This mixed-methods study aimed to explore the initial process of engagement with an online support group (OSG) for depression. Fifteen British National Health Service patients experiencing depression who had not previously used an OSG for depression were offered facilitated access to an existing peer-to-peer OSG for 10 weeks. Pre- and post-measures of depression, social support, and self-stigma were taken in addition to a weekly measure of OSG usage. A follow-up qualitative interview was conducted with a subsample of nine participants. Depression and self-stigma reduced over the 10-week period, but perceived social support did not change. There was no evidence of adverse outcomes. Perceived benefits of OSG participation included connection to others, normalization of depression, and stigma reduction. However, engagement with the OSG was generally low. Barriers included concerns over causing harm to others or being harmed oneself, feeling different from others in the group, and fears of being judged by others. OSGs may potentially reduce depressive symptoms and perceived self-stigma. However, considerable barriers may hinder people with depression from engaging with OSGs. Further work is needed to determine who will benefit most from participating in OSGs for depression and how best to facilitate engagement.

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