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Wounded Healers: How peer support workers help patients in crisis

Many patients in the midst of a mental health crisis find little comfort in the average emergency room. Peer support workers are there to bring relief to those at their lowest moments.
Peer support navigator Chris Fonteine (photo: Jeff Goodes)

Originally published on December 9, 2017

Marcelle Lallemand believes that the quiet intervention of Chris Fonteine saved her life.

Lallemand was brought to the emergency department of the North Bay Regional Health Centre in handcuffs after what she calls "a big show on Main Street."

"I was handcuffed to a bed, alone in a room," she said. "Police were outside laughing about me and making jokes and waiting for me to calm down, but their remarks and the way they were addressing me, I was just getting more angry and more in crisis."
Marcelle Lallemand with friends Jim and Judy Reid (Jeff Goodes)

Sitting alone, humiliated by her public arrest, Lallemand felt herself spiraling out of control, losing hope.

"I was praying and I was asking Jesus to come and save me. I had no hope and then Chris arrived."

Marcelle Lallemand talks about the night she met Chris Fontaine in the ER 1:09
Chris Fonteine is a peer support navigator, someone with lived experience with mental health issues. In Chris' case, he made many trips to the ER in his early 20's, when he struggled with what was later diagnosed as borderline personality disorder and dysthymia (long-term mild depression). 

Now in full recovery, Chris studies psychology while working for People for Equal Partnership in Mental Health Nipissing (PEP).  One of the country's oldest peer-support organizations, it's been offering services to those suffering from mental health and addiction issues for more than 26 years.

I think the peer support worker is fixing the downtime, the period between assessment and admission. Chris is giving that downtime significance by justifying the patient's needs. Keeping them calm...so nobody's ever left alone. You feel like you have a supportive person at your side.- Leeanne Nesbitt , triage nurse

"Between my education and my own personal experience, I can kind of provide strategies for coping with day-to-day struggles dealing with the symptoms of mental health issues."

Chris remembers his own experiences in ER waiting rooms without peer support workers as "terrifying."

"There was definitely that uncomfortable power dynamic where whoever I talked to, I felt like they were above me or better than me, and that made it a bit difficult. That's a big part of why I had to keep going back as well," he said. "I wasn't able to really connect with an individual and feel comfortable with what I was dealing with or understand that it was something other people struggle with too."

'It's invaluable'

Emergency departments can be intimidating and overwhelming environments. Doctors are often in a hurry, and the wait times are long. Letting the patient in crisis know they are not alone is the entire point of peer support, according to Deborrah Sherman, executive director of the Ontario Peer Development Initiative (OPDI).  

"The basic tenant of peer support is saying 'I've been where you are'," Sherman said. "I've been through it. I'm doing okay. What can I help you with? How can I encourage you? How can I support you?"

Sherman said peer support workers are not interested in making a diagnosis. They aren't there to cure or treat any ailments but rather "to provide hope and to exemplify that people do and can recover. That you're not alone and that there are far more people with issues than you might know about."

At North Bay Regional Hospital, Fonteine is embedded with the triage staff — having access to patients as soon as they arrive.

Triage nurse Leeanne Nesbitt (North Bay Regional Health Centre)

"I think it's invaluable," said Leeanne Nesbitt, a triage nurse who works with Fonteine. "I think Chris provides so much support to everybody that comes in and even us, as triage nurses and the emergency room nurses."

When a patient is identified as needing mental-health support, they are brought to a more comfortable private room. A little while later Fonteine arrives to ask them how they are feeling and allows them to express their concerns. 

The healing power of human connection

Chris dresses casually: Street clothes, big baseball cap, spacers in his ears. That helps too, he says. "Sometimes it can be difficult to talk to somebody about what your concerns are, what your needs are, especially if they're a nurse in scrubs or a doctor with their clipboard. It can be a little intimidating, so sometimes we can get extra information that is useful for their care as well." 
Emergency room physician Dr Erica Buck (North Bay Regional Health Centre)

ER doctor Erica Buck values the lived experience that peer support navigators like Chris bring to the team. "When one's been wounded you have something more to share," she says. "They automatically, because of their shared experiences can relate to a patient and make a patient feel at ease. Human connection is deeply healing."

And for Lallemand, that extra care provided by Fonteine was crucial to her recovery.

"For sure Chris has saved my life that night."