The Need for Peer Support in Every Hospital

Stigma, trauma, and broken systems keep people from care. Peer support can bridge the gap, and transform the system.

Frequently, I find myself in the emergency room, sitting beside someone who is unhoused, in pain, and often overwhelmed. I stay for hours, sometimes overnight, helping them navigate the hospital system, coaching them through difficult conversations, and doing whatever I can to ensure they’re treated with the respect and care every person deserves. I do this work because I’ve seen first hand how some people, who look a certain way, are mistreated. But I also know that this model, one unpaid person quietly filling the cracks, isn’t sustainable. We need structured, funded peer support programs in every hospital.

Most of the people I support avoid hospitals whenever they can. It’s not because they don’t care about themselves, or don’t recognize the need to access medical supports, they absolutely do, it’s because their previous experiences with healthcare systems have been shaped by stigma, trauma, and dismissal. Many have been judged for their appearance, ignored because some hospital staff think they’re ‘drug seeking’, or they’re spoken to in cold, clinical language that feels more like interrogation than care. Over time, these interactions erode trust, and the result is predictable: small medical issues that could have been addressed early are left to worsen, wounds get infected, and serious concerns become life-threatening before they let anyone get involved.

I have experienced this stigma myself. About a week after the first Belle Park encampment was dismantled in 2020, I ended up with a weird looking rash, from head to toe. I sent pictures to a nurse friend of mine, she was concerned it might be measles (I’m vaccinated for measles), and sent me to the hospital. Upon hearing that I help people without homes, the emergency doctor quickly diagnosed me with dermatitis neglecta, a skin disorder often associated with people who are unhoused and don’t have adequate access to showers. The doctor also reprimanded me for being around ‘those people’ and advised that I wear full PPE if I have to come in contact with ‘one’. While I was waiting for a covid test, I did an online search about this condition. The doctor walked in, and I showed him the pictures of blisters which did not look like the rashes I had. He challenged me and asked if I had a medical degree. I challenged him to think deeper about other possible causes, he dug in, so I left.

Shaking my head in disbelief, I went to a woman who had been without a home for over 10 years. She identified the rashes as wild parsnip, poison ivy and poison oak. Of course! After the encampment evictions, I spent hours in the dark woods helping to set up new tents. I sent the pictures to my doctor, she confirmed the diagnosis and prescribed some creams. The rashes cleared up eventually.

When someone does finally make the difficult decision to seek care, they often encounter even more barriers. Long wait times, confusing intake processes, or a brusque tone from staff can trigger past trauma or escalate anxiety. I’ve seen people break down emotionally or lash out in frustration, and, instead of compassion, they’re met with security guards and asked to leave. These patterns don’t just harm patients, they drain hospital resources, waste time, and delay care. The next time the person tries to access the hospital, staff will often wait to see if the person will “stick around” long enough to be seen, which perpetuates the revolving door pattern.

Peer support can disrupt that pattern, not only by helping individuals access care, but by transforming how care is delivered in the first place.

What I offer is what a trained peer support worker could offer on a broader, more sustainable scale: calm, grounded presence; plain-language explanations of what to expect; an acknowledgment of the very real harm the system has done in the past; and a commitment to listen without judgment. I make space for people to speak for themselves while staying nearby if they need help translating medical jargon or asserting their needs. I try to remind both the person in crisis and the hospital staff that we're all human beings doing our best in a deeply strained system.

Recently, I began working with someone who was temporarily housed and was in serious need of medical attention, but had been struggling with hospitals for years. Their housemates had contacted me to see if I could help this person. Instead of trying to push them through the doors of the ER immediately, I connected them with Ontario Health atHome, a program designed to reduce frequent hospital visits by bringing care to people where they live. Within days, they received a home visit from an emergency nurse, were paired with an exceptionally helpful social worker, and began receiving weekly in-home nursing support. That access helped build trust, and, just as importantly, it stabilized their health enough to prepare them for future interactions with the medical system.

Eventually, they needed to go to the hospital. I went with them, and we talked in advance about how to approach the visit. I suggested using “honey” - being kind and lighthearted, trying to keep the mood up, and helping medical staff do their jobs by making it a little easier to engage. We laughed, and planned. That time, they stayed in the hospital for six full days, the longest they’d ever managed, and finally had some of their long-ignored health issues properly addressed.

But perhaps the most powerful part of this story came the following week, when they started to feel unwell again. This time, they went to the ER on their own, without calling me first. When they came home, they told me about their experience with pride. They reported using honey(!!), they made the nurses laugh, and they advocated for a surgery they had needed for a long time. And they got it. They told me the time I spent with them; the calm presence, the coaching, the modelling of what it looks like to navigate the system, gave them the confidence to go in alone, speak up for themselves, and get the care they deserved.

This is what peer support makes possible, it builds trust where there was none. It creates pathways where people previously saw only dead ends, and helps people move from dependence to confidence, from being pushed out of care to stepping into it on their own terms.

Programs like this aren’t just compassionate, they’re also practical. Peer support has been shown to reduce unnecessary ER visits, lower readmission rates, and improve long-term health outcomes. By offering early intervention and sustained emotional support, peer workers reduce pressure on hospital staff, who are already operating under immense strain. And yes, it saves money. Fewer crisis visits, fewer complications, and better continuity of care all lead to lower healthcare costs over time.

There are already strong examples of this model in action. At St. Joseph’s Healthcare Hamilton, the Patient and Family Collaborative Support Services integrate peer support into mental health and addiction care. At the Royal Ottawa Mental Health Centre, peer specialists walk alongside patients as they navigate complex recovery paths. These programs work. They create safer, more accessible environments for people who have long been excluded or mistreated by traditional healthcare systems.

What we need now is scale. Peer support must be present in every hospital, not just in specialized mental health centres, but in emergency rooms, intake areas, and anywhere someone in distress might show up. This isn’t just about kindness. It’s about building a healthcare system that actually works, for everyone.

If you work in healthcare, advocate for funded peer support roles in your hospital. If you work in policy, prioritize peer support as essential infrastructure. And if you're a patient or a caregiver, ask your hospital if peer workers are available, and if they’re not, start asking why not.

Oh! And if you’re one of those hospital staff who assume that a person is ‘drug seeking’, know two truths. One, the person has far better access to better drugs on the streets. And two, the hospital seems to be a lucrative market for drug dealers. I’ve seen transactions in multiple parts of our local hospital myself; it helps to know who’s who in this messy community.