The Behavioral Health Institute at Harborview Medical Center is leading two complementary initiatives designed to strengthen and expand the role of peer support specialists in crisis and emergency settings.

Together, these initiatives build on Harborview’s longstanding Peer Bridger model and aim to improve how people experiencing behavioral health crises are supported during and after emergency care. One initiative focuses on strengthening and expanding Harborview’s Peer Bridger program within Psychiatric Emergency Services (PES), while the other focuses on developing a practical toolkit to help organizations across the field integrate peer roles into crisis and emergency care environments.

Peer Bridger Program Expansion

This project focuses on strengthening and expanding the Peer Bridger program within Harborview’s Psychiatric Emergency Services (PES). Building on a pilot launched in 2023, the Peer Bridger program includes evaluating program outcomes and identifying opportunities to further develop and sustain the program in a high-acuity crisis care setting. The work includes adding a peer supervisor and additional peer support staff; refining program infrastructure such as scheduling and referral pathways; and strengthening orientation and training for peers working in emergency settings. Insights from the pilot and ongoing quality improvement work help inform long-term program sustainability and guide future expansion of peer roles in crisis care environments.

Peers in Crisis Care Settings Toolkit

This project develops a practical, evidence-informed toolkit to support the integration of peer support specialists into crisis and emergency care settings. The toolkit will synthesize findings from a literature review, environmental scan, interviews with program leaders, and lessons learned from the PES Peer Bridger pilot. It will provide guidance on assessing organizational readiness, implementing peer roles in emergency and crisis environments, building effective supervision and support structures, and sustaining peer services over time. The toolkit will also include case examples, promising practices, and practical tools to support real-world implementation.

Together, these initiatives aim to strengthen recovery-oriented crisis care, improve engagement and transitions following crisis intervention, and support broader adoption of peer support roles across crisis and emergency care systems.