Cop Docs

One psychologist knows the terror and traumaof police work firsthand: He's also a cop.

The smoke from the shooting was still drifting through the intersection as my police car slid to a stop at the crime scene. The perpetrator, Ron, was a cop. He had already confirmed that the suspect was dead and was absentmindedly holstering his weapon, staring blankly into space. This was yet another fatal shooting in a string of shootings already being scrutinized by the media and activist groups. Ron knew that regardless of his legal and tactical justifications, things were going to get ugly again. As the department psychologist, I knew he was right.

I bought Ron something to eat to get his blood sugar up and had him call home to his family to let them know he was all right, but that they might see something on the evening news. The meal also gave Ron an opportunity to compose himself for the upcoming interrogations. We briefly explored ways to deal with the impending negative media coverage. Understandably, Ron was upset about having to kill the suspect. He was moderately anxious, but still fully functional.

Law enforcement officers are more stringently screened than people in any other occupation. Officers tend to be mentally stable and resilient. This allows them to absorb emotional blows, function during times of crisis, recover and go on. But that doesn't mean that they don't suffer psychological damage. Many officers pay a heavy price for trying to serve and protect. They can become depressed, lonely and suicidal. The job can erode one's soul.

Cops and deputies see a lot of death. The San Francisco City-County Medical Examiners Office reported 7,188 deaths for fiscal year 1998-1999; there were 7,051 in fiscal year 1997-1998, and around 1,700 of these are brought into the coroner's office for police investigation, so everyone sees a number of death cases a year. In the study I did for my doctoral dissertation, I asked officers in San Francisco how many times they had responded to a variety of cases. The mean estimated number of death cases for each officer was 4.5 per year. Following are the officer estimates of the types and number of cases they responded to in a 10-year period: homicide [14]; child abuse [28]; domestic violence [127]; death [45]; resisting arrest [45]; assaults upon a police officer [25]; drunk driving [58]; and family disturbance [452]. Ninety-one percent said they had been injured to the extent that they could not work.

Counseling police in trauma, like Ron, is part of my job. I've worked in crisis intervention and stress training for over 20 years. I am a licensed clinical psychologist. But l have a distinct advantage over other psychologists working with the police: I am also a cop. I've been in the San Francisco police department for over 50 years. The majority of my experience is in uniformed patrol. My familiarity with law enforcement and being part of the police subculture affords me a degree of credibility and access unavailable to almost all civilian psychologists, allowing me to help my fellow officers in ways that other psychologists can't. This involves not only understanding the mental health crisis cops face on the job, but implementing programs like peer support and making it easier for them to get health insurance.

Fighting Crime--and Burnout

There had been a time when I preferred patrol assignments to those involving psychology. I can remember the day and events that changed my mind.

Blood is bright red when it's fresh. There was a pool of it at my feet that Easter Sunday morning. It was coming from the back of a dead woman's head, filling the cracks in the sidewalk with a bronze sludge as it dried. Another woman had shot the victim during a drug deal gone bad. We were in the courtyard of the old Alemany Projects in San Francisco's Mission District. A female relative of the dead woman was wailing and trying to cradle the victim in her arms. The dead woman was bigger than her relative, however, and, being limp, was too heavy to be cradled. She would flop out of her relative's grasp and bounce back against the sidewalk. I knew from bitter experience that it would incite the crowd to separate the relative and victim forcibly, so the grotesque grasping, fumbling and flopping became bloodier and bloodier.

It was over a half-hour before the coroner arrived, and by then, the relative was finally willing to give up the body. By the time we beat our way into the suspect's locked apartment, we knew she was long gone. I remember leaving the apartment and realizing my shoes were wet from urine on the stairs. Walking out into the bright sunshine, I felt tired and sad.

Being a cop for over 28 years, mostly working uniformed patrol in San Francisco, had been a wonderful experience. Even so, I was feeling down. I know when I'm getting emotionally overloaded. I tear up over commercials for Hallmark greeting cards; it's the damn-dest thing. That Easter Sunday I felt, for the first time, that I didn't want to see and feel what I had that morning ever again. I had seen much worse. I had had someone die in my arms. But my ugly quotient had been reached. I was your typical burnt-out cop.

Little did I know that there were big changes ahead for me. I was chosen to be the San Francisco Police Department's first police psychologist and, subsequently, its first director of police psychology in charge of creating our Behavioral Science unit. I became one of the country's dozen of what I call "cop docs"--career law enforcement officers who are also psychologists. I had been bugging the police chief for years to expand our employee assistance program and get better mental health benefits for our officers. He decided he had just the guy to do it: me.

My goal was to fix the organizational defects most responsible for disciplinary problems on the force, namely low psychological screening standards and the elimination of probationary officers' performance evaluations. This allowed us to focus our energies on the real need: better mental health services for officers and their families.

General police psychology is like a three-legged milking stool with one short leg. The function of the first leg is the psychological screening of new applicants; 60% of all agencies do this. The second function is to conduct psychological "fitness for duty" evaluations of incumbent officers; no one wants emotionally unstable cops running around with guns. The third function of the third leg--the shortest but perhaps the most important one--is to provide personal psychological services to officers and their families. The necessity to, first, protect the public from unstable officers, and, second, to protect the agency from legal liability puts the care and protection of the officers' emotional issues a distant third. Cops and deputies understand this and tend to go without treatment.

Most people don't realize that frustration and a sense of futility are major parts of any law enforcement job. In order to be competent at their jobs, cops, construct thick psychological defenses, suppressing and denying their emotions. Normal, garden-variety emotions must be held in check, lest they get in the way. Fear cannot be entertained until a run is concluded. Anger can derail the best of game plans, lead to unnecessary use of force, cause citizen complaints and administrative discipline. Officers have to resist their natural revulsion to what they see and must do. Empathy must be held back too, since it can divert too much energy from apprehending suspects and restoring order. Developing gallows humor helps in this process. Through exaggeration and irreverence, they break the connection between a terrifying stimulus and an unwanted emotional response.

These tactics work very well on the job, but their usage becomes automatic and unconscious, causing problems in private life. Soon, nothing is sacred. No working street cop, detective, crime scene investigator or emergency worker can function effectively without denial, suppression and black humor. Unfortunately, what works so well on the job can adversely effect communications with loved ones. Emotional issues are commonplace in relationships. Hiding normal feelings means not recognizing them when they arise and not talking about them. Avoiding, dismissing or laughing them off on a consistent basis means that many important issues go unresolved. Over time, problems with relationships and with handling one's own emotional load are almost inevitable. Thus, it is imperative that cops get the psychological assistance they need. Most law enforcement agencies have a selection of health plans that their employees are required to select from. Each of these include a mental health component of hospitalization and outpatient services. However, officers tend to dislike the outpatient counseling services available. Obtaining an appointment takes too long and officers change their minds and don't go. Furthermore, there are few therapists out there that are knowledgeable about cops.

Fortunately, law enforcement is getting involved in its own emotional wellness. More and more administrators are realizing that if it's practical to have a maintenance budget for their radio cars, then it's practical to budget for maintenance of the officers who drive those cars. Agencies are increasingly embracing peer support programs, critical incident response teams and, in the case of the San Francisco Police Department, outpatient mental health insurance as a departmentally budgeted item.

"Mental Backup, Stat"

The peer support program was started in 1982 in the Los Angeles Police Department. The San Francisco Police Department implemented the peer support program next, and it has been a tremendous success. We have approximately 220 active members who volunteer their time to fellow cops. Now, around 50% of California police departments have a peer support program of some sort, as do most large U.S. police departments.

Peer support is a process whereby a person discusses a personal issue with a non-professional, usually a friend or coworker. The peer support volunteer uses good active listening skills, helps to clarify issues and supports the problem solving process without passing judgment and while maintaining confidentiality. The goal is to deal with common life problems--from stress and depression to relationship problems and substance abuse--early enough to prevent them from becoming crises. We have found that most of the issues divide fairly equally between job-related problems and personal ones, but relationship problems are the most common. Peer support members actively recruit mental health professionals that they find in the community who are interested in working with police officers. After extensive interaction and training, these mental health professionals then become referral resources for the peer support program.

Another key element of helping cops is outpatient mental health insurance. However, it is unavailable to most police and public safety personnel because most departments are too small, individually, to afford it. I believe there is a two-part solution to the problem. First, a new aggregate purchasing and service company (911People.com) has been launched to provide emergency personnel with collective purchasing access to everything from computers to an array of insurance coverage. The company will recruit mental health professionals to work with public safety personnel and to receive training approved by the American Psychological Association. This will be a national replication of what I developed three years ago in San Francisco. The second part of the solution is to "grow" more cop docs, fire docs, EMT docs, etc. To build a police and public safety psychology specialty requires a formal educational process. Towards that end, I have joined the faculty of the San Francisco based Saybrook Graduate School and Research Institute. Saybrook offers an external degree program that allows adults to obtain an accredited Ph.D. while still working.

Remember Ron, the cop forced to shoot a suspect in the line of duty? I checked in with Ron consistently during the aftermath of the shooting. Things sorted themselves out, and Ron is doing fine. Still, not all such situations turn out so well. Ron was lucky to have the resources he needed to get back on his feet and resume his job of protecting the people ,of San Francisco. Growing cop docs, getting cops the insurance they need and simply understanding the problems they hide beneath their tough defenses will ensure that we don't lose officers like Ron. We can't afford to lose them.

PHOTO (COLOR): PHOTO (COLOR): The streetside apprehension and handcuffing of a criminal may seem exhilarating, but the police officers involved can be as traumatized and anxious as the perpetrators they're arresting.

Adapted by Ph.D.

Alan Benner, Ph.D., a psychologist and police captain, recently retired from the San Francisco Police Department. He resides in California and continues to consult for police departments. For more detail on the topics covered here, visit www.copdocs.com.