Programs based on the ICISF-CISM model of peer support have shown to increase resistance to the psychological effects of stress and critical incidents, foster resiliency by equipping public safety personnel with the skills needed to “bounce back” to their normal functional levels, and inherent in any CISM program is addressing recovery through adaptive functioning or a seamless link to additional supports and services to address their specific need, which through our partners will be available.
Whether new to the role or after many years of service, any incident, regardless of magnitude, can have significant negative impacts on public safety personnel’s mental well-being. Having a network of trained peers accessible 24-7:
- Decreases lost time arising from psychological injury.
- Reduces the impact of psychological injuries.
- Increases public safety personnel’s length of service to their communities.
- Lowers attrition by helping to manage extreme workplace stress.
- Addresses the increased risk of suicide.
- Provides for healthier work and personal lives.
- Helps to support and educate spouses and families of public safety personnel.
Key Philosophies of Peer Support:
- Confidentiality: Confidentiality must be upheld in order for the program to maintain integrity and trustworthiness. Without confidentiality the program will fail and not be utilized. Peers need to be seen as trusted, ethical and safe so that any frontline staff member can access support in a time of need, regardless of the reason or issues causing the impact, knowing that what they share with a peer will be held within the normal bounds of confidentiality. Confidentiality statements should be prominent in program policy documents such as SOPs and Peer member Contract forms. (See templates of CISM SOPs, Peer Contract forms and Confidentiality forms in ICISF-Canada Best Practices & Procedures Manual. Exclusions to confidentiality only occur when physical safety is threatened in such cases as suicidal or homicidal ideation, child abuse or neglect and legal requirements which may vary from region to region and country to country. Since peers never record personally identifying information in the case that a peer were to be mandated by a spinae to divulge information of their peer support contact to a judge or courtroom, which has only happened once within Canada in over 30 years of practice, the peer only has their memory to go on and in such a case the right answer to respond to a judge or lawyer pressing for information is simply; “I cannot recall, or I do not remember.”
- Political Neutrality: Teams should be peer-led, peer driven, and not seen in a position of management or representative of a union. It is important that they maintain this difficult balance of being part of the organization while being as politically neutral as possible neither aligning with leadership or union. This includes avoiding taking on welfare functions such as Occupational Health and Safety Officers as well as harassment contact persons. Essentially, anything organizational should be handled by HR or a separate department or program so that the peer support program is never in a position that could be seen as aligning with their leadership.
- Self-Referral: The peer program is accessed by those who self-refer and identify with their desire to receive peer support services during a time of duress and never be mandated by leadership. When members in leadership notice individuals or a group may be impacted, they can notify the CISM Team who then are trained to monitor, assess and check-in with those involved to provide reminders of how to access support if they choose to, but should never be enforced or coerced to participate in any way.
- The voluntary nature of peer support: the majority of peer work is conducted within a voluntary basis. Most peer programs are independent of the organization although supported by leadership and is common to have training and expenses covered or reimbursed however the provision of peer support interventions are always free of charge where the peer is altruistically volunteering their time to provide support to a colleague in duress. This way there are no conflicts with a peer’s altruism for providing the support.
A Step by Step Guide for Developing & Implementing a CISM Peer Support Program
Phase I: Program Planning and Development:
- Identify the need for a peer support program: there should be members within the organization’s management and frontline that are both supportive and committed to the concept of peer support within their organization.
- Clearly state the goals of the CISM team and who the team is to support. What is the mandate, mission and scope of the program?
- Identify a project lead or two co-leads who are seen as key champions who are representative of the group this peer support program aims to provide services to. The project lead(s) will be responsible for coordinating the initial development of the program including forming a project committee that can support the lead(s) consisting of members within the organization’s leadership, HR department (if they have one), union reps, and anyone else within the organization who would be key in influencing the program’s success.
- Seek Expert Consultation regarding program development from an experienced Clinical Director or CISM Coordinator. They will assist the project committee in creating a strategic plan to develop, implement and evaluate your internal integrated peer-led, peer driven CISM program for your organization.
- Educate/Inform the project committee: Make sure the project lead(s) and project committee receive some kind of initial training or education of the model of peer support, including members in leadership who will then be able to best understand the scope and best practices of a peer support program and be in a more informed position to support the program appropriately and work on gaining buy-in from other members up the management chain.
- Adopt the CISM Best Practices & Procedures Manual for team membership and the specific roles to be performed:
- Administrative structure
- Dispatching functions
- Response functions, listing mental health providers’ roles
- Clinical mental health oversight/supervision from a Clinical Director
- Team member selection criteria
- Generate Standard Operation Procedure Policies based on how the team will be legally constituted.
- Determine how the team will be funded.
- Obtain legal counsel to operationally define issues such as malpractice, standards of care, confidentiality, “good Samaritan” practices, necessary liability insurance coverage, etc.
- Determine what criteria and mechanisms will be used to activate the team. Determine what backup systems will be used in the case of a mass disaster or widespread communication failure.
- Determine what criteria and mechanisms will be used to deactivate the team.
- Stipulate guidelines and procedures for the follow-up for team members after a crisis response. See templates for Peer Activation Contact Forms. ICISF-Canada Best Practices & Procedures Manual.
- Make arrangements for ongoing “in-service” training. See template for team meeting algorithm that includes structuring frequent training and practicing skills with other team members.