On a typical weekday morning, when most of his colleagues are just cracking open their briefcases, San Francisco Police Captain Alan Benner, PhD, has been in and out of his office, made a dozen phone calls, and is close to the bottom of his jumbo cup of coffee.

Today, as usual, fueled with caffeine, speaking swiftly and with descriptive gestures, he barrels down the corridors of San Francisco's Hall of Justice, dodging lawyers and defendants heading to court, and tossing off brisk greetings to assistant district attorneys, police officers and city officials who wave as he hurries by.

But then, quite abruptly, Benner comes to a stop. He stands solemnly at a marble plaque mounted on the wall of the Hall of Justice lobby. He slowly traces his fingers down the list of police officers killed in the line of duty, warmly recalling how he knew each of the officers killed since 1965--the year he became a San Francisco police officer.

When he reaches the last name, his smile about fond memories disappears.

"In the last 10 years, only one officer was killed in the line of duty," he says, "but six officers took their own lives."

As director of police psychology at the San Francisco Police Department, Benner battles numbers like these, and unfortunately, suicides aren't uncommon. Studies show that police officers are 3 to 8 times more likely to die by suicide than by homicide.

But the same factors behind the officer suicide rate--nonstop exposure to violence and human misery, the promotional process, shift work and a lack of control over their job--account also for substance abuse, illness or severe emotional problems that lead to officers leaving the force.

With his unique, dual career background, Benner helps the 2,200 officers in San Francisco stay on the force by showing them how to cope with their stress, and by ensuring they receive quality mental health services. In the last five years, he has converted an arm of the department's human resources branch into the Behavioral Science Unit (BSU) and stocked it with resources for officers that include a chaplaincy program, grief support workshops and a peer-support program where officers help each other cope with stress.

Through his efforts, referrals of San Francisco officers to mental health professionals are increasing so rapidly that Benner's unit is expanding its referral list to meet the high demand. And 35 officers who were in serious danger of leaving the force because of problems with substance abuse or stress, got the help they needed to remain on the job.

His approach serves as a model for other law enforcement agencies, perhaps because, unlike with most other police psychologists, Benner's years of carrying a badge and gun are as much a credential in the eyes of his colleagues as his doctoral degree.

"Many officers are uncomfortable talking to someone they perceive doesn't know where they're coming from," says Sgt. Frank McKee, a physical tactics instructor at the city's police academy. "But Al has had real life experience. Officers will seek him out for help."

Benner, former chair of the police and public safety section of Div. 18 (Psychologists in Public Service), has been an officer for more than 34 years, earning his PhD in clinical psychology eight years ago while serving on the force. In fact, Benner is one of only 10 officers in the United States with this unique combination of skills--colleagues he refers to as "cop docs."

Benner has worked in the tactical unit and on the mounted patrol and has been a hostage negotiator. He's suffered marital problems, fear and anxiety as a result of his experiences. So when officers say they can't forget a shooting incident or won't let their child out of their sight after working a youth homicide, Benner understands why. So does his second in command, Sgt. Forest Fulton, PhD, also a psychologist and 26-year veteran of the force, who once killed a gunman while on duty.

"Police have a code of silence," says Leon Leow, an officer in San Francisco's Chinatown district. "But Al and Forest are breaking through that here."

Peer support

Last January, Benner's and Fulton's counseling skills were in demand following a robbery at a branch of San Francisco's Bank of America. Two officers were wounded, a bank customer was shot in the face by the suspected robber, and a police captain died in a car crash leaving the site several hours later. Suspecting that the two wounded officers would be feeling frustrated and angry, and that many in the department would be stunned by the death of the captain, Benner and Fulton began counseling officers involved with the incident, along with their families and even police dispatchers.

Several days after the incident they brought all the officers together to discuss the robbery. The two wounded officers learned, during the dialogue, that their wounds were caused by the suspect firing at them, and not by "friendly fire" from other officers as they had feared. Knowing that helped them cope with the incident, says Benner. In addition, many in the department had a chance to eulogize the dead captain, he adds. Benner still checks in with each of the officers involved.

Most times, though, identifying which officers may need mental health services isn't as simple. Some may have problems with anger, stress or substance abuse that they are reluctant to disclose out of fear of suspension or receiving a desk assignment.

However, says Benner, "cops trust other cops," which is why the peer-support program he started plays an important role in the tight-knit police community. Benner and his colleague Sgt. Vicki Quinn have trained more than 400 San Francisco officers--including the chief of police--in skills such as active listening and problem-solving, so they can serve as an outlet for officers feeling stressed about an upcoming lieutenant's exam, abusing drugs or alcohol or having marital problems. The peer-support program also provides backup for Benner, who cannot communicate daily with all 2,200 officers. Each district station posts the names of officers trained in peer support so officers can contact them in confidence, he says.

"To do our job as police officers, we're trained to suppress our feelings," says Quinn, who has a master's degree in counseling. "But the goal of peer support is to change the atmosphere and encourage people to open up."

Benner collects data on how many interactions occur, the types of problems discussed and referrals to mental health professionals. Last year, there were more than 6,000 peer-support contacts, says Benner, twice the amount reported the year before. The most frequent problems discussed are promotion anxiety, overall job stress and relationships, he says.

Because peer support was so effective--leading to several success stories including the rehabilitation of an officer who attempted suicide following a near-death experience with a gunman--Benner developed a similar program known as the Critical Incident Response Team (CIRT). He and Quinn train officers in post-trauma support so they can assist other officers involved with a traumatic incident such as a fatal shooting or a severe car accident.

Recently, when officers and firefighters were shaken up by a call involving an infant who had died from sudden infant death syndrome, a CIRT team went immediately to the site to talk to them about feelings of shock and grief.

Because of the program, more officers are realizing that the stress of their work affects them and are seeking help more quickly, says deputy chief of police William Welch. In addition, the inexpensively run program saves the department $100,000--the cost of training a new police officer--each time an officer stays on the force instead of leaving for stress-related reasons, he says.

But cost-effectiveness isn't the program's real value, adds Welch. "As a career officer, I understand the stress that comes with this job," he says. "Whatever the program cost would be worth it."

Understanding the culture

The success of both programs is leading to more referrals to mental health professionals outside the department, says Benner, though, he argues, not all psychologists can work effectively with police officers. He has seen officers who abandoned therapy because they felt their therapist didn't understand police work, and even one case where the therapist was afraid of police officers. Benner believes that mental health professionals who treat officers should be trained by officers about the challenges of law enforcement.

So Benner is doing just that--developing a team of mental health professionals in the San Francisco area with expertise in law enforcement. Several times a year, he and Fulton put 15 to 20 psychologists through a rigorous training program that includes ride-alongs with officers, a firearms training exercise, a crisis-response team simulation, a lesson in incident-report writing and a visit to communications and dispatch. Officers in the crisis-response program and psychologists who have completed the workshop assist with the training.

"The training really synthesizes what the officers are dealing with when they come into your office," says Angela Hasty, PhD, a psychologist with California's department of mental health who recently attended the workshop. "I cannot imagine anybody trying to work with officers who haven't had this type of training," says Hasty, who has several Detroit officers in her family. "You have to walk in their shoes first to have a frame of reference."

Once psychologists like Hasty are trained, they become part of the network of mental health professionals to whom Benner, Fulton and peer support members refer officers who need counseling.

Benner is also working to help officers outside of his department. He is developing a web site that will be a resource for other psychologists who are police officers, and is working with Saybrook Graduate School and Research Center--where Benner earned his doctorate--to launch a distance-learning doctoral program that will train police officers as psychologists. In addition, he and Fulton are helping several other police departments transplant the Behavioral Science Unit model.

Despite his hectic pace, before leaving the courthouse Benner makes time to visit an officer preparing to testify in a case where the female passenger in a car driven by a suspect who was attempting to run him over, was shot. The officer will likely undergo a tough cross-examination by the defense attorney, says Benner. Several members of peer support and the crisis-response team are there to offer moral support to the officer as well, at Benner's suggestion.

Overall, Benner wants officers to know the department cares about their well-being.

"I can't take the stress and anxiety away from the job," he says. "But our unit can provide an outlet."