Providing peer-to-peer support

Providing peer-to-peer support
Ambulance NSW's peer support program provides front-line staff with someone they can talk to who understands the difficulties of the job, who they can relate to at their level. Paramedics undergo a two-day training program to become peer support officers and participate in refresher courses and regular contact with an EAP psychologist. 

About the initiatives

Ambulance NSW provides clinical care and ambulance services to more than 7.25 million people across New South Wales. It employs 4,000 people, 90 per cent of whom are operational staff on the front lines of service.

Because these front-line staff are regularly exposed to traumatic events, mental health in the workplace is a principal concern for Ambulance NSW. Its primary means of ensuring mental health is a thorough staff support system, one element of which is the peer support program.

The program consists of 140 peer support officers and a full-time peer support team coordinator. Peer support officers are paramedics who maintain their regular roles, but also take on a peer support role on a voluntary basis. Staff undergo a two-day training program to become peer support officers and participate in refresher courses and regular contact with an EAP psychologist. The training program covers topics such as mental health awareness, active listening and recognising the signs that someone is at risk of self-harm. It also acts as a screening tool to find the right people for the job.

Early intervention is believed to help prevent mental health issues. The intention of the program is to develop qualified staff members to support their peers – someone they can talk to who understands the difficulties of the job, who they can relate to at their level.

The program also incorporates a staff support activation policy. Through this policy, peer support officers proactively contact workers who have participated in jobs known to have a traumatic impact, such as the death of a child, to check on them and offer support.

Recent improvements include enhancing coverage of the peer support program and developing and distributing cards with contact details of all staff support services. The organisation is also developing a smartphone app that would make it easier for paramedics to find a peer support officer in their region when they need it.

Other workplace mental health initiatives of Ambulance NSW include:

  • managers are trained in supporting staff members, particularly in identifying mental health issues and providing assistance and referrals
  • stress management training is mandatory for new staff and refreshers are provided periodically for current staff
  • the 'Support Your Buddy' program is designed to encourage colleagues to support each other in the workplace
  • a dedicated committee has been set up to look for strategic ways to develop support staff and improve employee wellbeing and mental health
  • participation in community initiatives such as Mental Health Month and participation in R U OK Day
  • regular wellness checks for paramedics involving a one-hour, voluntary appointment with a psychologist about improving mental health and stress management


How the initiatives came about

The findings of a parliamentary inquiry in 2008 gave rise to a broad program of looking at how Ambulance NSW could better support its staff.

There were concerns that Ambulance NSW’s paramedic staff were not sharing and offloading the stresses of their jobs, that there was an organisational attitude that this would be a sign of weakness. With such a mindset, staff tend to be less likely to seek out support when they truly need it. Ambulance NSW realised it needed to be more proactive about providing support to its staff and overcoming attitudinal barriers to communicating about stress and emotions.


Benefits and outcomes

Benefits from these initiatives include that:

  • internal surveys have returned highly positive assessment of the effectiveness of the peer support program and indicate that the program is well-regarded by staff at all levels
  • there has been a shift in the organisational culture regarding talking about emotions and mental health - the feeling now is that it is 'okay to toughen up but it's also okay to look after yourself'
  • more than 1200 contacts were made last year between staff and pee support officers
  • the use of Ambulance NSW's EAP has increased over the past few years
  • the number of stress leave applications have dropped.


 Recommendations, considerations and lessons learned

Challenge: Breaking down the 'toughen up' wall


  • Get support from management to spread the message that asking for help is okay
  • Change the mindset to realise that it's just as important for employees to take care of themselves as it is to take care of others

​Challenge: Identifying staff and situations where greater support is needed


  • Identify the types of jobs that cause the most distress and proactively contact staff who have had these experiences in a timely manner.
  • Build the capacity of employees to deal with stress on their own

​Challenge: Ensuring access to information and resources


  • Peer support officers contact the peer support coordinator when they are worried about someone or need help
  • Train managers in identifying and supporting mental health issues in the workplace
  • Use the EAP for help with information and resources


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