Supporting young adults with mental health and substance use in the emergency department from the perspective of peer support workers

Mount Sinai Hospital

The RBC Pathway to Peers program is a novel service offered to young adults presenting to an urban hospital emergency department (ED) with mental health and substance use. The idea was to complement the care provided by hospital staff, and further support young patients that were increasingly coming into the ED. created prior to the pandemic, and rolled out during a pandemic, it has been well received by both patients and staff, in supporting young adults reaching out for help. We will discuss how to integrate peers in the ED, how to support them in a complex and possibly triggering environment, all while staying true to peer support values. Other infrastructure that has been identified as being vital to the sustainability of the program will also be discussed. Such as interprofessional collaboration to diminish role blur and ensure safety for both patients and the peers with onsite access to clinical supervision, opportunities for debriefing, community of practice meetings with a supervisor rooted in the lived experience perspective and well defined role expectations. We will share from the perspective of the peer support worker, how we successfully implemented this novel program and discuss some of the challenges and successes faced along the way, as well as areas for growth and expansion opportunities.


Yolanda-Nicole Delmonte
Yolanda Delmonte (she/her) is a Peer Support Worker in the RBC Pathway to Peers Program. She has an undergraduate degree in Sociology & Criminology, as well as a Social Service Worker Diploma. Working from her own lived experience, she provides support to young people and promotes safety, empowerment, and connection.

Jordyn Ethier
Jordyn Ethier (she/they) is a part-time Peer Support Worker in the RBC Pathway to Peers Program. Jordyn is in her second year of the Community Worker program at George Brown College. Her biggest passions include mental health, LGBTQ+ rights, and anti-oppression.

Bella Shulman
Bella Shulman (she/her) is a part-time Peer Support Worker in the RBC Pathway to Peers Program. Bella is studying Sexual Diversity at the University of Toronto and is in her final year.  She is passionate about equity, inclusivity, and anti-oppression frameworks. 

Christine Bradshaw
Christine Bradshaw (she/her) is a Social Worker at Mount Sinai Hospital’s Emergency Department and Manager of the RBC Pathway to Peers Program. Christine has been involved in the creation and implementation of the Pathway to Peers program and is motivated to make a difference in the lives of young adult patients. 

Key takeaways

  • The inclusion of peer support workers as trained, valued and paid members/experts as part of an integrated healthcare team is important for the social and emotional care of individuals presenting at emergency departments
  • Role blur between per support workers and clinicians can happen – regular communication and debriefing important to identifying any oversteps and to adjust approaches for better patient-centred care
  • Peer support workers should be considered part of the overall sustainability of programs offering acute/emergency mental health and substance use treatment

Key Learning Objectives (defined by presenters)

  1. Discuss how to work within a large fast paced healthcare institution while remaining true to peer support values, how to create boundaries, reduce role blur with other professionals and ensure safety for peers
  2. Discuss the importance of being integrated into the ED team so other team members know who peers are, what they do (and don’t do), and how to access their services
  3. Discuss the importance of institutional acceptance and role validation to ensure sustainability and legitimacy of the program, while being recognized as a valued asset and expert that can bring a young adult lens to internal trainings and committees

Key Themes

  1. Implementing peer support in hospitals

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