A Framework to Preserve Core Values And A Best Practice Example Of Digital Peer-To-Peer Support For Children And Young People.
Dr Suzi Godson
Protecting the principles of authentic peer support.
Recognition of the value of peer support for people struggling with severe mental illnesses goes back centuries. The best-known example is probably Alcoholics Anonymous, which was set up in Ohio in 1935 to support people with addictions. Peer support was always meant to be about shared lived experience, but as it began to be integrated into mental health services, efforts were made to make the model more structured; for example, in the US, Shery Mead developed an approach called Intentional Peer Support (IPS), which was designed around training people to be peer support workers (Mead & MacNeil, 2006).
The increasing professionalisation of peer support moved it away from its informal roots in the community, and the more recent shift to digital provision has distanced it even further. A proliferation of platforms claiming to offer peer support via everything from AI chatbots to broadcast videos or posting boards has now stretched the interpretation of what constitutes ‘peer support’ to its limit. In an attempt to protect the underlying principles of peer support, Simon Bradstreet from the University of Glasgow and lived experience researcher Karen Machin have published a framework that identifies five key ingredients that constitute authentic peer-to-peer support.
Bradstreet and Machin’s framework for testing whether a tool represents authentic digital peer support
Centered in lived experience
Does the approach involve two or more people with shared lived experience?
Has there been genuine and authentic engagement of people with lived experience in the design, development, and evaluation of the intervention or approach?
Digital
Is the digital nature of the tool or platform clearly defined?
For reviews of the literature, are the dates of the search likely to be relevant to current digital use and the current state of technology?
Values based
Can the tool be shown to align with a referenced local or international values-based (e.g., lived experience, mutuality and reciprocity, hope, self-determination, equity, and justice) framework for peer support?
Are peer supporters provided with appropriate training and guidance?
Transparent
Is the meaning of peer support clear in the context of the tool and in the anticipated behaviour for all parties?
Is the peer support role clearly defined?
Is the peer supporter’s contribution clearly valued and recognised?
Are all users of the tool made aware of how the data they contribute will be used?
Are all parties made aware of the risks involved with using the tool?
Active and intentional
Is there a two-way interaction between people, either synchronous or asynchronous, with opportunities for conversation?
Does the person seeking peer support have the choice to use digital or nondigital peer support?
Would the peer supporter and the person seeking peer support refer to their interaction as digital peer support?
Tellmi is a unique digital peer-to-peer support platform that meets all five criteria of the framework.
1. Tellmi is centred in lived experience.
Tellmi is a digital platform that enables young people aged 11+ to connect to each other anonymously to share anxieties and access support and advice. Human pre-moderation makes peer-to-peer exchanges safe and screens out anything that might be unhelpful or harmful. High-risk users are transferred to the counselling team for rapid support if required. Anonymity makes it easier to talk about difficult things.
“I find it nice to be able to share anonymously and I like to help others now that I'm getting better in myself.”
Connecting people who have had similar experiences is core to peer support (Lieberman,2005), but it can be difficult for young people to find appropriate peers (Gerritzen,2023). Tellmi makes that easy. Age-banding for users under the age of 21 means they communicate exclusively with peers within two years of their age. Users can also choose from 200+ topic tags to filter their feed and join relevant communities. For example, by adding the topic tags ‘Gender’ and ‘Sexuality’, LGBTQ+ young people can ask questions and share advice and support. Similarly, in the run-up to GCSEs, young people who add the ‘Exams’ topic tag can share their anxieties with others going through the same experience.
The following exchange shows how topic tagging (Autism & School) and age-banding (+/-2 years) ensures that peers are matched through shared experience and life stage:
Tellmi user post: “hi guys, i just got this app because i have really severe anxiety and autism. i’m 12 years old. i’m going into year 8 in a few days and i’m really worried about it. school sends my mh down the drain and it’s really hard for me. does anyone have any tips?
Tellmi peer response: “i’m year 8 and autistic with ehcp. do you have ehcp? if you dont you shld get one cos it is helpful for extra support. i got a support worker in year 7 and i also go to a lunch club. i’d say find a safe adult at school, one that will let you talk to them, and let you be in their classroom during break and lunch. good luck!!!”
The knowledge exchange in an authentic peer-to-peer relationship can sometimes make no sense to external observers. Outsiders don't speak the language, understand the vocabulary, or have the relevant expertise to engage in the conversation. This example from the Tellmi app is a good illustration:
Tellmi user post: “I've finally reached out for help for my needle phobia because it's affecting my life quite strongly (being a type 1 Diabetic whose scared of needles is a bad combination), I hope it goes somewhere and helps me in the end”
Tellmi peer response: “Bloody hell that's a nightmare. Can't you get a pump so you don't have to inject? Your phobia would be criteria enough for you to get one even they don't routinely give them to over 16s in your region.”
In this interaction, the response clearly comes from someone who has personal experience of the technologies available for diabetes management and the regulatory criteria for accessing them through the NHS. That’s a lot of useful information shared in just two sentences.
The critical difference between peer-to-peer support and other forms of mental health care is that it is non-clinical. It is not about receiving treatment from a qualified professional. It is two humans sharing their concerns as equals, and reflecting on their own experiences to help each other to feel better and move forward in life.
“It helps me to know that there are people who are struggling with the same thing as me and that I’m not alone” - Tellmi user
Lived experience gives people insider knowledge that is uniquely useful to someone else who is struggling with the same situation. Whether they have just been diagnosed with Type 1 diabetes, are being bullied, or are going through a divorce, peers with lived experience will understand the emotional arc that they are likely to go through because they too have navigated the NHS, had to manage bullies or dealt with the legal bureaucracy or financial implications of ending a marriage.
Connecting peers who face similar challenges helps to combat stigma and normalise lived experience. Inevitably, this means that Tellmi is particularly successful at connecting young people who share specific circumstances (living in care, young carers, minority groups, adverse life experiences) or concerns (LGBTQ+, autistic, lonely, anxious, disabled). The extensive involvement of young people in design and development has also been fundamental to the success of the Tellmi service. Over 6,000 young people have helped to shape the Tellmi model through user research, design testing and co-creation. All new features are co-designed and tested with our youth advisory board.
2. State-of-the-art inclusive digital support.
Tellmi is DTAC compliant and meets the criteria for a Tier B NICE Technology. It is available as a native app for iOS and Android and as a web app. The service is delivered entirely through the app or web app: users communicate with each other, as well as counsellors and therapists if required, via pre-moderated text messages. A digital directory of resources provides links to other vetted services, apps and videos. Our software has been tested extensively with children, including the 110,000 people who have used Tellmi over the past eight years.
Young people experiencing data poverty often have to borrow devices (eg a computer in a library) or only have access to devices with smaller storage limits and limited browsing data, so Tellmi’s native installation package is approximately 50MB compared to 100MB for social media apps. The app does not cache much content, so its overall footprint stays low during use. Young people from low-income families regularly use second-hand phones, so it is our policy for Tellmi to work on the oldest, supported operating systems and devices. The web app makes it easy to access Tellmi from alternative devices.
3. Values-based.
Tellmi is rooted in the positive psychology movement and its underpinning values are shared lived experience, reciprocity, hope and self-determination. Tellmi adopts a solution-focused stance, and ‘outcomes’ are measured in terms of changes in hope, social connectedness, resilience, self-esteem, confidence, loneliness and mental health self-management skills, rather than changes in clinical symptoms such as anxiety and depression.
Tellmi has developed the first text-based solution-focused therapy service for children aged 11+, so in addition to peer-to-peer support, Tellmi users in commissioned areas can also access 1-2-1 therapy with qualified practitioners.
The app does not offer direct messaging to avoid the risk of silos or cliques. Many Tellmi users feel isolated and struggle with social comparison, so the app is designed without competitive features such as ‘follows’, ‘likes’ or ‘reposts’. Instead, we offer an empathy button on posts and a gratitude button on replies. Typographic animations make the purpose of the interaction clear and make it easy for young people to interact when they may not feel confident enough to post or reply.
Training and guidance on how to use Tellmi are available through the integrated Directory; however, the Tellmi user interface (UI) has been designed using standard features and layouts that will be familiar to anyone who has ever been exposed to social media. This makes how to interact immediately obvious to even the youngest users.
4. Transparency, data and stealth education.
Tellmi operates a policy of partial anonymity because we need to be able to locate users in an emergency. The peer community is anonymous, but when users register for Tellmi, they provide a validated email or phone number, date of birth and postcode so that we can get emergency services to them if necessary. On sign-up, we inform users that we may break confidentiality if we are worried about them, but we always try to do this with their consent.
Tellmi’s privacy policy is available via the app. Its ‘in a nutshell’ section has been reviewed and edited by young people to make sure that it is easy to understand. When we host surveys within Tellmi, the introduction always explains that anonymised and aggregated data from the survey may be used for research purposes or to support further NHS commissioning, but individual data is never shared.
Our approach to self-harm and suicide support has been developed through a four-year research partnership with the Bristol Medical School at Bristol University. We never publish high-risk posts; however, we know some topics can be triggering, so an integrated sensitivity slider lets young people turn off topics they don't want to see. They can also moderate the risk level of the content they see.
Tellmi is a very low-risk service since all posts and replies are checked by a trained moderator before being published, and counsellors are on hand to respond privately to any high-risk posts. If users discuss more complex, sensitive, or risky topics such as medical topics, counsellors can join conversations to help users navigate more difficult issues.
When young people make posts that don’t meet our moderation guidelines, they get sent a message explaining why their post has been withheld. This is a form of stealth education which helps young people to both understand the boundaries of our peer-to-peer support model, and learn what was wrong with their submission so that they can resubmit while the issue, or the advice they were trying to give is still fresh in their mind.
5. Active and intentional bidirectional support.
Within Tellmi, the average time it takes to moderate and publish a post is fifteen minutes. Our users understand that moderation keeps them safe and ensures they are never exposed to abuse, grooming, or judgement. Autistic users in particular have told us that they appreciate having their responses reviewed because sometimes they unwittingly say the wrong thing.
“i like the fact that if i’m not sure how to reply to a post without worrying about being offensive or saying the wrong thing i can tap the heart instead. also it’s helpful to know that someone reviews my reply so i know it doesn’t come across badly because someone has deemed it appropriate I don't have anyone else so there's that.”
Good peer-to-peer support needs to be active, intentional and bidirectional, but it does not necessarily need to be synchronous. Because peers with relevant shared experience are not always using the app at the same time, the average time it takes for a post to receive a response is around two hours. The slow pace of Tellmi makes it feel a lot calmer than social platforms.
Tellmi is only available as a digital tool, but in commissioned areas we integrate local services into an in-app Directory, which is just one click away from the peer feed. User postcodes and topic tags link them to local, national and specialist services as well as 1000+ mental health self-management tools.
We honestly cannot say whether Tellmi users refer to their interactions as digital ‘peer support’ because we don’t know if the majority of our users even understand that term. However, we do know that they benefit from using Tellmi.
In 2026, an independent evaluation of the Tellmi service in Leicestershire, which was conducted by Edge Health, found that it improves mental health across multiple validated wellbeing measures (Shetty, 2026). The evaluation found statistically significant increases in self-esteem (+64%), hope (+33%), social connectedness (+20%), and a statistically significant reduction in loneliness (-9%). The study also found an 8% increase in resilience.
In 2022, an independent evaluation by the Evidence-Based Practice unit at the Anna Freud Centre UCL, which tracked 876 young people over nine months, also found that using Tellmi increased confidence and connectedness, decreased loneliness, strengthened resilience, and improved mental health self-management skills (Ravaccia, 2022).
Tellmi is commissioned by the NHS, Local Authorities and Public Health.
To find out more contact info@tellmi.help