Background: Digital mental health (DMH) delivered via peer support is of increasing interest following the pandemic. Such approaches have the potential to alleviate demand and increase access to support. However, little is known about the process of change while using these platforms from initial inputs to long-term impact. Purpose: This project used co-production to develop a Theory of Change (ToC) to understand the inputs, processes, outcomes, and impact of these platforms according to stakeholders. Methods: A series of semi-structured focus groups were held with stakeholders (n=23) in DMH peer support. Focus groups were guided by the ToC approach. The first focus group (stakeholder launch) involved a series 3 breakout rooms and participants were divided into 2 groups. The second set of focus groups aimed to expand on the findings and fill in identified gaps. The final focus group (stakeholder close) involved the researchers sharing the results with attendees and receiving their feedback on the ToC. Following this the ToC was updated. Data were analysed using a thematic framework approach to allow comparisons to be made between stakeholder groups. Results: The ToC generated 3 different pathways: platform, commissioners, and members. Each pathway supported member’s use of the platform through increasing engagement or maintaining resources. Stakeholders identified multifarious inputs, outcomes, and impact of the platform. These included increasing mental health literacy, improving self-management skills, and preventing worsening mental health. Insight into the processes of the platform was limited, although variations in member types and the role of user expectations were highlighted. Key risks, barriers, and how platforms fit into the wider mental health landscape were also reported. Conclusion: The ToC harnessed stakeholders understanding of DMH and peer support. Further research the active ingredients of a platform and how these effect members behaviour and mental health is needed.Digital mental health (DMH) services can reach more people, flexibly, anonymously, and more cost-effectively than traditional approaches. As more people use DMH expectations are raised as to how effective it is, and also how best to meet the needs of vulnerable people and those in crisis.  Building on existing work with Togetherall, we will use co-production and stakeholder engagement to create a Theory of Change for DMH, a digital peer support platform, and an associated DMH peer support toolkit. This will be used to support service users, developers, policy makers, commissioners and businesses to better utilise DMH platforms.  By using co-production, our project will ensure that resources on implementing DMH fully reflect end-user experiences and needs in using DMH platforms. -The project will enable stakeholders (commissioners, health and social care services and businesses, governmental organisations) to make evidence-based choices on designing and implementing DMH services. -As DMH provision grows, the outputs from our project will offer best-practice advice on scale-up and evaluation of DMH. -Key impact outcome indicators will be identified that enable ongoing evaluation of DMH (in general) and for our project partners Togetherall (specifically).

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