After the Crisis: Peer Support Issue Brief

Issue Overview

Emergency response protocols generally focus on addressing the basic survival needs of survivors and, from a psychological trauma perspective, employing early interventions to assist survivors.  Crisis response and short-term assistance can be very helpful, but for individuals with prior trauma histories, mental health concerns, or few personal and emotional supports, intermediate and long-term assistance is needed.  Peer support presents a cost-effective, accessible, personal, and community-driven approach to filling that need (Depression and Bipolar Support Alliance, 2004).

Peer support is widely regarded as an effective means of helping survivors of disaster through stress and trauma.  A compliment to professional services, peer support provides individuals with the connection, understanding, validation, and support that are essential to the healing process.  There are a number of models (Campbell, 2005) that have proven to be very effective in reducing anxiety, expediting the mental health intake and discharge process, and referring individuals to other services and community supports. 

This resource paper highlights some successful peer support programs initiated after recent disasters and provides recommendations for the expansion and broader integration of peer support initiatives.

Key Concerns

• Survivors of disasters may experience Post-Traumatic Stress Disorder (PTSD), depression, and other mental health concerns, and often need long-term support to pursue healing and avoid unhealthy ways of coping.
• Anniversary dates following disasters can be very stressful and typically require greater resources to meet increased consumer need.
• There has generally been a lack of understanding of the interrelation between trauma-induced behaviors and mental health concerns.
• Children are often severely impacted by traumatic experiences.
• Individuals with trauma histories may experience flashbacks and symptoms of PTSD when re-traumatized during disasters.

Potential Solutions and Recommendations

• Create a National Consumer-operated Disaster Recovery Network to assist each state in developing peer support programs and services and related training.
• Include peer support in disaster preparedness planning and response training at state and national levels.
• Ensure that the U.S. Department of Homeland Security involves peer support as part of its disaster response.
• Proactively prepare each state by creating a consumer organization to serve as a central peer training and material clearinghouse for disaster responses.
• Develop disaster response capabilities of national consumer technical assistance centers.
• Develop and implement a public education campaign from “the peer voice” that establishes connection and increases awareness of “normal” responses to abnormal events.
• Create an online repository of promising peer support models.
  Develop a means for peer service providers to connect, find support, and share stories online.
• Create peer support programs with a solid foundation at the local level.

Key Resources

An Evaluation of Peer-Delivered Mental Health Disaster Relief Services in New York City (May 2005)
Campaign for Mental Health Reform – Evidence-Based Services and Emerging Best Practice
Center on Women, Violence and Trauma – Wisdom of Women: Peer Support for Women with Co-Occurring Disorders and Histories of Trauma (Dec, 2001)
Emerging Peer Support Research
NASMHPD – Emerging New Practices in Organized Peer Support (2003)

We wish to thank Dan Fisher, Kay Rote, LaVerne Miller, David Romprey, and Beth Filson, authors of From Relief to Recovery: Peer Support by Consumers Relives the Traumas of Disasters and Recovery from Mental Illness, on which this issue brief was based.

The After the Crisis Initiative is Co-Sponsored by:  The National GAINS Center for Systemic Change for Justice-Involved Persons and the Center for Women, Violence and Trauma (CWVT) through the Center for Mental Health Services, SAMHSA.

Acknowledgement & Disclaimer:  The development of this publication was funded under Request for Proposal (RFP) No.280-04-0106, entitled:  “Center for Evidence Based Programs for Persons in the Justice System” from the Department of Health and Human Services, Substance Abuse and Mental Health Services Administration’s Center for Mental Health Services (CMHS), awarded to Policy Research Associates, Inc. (PRA).  The views and opinions expressed in this publication are those of the authors, and do not necessarily represent the official position or policies of PRA’s National GAINS Center or the Center for Mental Health Services (CMHS).

References

Campbell, J. (2005). Emerging peer support research. Available from the National Empowerment Center, www.power2u.org.

Depression and Bipolar Support Alliance. (2004, Winter). New evidence on the power of peer support. Newsletter of the Depression and Bipolar Support Alliance.