Anna* knows the one spot on her commute where she'll have to put her phone down: when the train darts through a tunnel.

Otherwise, she's online. Deleting trolls, and doing her best to hold together the threads of other people's lives.

Anna is a moderator on a Reddit forum that offers peer support for those struggling with suicidal thoughts. With more than 93,000 subscribers, it's one of the site's largest mental health pages.

At 59, she has never been formally educated as a counsellor or psychologist. Yet her own experience of depression and a volunteer position at a local suicide hotline have made this a calling.

The moderator queue is checked when she's having coffee in the morning, or during breaks at work. Anna has a day job, but this she does for free.

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Anna is one of an army of people who quietly keep the internet together — who from behind a smartphone or computer screen, manage online spaces for people in need.

Some are run by mental health specialists for charities.

Others, like Reddit's suicide forum, exist because humans have instinctively turned to every nook and cranny of the internet in search of connection.

Anna has been on Reddit for 12 years — almost as long as the site has existed.

When she first came across the subreddit (a forum within the site), she was horrified.

It violated many protocols around suicide prevention. There were no confidentiality rules; the people trying to help weren't trained.

Also, it was Reddit. The land of memes and trolls. It's not the easiest place to be vulnerable.

"Reddit is not a good place to do suicide intervention. It's a terrible place to do suicide intervention," she said.

When attempts to move the subreddit's users away from the platform failed, the "least worst viable alternative" was to carve out a space and try to make it as safe as possible.

Moderating other people's pain

Online peer support networks can play a role in mental health treatment, in addition to help from medical professionals.

Jane Burns, a professor in innovation and industry at the University of Sydney who has worked in suicide prevention, advised that people avoid Reddit and use moderated online forums that are operated by mental health charities such as SANE, ReachOut and Beyond Blue.

But she acknowledged that people might gather in online places that medical professionals are not always comfortable with.

Online peer support networks can play an important role in mental health treatment. ( Getty Images: Joel Sartore )

Looking at the suicide subreddit, Professor Burns said she didn't believe it was a safe space: up top, a banner warned users to beware a troll. The sheer number of subscribers also gave her pause.

"They're the things you can't control," she said.

"How do you moderate 100,000 users posting constantly? It just seems impossible.

"The most important thing I think, is … check they've got rules, check they're facilitated, and if you can see something that you think is going to trigger you, then don't read it."

For some people, managing these spaces is a full-time job.

Nicole Thomas, 35, is an online community manager in Sydney at SANE Australia, which runs multiple forums for carers and people living with mental illness.

SANE's anonymous forums are moderated 24/7 and have duty of care guidelines that can escalate serious cases to emergency services.

With around 11,000 members, Ms Thomas said the goal is to tackle isolation for people with complex mental illnesses such as schizophrenia, whether geographical or social.

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Important in a crisis, the forums are also used simply for social connection. Every Friday, for example, it hosts "Friday feast".

"People come there on a Friday night and bring a virtual plate of food," Ms Thomas explained.

"They'll upload an image, either from the internet or their own meal, and just talk."

No 'general uplifting content'

Reddit's suicide forum has some unexpected rules: no general uplifting content or platitudes, for example.

"People think, 'oh I know what will help! If people just read this, they'll realise that life is beautiful', and then we have to take that down with great force," Anna explained.

That's similar to SANE, where Ms Thomas said they ask people not to disclose specific methods of harm.

"We don't often get the simplistic type of band-aid responses," she added.

"In terms of our guidelines, a lot of it focuses around respect, safety and being anonymous."

Reddit's emphasis on anonymity is also vital to the forum's appeal, but that comes with risk: trolling, as well as people who seem to fetishise suicide.

"We [have] those people too, but over the years, we've learned a lot of their 'tells'," Anna said.

"The astonishing thing is the people who get off on inciting suicide online, feel righteously entitled to keep doing it … that's very disturbing."

There's also the impact of outside events. After some recent high-profile suicides, she and the moderation team stepped up their presence on the platform.

Peer support networks can play a vital role in mental health treatment. ( Unsplash: Hannah Wei )

'Selfcare' for moderators

Ultimately, Anna feels a sense of duty about her work on Reddit.

There is pressure to spend every moment there, along with the subreddit's other moderators. She has had to accept the lack of closure — in many cases, she won't know the fate of the people she's talking to.

Ms Thomas said sometimes, people on SANE's forums "feel connected enough to come back and give you updates".

"But more broadly, myself and the rest of the team are exposed to some pretty intense things at times, and what's great about SANE is there are some amazing processes in place … [to support] ourselves," she said.

In contrast, Reddit's forum isn't backed by a charity, so it doesn't have the institutional support for moderators like those at SANE Australia, who are offered training and debriefing.

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"People genuinely want to help each other," Professor Burns said.

"The role of services is to ensure their moderators are supported to stay mentally healthy and well."

That's why ultimately, she recommends moderated peer-to-peer services where the risk to staff is managed.

Anna said her hotline training helps because it has given her an education in self care.

This moderation must be done sustainably, she advised. You must avoid emotionally investing in what's beyond your control.

"It's the internet in general, and Reddit in particular," Anna laughed.

"You finally figured out the right way to say something, and somebody is going to completely misinterpret it, and twist it and go on a crusade against you."

The only way to find a version of peace is to let go of what other people do with your words.

"It's rewarding, but more importantly, it feels like what I ought to be doing," Anna said.

"It means that everything I went through isn't wasted."

*Anna is anonymous, due to the sensitivity of her work.

