Integrating Peer Support in Crisis Care Settings Toolkit

A practical, field-informed resource for integrating peer support into crisis and emergency care settings.

The Behavioral Health Institute at Harborview Medical Center developed this toolkit to provide practical guidance for organizations integrating peer support into crisis and emergency care settings. It offers actionable strategies for preparing organizations, defining peer roles, supporting supervision, preventing role drift, and sustaining peer programs over time.

Grounded in extensive collaboration with Washington’s behavioral health community, the toolkit combines lessons learned from the Harborview Medical Center Psychiatric Emergency Services (PES) Peer Bridger Pilot with key informant interviews, an environmental scan, and a review of research and best practices for peer support in crisis and emergency care settings. It reflects the combined expertise of people with lived experience, peer leaders, clinicians, researchers, and system partners working to strengthen crisis care across Washington State.

Who this toolkit is for

This resource is intended for:

  • Frontline managers and supervisors in crisis and emergency settings
  • Health system and organizational leaders
  • Policymakers and funders
  • Peer support organizations
  • Crisis response and emergency care organizations
  • Community partners working to strengthen behavioral health crisis systems 
What’s Included

The toolkit includes practical guidance on:

  • Organizational readiness and culture change
  • Program planning, funding, and sustainability
  • Defining peer roles, scope, and workflow
  • Hiring, onboarding, and training
  • Supervision, ethics, and documentation
  • Supporting long-term success for peer staff
  • Tribal context, considerations, and resources 
Acknowledgements

This toolkit was made possible with support from Ballmer Group and the Hoveida Family Foundation. The Harborview Medical Center Psychiatric Emergency Services Peer Bridger Pilot was launched through the generous support of the Hoveida Family Foundation and later expanded through continued support from the Foundation together with funding from Ballmer Group. These investments enabled the program to grow its peer workforce, deepen implementation, and generate the experiences, lessons learned, and insights that helped to inform the development of this toolkit.

We are also grateful to the many people with lived experience, peer support specialists, clinicians, researchers, behavioral health leaders, Tribal partners, community organizations, and the Washington State Health Care Authority (HCA) whose expertise, partnership, and collaboration helped shape this toolkit. Their contributions helped ensure this resource reflects the realities of crisis and emergency care and the diverse perspectives of those working to strengthen peer support across Washington State.

Download the Integrating Peer Support in Crisis Care Settings Toolkit

Questions or feedback? Contact bhinstitute@uw.edu.