Cops Helping Cops: Peer Support - New York-Style

Today, research shows that talking relieves pressure; yet talking doesn't come easily to cops.

First published in Police Officers Quarterly, Winter 2003
Reprinted in Police & Security News, May/June 2004

Fifty years ago, a cop who couldn’t deal with unbearable job stress had several options. He could drink, abuse his spouse, children, or arrestees, and/or commit suicide. It was tragic, but accepted as “part of the job.”

Today, research on substance abuse, spousal abuse, suicide, and similar problems shows that talking relieves the pressure. Yet talking doesn’t come easily to cops, who believe no one but other cops can understand their problems.

This was a problem in the NYPD between 1994 and 1995, when a record 21 police officers committed suicide. Pervasive feelings of guilt for “not knowing” these officers’ plights, along with their colleagues’ own problems of divorce and substance abuse, had dragged morale down. A New York City Council investigation revealed that existing NYPD resources, including in-house professional psychologists, weren’t effective at preventing and mitigating these stressors.

To that end, the city authorized an autonomous peer support program. Called the Member Assistance Program (MAP) until 2001 and known as Police Organization Providing Peer Assistance (POPPA) since then, the program combines peer support officers (PSOs) and licensed professional mental health specialists to provide cops with as much assistance as they need, for as long as they need it. That it receives funding from both the NYPD and the labor unions makes it a unique labor-management partnership in helping officers manage their stress.

How it works

Two factors are key to POPPA’s success, according to founder Bill Genet, an NYPD officer who retired with 33 years on the job. First, its volunteer basis means PSOs work on their own time and don’t use the service as a career stepping-stone. Second, it provides officers with “unobstructed accessibility.”

Most POPPA help starts with a phone call. An officer needing to talk calls POPPA’s digital Help Line, which records the officer’s phone number and a brief message about the problem. Within five to 15 minutes of that call, the Help Line automatically pages a PSO, who meets the officer in person at a neutral location such as a diner. The PSO assesses the officer during this meeting, determining whether the officer needs a referral to one of the 150 local mental health professionals who are “oriented to police culture,” according to Genet. He estimates that POPPA’s referral rate is about 40 percent, and says the PSOs are trained to assess the officer’s condition so accurately that, rather than send the officer to a random therapist where it takes two to eight sessions for the officer to feel comfortable, the PSO can send the officer to the right person the first time. This, says Genet, is a key element of trust between PSO and officer.

Dr. Ronnie Hirsh, an original MAP co-founder and faculty member of the Peer Support Training Institute (PSTI) as well as a licensed marriage and family therapist and psychotherapist in private practice, adds that PSOs are trained to recognize even conditions that can be masked. “An officer might contact the hotline with a family problem, but the real problem is alcohol abuse,” he says. “Although they can’t discern some mental health subtleties, they’re trained to deal with the most common problems among their peers.”

Hirsh also says that POPPA PSOs aren’t involved in “outreach” to officers. This means that officers can’t request PSOs if they call the service again, nor can PSOs follow up on officers. Although this reduces the chance of an inappropriate, or “dual,” relationship forming between officers, it also reduces the PSO’s ability to spot developing problems in the form of, say, a behavioral change. Hirsh notes that other peer support programs, like the one in Calgary (Alberta, Canada), do allow PSO outreach to officers.

If the professional (not the PSO) determines the officer needs immediate medical attention, the officer is referred to Dr. Gregory Mack, a liaison psychologist between POPPA and the NYPD. “[T]he clinician will brief me and POPPA’s clinical director Eugene Moynihan, [Registered Clinical Social Worker],” says Mack, “and then I will assess the officer and place him or her on sick report.”

Mack, who’s an active-duty NYPD detective and the department’s only uniformed psychologist, says his department employee status doesn’t present a conflict of interest. “My job is to act as a coach and a trainer to get the officers motivated to resume their careers and to do so in a healthier manner. My position is to monitor treatment, not to provide the treatment. Private clinicians provide the officer’s treatment.... My job is to balance the needs of the police department with [the mission] of POPPA. There have been minimal conflicts because of the common goals the NYPD and the POPPA program share, to provide officers with a safe, confidential alternative to existing police department programs.” In all, Genet estimates that POPPA intervention, from first contact to Mack’s level, has prevented about 50 suicides.

Genet stresses that only officers who ask for help will get it: POPPA refuses third-party requests from supervisors, colleagues, and family members because “the cop has to want the help.” Additionally, once the officer is in the system, everything else about the process – including weapons surrender – must be voluntary. PSOs don’t discuss their cases with anyone else, including other NYPD members, and no records enter the officers’ personnel files.

POPPA has been so successful that it’s broadened its outreach to cops’ families. “POPPA has attained a federal grant for the development and implementation of a program that would assist family members ... in dealing with the stress-related problems of being a police officer's family,” reads the POPPA website. “The family program consist[s] of information and educational workshops ... by teaching skills and techniques for identification and support of stress-related issues. Volunteer PSOs were utilized to facilitate family support groups in the ... counties where NYC police officers reside. The family program, in its one-year limited time span and resource availability, has clearly identified the need for an expanded effort toward the development of an ongoing family service.”

Because of the desire to expand POPPA’s services even while coping with the enormous amount of pressure 9/11 placed on it, POPPA has become a 501(c)(3) nonprofit organization that can accept private donations. “We’re a direct service, not a money management organization,” Genet says, stressing that without the volunteers, POPPA’s services wouldn’t be possible.

Who it is

POPPA's small regular staff comprises an executive director, a clinical director, an operations coordinator, and a secretary. Its PSOs, however, number 250. PSOs must undergo rigorous screening before being accepted. Little things count: for instance, says Genet, prospective volunteers aren’t solicited; they must call the office of their own accord, and stamp and address their own application envelopes. After the application process, three PSOs interview them and lead them through a “mini-orientation.” Follow-up interviews with other PSOs, mental health professionals, and POPPA’s executive staff evaluate the applicants’ sincerity. Above all, says Genet, they’re looking for a “true spirit of volunteerism” that will fit with POPPA’s lack of rank or assignment structure.

The PSOs are broadly diverse, and not only in terms of class and race. Two-year rookies and 35-year veterans apply; so do investigators and Emergency Services Unit members. Officers whom POPPA has helped become PSOs. (Genet says an officer who’s used POPPA services must be out of the program for one year before applying to return as a PSO.)

Training to become a peer supporter

The PSTI trains about fifty police officers per year to become PSOs, and Hirsh estimates there are now about 400 total PSOs in New York. A cornerstone of POPPA training is the textbook “Cop to Cop: A Peer Support Training Manual for Law Enforcement Officers,” written by Hirsh and his PSTI co-founders Drs. Rachelle Katz and Daniel Cohen. Now in its second edition, the manual covers peer support ethics, interpersonal communication, common problem areas in police officers’ lives, suicide prevention, stress management, how to make referrals, and how to develop a peer support program. Trainees receive many other materials, including pamphlets from professional associations and articles from relevant journals.

The training itself takes place over two weekends/nine days at a residential conference center; then trainees receive field training, and are required to meet once a month for five months. The first training sessions constitute an intensive retreat (Hirsh says the days comprise 9am to 9pm “marathon meetings”), requiring prospective PSOs to discuss deeply intimate personal details about their lives and their work. “In all the years we’ve been doing this, we have yet to see a group not walk out of there completely bonded,” says Hirsh.

The training isn’t so much conventional chalkboard teaching and learning as it is experiential, with the PSTI faculty in the role of facilitators rather than lecturers. Icebreakers, such as “Describe the most stressful event of your career,” begin the training; thereafter, role plays help trainees learn what it’s like to be a victim as well as a supporter. “Many people hate doing role plays,” says Hirsh, “but they later find it to be the one most valuable experience they needed in the field.” The trainers try to make the role plays as realistic as possible, drawing from their considerable experience counseling police officers over the years.

On the sixth training day, trainees are assigned a team and a mentor according to geographical location. The mentor takes the role of field training officer. PSOs must also have selected a “buddy” on the first day of training. Buddies are required to meet at least once a week during the first five months of training. “They’re critical to support each other,” says Hirsh.

After the initial training is complete, PSOs must meet as a group for refresher training on a quarterly or semiannual basis, allowing them to interact as a group as well as receive relevant information to their work. “Like any other skill, peer support needs to be practiced,” says Hirsh. “It’s important for the PSOs to have opportunities, whether real or role-played, to practice their skills.”

Critical incident response

“The last five years prepared POPPA for 9/11,” says Genet. In the beginning, he consciously decided not to pursue critical incident stress management (CISM) as a main POPPA objective “because every police department believed CISM was the answer,” even though CISM deals with the immediate – not long-term - effects of trauma. A year before 9/11, however, with extra budget money, he sent 120 PSOs to CISM training.

Directly affected by the attacks – POPPA’s main offices on Fulton Street were closed, and the staff had to relocate to temporary space in the Federal Reserve Bank on Maiden Lane - POPPA worked with CISM experts from the International Critical Incident Stress Foundation (ICISF) and peer counselors from other departments. Per week, two to three teams of three PSOs and one mental health professional each worked Ground Zero, utilizing ICISF’s three-phase CISM plan:

§ Demobilization. The peer counselors spoke one-on-one and in large groups to rescuers, introducing themselves and their mission through more than 75,000 informational brochures.
§ Defusing. Small groups of one to nine police officers were “defused” at POPPA’s stress reduction center in sessions of 45 to 90 minutes. According to the ICISF website, defusing is “provided ... for purposes of assessment, triaging, and acute symptom mitigation.”
§ Debriefing. Six weeks after the attacks, POPPA counselors began to discuss them with the officers. Debriefing is “designed to mitigate acute symptoms, assess the need for follow-up, and if possible provide a sense of post-crisis psychological closure.”

Despite its efforts, Genet says POPPA still missed many officers. “The timeline for post-traumatic stress disorder has run out,” he says, “and a lot of people now have it.” Thus POPPA has “reconvened” what it had been doing: healing wounds from what Genet calls the “invisible bullet” of terrorists. “You extract the bullet through a pinhole, then you repair the damage.”

Hirsh reflects that given recent controversy over the classic “Mitchell model” of CISM, using peer support’s “preventive maintenance” approach for post-9/11 trauma at this point is better overall for officers. “People have built-in emotional defenses that protect them from noxious emotional events,” he says. If CISM is introduced too late, it can interfere with and even harm the individual’s defense mechanisms. However, he notes, too many defense mechanisms can build over time, leading to problems like family issues. This is where peer support steps in, not as crisis intervention, but as crisis prevention.

Asking for help

How many officers has POPPA helped overall? Genet says that other than those 50 prevented suicides, it’s hard to tell. Prior to 9/11, the estimate was just 10 percent, or about four to five thousand members, of the total NYPD population. But at Ground Zero, peer counselors identified themselves by wearing jackets with “POPPA” embroidered on the backs; they also talked to a number of officers from both NYPD and other departments at Ground Zero, eventually reaching what Genet estimates was about 5,000 officers total.

Hirsh says the members of POPPA don’t try to educate NYPD members at large about what to expect, and not to expect from POPPA (for instance, ethics and professional boundaries prevent officers from using it to meet dates). Most important is advertising the service’s availability, and after that, its confidentiality. Beyond that, says Hirsh, the PSOs set the tone for contact.

Apart from 9/11, Genet points to the steadily increasing numbers of calls coming into the Help Line: from just 250 in 1996-97 to over 1800 in 2000-01 prior to 9/11. He says the help POPPA provides runs “contrary to the idea that cops don’t talk to anyone. They do talk if they trust you.” And POPPA, whose reputation has spread largely by word of mouth, is now trusted to help the officers handle a gamut of problems, including, in Mack’s words, “alcohol problems, depression, anxiety disorders, post-traumatic stress disorder, adjustment reactions due to divorce, past victim of child abuse, loss of a loved one, suicidal behavior. We see just about every disorder you could imagine.”

“That ten percent was enough intervention to prove our trustworthiness,” Genet says, adding, “We have to change the thinking in the culture. Asking for help is a strength, not a weakness.”
Mack adds his personal opinion: “[T]he formulation of a partnership between the NYPD and the POPPA program delivers a strong message to police men and women and to their families that ‘We care, the NYPD cares, and private citizens care about you.’ There is an alternative to suicide.”

Sidebar: Developing a peer support program in your agency

Hirsh notes that the NYPD is a unique agency because of its sheer size. “There are different types of peer support programs,” he says. “For instance, the programs in Calgary [Alberta, Canada] and Toronto [Ontario, Canada] are department-driven, but the PSOs are given a lot of autonomy.” The most critical element of a successful peer support program is confidentiality. “Some programs have been unsuccessful because the officers don’t have a sense of confidentiality,” he says. This includes the referral process, especially if the clinician is unattached to the agency.

Training doesn’t require the presence of professional clinicians. “It’s very straightforward,” says Hirsh. “A lot of material has been written about this.” (The IACP has information on how to start a peer support program on its website, http://www.theiacp.org/documents/index.cfm?fuseaction=document&document_id=168.) The clinician is critical, however, when it comes to referrals. “If you don’t have that backup for mental health issues, then there’s not much point in having a program.”

Another issue is funding. In New York City, POPPA’s funding came through the city council, but smaller agencies may not find support from town or county governments right away. Officers trying to start a program may seek corporate donations, or even a mutual aid or regionalization agreement with other agencies. “There’s an initial training cost, and the cost of having some officers go away for training,” says Hirsh. “After that, there really isn’t any cost. The PSOs are all volunteers, working on their own time instead of taking time away from patrol. They use public places like diners instead of needing offices.

“Ultimately, it comes down to a cost/benefit ratio. If one person isn’t calling in sick because of stress, that adds up to big savings.”

Uniformed NYPD members who need assistance should call POPPA’s 24-hour confidential Help Line at 1-888-COPS-COP (888-267-7267).
Other POPPA information is available through its offices at:
POPPA Inc.
26 Broadway, Suite 1640
New York, NY 10004-1898
Tel: (917) 464-0190
Fax: (212) 233-0548
http://www.poppainc.com

Information about the Peer Support Training Institute is available at:
(212) 477-8050
Email: info@peersupport.com
http://www.peersupport.com/