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Home , Absenteeism, Frank Serpico, Mentorship, Whistleblower

Notes From the Field Peer Support for

Jacqueline Garrick, MSW, LCSW-C

Employees who report , waste, , or illegality at a federal agency find that it is often the first step in a long process frequently marked by retaliation. Peer support may help whistleblowers persevere under these sometimes difficult circumstances.

histleblowers report il- gins when the per- at his hospital. Other legalities, improprieties, ceives wrongdoing or harm that whistleblowers report having mis- or injustices. They step is being committed in their work- conduct charges levied against W forward wittingly or un- place. At a health care , them, demotions or loss of position, wittingly to report perceived wrong- whistleblowing often is focused on obstruction from promotion, poor doing. But when a whistleblower individual or organizational illegal performance evaluations, details to takes on powerful and entrenched or unethical activities, such as fund- more minor assignments, reloca- systems or people, retribution and ing or contracting fraud, , tion to more meager space, or retaliation often ensue, endangering theft, discrimination, sexual harass- pressure to resign or retire.3 their and reputation. These ment, public health safety or secu- Whistleblowers are rarely re- negative consequences can have long- rity violations, persistent medical warded for reporting misconduct term impacts on the lives of those errors, , or other violations within their organization. The Joint who believed they were acting in the of rules and regulations. Commission describes barriers to re- public interest especially when pa- VA employees who experience, wit- porting sentinel events by medical tient care or public safety was at risk. ness, or discover wrongdoing may professionals fearing , liti- The following account is based on choose to disclose their concerns to a gation, peer pressure, and oversight personal and professional experiences, , senior leader, the Office of investigations if they identify medical conversations with more than a dozen the Inspector General (OIG), Human errors.4 other whistleblowers at the DoD, VA, Resources or Equal Op- Once allegations are made, the in- several other , and a lit- portunity (EEO) Office, Employee formation often is conveyed to a su- erature review. This documentation Assistance Program (EAP), Office of pervisor or leader. For example, some of those informal peer conversations, Special Counsel (OSC), Congress, or whistleblowers who have reported combined with the research, is meant to a news organization. a to the to provide insight into the experiences According to the 2013 National DoD EAP have noted that the EAP of a whistleblower and the need for Survey, more than representative contacted the whistle- peer support so that employees can re- 6 million American workers who blower’s manager to mediate the situ- main resilient. reported misconduct experienced ation. This process can take months some form of retaliation.1,2 Retribu- or years to resolve. In those instances, ADVERSE WHISTLEBLOWER tion can manifest in various overt or the managers are rarely relocated. EXPERIENCES covert ways, ranging from outright The whistleblower usually is the one Most employees do not set out to retaliation and further discrimina- forced to move or take another , be whistleblowers. The process be- tion to other forms of marginaliza- which is not always consistent with tion. For example, a VA physician their , and in turn, Ms. Garrick is the founder of the nonprofit orga- nization Whistleblowers of America. At the time alleged that he was detailed to an may impact their performance rating the article was initiated, she was a DoD political empty office with no patients after and opportunities for promotion. appointee. reporting patient wait list mis- Often, OIG and OSC investigations

38 • FEDERAL PRACTITIONER • JULY 2017 www.fedprac.com at the VA and other federal agen- RETALIATORY PRACTICES professional credentials, or state li- cies can take as long as 2 years. Once a whistleblower has stepped censure. The loss of income also can During that time the whistleblower forward, retaliatory practices may lead to loss of . The may remain in a lesser or unwanted follow. There are tangible legal, fi- legal and financial burdens impact position or leave the agency. How- nancial, social, emotional, and marriages, spousal job options, re- ever, even when OIG substantiates physical tolls to whistleblow- tirement, and other family choices claims of wrongdoing, the agency ing. “Be in for a penny. Be in for (eg, vacations, children’s schools, and can make recommendations only to a pound,” an OIG official advised caregiving obligations). , which may or may not one whistleblower. Once a dis- During investigations, social sta- be enacted. Whistleblowers report closure is made, the process may tus and the reputation of the whis- having to submit Freedom of Infor- become arduous for the whistle- tleblower are often impugned. For mation Act requests to learn of the blower and require individual resil- example, whistleblowers are some- outcome of an OIG investigation ience to face adversity. times depicted as snitches, moles, when leadership chooses to ignore Keeping in mind that OIG, EEO, spies, or tattletales and may be cat- the recommendation. EAP, and OSC are government agen- egorized as paranoid, disloyal, or Civilian government employees cies that investigate, police, and mon- disgruntled by leadership. Rarely are undervalued by society in gen- itor the system, they do not represent are whistleblowers labeled protec- eral, and the negative stereotypes of the civil servants who document tors, patriots, or heroes, despite the lazy, shiftless workers abound, even and identify much of the evidence of few high profile cases that come to though many civil servants work to wrongdoing on their own. Most civil light, such as Karen Silkwood, Erin protect the nation’s health, welfare, service employees are not subject Brockovich, or Frank . and safety. Civil servants are famil- matter experts on the U.S. legal code More often, whistleblowers’ repu- iar with derogatory expressions, that outlines prohibited personal tations, especially in civil sectors, are such as “bureaucratic bean-counter,” practices or the Federal Acquisition damaged through acts of discrimi- and “good enough for government Regulation. nation, such as ; work.” Even President Trump stated The Notification and Federal (asking other employees to monitor that he would come to Washington, Employee Antidiscrimination and and report on the activities of the DC, and “drain the swamp.” Yet civil Retaliation (NO FEAR) Act autho- whistleblower); ostracizing the em- servants can go years without a cost rized in 2002 (U.S. Code § 2301) ployee from the team; devaluing the of living increase, a promotion, or a is designed to inform and protect contributions or the performance of bonus but still be asked to perform those who file grievances or disclo- the whistleblower; blackballing from additional duties or work long hours sures, but operationalizing those other or opportunities; double- to the sacrifice of a work/life balance. protections can be overwhelming binding with difficult tasks to com- In the Federal Employee View- and confusing. If a whistleblower plete; by calling into points Survey and other employee wants advice, he or she must retain question the memory of the whistle- environmental climate scans, high legal counsel often at a substantial blower, the reality of the accusation, levels of workforce stress often are personal cost. Whistleblowers re- or its scope; and marginalization. related to the number of grievances port spending from $10,000 to Accusations of misusing funds, filed, the level of morale, the rates of more than $100,000 in legal fees for inaccurately recording time and at- and retention, recruit- a 1- to 2-year investigation. tendance, and disputing their judge- ment shortages, and lost productiv- These legal fees may force whistle- ment are all tactics used to socially ity.5 Success in toxic environments blowers to use family finances or bor- isolate and harass whistleblowers usually is based on trying to main- row money while hoping for justice into dropping their case or leaving tain a “go along to get along” status along with remuneration in the end. the organization.3 quo, which means looking the other In some cases, the financial impact Furthermore, this level of ostra- way when contracts are fraudulently is compounded when the whistle- cism has documented impact on the awarded or employee discrimination blower has been demoted, denied psychological and physical well-being occurs. If leadership is antagonistic to a promotion, or fired. For medical of the employee and negative conse- reform, then identifying wrongdoing professionals, the impact might re- quences to the overall functioning may come at significant personal risk. sult in the loss of hospital privileges, of the organization.6 Consequences,

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such as physical violence and prop- require some level of peer counselor vised call center peer support provid- erty damage at the time of termina- screening, competency on ers. This peer/clinician collaboration tion and at other have an intervention model, supervision, enhances the overall community occurred.3,7 Other whistleblowers monitoring, and case management by mental health efforts. have reported being threatened in per- a more senior or credentialed mental Temple University documented son or on social media, harassed, and health professional.13 the patient care benefits for behav- assaulted, especially in the military. The Defense Centers of Excel- ioral health services that augmented Whistleblowers, similar to oth- lence for Psychological Health and treatment with evidence-based peer ers who are bullied in the workplace Traumatic Brain Injury (DCoE) rec- support interventions.17 The re- often described feelings such as fear, ognized that health care systems that searchers found that hospitals that , , loneliness, and support civil servants, military mem- used a peer model improved patient humiliation.8 These feelings can lead bers, and veterans can benefit from outcomes as demonstrated by fewer to whistleblowers needing treatment partnerships with internal (eg, human hospitalizations, increased life satis- for substance abuse, depression, resources, unions, or dedicated EAP) faction and enhanced coping skills, anxiety, posttraumatic stress disorder or external (eg, nonprofit and service increased medication adherence, and (PTSD) and .9 Mul- organizations) employee peer support reduced substance abuse or suicidal tiple studies on depression and PTSD programs. The DCoE noted that peer ideation. Additionally, the peer pro- show a correlation to increased mor- networks facilitate referrals to medical viders themselves experienced posi- bidity and mortality.10 However, whis- care when threats of suicide or harm tive health benefits based on their tleblowing retaliation is not clearly to others exists, offer additional case ability to help others, improved their established as a traumatic stressor in management support, and assist pro- own self-efficacy and gained social relation to PTSD.11 fessionals in understanding the pa- and economic growth based on their Insomnia and other sleep distur- tient experience.13 employment satisfaction.17 bances are not uncommon among Peer support offered at VA hospi- whistleblowers who also note they tals is conducted by peers who are Peer Support Interventions have resorted to smoking, overeat- supervised by mental health clinic Peer support interventions have been ing, alcohol misuse, or medication staff (usually social workers).14 Law effective with various populations to manage their distress. Health con- enforcement EAP is another example and may be effective for whistleblow- sequences also include migraines, of peer support within an organiza- ers as well. Since whistleblowing muscle tension, gastrointestinal con- tion to augment mental health and tends to involve legal processes that ditions, increased blood pressure, and resilience among officers who have call for privacy and the confidential- cardiovascular disease.12 experienced first-responder trauma. ity of all parties, whistleblowers expe- External peer support resources rience isolation and alienation. Other PEER SUPPORT MODELS can be accessed through partnerships whistleblowers can better understand Studies of peer-to-peer programs for or referrals. For example, the Trag- the retaliation, discrimination, and veterans, law enforcement officers, edy Assistance Program for Survivors isolation that results. In some in- widows, cancer patients, disaster vic- (TAPS) relies on survivors of military stances, whistleblowers discovered tims, and others bound by survivor- deaths to support each other through years later that other employees ship suggest that peer groups can be bereavement. Although the DoD of- had similar experiences. An orga- an effective means of support, even fers casualty assistance and mental nized, structured program dedicated though the model may vary or be health care to grieving families, the to peer support can help employees adapted to a specific population. In level of peer support differs from within a health care system or EAP general, peer support is centered on TAPS.15 In another example, Cas- manage the impacts of identifying a common experience, shared cred- tellano documented the benefits of wrongdoing.18 Peers may be able to ibility, confidentiality, and trust. The a reciprocal peer support model im- down this isolation and help approach is meant to provide non- plemented across 10 peer-based call establish a new network of support judgmental support that assists with center programs that manage high for those involved in whistleblowing decision making and resilience and risk-populations.16 Core training was cases. Restoring a sense of purpose, provides comfort and hope. Most consistent across all programs, and meaning, and belonging in the work- peer support or models mental health professionals super- place is of significant value for the

40 • FEDERAL PRACTITIONER • JULY 2017 www.fedprac.com Whistleblower Support

whistleblower.19 Peers can mentor sexual and assault. They Military. Lincoln, NE; University of Nebraska Press, Potomac Books; 2015:60. a whistleblower through the inves- have protected taxpayer dollars from 6. McGraw K. Mental health of women warriors: the tigative process and help determine waste, fraud, and abuse. power of belonging. In: Ritchie EC, Naclerio AL, eds. Women at War. New York, NY. Oxford Univer- next steps. Peers can address build- Despite the personal sacrifices sity Press; 2015:311-320. ing, maintaining, and sustaining resil- often required, most whistleblowers’ 7. Blythe B. Blindsided: A Manager’s Guide to Cata- strophic Incidents in the Workplace. New York, NY: ience to overcome adversity. spirits are bolstered by the positive Penguin Group; 2002:136-145. Peers who already have experi- outcomes that their disclosures may 8. Dehue F, Bolman C, Völlink T, Pouwelse M. Coping with bullying at work and health related problems. enced their own legal, financial, so- produce. However, whistleblowers Int J Stress Manage. 2012;19(3):175-197. cial, emotional, and physical risks need compassionate and compe- 9. Panagioti M, Gooding PA, Dunn G, Tarrier N. Path- ways to suicidal behavior in posttraumatic stress and have developed the necessary re- tent assistance throughout the pro- disorder. J Trauma Stress. 2011;24(2):137-145. siliency skills to survive make ideal cess. Peers can foster the resilience 10. World Health Organization. Meeting report on 20 excess mortality in persons with severe mental peer counselors. These peers have needed to survive the adversarial na- disorders. November 18-20, 2015. https://www faced similar challenges but have ture of the whistleblowing process. .fountainhouse.org/sites/default/files/Excess 21 MortalityMeetingReport.pdf. Accessed June 6, 2017. perservered. Therefore, whistleblowers need to be 11. American Psychiatric Association. Trauma- and Although peer counselors cannot viewed in a new light that involves Stressor-Related Disorders. In: Diagnostic and Sta- replace an attorney or mental health advocacy, , and peer tistical Manual of Mental Disorders, 5th Edition. Arlington, VA: American Psychiatric Association; provider, they can provide back- support so that positive outcomes in 2013:265-268, 749-750. ground information on the roles and government can be realized for all 12. Ford DE. Depression, trauma, and cardiovascular health. In: Schnurr PP, Green BL, eds. Trauma and functions of EEO, EAP, OIG, OSC, Americans.  Health: Physical Health Consequences of Exposure to and the MSPB and how to navigate Extreme Stress. Washington, DC: American Psycho- logical Association; 2004:chap 4. those systems. Peers can assist whis- Author disclosures 13. Defense Centers of Excellence for Psychological tleblowers in preparing testimony The author reports no actual or poten- Health and Traumatic Brain Injury. Best practices identified for peer support programs. http://www before congressional hearings or for tial conflicts of interest with regard to .dcoe.mil/files/Best_Practices_Identified_for_Peer press interviews. Peer supporters also this article. _Support_Programs_Jan_2011.pdf. Published Janu- ary 2011. Accessed June 6, 2017. can encourage whistleblowers to seek 14. O’Brian-Mazza D, Zimmerman J. The power of peer care for mental and physical health Disclaimer support: VHA mental health services. https://www .mentalhealth.va.gov/docs/peersupport.pdf. Pub- care and to remain adherent to treat- The opinions expressed herein are those lished September 21, 2012. Accessed June 6, 2017. ment regimens. They case manage of the author and do not necessarily 15. Bartone PT. Peer support for bereaved survivors: systematic review of evidence and identification of a team effort to enable the whistle- reflect those of Federal Practitioner, best practices. https://www.taps.org/globalassets/pdf blower to overcome the adversity of Frontline Medical Communications /about-taps/tapspeersupportreport2016.pdf. Pub- lished January 2017. Accessed June 6, 2017. retaliation. Inc., the U.S. Government, or any of its 16. Castellano C. Reciprocal peer support (RPS): a de- agencies. cade of not so random acts of kindness. Int J Emerg Ment Health. 2012;14(2):105-110. CREATING A NEW NORMAL 17. Salzer M. Consumer-delivered services as a best After the Civil War, the False Claims practice in mental health care delivery and the REFERENCES development of practice guidelines. http://www Act, known as the Lincoln Law, 1. Ethics and Compliance Initiative. National Busi- .cdsdirectory.org/SalzeretalBPPS2002.pdf. Published ness Ethics Survey (NBES) 2013. http://www.ethics 2002. Accessed June 14, 2017. served to protect federal reconstruc- .org/ecihome/research/nbes/nbes-reports/nbes-2013. 18. Robinson R, Murdoch P. Establishing and Maintain- Published 2013. Accessed June 5, 2017. tion activities in the South from in- ing Peer Support Programs in the Workplace. 3rd ed. 2. Schnell G. Whistleblower retaliation on the rise— Ellicott City, MD: Chevron Publishing ; dividuals who attempted to defraud bad news for whistleblowers and their employers 2003:1-24. 22 alike. http://constantinecannon.com/whistleblower the federal government. Today, 19. Baron SA. Violence in the Workplace: A Prevention /whistleblower-retaliation-on-the-rise-bad-news-for and Management Guide for Businesses. Ventura, CA: most Americans are familiar with -whistleblowers-and-their-employers-alike/# Pathfinding Publishing; 1995:99-106. .WNJ1s4WcEYh. Published January 18, 2013. Ac- WikiLeaks. For generations, whistle- 20. Southwick SM, Charney DS. Social support: learning cessed June 5, 2017. the Tap Code. In: Resilience: The Science of Mastering blowers have exposed wrongdoing 3. Devine T, Maassarani T. The Corporate Whistle- Life’s Greatest Challenges. Cambridge, United King- in order to protect or reform govern- blower’s Survival Guide: A Handbook for Committing dom: Cambridge University Press; 2012:100-114. the Truth. San Francisco, CA. Berrett-Koehler Pub- ment programs. Whistleblowers have lishers; 2011:19-40. 21. Creamer MC, Varker T, Bisson J, et al. Guidelines exposed graft and corruption at the 4. The Joint Commission. What Every Hospital Should for peer support in high-risk organizations: an in- Know About Sentinel Events. Oakbrook Terrace, IL: ternational consensus study using Delphi method. J highest levels and in daily operations. Joint Commission on Accreditation of Healthcare Trauma Stress. 2012;25(2):134-141. They have fought for and Organizations; 2000. 22. Downs RB. Afterword. In: Sinclair U. The Jungle. New York, NY. Signet Classics; 1906:343-350. inclusion and a workplace free of 5. Reed GE. Tarnished: Toxic Leadership in the U.S.

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