We are learning about the stress and emotional pain felt by police officers as a result of cumulative exposure to trauma like fatal accidents, shootings, child abuse, and more. The peer support system across the country can provide solace to a brother or sister in crisis when available. “People absolutely find common ground in both trauma and the journey of healing” according to @JoeSmarro, a CIT trainer in San Antonio who recently provided a TED talk on the subject of LEO well-being. Cases are referred to peer support from San Antonio Police Department police psychologist Melissa Graham, Ph.D. They will get notified of a situation and she will send out a vague email to the group, providing only situation type details but no personal information. Once someone agrees to accept the case, she will then provide them with the officers information and further specifics. This is one of the approaches that make it easier to transition the officer to professional services because the specialists already know the facts of the case to some degree. This also doesn’t mean we will automatically refer the officer to the department psychologist, most prefer to seek therapist outside of the department (paranoia, fear, disbelief of actual confidentiality, etc.) according to Smarro, a peer support and member of the SAPD Mental Health Unit whom I visited with in February 2017. Officer Smarro and his partner @erneststevens appeared in the @HBODocs film Ernie and Joe: Crisis Cops, directed by Jenifer McSheery in 2019. The film has been widely acclaimed as the national model for LEO-mental health interaction.  Another way people utilize peer support services is self-reporting. People will simply ask for help on their own behalf. There is not a formal tracking system of officers who have been referred to or have utilized peer support services. One of the benefits of peer support existing is the help it affords officers without all the formal reporting, note taking, and documentation. Brothers and sisters helping each other – now once it exceeds the scope of PS, then yes everything is tracked. When it comes to disciplinary action, depending on what the issues are / were, they (Chief’s Office) has allowed us to provide treatment options in lieu of punishment, again, depends on the circumstances. This has not returned great results because when people are “caught” and haveoptions of treatment or punishment, they will most always choose treatment.  The problem with this is the officer has yet to accept they have a problem,whatever it may be. So they try and go through the motions, checking boxes, and end up getting in trouble again soon after they return to duty. Where we have seen best results is from the officers who reach out on their own asking for help. Whether they are suicidal, or abusing alcohol or pills they get to a place of asking us for help and  we are able to get them back to work and thriving. We have sent numerous officers away to Warriors Heart for a 42day inpatient stay and they come back to work completely in a different place, in a good way. “In my experience, the transition from providing peer support to a referral for licensed – professional services comes down to a few factors. First let me explain how the beginning of this type of interaction would take place. If we are operating under a peer support function we start with a clear disclaimer: “Understand everything you tell me will be kept confidential up until the point you tell me if you are suicidal, homicidal or if you tell me you are committing crimes.” The normal role of peer support is just a safe, relatable ear – as you know. We take a different role as the mental health unit. I don’t mean to be long in this response but content matters” according to Joe Smarro in a phone conversation.  Now, once the officer receiving peer support services requires more than the peer is able to provide, a referral may be necessary. Again, in my experience this transition usually takes place with cooperation after further explanation. If done appropriately it should be a smooth hand-off.  The benefits of talking to a licensed professional are in further protection for the officer, extended confidentiality. I don’t communicate that as a bad thing, rather it is something good for the officer, and I can provide the “been there done that,” for further credibility. I have never seen or heard of anyone experiencing feelings of abandonment when being passed from a peer support onto a therapist / doctor. In my opinion, if feelings of abandonment are surfacing, then there is a good chance there were some feelings of attachment going on – which also isn’t healthy. Boundaries are important. Training and on-going training is important. If I have an officer wanting to schedule weekly meetings with me, I will refer them onto professional services. One or two chats about a topic is normal, but once it becomes a scheduled routine, I think its safe to assume it needs to be passed on to the next level of screened out.