We don’t need to really iterate the why here – it’s obvious. First responder, military and front line health communities are plagued by increased markers for stress, depression, anxiety and a host of other job-related mental health concerns. On the other side of that, there’s people who establish, train, continue and move forward the specialized groups in these agencies that have a common goal; helping our own figure out how to better navigate the road. In this series, we’re going to cover a specific, frequently-searched topic; how to start a peer support team.
There’s a lot of fluff we could add here. Defining things like ‘mental health’, ‘wellness’ and ‘resilience’. We’ve already written a ton on that. Instead, let’s get concrete.
Here’s how to start a peer support team:
- Personal Preparation (Part 1)
- Build a Buzz (Part 1)
- The First Meeting (Part 2)
- Objectives for Q1 (Part 2)
(By the way, this list is going to build out as this series is written.)
Let me build a little context. I’m Bill – the lead goon behind SIXFEET, a practicing psychotherapist (RSSW) and a newly minted team lead for a County Fire Department’s CISM team. Now, there’s the first point. Our current support structure is based on a model that has worked for us. CISM, or, Critical Incident Stress Management is an approach for debriefing traumatic calls. It’s hinged on rapid deployment and a formal structure.
Where I think CISM falls short is in follow up. Or, availability in general. You see, CISM gets called out to help a firehall debrief from a traumatic call. But, that activation is a decision made through chain-of-command. There’s a gap there – we’ll all say ‘I’m fine’ after a call. The people who might need to bend an ear would have to speak up or seek out CISM activation through chain of command which might allow some people to go without access to support for fear of being seen as weak or lesser-than.
But, we’ll get to making change a little later. For now, let’s lead up to that point. The real nuts and bolts of ‘how to start a peer support team’ comes way before the first meeting.
Because, somebody has to identify the gap and step forward with more than just complaints about how the admin office handles mental health within the ranks.
That somebody could be you.
To land a spot in emergency response, you have to be different. You have to not only possess the character, fortitude and physicality the public desperately wishes you would have, but you need to be able to activate those parts of yourself at a moments notice. Then, after you’ve sworn in and suited up, you’ve landed here. You’ve Googled your way into wondering how to start a peer support team.
That suggests that you have eyeballed a spot in your service that needs attention. It might even be that you believe you’re the one who can do something to move forward on that. As if you have the guts, willpower and endurance to actually shift your department toward something worthwhile. Beyond the hushed cursing about this officer or that chief. Out past the rumors of this person getting an undeserved promotion.
Do you think you’re the person that can move this thing forward?
Well, allow me to drop this idea on you as it was presented to me.
Maybe you’re great.
Greatness spans the pages of memoirs that we read and review for the lessons of leaders from generations past. Greatness is memorialized on plaques and statues that immortalize the courage of those who dared to put themselves into precarious positions on purpose. In the halls of our service, there’s pictures of greatness spanning generations of people who have made our service better for their having been a part of it.
People just like you.
To suggest that the service could be better does two things at once. On one hand, questioning the current state of our service says that things could be better than they are. Which in turn means that changing things would make things better. And, there are a great many people who really do actively seek status quo. Second, When you bring forward the concept of change, it alludes to your saying that you are the one with the ideas to make things better. So, before you go about saying that changing ‘normal’ is a step forward, you had better have concrete and actionable plans for what that might mean.
And another thing – I’ll go a step further. If you’re thinking about starting a mental health program that serves first responders, military folks and front line health personnel where there is no formal support; things could be better, changing things would be better and you are the one with the ideas to make it happen.
Personal Preparation
Undoubtedly, the decision to pursue change is one that is paired with leadership. To be on the team that moves forward the boulder of progress requires you to be prepared in the cognitive, emotional, physical and spiritual arenas. And, while we’re on the topic, right now would be a great time to review ‘the man in the arena.’
“The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs, who comes short again and again, because there is no effort without error and shortcoming.”
Citizenship in a Republic, Theodore Roosevelt
Know that when you try to do anything, even if it’s something you really believe in and especially if it means making changes to the way things are – you will form a relationship with failure. Failure by way of decision, politics, trial and time itself. You will fail. The team will fail. The mission itself may seem like it’s failing at times.
Endurance is the basis of all progress.
To bring about the necessary work to build a peer support team, you must be acquainted with endurance. In order to push past the inevitable obstacles, your will has to be hardened enough to continue. That’s something we’ve written about, talked about and practiced quite a bit around here – and it’s rooted in an unavoidable truth; endurance is a skill.
Alongside some of the more talked-about emotional skills that coincide with the pursuit of progress, I think the would-be Peer Support Team Lead would do well to brush up on the cognitive, too. If you haven’t already, now is the time to get certified in Peer Support, MHFA, CISM – and, maybe even some more in-depth study around baseline CBT skills. Your physical should be in check, too. If you’re going to be telling people that a healthy lifestyle can help overcome exposure to trauma via your peer support channel, health should be an obvious feature of your lifestyle.
Lastly, and this one will be different for everybody – you need to make sure your spirit is in check. That might be built up in a church. It might be from hard rounds in a Jiu Jitsu club. Maybe your spirit needs quiet, calm walks through a garden. Or, maybe it’s the thrashing, desolate screams of a hardcore band. Either way, the vying peer support leader should be able to make out a well-built spirit from close self-examination.
Building a Buzz
Let me offer something here. Through the work we’ve been doing with SIXFEET and the sideline projects that are influenced by SIXFEET, one thing has really helped to fortify a positive image for the work.
We don’t call it ‘mental health’.
Sure, it’s unfortunate. It’s also true. When we shoe-horn our people into conversations about mental health, it most often ends with eye-rolls, long sighs and half-attention. To circumvent this, we’ve started referring to this work as a ‘movement’ in and of itself – one that focuses on ‘operational readiness’. These two important ideas blend together two ideas. First, that if people make the decision to be a part of this action, that they’re involved in something. Then, classifying the topic as operational readiness allows us to talk about much more than just mental health. After all, our capacity to respond to emergencies is based on the habits and systems that form up our physical, emotional, cognitive and spiritual selves.
Operational readiness hasn’t been captured by HR.
As instructors, we talk about it the very first time we meet recruits. As co-workers, we openly and deliberately bring it to the table. On the internet, we give voice to the vulnerability required to be real in real life. As we talk to current and future peer supporters, we reinforce the need to actually say these things out loud. If we can take on the vision of bringing operational readiness to our people as a necessary concern, that idea will never be held captive by corporate.
We can claim the notion that readiness is our responsibility. We can fly the banners of the heroic ideal.
Without mental_health_week PDFs and dusty flyers pinned to our station cork boards. With no victimhood attached to our experience.
We are securing our operational readiness in all corners of ourselves because we promised we would.
That’s a message that resonates.
Before the policies are written and the phone numbers are posted to your stations, the team needs to assemble. Now, this sort of discounts a big step – how do we get a team together?
Well, part of that is going to be a pretty subjective experience. On my side, I started with a handful of people who were already part of the CISM team – and, I’d taken on a leadership role to try to improve the capacity, training and response of the team.
If you don’t have a number of people already interested, you’re going to have to put yourself out there. After all – if your ambition is an ‘unknown-unknown’ to most of your members, it’s going to be tough to get people to sign on with your team!
Get into some inboxes. Email through the chain of command to ask for a conversation about mental health support at the crew, station and department level – in that order. That simple sentence could take you two years.
Read that again.
You may have to start things out at the ‘one of five’ crew level to get things going. If your leadership isn’t keen on injecting new or different ideas, you’ll have to find a flank.
It’s about figuring out what is a priority for decision makers and finding some room to slot in operational readiness as a means to achieve that goal. Let’s look at an example.
Say your department is actively working on timings at medical calls. So, radio call outs, hands on chest and time to scene are all documented and measured on some sort of interval. You might not even have anything to do with that directly but have had those orders passed down through the chain of command. Well, build a narrative around that.
Stories sell.
You might phrase something like this in an email eventually. But at the start of the push, these points would be sprinkled into casual conversation – especially when responding to or recovering from the calls in question.
The people who respond to emergencies should be built well to manage the stress reactions of being a responder. Now, without actually measuring that by way of survey, we can’t know for sure. But, let’s say they’re good to go; what about the cognitive and emotional spaces in the actual call?
Maybe our firefighters/police officers/paramedics could make better numbers if they had a structured way to build better thinking habits. So, when we get to the call, they wouldn’t have to try as hard to be good.
I found that identifying problems with a solution on board was the best way to get things rolling.
Everybody has ideas. Bring solutions.
I actually got face-time with the Chief by way of a well-articulated email that had been okay’d through the entire chain of command. Over about a year, I had been chatting people up at the hall, in training and online. I’d been coursing up as an instructor for the Resilient Minds program. I wrote a handful of articles for industry magazines – including, strategically, one of the magazines that gets delivered to our hall.
When it came time to formally address the problem; I came armed with the solution.
I think that’s pretty key. Imagine you’re the chief – you probably know about the problems fluttering around your stations. If I had to guess, there’s not only a problem of mental real estate at that level, but of action via time and help.
Instead of suggesting that our department ought to just start a mental health program, I dropped into the chiefs’ inbox with tools at the ready to help fix the actual problem. Here, he had a motivated, learned, prepared volunteer stepping forward to actually start the program. Again, imagine you’re the chief – how attractive can you make your argument?
Be the fix.
That might be the most valuable albeit time consuming insight I have for you in the first part of this series. Problems addressed through chain of command can be split into two groups. There are some things you can’t get in front of. For example, if a piece of equipment has broken, you’ll need the department to replace it. However, personnel problems (save for maybe the most egregious) can (and should) be tried in-person before bothering department leadership. At it’s root, instituting a mental health program is a personnel problem. If you come to bat with the tools, time invested and tenacity needed to get a program off the ground, your chief might give you the green light. Are you ready?
