As mental health challenges surge on college campuses, a new study led by Duke University researchers finds that peer support programs—initiatives where students provide emotional support to fellow students—are rapidly expanding at colleges and universities across the country. The study, published in the Journal of American College Health, offers the most comprehensive look to date at the availability, structure, and quality of these programs.
Researchers reviewed the websites of 776 institutional members of the American College Health Association and identified 171 active peer mental health support programs at 126 colleges and universities. Many programs offer services during evenings and weekends—outside of traditional counseling center hours—filling crucial gaps in care.
The study also highlights significant variation in training standards, program scope, and institutional support—raising questions about consistency and sustainability. The authors suggest that greater collaboration and shared data practices could improve both the quality and reach of peer support nationally.
“Peer mental health support programs are increasingly being developed at universities, but few are collecting data,” said Nancy Zucker, PhD, senior author of the study and professor of psychiatry and behavioral sciences at Duke. “DukeLine, Duke’s anonymous peer support text line, launched in 2022 and we’ve been collecting data on processes and outcomes. We hope to partner with schools around the world to learn from each other and expand the range of emotional support services for students.”
“We hope to partner with schools around the world to learn from each other and expand the range of emotional support services for students.”
— Nancy Zucker, PhD
The team also surveyed program leadership, finding that while training requirements of students varied widely, more extensive training was associated with greater student engagement.
Sarah Gaither, PhD, a co-author of the study and associate professor in Duke’s Department of Psychology and Neuroscience who collaborates with DukeLine, notes that peer texting programs are a perfect opportunity to make mental health resources more accessible. “This is especially true for students from marginalized backgrounds since it can help break down the stigma of seeking out mental health support,” she said.
Libby Skiles, EdD, assistant vice president of student well-being at Duke, sees DukeLine as a valuable addition to the network of mental health support for students at Duke. “The ability to connect with peers for support has been deeply impactful for our students and has been instrumental in our efforts to normalize reaching out for help,” she said.
The past decade has seen a 60% increase in these peer-led initiatives, signaling growing student demand and institutional recognition of their value.
“Student mental health needs have outpaced the capacity of traditional services, and peer support programs aren’t just stopgaps—they’re a critical part of a broader strategy, especially when paired with clinical care.”
— Gary Bennett, PhD
“Student mental health needs have outpaced the capacity of traditional services, and peer support programs aren’t just stopgaps—they’re a critical part of a broader strategy, especially when paired with clinical care,” said Gary Bennett, PhD, professor and dean of Trinity College of Arts & Sciences. “And they do more than help the recipients: peer counselors gain training, purpose, and leadership skills. It’s a win on all sides, but only if we invest wisely.”
The lead author, Savannah Erwin, PhD, conducted the study as a Duke University clinical psychology graduate student and is now a postdoctoral fellow at the University of North Carolina Chapel Hill School of Medicine.
This research was a collaboration among faculty and students across multiple Duke entities, including the Departments of Psychology and Neuroscience and Psychiatry and Behavioral Sciences, the Pratt School of Engineering, and the Duke Global Health Institute.
For media inquiries, contact Stephanie Lopez (stephanie.lopez@duke.edu or 919-724-5934).