Table 3 Interventions proposed for key issues identified and prioritized

Recognition of Peer Work

• Peer workers felt that they do not get the respect they deserve from other professionals.

• Peer workers face considerable amount of stigma from the general public which hinders their access to services.

• Peer workers are not taken seriously at work and pushed aside when “professionals” such as paramedics arrive, especially at the scene of an overdose.

• Organize meet and greet events between peer workers and other professionals such as police and paramedics to facilitate relationship-building.

• Create a video featuring a day in the life of a peer worker to create awareness about the work done by peer workers.

• Introduce photo IDs and business cards as symbols of professionalism and to increase legitimacy for peer workers’ roles.

Organizational Support

• There is lack of clarity around the role of peer workers and the word “peer” is stigmatizing.

• Peer workers are paid less than other staff without lived/ living experience of substance use.

• Lack of clarity around expectations at work.

• Lack of effective communication between peer workers and staff without lived/ living experience.

• Lack of opportunities for peer workers to unwind, debrief or de-stress despite the stressful nature of their work.

• Unstable living conditions and lack of access to external resources which affect peer workers’ productivity and mental health.

• Create job descriptions with a formal job title.

• Indicate recommended pay on the job description based on BC peer payment standards [22].

• Create a contract highlighting expectations at work, scheduling guidelines, break policies, etc.

• Introduce team-building days to foster relationship-building and improved communication.

• Introduce a Peer Supporter role at each site so peer workers have someone to reach out to for debriefing and support.

• Introduce a Systems Navigator role at each site to provide referrals for external services including housing.

Skill Development

Peer workers identified several skills they would like to develop further for increased competency and self-confidence. These include: First Aid and CPR, overdose response techniques, self-defence, communication skills, mental health awareness, cultural competency, conflict resolution, self-care, etc.

Introduce training for peer workers covering the topics identified by them as priorities. For topics where existing training was adequate, in-person sessions were organized. For topics that did not have existing trainings for peer workers, online training modules were developed with input from the team.