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Article by: Andrew Ruiz, Firefighter Paramedic
Peer Support has been a buzzword title thrown around the emergency services for the last two decades. It has morphed through the phases of being a rushed reaction to a rapid escalation in responder substance abuse, mental health issues, and suicides, to now an empty box on industry standard or accreditation self-assessment checklist. There is little standardized guidance on how or what to do with a peer support group other than to have one. The simple response to the empty box is to task a junior supervisor to head a program and maybe ask for a couple of volunteers. Then an email goes out, stating, “We’re your new Peer Support Group … if you have any problems, come to us.” If the group ever meets, it's usually on a rare occasion and unproductive. Eventually, a member of the agency encounters a behavioral health stressor, and confusion ensues.
The first step towards operating a functional and successful Peer Support Group (PSG) within your organization is to reflect and understand that beyond any checklist item, your people need and deserve one. Poor behavioral health and wellness have been ignored in emergency services since its beginning. Substance abuse plagues the family relationships of some of our responders, and your agency is lucky if suicide hasn’t hit close to home yet. The responsibility of dealing with these ugly truths lies not just at the feet of organizational leadership but at the feet of us all as peers and friends of those impacted by them.
Where do we go from here if the problems are always easier to identify than the solutions?
Reach Out: Explore your organization and the people in it. Meet them at their level and engage in conversations that have nothing to do with their job. Seek to understand things like why they are who they are and what their life is like outside of work. Create a categorized list of what can be improved upon with the goal of high levels of wellness in mind.
Develop the Right Culture: Cultural change is a process. It is best achieved through simultaneous engagement from the top, middle, and bottom. Leadership, governing councils, labor organizations, wives’ clubs, and any other subsets of your agency should be educated on the facts of behavioral health issues in emergency services and the goals we intend to reach with a peer support group. Focus on developing the convictions of the influential change agents in your agency and allow them to lead the culture at their levels.
Discover the Right Peers: The selection process for membership within your organization should be stringent, and the one to become a member of its Peer Support Group should be even more rigid. For me to be comfortable with bringing my issues to you, I must be confident in your character and ability. Finding individuals with the highest moral character can be difficult sometimes, especially in the beginning phases of a cultural shift within your organization. An excellent place to start is with a closed vote of confidence. Confidentially ask each person in your organization from top to bottom, “Who do you feel comfortable with and confident in to help you with a personal problem?”. The results tend to vary at different levels and between shifts. Stay committed to recruiting the best members for the job, not a specific number of members. If the results all point towards only one or two individuals, then so be it for now. More will follow with the time and experience that they’ll receive through the PSG.
Get Organized: It’s time to select your team and put pen to paper on this. Reiterate the importance of what is to be achieved to the PSG and provide them with their first tasks. One of which should be to become certified Peer Coaches. They don’t know what they don’t know. This training will open their minds and instill in them the ability to help your people. Begin to develop a guideline on how your PSG will operate, what it will offer your people, and whether it will respond to their needs.
Find the Right Resources: If you wait until you’re in the middle of a crisis involving your people to find resources to assist them, you’ve failed them already. There are many organizations and other resources that are highly qualified to aid your people through many different challenges. Not just with behavioral health either. Peer Support Groups can be the bridge for people to receive assistance with managing their finances, being a better spouse, parent, or single parent, and much more. There are resources in place at many different levels that can be ready to assist when called upon. It is imperative to discover, contact, and develop a plan and relationship with them early.
Train: To be effective, we must continue to train. This concept has been proven to be true of emergency services operations, and it’s no different for emergency services PSGs. As certified Peer Coaches, your PSG staff will be equipped with the knowledge and ability to effectively communicate with and aid the individuals that make up your organization. The provision of Peer Coach interaction and behavior health awareness training to your people will help them to identify and deal with the minor stressors that they face in life as they occur. By doing so, the likelihood of their stress compiling over time and resulting in a major crisis is reduced.
Coach: Peer Coaches aid your people with becoming the best version of themselves and positively impacting the culture of the organization. Employees and sometimes even their family can interact with peer qualified coaches and receive constructive feedback and assistance with things like decision issues, prioritization conflicts, goals and plans toward achieving them. Coaches offer non-clinical assistance with navigating stress and its effects on behavioral health. They play an essential role in any functional peer support group.
Prepare and Practice: The trained PSG staff has its mission and has developed a plan of attack. To prepare the organization for the launch, it’s always good to determine the baseline for a comparison of effectiveness later. Non-clinical and anonymous diagnostic assessments can be used to draw that baseline out. Adding additional rounds of these assessments will be beneficial for both the leadership and the individuals to use while evaluating stress levels and the effectiveness of the PSG.
I’ll be the first to admit that this 6-minute read of a blog post makes establishing an effective PSG seem simple and that if it were this simple, every organization would have one already. The truth is that the difficult steps are always the first in this process. As I mentioned in the beginning, there is little standardized guidance behind operating an influential peer support group for your people other than to do it. It's one of the most important boxes on many of our self-assessment and inspection checklists. However, we can’t be in such a hurry to check the box that we miss the point of what an effective PSG can achieve for our people.
If you need more help with this topic or have any questions, please feel free to contact us at Battalion 1 Consultants. We’d like to hear from you and assist wherever we can.
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