Developing a Sustainable Model of Text-Delivered Peer Support for Undergraduate Mental Health

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There is increased need for mental health support on college campuses: existing campus resources are increasingly unable to meet the mental health needs of their undergraduate communities. There is also increased preference from students for some forms of emotional support to come from peers. Peer support programs, in which students act as supportive listeners towards their fellow students, are increasingly common on college campuses, but the uptake and utility of these programs is not routinely examined. There is also a need to ensure that the mental health of students providing support is protected. Providing support for peers can be a positive source of meaning and life purpose, but also a source of perceived stress, emotional exhaustion, and, potentially, burnout. If such programs are to be developed and disseminated, it is critical to understand the mechanisms whereby communicating with a peer in a moment of distress can improve mental health outcomes. This dissertation aims to address the critical need of identifying key components for sustainability by providing an updated review of the prevalence and nature of existing undergraduate peer support programs (Study 1), synthesizing research on the impact of providing peer mental health support (Study 2), and evaluating the acceptability and feasibility of a novel text-based peer support program with a sample of undergraduates (Study 3). We found that approximately 10% of institutions affiliated with the American College Health Association have a peer program dedicated to supporting student mental health. Moreover, there has been a recent surge of interest in these programs: over 50% of programs identified were founded in the last 10 years. However, there is limited data collection and even less peer-reviewed research on the impact of these programs for the students receiving and providing support. DukeLine, an innovative text-based peer support program, was designed, implemented, and assessed for sustainability. Peer coaches were trained through a for-credit, semester-long course taught within the Department of Psychology and Neuroscience and committed to providing peer support in two-person shifts for two semesters while enrolled in a practicum course with weekly group supervision. No coach reported experiencing significant emotional exhaustion and, on average, coaches report deriving moderate levels of meaning and purpose from their role as a peer coach. Over a quarter (29.73%) of students who reached out to DukeLine for support did so more than once and 88.89% of texters reported feeling extremely satisfied with the support they received. DukeLine offers a sustainable model for peer support programs targeting undergraduate mental health that is acceptable and feasible, for students who seek and provide support.





Erwin, Savannah (2023). Developing a Sustainable Model of Text-Delivered Peer Support for Undergraduate Mental Health. Dissertation, Duke University. Retrieved from


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