Power of Peer Support

“People don’t understand what exactly dispatchers see, hear and go through. You’ve got a lot of dispatchers who shrug it off and say ‘I’m okay. It’s okay. It doesn’t affect me. I can deal with it on my own. I can get through it. I’m strong enough.’” –Kelly Rasmussen, Ph.D., Success Communications Inc.

“People often say, ‘I’m just a dispatcher.’ A comment like this means you’re not worthy of all the other stuff that happens to everybody else. Yet, the dispatchers talk to the folks who are suicidal. They talk to the family members of those they help. They listen to the officers or firefighters. They have to remain very calm on the radio. They have to be that very steady voice so that everybody else can get their job done. They have to recognize that it takes a toll. To think that they’re not worthy of getting help is a disservice.” –Joel Fay, PsyD., First Responder Support Network (FRSN)

Police Officer. Fire Fighter. Paramedic. 911 Dispatcher. All first responders. Unfortunately, the last category are often dismissed or forgotten about. More and more research validates what those of us who have sat under the headset have known for years—911 Dispatchers experience stress, both cumulative and traumatic as a result of their work. We experience physical, psychological and emotional consequences. As we buckle under the tremendous load of being the first first responders, we fight against acknowledging the truth. We ignore. We stuff. We laugh it off and become defiant, denying anything is wrong. We refuse to appear “weak” in front of our peers or even to ourselves.

“They want to make sure they fit in,” says Jim Marshall, Co-Founder/Director of the 911 Training Institute (911TI)/911 Wellness Foundation. “We all need acceptance. What happens is (dispatchers) began sucking it up because that is what the emergency response field did. I call this the emotional code, what you believe you should do with what you feel.” When we believe expressing emotions, such as fear, anger, or sadness are seen as weak or threatening, we aren’t going to allow ourselves to go there. “What the 911 Wellness Foundation is advocating for is that we revise the emotional code as a culture of emergency response. We’re not going to allow ourselves to just carry it around until the next suicide, to the next person who’s been fired for explosive behavior or for burnout, says Marshall.”

A revision to a healthier emotional code would allow us to accept support, feel emotion without acting out, grieve when we need to and support each other. Joel Fay, Clinical Director of FRSN agrees that the fight is internal. “It’s a stigma,” he explains. “It’s the idea that we take care of everybody else. I don’t have to be taken care of.” He describes dispatcher culture as one where, when we are approached and asked how we’re doing our appropriate response is “fine” regardless of whether or not we are. If we have a bad call, we move on immediately. “During the call is one thing,” Fay says about the necessity of taking some space. “But, when the call is over they need to chill out. I’ve heard too many stories of dispatchers being involved in a really difficult event, like where officers were killed and nobody remembers to take them off the radio. Then, a lady is complaining about why it’s taking so long to get someone out to handle their barking dog complaint, and the dispatcher just loses it—starts crying and becomes overwhelmed. We all understand that officers in the field are going to take a break. But, for dispatchers frequently it’s the idea that I just need to go on.”

So what do we have to show for all the years of the show must go on? We have depression, negativity, divorce, anger, obesity, migraines, autoimmune diseases, anxiety and cumulative and post-traumatic stress disorder. Thankfully, we are beginning to seek ways to shift the course of our careers, and peer support programs are playing a huge role.    

We’ve always been there

Nobody understands our struggles like our coworkers. “The idea is they get it,” says Marshall. “They’re accessible and it’s so important.” Informal peer support has been around as long as 911. Like other first responders, we understand each other. We’re like a loud, bossy, lovingly dysfunctional family. We care deeply for each other. But when a program becomes formal with agency support and certified training, we’re given the tools we need to become even better.   

Making it official

First, for a peer support program to be truly successful it needs to come from the top. Fay says people at the lower levels can certainly advocate for it, but unless management buys in and supports it, it’s not going to go anywhere. He confirms informal peer support is happening already.

A peer support program is really a statement that an agency values its employees’ psychological health, and that it wants to create a program that supports their psychological wellbeing. Formal programs also help lessen the stigma according to Dr. Kelly Rasmussen, CEO, Strategic Communications Inc. and a former 911 Dispatcher. “[Dispatchers] don’t want to show that weakness,” she says. “If they have a formal program, they know they can go to a peer, make a connection and understand that maybe this is something that will benefit me. Then it motivates others. Peer support is incredibly necessary.”

Next, there needs to be an understanding that peer support is different from critical incident stress management (CISM). “Peer support is not just about critical incidents at work,” says Fay. “It’s not just about that officer involved shooting. It’s about divorce, sick kids and elderly parents, kids that are addicted to something, and leaning on your friends to get you through those difficult times. A good peer support team spends most of their time doing that. Then, when the big incident happens, they’re available to handle that as well.”

After the Century 16 Theater shooting in Aurora, Colorado Public Safety Communications relied on their formal peer support team (established in 2007) to help them through. Aurora’s Manager, Diane Culverhouse, recognized that it was great for the team to be in place to help in the aftermath but that their real success is in helping deal with those day-to-day stressors. In 2015, the team did about 2,800 peer support contacts. “It’s important for your employees to have somebody that does the job, that knows them, that knows the situation that they can talk to,” she say. “If a peer support member just knows an employee took a tough call, they won’t wait for someone to come to them but they’ll take it upon themselves to just go out and check on that person. Just let them know that they’re there.”

Fay reiterates another 911 Dispatcher will notice when a peer is struggling long before a supervisor will. “(They) are going to see the subtle change in behavior in the person that works next to them,” he says. “They’re the ones who can then step in sooner and try to help that person get their life back under control or make a plan so they can go get some help.” How is a formal peer support team developed? “You could probably ask five different people and get five different answers,” says Marshall. Regardless, there are a few key elements.

Get the program off the ground

Who do you select to participate? Marshall recommends having criteria for who would be appropriate. “This has to be somebody who is obviously mature. They honor confidentiality. They have proven credibility with their peers. They’re trusted by their leadership. They don’t have the compulsion to fix. They’re emotionally stable and well enough that they’re not going to be hurt by this. Also, they’re not going to spill their issues into their peer’s issues.” Rasmussen adds that this person has to be tough. “They’re going to fight you as much as you’re trying to help them,” she says. “Dispatchers have a hard time wrangling the fact that they are the fixers. They’re the ones who make it right. They’re the ones who everybody calls for help. So for them to actually break or even bend and say ‘I need help fixing something,’ I think that’s the fight that you’ve got to get through.”

Second, include the right training. 911TI offers a certified peer supporter program which begins with 16 hours of stress resilience (Strive & Thrive). Part of it is a reevaluation of the emotional code. “You have to…know that they aren’t going to convey the ‘suck it up’ [mentality] to the people they are helping,” says Marshall. Assessing their own psychological readiness to be a peer supporter is also an essential part of training.

Next, they offer an introduction to peer support class. Here they cover the basics, followed by the 16-hour certified peer supporter course, which includes intensive and specific training. “The training is really drilling down into the kinds of problems you can experience as a peer supporter,” says Marshall. “They’re not all related to the 911 work. There has to be an understanding of different types of challenges and how you relate to each of these...” but not as a diagnostician or clinician. “Part of the preparation for a certified peer supporter is what you are not there to do, what your role is not,” he says.

Peer supporters also need to understand how to communicate. Says Marshall: “The kind of communication you do at the console is very different than the kind of communication that works in peer support.” He likens 911 dispatchers to paid interrogators and interrupters. “But when you’re sitting with somebody who is struggling with emotion, then you have to be a superb listener.” FRSN also offers certified peer support training. It is a three-day course with active listening as the foundation. The course also covers issues such as depression, suicide, PTSD and how to develop interventions. FRSN has an advanced peer support training as well, and they don’t charge for their courses. “You just come out and spend the week with us,” says Fay. “Our goal, our hope, is that you’ll learn from us, take it back to your agency and pay it forward.”

Initial training also includes how to make appropriate referrals. Peer supporters need to know what kind of help exists, how to network with clinicians and agency administration without violating peer confidentiality. They also need to know how to handle an immediate emergency or crisis. After the initial training is complete, a candidate needs to be assessed for readiness to perform in the field. During Marshall’s check for readiness, they’ll have a candid discussion of the trainee’s strengths, weaknesses and assessment of fit within the role. “We can’t say this is for everyone,” he says. “It’s not.” Once a candidate passes, Marshall’s model continues supervision for a year. Continuing education is important as well. Aurora’s peer support team, for example, takes annual training to stay certified.

“Peer support is part of realizing the fact there is probably a higher rate of PTSD among telecommunicators, a higher rate of clinical depression, so we have a real issue here,” says Marshall. “We don’t need to be alarmists, but we need to acknowledge reality and build up a level of support that’s comparable to the demand we place on the very first responder. Show them respect and show them care.”

Culverhouse, who attended the week-long course not because she was ever going to be a peer supporter as a supervisor, but because she wanted to help her team be successful, states it’s worth the time and effort. Rasmussen agrees, “I think this is the way to their hearts. This is the way to their souls. This is the way to their minds.” Peer support gives us the tools to take care of each other and improves our quality of life.