Combatting silence through peer support in the Canadian Forces Health Services

Abstract

Introduction: Health care providers in the Canadian military face substantial operational pressures that increase their risk for mental health challenges, moral injury, and burnout. Technology can reduce barriers to accessing support, but systematic evaluation is needed. This study examined the implementation and uptake of Beyond Silence, a bilingual mobile health platform designed for health care workers that provides confidential access to customized content, mental health resources, and peer support. Methods: Over the seven-month implementation period, aggregate usage metrics were collected. Baseline and follow-up interviews with four Canadian Forces Health Services (CFHS) leaders and focus groups with nine peer supporters were conducted to explore facilitators and barriers to adoption. Analysis was informed by the Consolidated Framework for Implementation Research (CFIR). Results: Approximately 343 members (7% of all employees) downloaded the app, and 22 peer support appointments were completed. Despite strong leadership support for the relevance, confidentiality, and accessibility of the platform, fear of reputational harm and technological constraints limited broader adoption. The paradox of peer support was a key tension: while shared experiences among peers was valued, dual professional and collegial roles were barriers to outreach, including concerns regarding confidentiality and career impact. Discussion: Supporting mental health in military health care environments requires tools attuned to the unique context and culture of military service, as well as the complex roles of CFHS providers. Confidential, peer-based, and mobile platforms such as Beyond Silence are promising tools, but implementation requires tailored implementation strategies to build awareness and trust.