British Columbia mental health and substance use peer support services have a long history. Today, most government and nonprofit clinical mental health and substance use services include peer support services. This includes both community care, and in-patient hospital care. Here in B.C. some of the earliest formal, health authority funded peer support programs began in the 1990s. Although some agencies are further ahead than others, in general peer support in the community is now viewed as a valid career choice. Peer support workers receive competitive compensation and benefits. There is a common understanding of what peer support is, and what it isn’t within the healthcare sector.

Currently, peer support in post-secondary campuses is not standardized, and there is much variance between programs. Some peers are volunteers and others are paid.

Peer support can mean varying things within each post-secondary institution. The purpose of this document is to offer a framework that can be used to provide definition and context to the different roles within the umbrella of peer support in PSI settings. In order to create continuity, it’s important that institutions work from a similar framework, and that there is some level of cohesion with peer support in the larger community.

Each campus has a diverse set of needs, available resources and infrastructure for the delivery of services. We recognize that students are busy and have limited availability to provide peer services. Some campuses may deliver a more traditional peer support model, and others may offer a more streamlined resource-based service. Some campuses offer drop-in peer services, and other peer support workers might have ongoing relationships with students. Therefore, peer support will continue to look different throughout BC campuses.

The aim of this training curriculum and facilitators guide is to provide information for a large range of campus peer support services.

While aspiring toward a shared framework regarding peer support roles and values, each campus can decide what is relevant to their program and feel free to leave out anything that is not applicable within their context.

What Sets Peer Support Apart

Peer support is about tapping into one’s own lived experience of struggle and resilience while using the wisdom gained from it to support someone else who is on a similar journey. Though many healthcare clinicians, campus staff, and social workers have lived experience, not all of them are able to share it within the scope of their role. This is what makes peer support unique. The people in the support roles have all been through something similar and are free to share their story.

When we are struggling with something like severe anxiety, depression, managing a chronic illness like diabetes, or dealing with a substance use issue, it’s a gift to have someone to talk to and listen to us who personally understands what we are going through. It is inspiring to see someone come out the other side of a situation that we feel stuck in.

The following is a simple adaptation of the definition of peer support worker that is used within community mental health and substance use programs:

A peer support worker is someone who:

1. Has lived experience,
2. Can draw from their lived experience and
3. Engages in a mutually supportive relationship with someone struggling with a similar issue.

While the service scope may look different depending on the unique people within the peer support relationship, the relationships are always intentional and purposeful. Everything begins with connection and mutuality. Peer support is about coming alongside one another and walking together.

In the article, Defining “Peer Support”: Implications for Policy, Practice, and Research (2018), author Darby Penney provides a great definition of peer support:

Broadly defined, “peer support” refers to a process through which people who share common experiences or face similar challenges come together as equals to give and receive help based on the knowledge that comes through shared experience (Riessman, 1989). A “peer” is an equal, someone with whom one shares demographic or social similarities. “Support” expresses the kind of deeply felt empathy, encouragement, and assistance that people with shared experiences can offer one another within a reciprocal relationship.

Peer support is all about relationship and connection. What brings together a peer and a peer support worker is the lived experience of struggle and the desire for growth.

We recognize that within PSI peer support services there will be less time available for an ongoing relationship. Many connections will be a one-time conversation. However, we also recognize that there is still a relationship and connection that can be formed in a very short-term exchange. Many people receive support from someone just once, and it can impact their lives in a positive way. Because of this, within this training we still choose to focus on building capacity for relationships. These skills that students receive through this peer support training are also transferable to their relationships outside of peer support services, and could be applicable in their future employment.

The Ministry of Advanced Education, Skills and Training in British Columbia recognizes that many post secondary students are struggling with their mental health. There has been a significant effort to increase mental health resources within the sector, including counselling through the here2talk app and other similar initiatives. Peer support services in mental health are evidence-based best practices, and integrating peer programs can provide a significant impact on the mental health of post-secondary students.

Peer support practices, applied with intention and adherence to the standards of practice as outlined in this document, can be a major catalyst to support change. That change can show up as personal individual growth, overall systems change, and in the development of more inclusive communities.

Peer Support vs. Peer- or Student–Delivered Services

There are several different roles under the umbrella of peer support. Some campuses may have funding to pay students, others may offer volunteer positions. In this section, we’ll take a look at some of these roles.

Traditional Peer Support

Traditional peer support is when people with lived experience (mental health/substance use/eating disorder/health issue) receive training to provide support to others who are also struggling. The person receiving peer services is dealing with a similar condition and is likely not as far along in their journey. It can be encouraging for them to engage with someone who has walked a similar path and come out the other side. Sufficient and intensive training is an important aspect of this form of peer support.

Traditional peer support services can be delivered in different ways, including:

• One-to-one drop-in services: The peer support workers take shifts at a student center, and work with anyone who comes in looking for support or resources.
• One-to-one ongoing support: Peer support workers are assigned students to work with on an ongoing basis. The length of time should be established at the start of the relationship, as there is likely a limited amount of available sessions. It’s important that people know about that from the onset of service.
• Group facilitation: Many campuses provide regular support-type groups for students led by a peer support worker. If this is the case, the peer will need traditional peer support training, and some guidance in facilitation.
• One-time events: These events can be workshops, or gatherings that are peer-led.

Some campuses simply do not have the infrastructure to run a more traditional peer support program. Utilizing peer support in whatever capacity possible is the best thing we can do.

The Mental Health Commission of Canada’s document Making the Case for Peer Support (2016) states the following about peer support services.

We now know what helps people to recover. While many acknowledge there is a role for mainstream services and medical treatments, people are virtually unanimous about the paramount importance of personal resourcefulness, personal support and self-belief in their recovery. Peer support initiatives are probably the best evidence-based approach to foster these. (pg. 106)

Here is another excerpt from the document:

Peer support works. Peer support is effective.

People with lived experience of mental health problems or illnesses can offer huge benefits to each other. We found that the development of personal resourcefulness and self-belief, which is the foundation of peer support, can not only improve people’s lives but can also reduce the use of formal mental health, medical and social services. By doing so, peer support can save money.

Canadian research has contributed significantly to our knowledge base. Several experimental and quasi-experimental studies have demonstrated not only the benefits to individuals involved, but also to the mental health system and communities as a whole, by saving millions of tax-payers dollars through reducing the use of the most expensive types of services. (pg 4)

Some of the challenges that make implementing a tradition peer support program challenging for post-secondary campuses are:

• Lack of funding and staffing to provide mentoring and supervision for peer support workers
• Limited amount of time for training based on resources, facilitators, and student availability
• Lack of available physical spaces appropriate for offering confidential peer support services
• Limited student availability: Students are busy. Some campuses only encourage student involvement from second year up, and that means the time people can serve in peer support is three years maximum. This leads us to;
• High turnover for peer support workers

Student-Delivered Services

On many post-secondary campuses it is common to classify peer support as students supporting students. When used this way, the term peer may not refer to someone who has lived experience with mental health or substance use. The commonality is that both people are students, even though they might have very different backgrounds and life experiences. Students supporting students in this way would be considered student-delivered services.

Student-delivered services, however, are not the same thing as peer support. Student-delivered services are less focused on mental health and emotional support, and more targeted toward accomplishing specific tasks and providing resources. It’s important to be clear about the difference to avoid confusion.

Role Definition

In this section, we’ll look at some ways to label the different roles that can be housed under Post-Secondary Peer Support Services. In the Facilitation Guide, we will cover the minimum level of training needed for each. We recognize that there may sometimes be significant overlap between roles; doing our best to clarify roles and ensure appropriate support and training is key. Program coordinators may benefit from reflecting on which parts of these training modules may be relevant for student leaders from a variety of roles.

It’s important to acknowledge that sharing stories from  lived experience is the basis of all roles under the umbrella of peer support and peer-delivered services. Many peer support volunteers/staff will have lived experience with mental health, substance use, eating disorders, trauma, health issues, disability, etc.. Others might be tapping into their experience of coming from a different culture, or simply being a student.

Regardless, utilizing lived experience is what differentiates peer support from clinical or administration staff. Sharing stories in an authentic, open, honest, and empathetic way breaks down hierarchies. Some of the following roles will require more intensive training than others, and therefore some will be more equipped to deal with difficult situations than others. Supervision is always important, so that peer support volunteers/staff can feel supported when difficult situations come up.

Peer Support Worker/Facilitator: Someone with lived experience (e.g. mental health, substance use, eating disorder, trauma, health issue, disability) who is providing emotional support and a listening ear to another student who has a similar struggle.

Student Support Worker: This is a student who wishes to support other students with various aspects of student life. Though there is no required element of mental health to this role, it might still come up from time to time.

Student Resource Navigator:  These students would be trained to support other students in  finding and accessing relevant resources both inside and outside the campus. They are trained about campus policies and procedures and support other students with navigating the system.

International Peer Support Mentor: This worker is also an international student who has had some time to adjust to life on campus and has settled into the local community. They work with new international students and share their lived experience of adjusting to a new culture with them.

International Student Peer Mentor: This is a student who is local to the area, or from another city in Canada. They are not peer in the sense that they have a similar lived experience. However, they are interested  in supporting new international students to get comfortable on campus and want to support them to get plugged into student life.

Peer Academic Coaches: Students who provide support with topics such as time management, goal-setting, study strategies, giving presentations, note-taking, test-taking and dealing with exam anxiety. Though there is no required mental health element to this role, it might still come up from time to time.

Peer Educator: Students who lead workshops, small groups, or even provide one-to-one support on a specific topic related to student life. Topics can range from self-care, health tips, academics, writing skills, finances, studying habits, adjusting to student life. Minimum training for peer educators will depend on the topics they are covering in their sessions.