Support groups and peer support

A support group is a small group of people who share a similar challenge. They meet, in person or online, to talk, listen and swap ideas. Peer support is help from someone who has "been there" themselves, such as a person in recovery from depression or a family member who has cared for a loved one.

Many people say the hardest part of a mental health condition, or of caregiving, is feeling alone. Being with people who understand can ease that. This page explains the main free options, what a first meeting is like, and how support groups fit alongside treatment.

Support groups, peer support and group therapy: what is the difference?

These three things can sound alike, but they are not the same.

A support group is not group therapy. DBSA, for example, says its groups are peer-run self-help, even though many chapters have a professional adviser.⁴ If you want treatment from a professional, see how to find a therapist and paying for therapy.

Groups for people living with a mental health condition

NAMI Connection

NAMI (the National Alliance on Mental Illness) offers NAMI Connection, a free group for adults 18 and older who have had symptoms of any mental health condition. Meetings last about 90 minutes. They happen weekly, every other week or monthly, depending on the location.²

The leaders are trained and have their own mental health condition. Each meeting follows a set format so that everyone gets a chance to talk. What is said in the group stays in the group. NAMI groups do not push any one treatment.² Many meet online and are open to people anywhere in the country. A Spanish-language version is offered in some states.^1,2

DBSA groups for depression and bipolar disorder

The Depression and Bipolar Support Alliance (DBSA) has local chapters around the country. Most of their groups are run by volunteers who live with a mood condition themselves.⁴ DBSA also holds free national groups online.⁵

Some DBSA online groups are meant for a specific community. Examples include groups for young adults, veterans, Spanish speakers, faith-based groups, rural communities, and family and friends.⁵ Online groups ask you to create an account and fill out a short intake form before your first meeting.⁵ If you live with depression or bipolar disorder, a DBSA group can be a place to talk with people who know what mood episodes feel like.

Groups for families and caregivers

Caring for someone with a mental health condition or dementia can be lonely and tiring. Groups for caregivers give you a place to be heard, too.

NAMI Family Support Group. This free group is for adult family members, partners and friends of a person with a mental health condition. It is led by family members who have been through it. Meetings last 60 to 90 minutes and follow a format that gives each person time to speak.³

NAMI also offers a class called Family-to-Family, which teaches families about mental illness over several weeks. In a study of 318 family members in Maryland, people who took the 12-week course gained more knowledge and felt more able to cope than people who waited. Their sense of burden, though, did not change.¹⁴

Dementia caregiver groups. The Alzheimer's Association holds support groups for caregivers, for people living with dementia, and for others affected by it. Many areas also have special groups, such as groups for people with younger-onset or early-stage Alzheimer's and groups for children. All groups are run by trained facilitators. Some are led by peers and some by professionals. Groups meet in person or online, depending on where you live.⁶ To find one, search the group listings on alz.org or call the Association's 24-hour Helpline at 800-272-3900.⁶ See also caregiver stress and burnout and the first 30 days after a dementia diagnosis.

Local aging services. A federal program, the National Family Caregiver Support Program, pays for local caregiver help. This includes counseling, caregiver training, respite (short breaks from caregiving), and help setting up support groups.¹¹ It serves adults caring for someone 60 or older, or for a person of any age with Alzheimer's or a related dementia.¹¹ Services are offered through local agencies, such as your Area Agency on Aging. Find yours through the Eldercare Locator at 1-800-677-1116 or eldercare.acl.gov.¹²

Peer specialists: one-on-one help from someone who has been there

A peer specialist (also called a peer recovery specialist or peer support worker) is a trained worker who has lived through a mental health or substance use problem and is now in recovery. They build trust through shared experience and help people stay engaged in their recovery.⁹

At the VA. VA peer specialists are veterans with their own mental health experience who are trained and certified to help other veterans.⁸ VA has hired more than 1,000 of them for mental health care.⁸ They help veterans set recovery goals, make follow-up calls, lead groups and find their way through the VA system.⁸ Ask your VA clinic or local Vet Center about peer support.⁷ You can also call the Veteran Combat Call Center at 1-877-927-8387 to talk with another combat veteran.⁷ For more, see PTSD in older adults and veterans.

In Virginia. Virginia certifies Peer Recovery Specialists. To earn the main state credential, a person finishes a 72-hour state training, logs 500 hours of peer support work and passes an exam. Peer specialists must also register with the state Board of Counseling before Medicaid can be billed for their services.¹⁰ To find peer services, contact your local Community Services Board (the public mental health agency for your city or county) or NAMI Virginia.¹⁰

What does the research say?

Research on peer support shows real but modest benefits. It does not show that peer support treats symptoms on its own.

• A 2014 review of 18 trials, with about 5,600 people living with serious mental illness, found little or no effect on hospital stays or overall symptoms. There were small gains in hope and in a sense of recovery, but the evidence was weak.¹³ Limited research
• The NAMI Family-to-Family trial found better coping and more knowledge for family members, but no drop in their feeling of burden.¹⁴ Promising
• The VA's National Center for PTSD says peer groups have not been shown to reduce PTSD symptoms. They can still help people feel more connected and less alone.⁷

In plain terms: a group is a good companion to treatment. It is not a substitute. If symptoms last more than a few weeks or make daily life hard, see a professional too.⁷

What to expect at your first meeting

It is normal to feel nervous before your first group. Here is what usually happens.

1. Check the details first. Look up the time, place or video link. Ask if you need to sign up ahead of time. Online DBSA groups, for example, ask for a short intake form.⁵
2. Arrive a few minutes early. The leader may greet you and explain how the group works.
3. Hear the ground rules. Most groups keep what is said private and give each person a turn.^2,3
4. Share only if you want to. You can say your first name and "I'd just like to listen today." Listening is a fine way to take part.⁷
5. Notice how you feel afterward. Calmer, more hopeful or less alone are good signs.
6. Try it two or three times. Each meeting is different. If a group does not fit, try another one, an online group, or a different time.

How to choose a good group

A healthy group feels safe and respectful. Look for these signs:

• The group is run by a known organization, or has a trained leader.
• Everyone gets a turn, and no one is forced to talk.
• Privacy is taken seriously.
• People share experiences, not orders.
• It is free, or costs are clear from the start.

Online groups and forums can be very helpful, especially late at night or if you live far from town. Use only your first name. Do not share your address, finances or medical record numbers. For more on online tools, see online therapy and mental health apps.

Helplines that can point you to a group

When to get more help

Support groups are not crisis services. Call or text 988 any time if you or someone you love is in emotional crisis or thinking about suicide.¹ Call 911 if someone is in immediate danger or has a medical emergency. A safety plan can help you prepare ahead of time.

If a group helps but you still struggle, that is a sign to add treatment, not a sign you failed. Start with our beginner's guide to therapy. Caregivers can also see caregiver burnout and build a care circle of people who can share the load.

Education only. This page is general information written from the sources listed. It is not medical, legal or financial advice and does not replace a doctor, therapist or lawyer who knows your situation. How we write and check pages.