By the Peer Support Advisory Board of Minnesota, in partnership with the League of Minnesota Cities Insurance Trust
Less than five years ago, very few first responders were familiar with the term “peer support.” Today the term is normal to hear in conversations between first responders. Peer support teams, resources, and discussions around the topic are common in first responder culture.
Despite this change, many first responder groups have yet to take the jump into this critical part of a wellness program. This article will cover nine things you need to know about peer support, in hopes of answering questions that may be barriers to starting a peer support program.
Confidentiality Is Key
Loose lips sink ships! There’s no quicker way to lose trust and credibility than through gossip and side talk. Peer support will not work when this is the culture of an organization or a concern of those participating in the program. Fostering trust in an organization for a peer support program requires that:
- The organization actively creates an environment that allows and encourages safe, open, honest, and vulnerable communication.
- Information shared in peer-to-peer communication must be held in confidentiality to build trust. Trust is the base of the process of sharing, listening, normalizing, validating, and healing.
- Confidentiality must be stressed during recruitment.
Recruit the Right Team Members
Finding and empowering the right people to create, manage, and participate on your peer support team is critical to the success of the program. Key characteristics to look for include trustworthiness, compassion, empathy, and peer acceptance. However, it’s equally important to identify "true believers" — those who deeply understand and are committed to the peer support program. The “true believer” is someone whose motivation is the wellness of their peers and the organization. They are willing to do the hard work, is a team builder, and self-motivated to overcome challenges.
The selection process should include input from both management and frontline employees. Management can ensure alignment with organizational goals and provide resources, while employees can offer valuable insights into potential candidates' peer relationships and suitability. The process should maintain consistency and fairness, recruit from a variety of ranks, and questions should be asked to assess empathy and ability to handle sensitive situations.
Build a Balanced Program
It is essential to avoid creating a peer support program that is either too expansive or too limited. A program that tries to cover too many aspects or includes too many participants may struggle to deliver meaningful support. It may also become complex to manage, making it difficult to maintain quality, consistency, and effectiveness. A program that is too narrow may not address the needs of all employees, reducing its overall impact. A narrowly defined program may also lack sufficient resources, resulting in a lack of comprehension and support.
Achieving balance in a peer support team is critical to its effectiveness and sustainability. An appropriately scaled program will be comprehensive enough to meet diverse needs while remaining focused and manageable, ultimately providing a supportive environment that benefits all participants.
Involve Professional Mental Health Providers
Culturally competent mental health providers are a critical component of any effective peer support program. While the degree of provider involvement may vary between programs, their roles often include contributing to training, supporting program development, and providing appropriate clinical handoffs when a peer’s needs exceed the scope of peer support.
A clear understanding that “peer support is not therapy, and therapy is not peer support” is essential. This distinction reinforces healthy boundaries, ensures team members stay within their role, and helps build trust between peer supporters and mental health professionals.
Clinical partners should have demonstrated experience working with first responders and an understanding of public safety culture. Selection should be led by individuals involved in the peer support program, with input from trusted team members and consideration of qualifications such as training in trauma-informed care, critical incident response, and familiarity with first responder roles. The mental health provider’s role is to support, not to manage, and to serve as a resource when peer support team members identify the need for professional intervention.
Define Goals and Encourage Feedback
Well-defined roles are essential to set clear expectations and reduce confusion within peer support programs. When roles are collaboratively established by a diverse team, including peer supporters and administration, it fosters shared understanding and helps build lasting trust across the organization.
We know that first responders can be skeptical of change. Therefore, providing detailed explanations and education about the program to build trust and buy-in is vital. This includes sharing what peer support is and what it is not. Emphasize that participation in the peer support program is separate from performance or fitness-for-duty evaluations to alleviate any concerns about confidentiality and evaluation.
To effectively change culture, start by planting early seeds of change. This involves encouraging open dialogue and asking for and acting on feedback. Create channels for ongoing communication where everyone can ask questions, and the team can explain its benefits and address any concerns.
By systematically addressing these steps, you can build a robust program that effectively integrates into the organizational culture, supports positive change, and ensures successful outcomes.
Pursue Ongoing Training
In 2020, Minnesota enacted Statute 181.9731, which mandates that peer counselors complete a minimum of 30 hours of standardized training provided by the Minnesota Department of Public Safety. This training is available to organizations through approved providers and includes training sponsored by the League of Minnesota Cities. It is offered in different formats, including in-person and with limited parts of the training offered virtually.
Although continuing education is not required by statute, it’s always a good idea to refresh and sharpen skills. Many teams enhance their skills by participating in monthly or quarterly sessions that delve into advanced aspects of behavioral health, including various therapeutic modalities and crisis intervention strategies. The Peer Support Advisory Board also provides free quarterly training to peer counselors across the state. Learn about the Peer Support Advisory Board.
Use the Team Model That Works Best for Your Organization
There are common fundamentals throughout programs, but team structure and make-up are typically dictated by current agency modeling — organizations use what works well for their daily operations and culture.
- Internal Model: In this approach, peer support teams operate within a single organization and are composed of individuals from that agency. These teams provide support and resources exclusively to their own members.
- Consortium Model: This model involves collaboration between multiple organizations, pooling resources, training, and expertise from a wider network. By drawing on the experience and capabilities of various agencies, the consortium model can offer more comprehensive support and specialized knowledge than what might be available within a single organization. The consortium model may work well for agencies that feel they are too small to support their own program.
Initial training and clinical oversight represent the most significant expenses for both models. Thereafter, the consortium model is typically the most cost-effective. However, it is important to look at the long-term value of the training and how each model can contribute to policy recommendations, health and wellness, and a culture that supports employees by listening, relating and validating each other.
Make Note of Legal Considerations
When setting up a peer support program, organization leaders should understand the statutory limits to privacy, confidentiality and privilege. Minnesota State Statute 181.9731 helps first responders define roles and limits in peer-to peer communication but also recognizes exceptions as mandated reporters. It protects peer-to-peer communication and classifies the interaction as private and not disclosable to third parties, except in federal cases.
As a mandated reporter, the duty to warn supersedes the protections provided by state statute. During a protected conversation, if a first responder communicates a plan for suicide, any homicidal violence, or abuse to a child or vulnerable adult, mandated reporting is still applicable.
When setting up a program, your organization should consider these limits. Adding a clinical director to the team structure and implementing policy can help alleviate concerns when these limits are approached.
Think of Peer Support as ‘Mental Health First Aid’
Peer support teams create a caring work environment, where trained personnel are readily available to provide psychological first aid. Through training and collaboration with mental health providers, peer support teams work to prevent mental illness and may help those who suffer recover more quickly. Peer support can also improve organizational morale, reduce sick leave, increase retention, and increase overall organizational performance.
