When Stress Gets Severe, Police Turn to POPPA

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>.▪