Can We Talk? Peer Support as a Standard of Care

Can We Talk? Peer Support as a Standard of Care

NOTE: The legal information contained in this article is specific to the State of Michigan.  Please refer to your own state's laws regarding critical incident management and peer support.

Because members of the public depend so heavily on our law enforcement officers to perform their duties effectively and to be able to make sound judgments in the field, police departments have a clear and compelling reason to look out for the mental health and psychological well-being of their officers.  Due to the stressful nature of the job, and especially the risk for exposure to traumatic incidents which occur fairly frequently, police officers are at greater risk for a number of trauma and stressor-related issues:

  •  30% of police officers have symptoms of depression and/or anxiety
  • 30% of police officers have symptoms of post-traumatic stress
  • Up to 15% of police officers meet the diagnostic criteria for PTSD
  • The suicide rate among first responders is 1.5 times greater than the general population
  • 90% of first responders say they are bothered emotionally by the things they experience on the job

If we want our police officers to be able to perform well, it only makes sense that we offer a variety of programs to help them be well.  Among those programs that should be considered is a peer support program, the ultimate goal of which would be to provide officers with emotional and tangible support in times of distress and/or crisis.  According to the FBI, using peer support as a strategy for helping to identify and intervene with officers’ behavioral and psychological issues is now widely recognized in the first responder community (Cnapich et al., 2022). 

Due to the frequent exposure our officers have to traumatic incidents, a program should also include a critical incident stress management (CISM) component.  Generally, police officers are hesitant to use outside counseling services following a traumatic event.  However, they are more likely to communicate with their peers about the incident. Therefore, it is important for agencies to have strong, formal peer-support programs in place along with an established CISM policy (Sadulski, 2017).

Psychological First Aid

Although the current models for peer support and CISM have been in use for several years, many agency leaders are still unfamiliar with the practices and what they are designed for.  Peer support and CISM are not counseling or psychotherapy, nor are they to be considered a substitute for counseling or psychotherapy.  They are not a “treatment” for depression, anxiety, or post-traumatic stress disorder (PTSD).  These practices are a form of “psychological first aid”, a short-term helping process designed to stabilize and mitigate acute distress, assess the need for continued care or support, and facilitate access to a higher level of care if indicated.  Psychological first aid focuses on acute behavioral or psychological distress and dysfunction, not on more chronic or underlying psychological syndromes (Everly & Mitchell, 2020).

So, what are the essential differences between utilizing peer support/CISM and visiting a licensed mental health professional?

  • Peer support/CISM are psychoeducational in nature rather than psychotherapeutic
  • Peer support/CISM address acute and sub-acute conditions rather than chronic conditions
  • Peer support/CISM team members keep no written records of peer interactions versus therapists, who keep extensive records of patient contacts
  • Peer support/CISM team members are not subject to subpoena and statements made during peer support/CISM interactions are not subject to disclosure in any administrative, civil, or criminal proceeding (MCL 333.20982)
  • Records kept by licensed mental health professionals may be subject to subpoena, and may be subject to disclosure in administrative, civil, or criminal proceedings (MCL 333.1748)

How Does it Work in Michigan?

Public Act 40 of 2016 amended Michigan’s Public Health Code to include definitions and rules for the use of peer support/CISM services, and compliance with that law is what ensures the confidentiality of communications between emergency services personnel and those providing peer support/CISM services.  Compliance means that all peer support/CISM team members have been trained in both individual and group crisis intervention models through the International Critical Incident Stress Foundation (icisf.org), and that the team to which they belong is properly constituted and registered with the Michigan Crisis Response Association (mcrainc.net). 

Although there are a number of well-known organizations that provide peer support training, the training described here is the ONLY training that complies with the Michigan law governing confidentiality.  While it is important to note that Michigan law may not provide protection in a federal court, peer support/CISM services are also generally protected at the federal level.  Consider this quote from the Federal Law Enforcement Training Center (FLETC):

“The FLETC CISM and Peer Support Program (PSP) provide assistance to individuals and families who are going through a stressful time in their lives.  We understand that stressful events may be work related, family oriented, or a personal struggle.  Information that you share with any CISM personnel is confidential.  CISM is legally bound [emphasis added] to protect the privacy of all individuals and their confidentiality.”   

Team membership with MCRA also includes the requirement that the team must have a clinical director whose responsibility it is to provide oversight to the intervention activities of the team, ensure that the right kind of service is provided, and that all team members work within the limits of their training and experience.  Teams are encouraged to have additional mental health professionals as team members, and to also include chaplains as members of the team. 

For information on training programs and establishing a peer support team at your agency, you may contact the author at david@the227project.org.

About the Author

David R. Edwards is a Certified Trauma Services Specialist, and a member of the American Academy of Experts in Traumatic Stress.  He is an approved instructor for the International Critical Incident Stress Foundation, and a member of the International Law Enforcement Educators and Trainers Association.  The 227 Project is a supporting member of MACP.

References

Cnapich, E., Rodriguez, S., Schuhmann, B., Couwels, J., Van Hasselt, V., & Blalock, J. (2022, April 6). First responder peer support programs. FBI Law Enforcement Bulletin. https://leb.fbi.gov/articles/featured-articles/first-responder-peer-support-programs

Everly, G., & Mitchell, J. (2020). The SAFER-R Model: Psychological crisis intervention. Resiliency Sciences Institute. 

FLETC. (n. d.). Glynco Welcome Packet. https://www.fletc.gov/sites/default/files/imported_files/files/glyncowelcomepacket.pdf

Sadulski, J. (2017, May 9). Promoting police resiliency through peer support. Police1. https://www.police1.com/police-products/training/services/articles/promoting-police-resiliency-through-peer-support-q4gkID4l2bxWrH3e/     

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