Abstract
Higher education students face elevated mental health risk as they undergo a transitional and developmental period. The demand for support has outpaced the capacity of university and health care systems to provide professional care. Peer support offers a viable alternative approach that can reduce the burden on the health system. This scoping review aims to identify existing peer support programs in higher education and synthesize evidence-based design and implementation strategies that support co-creation, sustainability, and institutional integration. It was conducted in accordance with PRISMA guidelines. Six scientific databases were searched using structured terms related to peer support, mental health, and higher education. Two reviewers screened 2,300 titles/abstracts and 126 full-text articles; grey literature was also reviewed. From the resulting 39 sources, data were extracted and categorized by program design, implementation, and evaluation characteristics. The peer support programs assessed were diverse in design reflecting complex student needs. Commonly used practices included co-creating program objectives, flexible delivery to support prevention, and inclusive recruitment strategies. The programs emphasized structured training and ongoing professional supervision to ensure safety and fidelity. Integration into existing university mental health systems supported coordinated care and organizational learning. Thus, peer support programs can strengthen university mental health systems when they are co-produced with students, designed for local context, and integrated within existing services. Sustainable programs require organizational buy-in, interprofessional collaboration, and ongoing evaluation to adapt to complex student needs. Gaps remain in standardized terminology, outcomes, and evaluation frameworks.
Key messages
• Higher education students face elevated mental health risk. The demand for support has outpaced the capacity of university and health care systems to provide professional care.
• Peer support programs can strengthen university mental health systems when they are co-produced with students, designed for local context, and integrated within existing services.