Science, ACM Digital Library. To ensure a thorough understanding, this was supplemented with a purposive search to identify grey literature on community guidelines for moderation of online mental health communities.

Results:

The 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 practices, (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

Conclusions:

The 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. Clinical Trial: N/A