Peer Work

Heidi Dickson

“Peer” Works is an abridged version of a presentation Heidi made for a forum called “Peers on Peering” for the Toronto Harm Reduction Task Force in August 2001.

I was formally introduced to the peer employment program offered at Syme /Woolner Neighbourhood Centre through Toronto Public Health in 1998. I jokingly referred to the unnamed position as a “Professional Addict”. It wasn’t long before I was informed the position was called a “peer”. I’ve learned to not only appreciate but also prefer that title. I found that I was going to get paid and be offered support, materials and education, to do what I was already trying to do.

The support came through advice toward finding a more effective means to encourage harm reduction behaviour. The materials offered made this easier, like condoms, lube, information on current health recommendations as well as anonymous testing and supportive handouts to aid in educating on matters related to substance use. I provided bimonthly ethnographic reports on popular substance/s, current practices, observations of and alternatives to unhealthy behaviour, as well as on any needs that service providers may not currently know of. I was consulted on activities and options that apply to clients coping with substance use, sextrade practices, HIV/AIDS, Hepatitis, homelessness, and any combination of these. Since the people I connected with weren’t aware of all of the available services and resources, another responsibility I had was to convey that information where Public Health had had difficulty. In short, as a peer I acted as a ‘middle man’! Duties I participated in include street outreach, needle exchange, networking, public speaking, attending workshops, brainstorming and assisting with public functions. T

he existence of “peer projects” means there exists a willingness to give credence to, respect for, and a means to learn from those like myself who have experienced suffering. Suffering which has incited the development of life skills that today are in great demand as well as need. Support offered to me personally went above and beyond my wildest expectations. Despite many instances where I felt a lowered level of self-esteem, so many people believed in me. They have never wavered in having faith in me. I was personally too insecure to attend the initial group training session, so my supervisors offered me individual training in the presence of several peer leaders.

They trained me on the appropriate methods of handling difficult situations, distributing materials, and responding to queries from injection drug users. I was given training in outreach procedures and policies, the buddy system format, basic information on the topics of HIV/AIDS, STDs, Hepatitis A B and C, and much more. I did follow up, one to two years later, in a group training session as a form of refresher, for which I co-facilitated a section on the topic of overdose. I made a presentation at one of the ‘Train the Trainer’ workshops recently, and elected to stay for the duration of the workshop and participate. In my opinion, the peer program would greatly benefit if all the peers took this type of training.

With all the confidence and self respect that I have gained as a result of my participation within the peer program, even to this day I am offered a greater level of faith from my colleagues and have learned to truly believe I am capable of further growth and a continuing (even more comprehensive) contribution. I have two complaints about peer programs, which I’ve discovered are broadly shared. They are directed at the manner of pay, and the system of scheduling. By ‘manner’ of pay I refer to the fact that after several years in the peer program, I am still being offered payment as an honorarium. I feel it would be more appropriate for me to be acknowledged as an employee and be offered a pay cheque complete with deductions and benefits.

Initially, 4-6 hours per week provided a challenge easily accomplished. After a while, however, that was not enough. The only way to grow was to seek other peer programs in order to increase my income to accommodate my wish to increase my responsibilities. After a predetermined involvement period in a peer program, there should be established some form of option for advancement like being “put on the books”. Yet still I am being offered the same 4-6 hours per week, paid as an honorarium, even after active involvement for more than three years now. I felt and still feel a need to advance and grow on a professional as well as economic level. Which is not to say the amount paid is unacceptable, it is the number of hours that is no longer sufficient. There are many arguments supporting the need for establishing the possibility to aim for additional hours, promotion, and the final integration into the mainstream¼paying taxes.

I would indicate to a future peer the ways they already do practice harm reduction, then detail how the peer program helps, supports and teaches us how to help others more effectively with up-dated supplies, educating materials and direction. I would also make it a point to stress how their life skills are a valuable commodity in the field of harm reduction, specifically within a peer program. To future agencies considering the implementation of a peer program, I would detail to them how my being offered respect encouraged not only my reciprocation, but also my desire to earn that respect and more. This process took time, and though it is possible may not work for every individual, it does work in the “Big Picture” ...Healing! Watch, learn and listen and you can’t go wrong!

If I were running a peer program myself one thing I may do differently would be to have regularly scheduled evaluation meetings to discuss the program in depth and seek out each member’s suggestions, etc., and gather feedback on feasibility options for implementing these suggestions. I would include a more comprehensive crisis intervention training, indepth desensitization, incorporate an awareness of mental health and concurrent issues, and encourage the peers to personally familiarize themselves with the agencies they may require giving clients a referral to. I would allow for payment as an honorarium on a trial basis with an incentive of part time employment, and possible full time employment. That way, each peer can strive for growth within that agency utilizing the peer program as a starting point. I also would make an effort to determine each peer’s strengths and weaknesses for effective honing and utilization of their skills. I am proud the peer program has made it possible for me to rise above my afflictions and be able to offer something of value to others with similar difficulties. Each one of us, in our own unique way, can and does make a difference.

Heidi Dickson is a student in the Human Services Counsellor Program at George Brown College in Toronto. For her student placement at a Toronto agency, she is working on the development of a street outreach peer program. Heidi is the coordinator for the W est End Harm Reduction Coalition as well as part of a team collaborating on writing a relapse prevention booklet for ‘The Works’, the needle exchange program of Toronto Public Health.