Safer Space for BLM: Mental Health Peer Support Volunteer

  • Safer Space for BLM

    Mental Health Peer Support Volunteer Form

  • We are seeking volunteers with mental health experience to provide peer-to-peer emotional support to protesters supporting Black Lives Matter. Peer support is provided in partnership with volunteers from Don't Shoot Portland. Activities may include: setting up/taking down the volunteer tent; passing out mental wellness flyers; talking with protesters experiencing emotional distress; and providing referral resources.

    Guiding Principles:

    • Uplift BIPOC community through mental health advocacy.
    • Improve accessibility to mental health support during BLM movement.
    • Build resilience in community members to continue direct action that advances the BLM Movement.

    Our purpose is to provide the following:

    • Mutual aid peer support on-site during protests by facilitating a Mental Health Safer Space Tent.
    • Educational information to build resiliency.
    • Peer-to-peer mental health support (in-person and virtual) through a Safer Space for BLM Mental Health Clinic.
    • Resources to access ongoing mental health support.
  • Are you completing this form as an individual provider or as a representative of an agency?

  • Agency Information

    We invite participation from agencies and organizations that are in a position to donate volunteer hours, time, or physical spaces to support the guiding principles of Safer Space for BLM. Please fill out this Agency Information section in its entirety.
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  • I understand that tear gas and other safety risk factors may be present during protests. I agree to provide and wear my own personal protective equipment (ex: goggles and a respirator/mask) and I consent to voluntarily participate at my own risk.

  • Individual Information

    We invite participation from trained and experienced clinicians who are in a position to volunteer hours, time, or physical space to support the guiding principles of Safer Space for BLM. Please fill out this Individual Information section in its entirety.
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  • Preferred Contact Method
  • Pronouns

  • Are you a BIPOC?

  • Professional Experience

  • Do you have previous volunteer experience?
  • Have you completed trauma informed training?
  • Do you have experience working with neurodiverse and/or neurodivergent individuals?
  • On-Site Support: Areas of Volunteer Interest

  • Off-Site Support: Areas of Volunteer Interest

  • For providing peer-to-peer support with individuals, will you need office space to conduct sessions?
  • I understand that tear gas and other safety risk factors may be present during protests. I agree to provide and wear my own personal protective equipment (ex: goggles and a respirator/mask) and I consent to voluntarily participate at my own risk.
  • Please indicate the shifts for which you are generally available to volunteer:
  • Should be Empty: