Psychiatr News September 1, 2006
Volume 41, Number 17, page 21
© 2006 American Psychiatric Association
When Stress Gets Severe, Police Turn to POPPA
Eve Bender
A peer-counseling program succeeds in helping New York City police deal
with stress and mental health problems by providing easy access to
confidential and supportive assistance.
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Bill Genet, the founder and director of Police Organization Providing Peer Assistance. Steve Dell/Dell Graphics
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Each day, about 40,000 men and women working for the New York Police
Department (NYPD) help save countless lives.
Sometimes, however, they are the ones who need to be saved.
While in the line of duty, they may be called to the scene of a fatal car
accident or a grisly crime or find themselves dodging an assailant's
bullets.
When New York City's finest are over-whelmed by the stress associated with
their work or are experiencing personal problems, they can turn to POPPA.
The Police Organization Providing Peer Assistance (POPPA) is an independent
agency that works in conjunction with the NYPD to help police cope with their
distress and find mental health treatment when necessary.
The program uses a cadre of volunteer officers who are trained to counsel
their peers and guide them to a panel of mental health professionals who are
also trained to work with police.
POPPA founder and director Bill Genet created the program in 1996 in
response to 26 NYPD suicides that occurred in 1995 and 1996. It is a 501(c)3
organization and relies largely on funding from donations and corporate
support.
POPPA's headquarters is located at 26 Broadway in lower Manhattan in space
donated by Koeppel Companies L.L.C., a real estate investment and management
firm. There, POPPA staff administer its programs, train volunteers, and
coordinate client services.
Genet worked for 33 years as a police officer with the NYPD, but it was his
long-standing position as trustee of the Patrolmen's Benevolent Association
that opened his eyes to the emotional difficulties experienced by his fellow
officers and the need for an independent organization through which officers
could find support without worrying about whether they were jeopardizing their
careers by doing so.
He also recognized that many police are reluctant to seek professional help
and so contracted with a counseling and psychotherapy group to train 25 police
to become peer support officers (PSOs).
The nerve center of the POPPA program is the 24-hour helpline, which can be
reached by dialing (888) COPS-COP.
The thrust of the program is preventative, Genet told Psychiatric
News. "The idea from the beginning was to aid these officers before
they reached crisis and destroyed their jobs, families, and other aspects of
their lives."
Call volume has increased since the program began, and in recent years,
about 800 officers have called the help line annually.
Police Linked to Professional Help
When an officer in distress calls, he or she is asked to leave a name and
number on a digital answering service. Two PSOs, one primary and one
secondary, receive a page with this information, and the primary PSO returns
the call. In case the primary PSO is unable to return the call, the secondary
PSO assumes this duty.
The PSO speaks to the caller and tries to determine the nature of his or
her problem. Within a day, the PSO meets with the officer in a public
place—usually a car, coffee shop, or diner—to listen supportively
and screen the officer for major safety risks, including suicidal or homicidal
ideation, alcohol abuse, or risk of violence.
The 150 or so PSOs working with POPPA have received training on spotting
signs and symptoms of mental health problems, such as depression, anxiety, and
posttraumatic stress disorder, and knowing when to refer their peers to a
trained mental health professional.
The PSOs refer about 40 percent of the callers to a panel of mental health
professionals who have been trained by POPPA staff. Many callers do not need
professional help, while others may be identified as needing professional help
but are not given a referral because they've made it clear they will not
follow up.
The training of clinicians "is more of an indoctrination into police
culture," Genet said.
Less than 5 percent of the calls are what Genet refers to as
"critical cases"—officers who pose a risk to themselves or
others. These officers are usually hospitalized until they are more
stable.
Interactive Style Best
Psychiatrist and POPPA medical adviser Frank Dowling, M.D., grew up in a
family of police officers, firefighters, and bricklayers in what he described
to Psychiatric News as "a typical Brooklyn Irish and Italian
family."
As medical adviser, Dowling helps to train PSOs about mental health issues
and POPPA clinicians about how to work effectively with the police officers.
Sometimes he sees the officers in distress if a POPPA clinician can't see them
soon enough "to bridge the gap," he said.
Educating POPPA clinicians involves giving them the dos and don'ts of
working with police.
"Police will be more receptive to clinicians who are expressive or
interactive" he noted, which indicates to officers that they are being
heard and understood. He advises them to speak to their police clients
"intelligently but in plain English" and to avoid using mental
health jargon.
When Dowling informs clinicians that "police are the most
psychologically minded individuals you will ever meet," he is sometimes
met by blank stares, he said.
"What do police do all day long?" Dowling asks them.
"They are listening and watching," whether observing the community
or reading the body language of a crime suspect.
Police clients need only to turn that acute level of observation
inward—though not always an easy task, he acknowledged— and they
make great strides in the therapeutic setting.
'Psychological Battering Ram'
The average police officer is exposed to some type of traumatic event
multiple times over the course of his or her career, Dowling noted, including
"injuries and deaths from drive-by shootings, pulling bodies out of cars
mangled in collisions, and dealing with victims of rape, child abuse, and
assault."
"This job is like a psychological battering ram," he
declared.
Each traumatic event can have a cumulative effect on officers' mental
health, he noted, and one incident may be "the proverbial straw that
broke the camel's back."
Dowling also observed that police are typically extremely resilient people
but tend to cope with traumatic issues in solitude.
"In police culture, the thinking is, `We're strong and our job is to
protect others. We take care of everyone else.'" They tend to view their
mental health problems as weaknesses or even "a betrayal of other police
officers," Dowling said.
Genet noted, "It's their job to make the public feel safe. So if they
break, they feel as if they are not doing their jobs."
In addition, officers may be reluctant to seek help for mental health
problems because of their experiences on the job.
Dowling said, "Many have brought psychotic and agitated people to the
psychiatric emergency room and think, `This is not my world.'"
One of POPPA's long-term goals is to persuade officers that seeking help
for mental health problems is not a deficiency and that recognizing such
problems and reaching out to others are signs of strength.
One of the reasons POPPA works, Genet said, is because the PSOs assure the
officers who contact POPPA that disclosures about mental health problems will
not get back to their supervisors or jeopardize their careers. The assurance
of confidentiality is of utmost importance to the officers, Genet
observed.
The vast majority of officers who are referred to a mental health
professional stay on the job, Genet said.
About 10 percent of the officers require time off to deal with their mental
health problems. This is known as "blue-line sick" time, and no
one at the NYPD is told the reason for the absence other than they are out
sick with POPPA.
Almost all of the officers who take blueline sick leave return to their
full-time duties, noted Dowling. Returning officers to work is a goal of the
program.
According to POPPA Clinical Director Gene Moynihan, L.C.S.W., nearly 70
officers have told him they would have committed suicide if it were not for
POPPA—they remembered seeing one of the POPPA posters or hearing PSOs
and mental health professionals talk about the program at their precincts.
The program has gained recognition through POPPA's outreach efforts,
Moynihan said. For about five years, outreach teams composed of two PSOs and a
mental health clinician have been traveling to different precincts to talk to
the officers about POPPA after roll call.
"They talk about the confidentiality of the program and how it
works," he said. Actors Michael Douglas and Danny Aiello have also
appeared in PSAs for the program.
Moynihan served as a police officer for 20 years. He was involved in a
number of shooting incidents that left him with symptoms of PTSD, but he
didn't seek help until he had retired from the force and entered a social work
program.
"Even though being a cop was my job and I functioned well, I didn't
understand what was going on inside me," he said. This is not uncommon,
he added. "There are walking wounded all over the NYPD right
now."
POPPA won APA's Silver Achievement Award in 2005 in recognition of
its success in encouraging NYPD officers to seek help for mental health
problems. More information about POPPA is posted at
<www.poppainc.com>.
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