Workplace mental health programs have taken a back seat to physical health programs. Now, a Peer Support program may be the breakthrough operational model that will finally give employees the support they need.
By Jeremiah Prince

The idea that a co-worker has mental health issues of any kind makes people uncomfortable. The end result is that employees do not ask for help or support out of fear of being shunned. A new model is emerging to overcome this fear of asking for assistance, and to take the stigma out of "mental health."

Peer Support is a structured program that trains qualified employees to provide the support that other employees need as they struggle to overcome mental health challenges. The trained Peer Support employees are people who have empathy for those struggling psychologically because they have experienced mental health issues in their own lives.

Empathy Combined with Practical Advice
A Peer Support program is a fairly new model for addressing workplace mental health. It is a carefully constructed program that utilizes trained employees to provide peer support that is safe and effective. The program focuses on assisting others with managing mental health challenges that already exist and promotes mental health in the workforce as a component of health and well-being programs.

Peer Support programs are not counseling programs, and Peer Supporters are not licensed therapists. The program is relationship centered in that Peer Supporters and the people who utilize their services can relate in an equal manner.

In fact, a Peer Support program has a characteristic called “mutuality” in which the people who relate experience a mutual benefit. The two people can find something they relate to as a personal experience or in relation to people in their lives, like a family member experiencing mental illness. The give-and-take principle is founded on principles of shared responsibility, respect, mutual agreement and personal awareness.

The ideal program offers multi-level intrapersonal interventions that work together to provide what people need to promote good mental health. For example, a Peer Support program that promotes physical exercise as a strategy for improving mental health would offer written influential materials (intrapersonal), buddy system (interpersonal), workplace wellness program (organizational), free or discounted gym memberships (community), and rewards for positive outcomes (financial).

Peer Support programs can work for everyone, from the person experiencing high stress levels to the person diagnosed with mental illness. Too often, people get formal medical assistance but are eventually left on their own and unable to sustain improved mental health.

One Out of Five
There are a plethora of mental health issues impacting employees. They include depression, substance abuse, stress, anxiety and mental illness. One-out-of-five people will experience a mental health issue in their lifetime, but two-out-of-three will not seek help. Depression is the leading cause of poor health and disability globally.

Peer Supporters are people who are carefully selected and trained because they have experienced mental health challenges in their own lives and embraced recovery. They hold informal conversations with peers and offer as many interactions as needed, focusing on recovery rather than specific illnesses or symptoms. The supporter and the coworker may not necessarily share the same mental health challenges but have common ground in terms of impacts, like depression, loss of hope, loss of independence, lack of family support, and loss of career.

A supporter has worked through the challenges and recovered hopefulness, and wants to share the journey with others. The person must be empathetic, non-judgmental, good at identifying personal stressors, able to determine true needs of a peer and recognize a person approaching a crisis, ethical, and collaborative. Also, the Peer Supporter must successfully include all persons, honoring diversity and cultural differences, and understand the impact of bias on people. There are no one-size-fit-all interactions, so supporters need a high level of sensitivity to the needs of others.

Implementing a Program
There are three main components of a Peer Support program: Policy development, peer supporter selection, and peer supporter training. It is an intentional program, but it is not based on any psychiatric model nor does it use diagnostic criteria. The support given is therapeutic, but it is not formal therapy.

The program is built on the belief that giving people hope for developing well-being is the first step toward recovery. The Peer Supporter is living proof that hope and recovery are possible, and that any mental health issue disrupting an employee's life can be managed.

The employer benefits also because there will be fewer sick leave days, disability claims and injuries, and productivity is likely to increase. Society benefits, too, because a Peer Support program brings the employer into the effort to raise community awareness of mental health.

Peer Support program policies should make it clear to supporters that it is voluntary, therapeutic but not medical therapy, confidential, iterative, and recovery-focused. It should establish objectives and measures for success, in addition to identifying the roles and responsibilities of a Peer Supporter and the training path each supporter should follow. A company needs to determine how the Peer Support program intersects with other health and wellness programs and organizational policies on aspects like disability leave and accommodation. Also, the policy should address the time commitments, where interactions will take place, and how time will be tracked without breaching confidentiality.

Taking Action
Policies are implemented via an action plan. The recruitment and selection criteria for Peer Supporters are established, along with a training plan and a plan for providing ongoing support to trainers. Supporters need a communication plan and a method for confidentially reporting interactions. Supporters are recruited and selected, and then trained.

Training addresses things like understanding mental health and mental illness, the roles and responsibilities of the Peer Supporter, emotional intelligence which includes biases, crisis intervention, suicide prevention, self-care, stress prevention, and boundaries.

Developing the right communication skills is crucial to success. Peer Supporters must know how to engage people, respond appropriately, intentionally listen, interview, and resolve conflicts. Also important is being able to successfully end a peer relationship.

Measuring the program is tricky because confidentiality must be maintained at all times. Organizations do have a number of measurements that will let the employer know the program is being utilized and is working. Typical metrics include the hours spent relating to others, inside and outside the workplace, how the two people found each other (i.e. coworker recommendations, HR referrals, supervisor, outside agency, etc.), sick leave hours, disability claims, productivity, grievances, and so on.

Employers can and should develop strong working relationships with mental health advocacy organizations that can serve as resources for employees. Peer Support programs are ideal for today's workplaces where unrelenting stress is something they all have in common.