Peer Supporters Face Systemic Hurdles in Digital Mental Health Rollout

Peer supporters were supposed to help bridge the mental health gap with the aid of new digital tools, but the system set them up to fail.

A new study examining California’s roughly $100 million Help@Hand initiative reveals that peer workers were given unclear roles and limited resources. Many struggled to support their communities while navigating vague expectations and competing demands. The findings raise broader questions about what it really takes to make digital mental health interventions work and who gets left behind when they don’t.

“The skill set that we need is someone who is organized, comfortable with public speaking, can work somewhat independently, can coach around digital health and technology,” said one program staff member when describing the nearly impossible expectations placed on peer workers.

The study, led by Biblia S. Cha, a researcher in the Department of General Internal Medicine at the University of California, Irvine, along with colleagues from multiple University of California campuses, examined the real-world challenges peer workers faced while implementing digital mental health tools within a public health system.

By documenting how peer workers were simultaneously essentialized and unsupported, the research offers a compelling account of how systems that claim to value lived experience often fail to center it meaningfully. The findings illuminate how technological solutions, when imposed without attention to equity, context, and power, can replicate the very hierarchies they aim to disrupt. For those who have long challenged the top-down production of psychiatric knowledge, this study offers empirical confirmation that inclusion without infrastructure is a form of tokenism, not transformation, and that participatory intent must be matched by participatory design.