National Peer Support Programs (NPSP)

The National Peer Support Program is comprised of two sister programs that provide social and peer support:

Operational Stress Injury Social Support Program (OSISS); and
Helping Our Peers By Providing Empathy (HOPE) Program.

The term “Peer” is used to describe the person accessing the programs, as both of these programs are non-clinical and are based on similar experiences of the staff and the person seeking support.

HOPE is a unique program in that offers peer support to the families of the fallen.  Peers seeking support are matched with HOPE volunteers who have gone through similar experiences.

The hands and stones in the poster seen here, symbolizes support, solidity, strength and resilience. Similar to these stones, the human being has the capacity to adapt to difficult situations.

All peer supporters in this program comprise of volunteers and have lost a loved one who was a serving CAF member or Veteran.  These casualties were mostly from the war on Afghanistan but other circumstances like suicide, accidents and illness were causes as well.

HOPE volunteers are now in a place of well-being and have healed enough that they can offer support to other peers. 

The program is supervised by a clinical Social Worker.

Grief is painful and loss is one of the most difficult human experiences.  Research has shown that losing a loved one can be one of the most stressful events in ones’ life. 

The quote on this slide, by Mr. Jim Davis, Father of Cpl Paul Davis who died in Afghanistan on March 2nd, 2006, is a good example of how the peer support program has a positive impact on regaining a families well being.

Mr. Davis has been with the program since it’s beginning, and continues to volunteer as a peer supporter.

As Mr. Davis stated, speaking with someone who understood his pain made a difference, and was the beginning of his healing journey.

Key important factors of the HOPE program is that it is:

Non-judgmental;
Safe; and
A place for people to connect with others who have been through similar experiences and understating.
HOPE is unique in that it bridges the military and civilian experiences.

For example, a parent of a CAF member may never have served in the military themselves and may have minimal/no context or understanding of the military culture. They may not know what to expect or have any knowledge on where to connect. HOPE is able to provide that context and connection.

Main goals of HOPE are to:

Offer important and much needed support to families of the fallen;
Focus on realistic expectations and what to expect about the grieving process;
Ease isolation;
Help make grieving families feel part of the community as their loved one may be gone but the family is not.

Here are some words from families who have utilized HOPE:

“Honestly, it helps me through my mourning process…helping others get through their mourning helps me too. It’s not just others who get something out of it. That’s why I do it. It’s just that I get a lot out of it…it’s about what’s inside, about my emotions, about my own experience.”

“I was just so inspired by this program. Again, I just couldn't explain to you how much my helper was able to lift me up and just make life seem less hopeless. I really felt that she made a significant change in my life.”

“When people die, they don't leave. So it's important that they aren't forgotten….I know that the reason that HOPE is going is because they want no one to forget that there are people who gave themselves for this country that are now gone. I think it's a tribute to the people who have died. So how could I help but not want to do it?”

Some family members who have experienced loss of a loved one may choose to become a HOPE volunteer, in order to help other families in their grief. HOPE volunteers receive training, support and mentorship and often disclose the positive rewards of helping others.

The Operational Stress Injury Social Support (OSISS) program was created in May 2001 to meet an important need. Research has confirmed the value of peer support and almost 25 percent
of those suffering from an Operational Stress Injury (OSI) do not seek professional help.  For those that eventually do seek help, due to the stigma associated with OSIs, can delay doing so for up to seven years and in these cases, peer support programs have connected with OSI sufferers, and have assisted them in getting much-needed help more rapidly.

OSISS Support Coordinators increase the level of social support to serving members and Veterans, as well as their families, who have experienced symptoms consistent with OSIs. 

OSISS complements existing services available from the Department of National Defence, Veterans Affairs Canada, and local communities; to empower CAF members and Veterans by
reducing OSI symptoms, improving their functional status and occupational performance; and ultimately improving their quality of life.

An OSI, is a non-clinical term used to describe a psychological injury that may include anxiety, depression, or PTSD. The injury itself can develop following a traumatic event, grief or loss, working in high stress situations or from operational fatigue.

OSIs do not have to originate from employment in a special duty area or an overseas deployment.  They can originate from domestic operations or accidents that happen in Canada as well.

There are different factors and experiences that may contribute to an OSI. The model in this slide illustrates four possible contributors: Trauma, Fatigue, Grief, and Moral Injury. One persons experience may come from a single area of impact or may be a combination of any of these contributors.

Here are some possible examples for each contributor:

Trauma or Impact Injury
IED explosion
Training accident
Witnessing an incident
Fatigue or Wear and Tear
Burnout back home
Being responsible for the safety of other people
Multiple tours/Taskings
Grief Injury
Loss of people you knew
Don’t have to be in location during the loss to feel grief
Anticipatory loss
Loss of “normal”; loss of previous self; losing the partner they knew before
Moral Injury or Loss
Witnessing an event but being unable to help
Guilt and shame; things that weren’t done; having no control

Physical Injury- These are generally more obvious injuries and are much harder to ignore.  The process from injury to treatment is usually fairly quick and the adjustment required to find a new normal is normally socially accepted.

Mental Health-  The process or timeline for these injuries are often delayed as they are not always immediately noticeable.  It may take time to accept the reason for the change and to seek help.  If is often difficult to adjust to these life changes.

However, the earlier help is sought, the better the prognosis with both physical and mental health injuries.

IMPORTANT NOTE: Not all injured will follow this delayed process.

A Peer can be a serving CAF member, Regular and Reserve; Veteran; and Allied Force Veteran from other military forces, such as the United Kingdom, United States, etc. who live in Canada

OSISS definition of family is fairly broad in that a person supporting someone with an OSI will receive support through the OSISS program. 

A family peer can be your partner, adult children (other resources can be suggested for minors), a sibling, close friend or friends, and even a parent.

National Peer Support Program coordinators represent the diversity and range of peers accessing the OSISS and, they themselves, have lived through similar experiences.

OSISS coordinators have three core mandates:
to provide one to one support;
to provide group support; and
to manage volunteers.

One on One Support
Usually begins with this stage and the Coordinators primary role is to listen.
One on one meetings allow the ability for more in depth and private discussions and Coordinators can suggest resources that may assist as well as provide referral and advocacy. The key here is that they walk alongside the peer.
If a peer would like to attend group support, the Coordinator will assess at this stage if the peer is ready to ensure safety and comfort for the peer as well as the group.

Group Support
Is optional for peers. 
OSISS staff will plan, coordinate and facilitate group support.
* It is important to note trauma is not discussed in groups. Their primary focus is on providing social support, positive coping skills, mutual support
while always maintaining confidentiality at its core.

Volunteer Management
In addition to direct peer support, OSISS Coordinators also recruit, retain and manage volunteers who extend our outreach to peers.
All OSISS volunteers are given one week training by a qualified program Psychologist.

Everyone’s path is different and customized to the wants and needs of the Peer.

One On One Peer Path
Every new peer starts with One on One.  This occurs so that the Coordinator understands where the peer is in their recovery and the coordinator can tailor the level of peer support at this stage.  This path also gives a peer time to determine what they are looking for from OSISS and to get to know their local OSISS representative.  At this stage, peers often describe a sense of relief knowing that they are not alone; can speak to someone who is non-judgemental; and has someone who can help them understand resources and possible options.

Volunteer
The recovery process from an OSI can seem like a long and difficult journey; volunteering for OSISS can be an opportunity for a peer to use their journey for something positive. Volunteering for the program involves a screening process, training and support from the OSISS team.

Group
This is another option, or path, of support through the OSISS program and is based on peer needs as not every peer is immediately interested in attending an OSISS group. It is important for the Coordinator and the Peer to ensure that group support would be a benefit to them and that the peer is healthy enough to participate with existing peers. The benefits of group is that Peers can hear about how others cope, provide mutual support, and the creation of a support network.

Referral and Advocacy
OSISS Peers can receive referral and advocacy from the program as Coordinators have connections to community resources and can often assist in helping a peer to advocate for themselves. It is important to note that no formal referral is necessary; you can call yourself

At any time, a Peer can choose not to progress in the model: it is a voluntary process.

A critical and essential characteristic of how we provide peer support is through our Principle of Confidentiality.

Confidentiality is the Cornerstone of OSISS.

There are three tiers to the release of information and confidentiality:

1. Completely Confidential:
Coordinators are obligated to maintain confidentiality and protect the information provided by Peers. 
Information is treated in a respectful and sensitive manner and will only be shared within the OSISS Program on a need to know basis.

2. Specific Information Released with Consent:
Information may be released to outside parties with written consent of the Peer, unless it falls within the Safety at Risk as seen on the slide. The Peer determines who the information is released to and what type of information will be disclosed.

3. Safety at Risk
As with any other professional organization, OSISS is bound by professional ethics to disclose if safety is at risk. 

Peers are in control of their level of involvement with OSISS and they direct the type of support they want to receive.

The following bullets outline some examples of the potential benefits of OSISS:

Provide hope;
Connect peers to other peers;
Provide an opportunity for new perspectives; and
Model healthy coping skills while living with an OSI.

Other benefits of the OSISS program include:

Encouraging peers to comply with Doctor recommendations;
Empowering peers;
Helping peers to find appropriate resources; and
Encouraging peers to participate in programs and supports.

Coordinators can adjust to walk alongside a peer on their own path.  However, this will be dependent on the wants and needs of the peer.

OSISS coordinators can support peers where needed. We connect face to face with peers whenever possible and have staff and volunteers located in multiple locations Nationally.

We are equipped to provide support over the phone and through email. Because of this, our program is accessible to peers currently living abroad.

Referrals can flow back and forth from these and many other agencies in local Military and Civilian communities.

Here are examples of peer support program partners:

National OSI Clinic Network
MFRCs
VAC Case Managers
Legion Service Representatives
JPSU/IPSCs
Community organizations

There are three key messages we want you to take from this presentation:

Interactions with OSISS are confidential and will not be shared outside the program unless it crosses ethical boundaries as previously discussed.

We live these injuries and understand the difficulties that can accompany an OSI for both the person living with the injury and the families supporting them.

Returning to a quality life is possible. 

Visit our website at:  WWW.HOPE-ESPOIR.COM

If you have any questions about our National Peer Support Programs, HOPE and OSISS, outlined in this presentation, or you want to find peer support local to you, please do not hesitate to use the contact information here.