Temporalities of peer support: the role of digital platforms in the ‘living presents’ of mental ill-health

ABSTRACT

This paper considers matters of time in online mental health peer support. Significant evidence of the value of peer support exists, with new digital platforms emerging as part of the digitisation of mental health support. This paper draws from a project exploring the impact of digital platforms on peer support through interviews with users of a major UK-based online peer support platform. Drawing on Gilles Deleuze’s concept of the ‘living present’, the paper highlights how notions of past, present and future operate as co-existing dimensions of the present. The analysis highlights how the immediacy of digital platforms elicits expectations of peer support being ‘on tap’, which creates challenges when support is not received synchronously. Unlike in-person support, digital platforms facilitate the archiving of support, which can (re)enter the present at any moment through asynchronous communication. Anticipations of the future feature as dimensions of the present in terms of feelings regarding when support may no longer be needed. The paper offers potential implications for social scientific understanding of digital peer support, which include valuable insight for mental health services designing and delivering digital peer support.

KEYWORDS:

• Peer support
• digital mental health
• Deleuze
• living present
• temporality

Introduction

The current article focuses on the intersections of temporalities of mental health support and digital platforms through examining how temporalities of support render traditional chronological models of time problematic. Addressing the simultaneity of past and future as dimensions of the present has been shown to highlight important factors in experiences of mental distress (Brown & Reavey, 2015; Reavey & Brown, 2006; Tucker & Lavis, 2019). The immediacy of digital platforms, their 24/7 nature, frequently features as the primary definition of digital temporalities (Martínez Fernández, 2017; Tucker & Lavis, 2019), and yet we know that digital platforms can operate in relation to a range of temporalities, including those that ‘accelerate’, and ‘slow down’ life (Wajcman, 2015).

Widespread evidence exists as to the value of peer support in mental health (Repper & Carter, 2011; Shalaby & Agyapong, 2020). Peer support operates in formal and informal spaces (e.g. in-patient settings, community centres), and involves developing new friendships with others who have experienced similar mental health challenges. Peer support has increasingly become part of primary care services, as well as being a long-standing part of voluntary sector support (Kaplan et al., 2011; Lavis & Winter, 2020; Shalaby & Agyapong, 2020). It can be argued that peer support has always been a part of mental health services that have involved bringing service users together into specific spaces of support, from the mass asylum-based care that featured for most of the twentieth century to contemporary community care (Cromby et al., 2013). For instance, community spaces such as day centres in which service users can access formal support (e.g. art-based therapies) alongside informal support (e.g. eating, board games, talking). Peer support typically involves individuals sharing experiences outside of engagement with formal care, and can lessen feelings of isolation, along with providing valuable practical advice for living with mental ill-health (Repper & Carter, 2011).

Changes to funding models for mental health have limited the availability of community spaces for peer support (Tucker & Lavis, 2019), which has contributed to the development of digital forms of peer support, such as digital platforms designed to facilitate peer support (Fortuna et al., 2020). The ability for digital platforms to connect people presents significant promise for peer support, although the lack of in-person contact can challenge the development of empathic relationships (Tucker et al., 2023). These factors have led to digital peer support being identified as a priority research area (Shalaby & Agyapong, 2020). Benefits of using digital platforms for peer support include their 24/7 availability; access to many other service users; and being able to engage from home (Prescott et al., 2020; Tucker & Goodings, 2017; 2018). Challenges include concerns regarding the authenticity of other users; exposure to unfiltered accounts of other people’s distress; and potentially lower sense of empathic support due to lack of in-person interaction (Andalibi & Flood, 2021; Tucker & Goodings, 2017; 2018).

Digital times

It has been widely discussed how the digital produces new forms of spatialised experience, e.g. feelings of disinhibition when using an anonymous social media profile (Lapidot-Lefler & Barak, 2012; Lowry et al., 2016). As the digital media theorist Grant Bollmer (2018) argues, ‘[E]very medium extends the body in space and time, albeit in different, medium-specific ways’ (p. 27). I will demonstrate the medium-specific way/s that digital peer support platforms transform people’s experiences. Digital technologies have been demonstrated to affect temporal experience, and therefore have increasingly focused on time in the study of digital life (Kaun & Stiernstedt, 2014). For example, how digital technologies create forms of memory that work ‘in constructing a sense of individual identity and collectivity at the same time’ (Van Dijck, 2007, p. 9). The temporal effects of media technologies have been analysed through the lens of mediated memory (Van Dijck, 2007).

The integration of digital technologies in all areas of life has led to notions of their prevalence accelerating life (Wajcman, 2015), with the idea that life will become increasingly rapid due to digitisation, becoming a common trope (Ulferts et al., 2013; Xiang, 2018). This notion has been challenged by suggesting a hetero-, rather than homo-, geneity to digital life, e.g. how certain digital practices can involve a slowing of pre-digitally paced social practices and/or changing temporalities of accelerating and slowing (Duclos et al., 2017). Attention has also been paid to developing approaches that focus on the generative and agentic role of the materiality of events and practices in enacting time. Coleman states ‘how “the now” is (or is becoming) a dominant way in which temporality is constituted and organized in today’s digital societies’ (2020, p. 1696). Emphasis is on how time is made by matter in the form of the material practices and events that constitute everyday life.

In digital mental healthcare, a significant rise in the availability of digital forms of support is drawing attention to the temporal elements of support due to the significant temporal differences between formal in-person support and digital forms of support that can be accessed via personal digital devices at any time (Berg, 2017; Trnka, 2016). The use of digital platforms to facilitate peer support is well established, although the impact these have on the temporalities of support is lesser known (Tucker & Lavis, 2019). It is the intersection of digital peer support and the living present of users that is conceptualised as temporal in nature in this paper. The next section discusses the concept of the ‘living present’ to capture how present experience always-already involves notions of the past and future.

Past, present and future as the ‘living present’

Seeking peer support often occurs during periods when people feel overwhelmed by past experiences and/or anticipations as to what the future may hold (Read et al., 2005). Such periods are not necessarily predictable, and as such the perceived instantaneity of digital forums can be welcome, particularly at times when contact with formal services is not possible (e.g. overnight). The pressure of past experiences can lead to negative anticipations of what the future may hold, making the present feel like a concentrated mixture of past, present and future, which resonates with Gilles Deleuze’s concept of the living present. This is an approach attending to the phenemonology of lived time, in which time is not considered as a linear one-way movement from past, through present, to future, but as a temporal experience of varying configurations of past-present-future, in singular form. Crucially, the past and future are considered as dimensions of the present, as Deleuze notes, ‘synthesis constitutes time as a living present, and the past and the future as dimensions of this present’ (1994, p. 97). This breaks the chronological idea of succession, and in doing so, recruits past and future as constant features of the living present. It is an active conceptualisation, with Deleuze stating that ‘there is nothing moved which is distinct from the received movement’ (1986, p. 58). The concept emphasises notions of process and movement.

Deleuze urges us to shift the unit of analysis away from a notion of a bounded unit of present time, to consider time dimensionally as duration (following Bergson, 1988); the indivisible qualitative movement of what is experienced as conscious time, but which is indelibly linked to past and future. The Deleuze scholar James Williams notes, ‘[T]ime unfolds thanks to this present, that is, past and future events meet in it, rather than remaining separate entities with no interdependence’ (2011, p. 25). The model of temporal co-existence is of value to analysing digital peer support as it captures how people are never disconnected from previous life events due to the default archiving of peer support platforms. This approach recognises that present experience involves memories of the past and anticipations of the future. At times, these may be relatively passive, and distress deemed manageable, at other times, distress may increase due to the active nature of the past and/or the future in the ‘living present’.

Deleuze provides an overarching temporal framework for lived experience, urging us to shift the unit of analysis away from a notion of a bounded unit of present time, towards a framing of time as quantitatively indistinguishable. To consider time as not existing ‘outside’ of experience, but rather as being created in and through material and embodied practices makes it essential that social scientific studies of mental health address time. The key question of the paper is ‘How does the concept of the living present capture the intersecting temporalities of digital platforms and mental distress in the operation of digital mental health support?’

Methodological considerations

Interviews were undertaken with users of a large UK-based digital peer support platform run by a major UK mental health charity. Participants were recruited through an advert posted on the site by the charity. Participants were provided with an information sheet and consent form to sign. The information sheet detailed the nature of the study, research question and the project team. The main research question was to understand participants’ experiences of accessing peer support online. Interviews were semi-structured and focused on all aspects of participants’ experiences with Peer Support Together (PST), including: their reasons for joining the platform, frequency of access, feelings about the support provided, whether they provided and sought support, changes in their experiences over time, breaks in use (and the reasons why) and other aspects of their experiences that arose during interviews. PST is a non-medical form of mental health support that does not require referral from mental health services to access. As such, medical/diagnostic details are not collected from users, who are typically experiencing so-called common mental health issues, such as anxiety and depression. PST does not describe itself as a crisis intervention tool for people with more acute mental health challenges (e.g. psychosis).

Nine adult users were interviewed via MS Teams (six female; three male), with analysis focusing on participants’ practices of engaging with PST, past and present. This resonates with recent methodological developments in digital ethnography (Pink et al., 2016) focused on the impacts of ‘archived by default digital traces’ as new forms of mediated memories, such as the scroll back method (Møller & Robards, 2019). A systematic process was undertaken, which followed a ‘thematic decomposition’ approach (Stenner, 1993; Ussher & Perz, 2018). Thematic decomposition provides analytic insight regarding the meaning of participants’ discourse and can be data-driven and/or conceptually informed. The first stage of the analysis was an ‘immersion’ in the transcripts through repeated reading and coding. This culminated in identifying several first order codes, such as ‘openness/flexibility of digital platforms’, ‘digital immediacy’, ‘discussing the past in terms of concerns in the present’, and ‘anticipating future support’. The second stage was a ‘tacking’ between first order codes and participants’ transcripts multiple times, as part of a verification process. The analysis was dual dimensional in terms of being informed by the theoretical insight provided by the concept of the living present, along with an inductive element of being grounded in the lived experience of participants’ engagement with digital peer support. No existing conceptual literature on digital temporalities was used to inform the analysis. The principles of the concept of the living present informed the analysis in terms of being attuned to capture the ways that participants discussed their past and future experience in relation to their present life. In the third and final stage codes were sorted into analytic themes, informed by the notion of past and future as dimensions of the present. Ethical approval for the project was granted by the University of East London Research Ethics Committee. This includes removal of any identifying information in the data, with pseudonyms used throughout.

Analysis

The temporal openness of digital platforms

PST operates very much like a mainstream social media platform, with users able to create their own profile, post visual and textual materials, comment on others’ profiles, and direct message. In the extract below follows, peer support operates through an openness and flexibility afforded to users to discuss aspects of the past that could have led to the onset of their mental distress. Maya discusses how important it was for her to be able to do this, and how it was not facilitated by other forms of support:

Interviewer: Do you think it helps that it’s online?

Maya: Yes, because I don’t mind face to face, like doing one to ones, but group, like I really struggled with the DBT a few years ago and like I said to you, we’re not allowed to talk about things, like why we were there and stuff like that. Like we did therapy and stuff, but we weren't allowed to talk about why we were there and that’s what I kind of needed. I need to talk about why I’m there, talk about how I’m feeling and stuff and I couldn’t do that, so having that platform online is rather beneficial, now that I think about it.

Maya compares their experience of PST to a more structured and constrained previous form of support, Dialectical Behavioural Therapy (DBT), where ‘we weren’t allowed to talk about why we were there’. This was a temporal narrowing in terms of limiting what could be spoken about, which restricted how past experience could feature in the present. PST provided a more open shaping of temporal experience as Maya felt able to talk about any part of her past life, which was important in terms of processing difficult experiences. Being able to engage meaningfully with difficult life experiences in a manner that elicits a sense of agency over one’s life can be of significant value for people experiencing mental ill-health (Brown & Reavey, 2015). PST allowed Maya to talk openly about her experiences; past, present and future. Its digital presence operates with a temporal flexibility that Maya experiences as more expanded than structured in-person interventions such as DBT.

For Maya, the living present enacted by PST as a digital platform allowed for more of the past to be open to be actualised in the present. This links to the concepts of the actual and virtual used by Deleuze (1994), which in relation to the living present feature in terms of the past and future, respectively. The past features as the multiplicity of particular actualities. The past is actual because it has happened in specific ways, which feature in the living present through a process of contraction. This is not to suggest all the potential past will be actualised but that PST helped to elicit a feeling that it could be, an expanded sense of the past compared to the narrowness of DBT. This was not specific to DBT as an intervention, but because it is delivered in person. Furthermore, the fact that PST is an online platform connecting thousands of users makes it harder to prescribe how peer support works in that space. This is distinct to an in-person intervention such as DBT, which can control how people interact with it. PST describes itself as a platform for sharing experiences with others, where you can ‘listen, share and be heard’. There is limited restriction on what can be posted although PST states that posts relating to suicide, suicidal ideation and self-harm will be hidden

Digital platforms such as PST enact a very specific digital form of the living present in which the whole of past activity on the site is available to be (re)called in the present, either by users themselves or another user, e.g. when posting a new comment on an older post. This is a point previously made in relation to the introduction of Facebook’s Timeline (Goodings & Tucker, 2013). Moreover, the flexibility afforded by digital platforms such as PST, in terms of providing a platform to discuss a range of experiences from the past and present, is not necessarily exclusive to digital platforms. It could potentially be a feature of in-person peer support, but what the digital element adds is the layer of anonymity that for some people allows them to feel comfortable to discuss their mental health challenges. The digital immediacy of the platform provides a valuable temporal flexibility in terms of accessing 24/7.

Editing the past online

Media technologies operate as forms of digital memory by ‘holding our past experience and knowledge for future use’ (Van Dijck, 2007, p. 2). This is one of the features of PST, which facilitates the reviewing and editing of the past in the present by allowing users of the platform to edit or delete previous comments posts in light of their feelings in the present. This can be considered part of the creation of temporal experience in the present through engaging with digitised experience from the past. This arose in an interview with Mary in a response to a question regarding whether engaging with online platforms impacts one’s sense of control over life:

Interviewer: I think you touched on this before, but did sort of being part of Peer Support Together change how you felt? Did it change in any way your sense of control over your own life or your feeling of your sense of control over your life?

Mary: Yes. It meant that I was able to compartmentalise some of the more difficult and uncomfortable feelings that I didn’t know how to deal with, I didn’t need to talk about them to people in real life; I could talk about them online as much as I wanted and I could delete things if I didn’t want and edit things, yeah.

Central to the issue of control for Mary was the sense that one temporal dimension of using PST was its allowing users to edit their present life online. This was part of a broader sense that online platforms can provide a temporal flexibility in terms of allowing anything to be talked about, and that the choice about what is discussed is in the hands of the individual themself. This is a new form of temporal experience enacted by the digital technology of PST. Mary talks about how PST facilitated a compartmentalisation of parts of her past life. These are things that can be difficult to talk about in person, and therefore having access to an online platform can allow a sense of temporal control, a channelling of difficult aspects of the past into an anonymous online space, which can provide some helpful distance through a slower emotional release of challenging feelings (Tucker et al., 2023). PST gave Mary greater control over how she discusses her past difficult experiences than an in-person setting, where the synchronous responses by others may lead her to feel pressured to discuss these experiences in greater detail. PST therefore enables Mary to look back at her old posts and comments to review her past feelings. This can enact a new form of temporality affecting Mary’s current feelings. Furthermore, Mary can review and edit her posts and comments before posting them, allowing her to curate current feelings in a reflective way that is not possible in the same way through in-person peer support.

Mary: And at one point it definitely helped me realise I’ve been ill for longer than I realised as well because I could go back, say, two years and I’d still be saying the same thing as I was two years later, and I’d think, ‘Oh, I thought I was kind of like, you know, it was shorter than that’, and it was quite useful to verify.

The living present for Mary operates through reflecting upon her mental health journey over time, and how this changed her feelings in the present. The default archiving of content on PST connected Mary’s past and present feelings, eliciting a realisation that she had been ill for longer than initially thought. This provided a veracity regarding the length of her illness, which can shape anticipations as to future wellness.

Social media archiving practices have been demonstrated to be valuable in terms of facilitating the creation of collective memories, e.g. Facebook pages (Kaun & Stiernstedt, 2014). This has led to a new social media time being proposed, which captures the ways that platforms such as Facebook enact new forms of temporal experience, which goes beyond mediating life events in a relatively passive sense, towards constituting life events as temporalities. PST offers a different form of digital archiving practice, in terms of serving as a digitised past for Mary. The presence of PST as a digital archive of her online life is experienced as an ever-growing realm that is potentialised and ‘carried with’ the present, meaning that the past is always-already on hand as a virtual force that can actualise to shape feelings in the present. The next section focuses on the implications of disruptions to the technical functionality on participants’ temporal experience of online support.

Disruptions to expectations of the immediacy of support

One of the issues with PST that can impact on the temporal experience of communicating on the platform relates to the development of PST as a new platform, based on a previous online peer support platform that had run successfully for several years. Existing and new users were asked to register with PST when the old platform was retired. The new platform (PST) suffered with an issue with the notifications system, with implications for the temporal experience of using the platform:

Maya: Like sometimes you’ll get a message but you don’t get notified for it straight away, so there's been quite a few occasions where I’ve had people that I’ve not spoken to before message me and then they’ll be like – like get annoyed because I’ve not replied straight away. Then I’ll message them eventually, like I’m really sorry I’ve not seen your message until now because I’ve only just been notified and people just get really annoyed and all I can do is apologise.

Maya’s extract demonstrates a new temporality emerging in relation to the immediacy of support available. The immediacy produced through the temporal openness of the platform can lead to expectations for support being on tap in terms other people being readily available. Maya reports on other users becoming frustrated when requests for support are not responded to quickly. The disrupted notification process led to delayed responses to messages, which ‘really annoyed’ some users. The sense is that PST creates a temporal openness operating as the bringing together of users’ living presents into a communal present in which people can seek and receive support. The glitch was not consistent as it involved delays, as well as relentless inundation of notifications:

Maya: So this time round, I’ve not actually been able to feel like I can actually keep up with everyone. Whereas on [the old platform] I could. I know they keep saying we’ll sort this and all this and all that, but this time round, the site has been open for a few months now and I’ve actually really struggled, like I just can’t keep up. Notifications, if you react to someone’s post, like you can’t get rid of notifications for that post, so you’re constantly getting notifications for someone’s post. You can’t turn off notifications.

So like a lot of the time, I don’t want to react to someone’s post because I can’t turn off notifications. I’ll get like 60 notifications within like ten minutes because I’ve reacted to so many posts and I’m just like I don’t – it’s really hard to – I just don’t know how to explain it, but if I react to ten posts at a time, then I’ve got like 40, 50 notifications within like ten minutes and then you can’t turn them off.

Users could receive notifications every time another person posted or commented in a thread that they themselves had posted or commented, which became unwieldy to manage and led to a feeling of frustration. The relentless notifications came to dominate the temporal experience of the platform. For Maya this impacted on her engagement, as she came to realise that one way to avoid the barrage of notifications was not to post or comment on threads. This is a temporal contraction of the platform in terms of its potential to connect with and support others. Maya captures this when stating that ‘this time round, I don’t feel like I’ve been able to keep up with everyone’. The temporal experience changes as the possibilities to seek and provide support are limited by the technical glitches affecting notifications on the platform.

Disruptions to expectations relating to the immediacy of support can also be impacted by the temporal rhythms of users’ everyday environments:

Interviewer: Yeah, and do people that you don’t know, do they say supportive things, you know, in answer to your comments or does that not really happen?

Hannah: Occasionally. It doesn’t always happen. As I said, I think it depends what time of day you’re posting. If it’s a busy time of day then your post just drops off the bottom and disappears, so people don’t see it. Or if it’s a quiet time of day with no people on there, your post might go unanswered for a long time, and then again it might drop off the bottom again after a while because other people have posted.

Online support is impacted by the presence of other people on the platforms and the rhythm of communication. At busy times posts can become buried under newer posts before other users have responded. However, this is not simply overcome by posting at a quieter time, because times with fewer users on the platform can result in lengthy response times. This demonstrates a further layer to the temporal complexity of online support, in terms of connecting users in different places and times. Its availability can provide a sense of immediacy and support being on tap, but the experience of using platforms such as PST is not always immediate. The platform is available 24/7 but that does not mean that other users are available in the same way. Here, the digital immediacy of the platform itself can create an unrealistic temporal expectation regarding the availability of support. PST as a digital materiality constitutes Hannah’s temporal experience, it literally makes her time. The temporal impacts of this are not felt only in terms of the when of available support, but also in relation to the content of communication and support. This extends the insight offered by the concept of digital immediacy (Martínez Fernández, 2017; Tucker & Lavis, 2019), with specific reference to online peer support.

Digital connecting of multiple pasts and presents

One of the challenges for online peer support is managing difficult past experiences in the present, due to the high likelihood of past challenges and potential traumas in life contributing to current distress (Read et al., 2005). Thus, managing and living with one’s own past can be difficult. Platforms such as PST allow people to share their stories, which can be valuable. However, this comes with a risk in terms of the potential for others’ stories to trigger negative thoughts and feelings. This demonstrates another temporal feature of online support, namely the interaction of the temporal multiplicities of people’s individual living presents.

Interviewer: So how do you feel when you see people posting things that make, you know, where you recognise them from your past, you’re like, ‘Oh, that’s how I used to feel at that point’, how do you sort of feel when you see those kind of posts?

Hannah: It varies. So on a day that I’m not feeling so good, I will skip past them because, you know, sometimes you don’t want to be reminded of things that might kind of trigger you and start ruminating and bad thoughts, so I kind of use a lot of self-care and think, ‘Not today, I can’t deal with that’. But then on other days it’s like, ‘Yeah, I see myself in you. I see we’ve had similar experiences and you’re really struggling’, and, again, sometimes I say, ‘I tried this and it worked for me’. Sometimes I listen and just say, you know, offload, say everything, if it gets it out your head and helps, you know, say that. Yeah, just to be able to kind of offer a bit of hope to people makes me feel good that, as I said, I can use what I’ve been through to offer that little bit of hope and say, you know, ‘Things won’t always be that bad’.

Hannah discusses the kind of temporal fluidity that she experiences when using PST, which includes ensuring that engagement with the platform does not negatively impact feelings in the present. On days that she is ‘not feeling so good’, she will ‘skip past’ posts/comments from others that she feels may trigger negative thoughts. Hannah does not detail how ‘skipping past’ operates, but it suggests some form of quick screening of post/comments to check for potential triggering content. Providing support at these times consequently becomes difficult due to the potential for one’s past to flood the present in the form of being triggered by others’ posts/comments. At times when Hannah is feeling less vulnerable to triggering, she can engage with providing support to others, e.g. ‘I tried this and it worked for me’. The experience of using PST is therefore a temporal multiplicity, involving the immediacy of the platform, the temporalities of other users, and one’s own past and present feelings. This is the transformation that PST makes possible as a digital platform. It facilitates a living present that manifests as the inter-connection of the temporalities of multiple individuals. It is not possible to know in advance which will be actualised as any given living present, due to the sheer scale of the number of users. This is a significant distinction between in-person and digital peer support.

Anticipations/Expectations of the future shaping experience in the present

This section examines how the future shapes the living present in the form of anticipations and expectations. For Laura this involves the presence of PST in her future life, and what that means in terms of anticipations of support, present and future:

Interviewer: Does being part of the group change how you feel about the future at all, is it affecting how you think about the future?

Laura: It’s nice to know it’s there. So I think, I think that and going through the CBT stuff, which I’d sort of say, it’s nice to know that I’ve got a foundation if I do wobble, if I’ve got something there. So I do feel, I feel less anxious about maybe being anxious … ..but – it’s nice to know if I do dip again mental health wise, that I know that I’m not going to dip all the way back to the bottom because I know that there are other things, not quick fixes, but other quick access things that can be helpful.

The presence of PST can be reassuring in terms of future support, and for Laura support does not need to be activated to be felt. Having used PST in the past, anticipating one’s future life can be supported by the expectation of being able to access PST should one need to. The digital assemblage of PST constitutes a multi-dimensional temporality that is experienced as Laura’s living present. Consequently, the support enacted with the platform is temporal. It shapes the experiences of mental ill-health of users. These do not exist in isolation in terms of taking a digital form distinct from in-person support but exist as a core part of the multiplicity of the living present. Laura’s anticipation of her mental health in the future, in terms of the potential to experience anxiety, impacts positively on her current experience, lessening anxiety about her future mental health. As such, anticipation operates as the future dimension that makes the living present through shaping current support.

This is part of a synthesis of past, present and future that Deleuze frames as a passive one, due to there being no actor who initiates and enacts time. This would be an actor external to time, and therefore would be incongruous with Deleuze’s philosophy of time. As Deleuze notes,

[T]he present does not have to go outside itself in order to pass from past to future. Rather, the living present goes from the past to the future, which it constitutes in time, which is to say also from the particular to the general: from the particulars which it envelops by contraction to the general which it develops in the field of its expectation. (1994, p. 91)

The future is constituted by the present in a generalised way, which is virtual as has not yet been actualised. For instance, the general sense that Laura has of the future availability of PST is reassuring. The living present therefore is constituted as a process of moving from the particular to the general, through processes of contraction of the past and anticipations/expectations of the future. The past is constituted by the living present through a contraction because it is not possible for the entirety of all past to be actualised in the present. As such the past exists through a process of contraction.

Concluding remarks

This paper has offered conceptual and empirical insight regarding the making of temporalities of mental health support in relation to digital peer support. The concept of the living present constituted as the contraction of the past and the generality of the future coming together as present experience informed analysis of the support provided by digital platforms such as Peer Support Together. The chronological account of time as discrete quantifiable units, with moments in the past moving quantifiably more distant with the passing of each day was seen to be inadequate in terms of capturing the lived reality of the past being an ever-present, any part of which can be actualised as lived experience in the present. Digital platforms such as PST archive the past, not all of which is visible in the present, but any part of which can be actualised in the present through reviewed past posts/comments, and/or through other people interacting with a users’ past communication on the platform.

Disruptions to communication on peer support platforms can also make support feel precarious through introducing a sense of fragility. This highlights how the materiality of digital support is made visible, in terms of being a technology that is subject to glitches and issues relating to functionality. This is the tension experienced with digital support – its 24/7 availability is valuable, but this comes with a potential to experience issues regarding functionality. The model of temporal co-existence, rather than chronological linearity, is of value to addressing questions relating to the constitution of peer support online. What it does is to consider that people are never disconnected from previous life events, which do not gain quantifiable distance with the passing of time. Indeed, present distress involves living in direct connection with past and future, they are dimensions of present duration. In relation to mental distress, what this approach does is to recognise that past experiences are always-already ‘carried’ with the present, simultaneously with anticipations of the future. At times, these may be relatively passive, and distress deemed manageable, at other times, distress may increase due to the active nature of the past and/or the future in the ‘living present’. Digital platforms such as PST create new ways for our own pasts, and those of others, to be actualised in the present, and consequently to impact on experiences of mental ill-health. Addressing mental health support then becomes about unfolding the multi-dimensionality of the ‘living present’ in terms of how past experience intersects with anticipations of the future in the constitution of peer support.

The analysis contributes to existing literature regarding the temporal impacts of digital technologies (e.g. Kaun & Stiernstedt, 2014; Møller & Robards, 2019), with specific focus on growing the nascent focus on temporality in terms of digital mental health. Furthermore, the insight regarding digital peer support adds to the growing focus in research and mental health services on peer support as a major priority form of non-medical support (Shalaby & Agyapong, 2020). This is part of the move to digitise large parts of mental health support. Addressing digital mental health support through a temporal lens makes an important contribution to existing theory and practice. Conceptual insight is delivered in terms of knowledge of the ways that peer support platforms potentialise the present in terms of digitally archiving past support on the platform. The past can be actualised for individuals through their own activity, or that of others, with the platform facilitating experiences constituted through specific relationships of individual and collectivity. This has implications for the guidance provided to people regarding digital peer support platforms. Their temporal availablity and openness offers several benefits in terms of the of accessibility support. However, it can also connect people with a large range of difficult experiences of other people, which can be triggering regarding one’s own mental health. There is a delicate balance between seeking and providing support, and managing one’s own mental health in the present. This is not always a straightforward process to navigate as support seeking depends on individual need, with people often seeking support when feeling distressed, and yet it is at those times that people can be most vulnerable. This kind of potential needs to be considered in designing and delivering digital support. We need to ensure that new tools that are developed are analysed and evaluated in terms of their specific impacts on people’s mental health.

The findings from this study should be contextualised as being from a small sample of users of Peer Support Together. While rich insight was gained from the participants regarding the breadth and depth of their experience, it is important to note that the sample of nine is a limited one. It would be helpful to use the findings from this study to inform future studies with larger samples. Digital technologies offer much promise, particularly in terms of accessibility but we need to ensure that their impact is considered carefully alongside existing in-person services, including in primary care and the voluntary sector. This paper therefore contributes to the evidence base regarding the impacts of new forms of digital mental health support, and­ conceptual understanding in the social sciences regarding time, materialities and mental health.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The work was supported by the UKRI March Mental Health Network+. There was not a formal grant number.