HEALTHPeer Support: Two In, Two Out

Peer Support: Two In, Two Out

By: Christina Bott, MA and Chelsea Kavanaugh, MS, CHES®

Peer support has become a hot topic lately, and for good reason. The peer-to-peer support model has been around since the late 1700s and has been used to help improve health outcomes and quality of life for a range of mental and physical health conditions, including asthma, cancer, diabetes, and substance use disorder.  

With this history is an extensive body of evidence demonstrating that peer support is effective. It can be a game changer when it comes to coping with stress, improving self-care, and having renewed perspective and hope for the future.  

What we’ve learned in the fire/EMS field is that peer support can buffer the effects of burnout and secondary traumatic stress, encourage more open discussion about mental wellness, and decrease stigma around seeking professional mental health support.1,2 The fire service is leveraging this effective approach as an element of wellness programming, and the pace of progress is encouraging.  

As peer support becomes increasingly available, it’s important to remember that this valuable resource is not meant only as a tool for debriefing after a critical incident, or as a last-ditch effort to intervene once a member’s substance use or mental health symptoms have progressed to a dangerous level. Certainly, peer support is appropriate and beneficial in such scenarios, but peer support can, and should, also be used proactively to manage health and prevent minor issues from becoming worse.  

You may understand the concept of peer support but wonder about the details, so let’s demystify it.

Peers meet up to talk, and the topics could cover a variety of areas. You may be feeling symptoms of burnout, and a peer can help you come up with strategies for feeling better and rediscovering your love for the job.  

Someone recovering from an injury, battling cancer, or managing a chronic illness might be feeling overwhelmed and worried. A fellow firefighter can offer hope and encouragement and remind them they don’t have to go through it alone. Or maybe a retiree or firefighter on extended leave is feeling isolated, separated from their fire family, and lonely. Regularly meeting with a peer can help them feel connected and valued. 

Anyone who is going through something difficult – relationship or family issues, financial problems, or just the day-to-day stress of life – can feel some relief by talking through what they’re experiencing with someone who gets it. It can help to simply be heard.  

Peer support can also help you set and stick to goals. Firefighters looking to create or maintain healthy lifestyle habits such as eating better, increasing physical activity, quitting tobacco, or improving sleep quality can benefit. You’re more likely to succeed with the support of a peer. 

The reality is everyone can benefit from peer support – including those who are providing it. If your department has a peer support team, make sure you know how to reach out to them and keep their contact information handy to share with others who might need support along the way. 

If your department doesn’t have a peer support team, maybe you could help organize one. Either way, you have options. There are many culturally competent support resources out there, including peer-to-peer helplines staffed by current or retired first responders who know what it’s like to do the job.  

Everyone experiences difficulties at some point in their life. Fortunately, you don’t have to experience them alone.  

Two in, two out. 

The NAMI Frontline Wellness website ( provides information and rapid-access resources that are free, confidential, and available anytime. NAMI Frontline Wellness also offers no-cost course materials for1-1 Peer Support Leader Trainingfor fire and EMS, as well as law enforcement professionals. To learn more, contact your local NAMI or email[email protected]. 


  1. McCall WT. Piloting peer support to decrease secondary traumatic stress, compassion fatigue, and burnout among air medical crewmembers. Air Med J. 2023;42(3):157-162. doi:10.1016/j.amj.2023.01.004 
  2. Horan KA, Marks M, Ruiz J, Bowers C, Cunningham A. Here for my peer: the future of first responder mental health. Int J Environ Res Public Health. 2021;18(21):11097. doi:10.3390/ijerph182111097 

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