practices. we are concerned about hearing about the issues that officers are dealing with. i think it is time for the public to know a little bit more than is in your initial presentation. you came up with some recommendations. i will turn it over to you. i would like to discuss this with the city this afternoon. >> good evening, commissioners. we did have a nice discussion about follow-up from the last presentation. we came up with some very important proposed action items. if you have any questions about any of them, please feel free to ask. if you want me to read them aloud or speak on each one. one of the items that we proposed, we are in the process of sending the proposals through.

that is in the process of being signed off. it allows some of the commission's we are dealing with to be involved in the debriefing process of officer involved shootings. we want to make sure that there is further follow-up so that they do not slip through the cracks. they do not fall into that place of discipline that you are seeing. we want our officers to return to work full duty and not fall into discipline. aside from being involved in the debriefing process, do what is called a critical check in with our officers immediately following the shooting within that 10-day investigative period. we will have another check and at the four-week mark. according to posttraumatic

stress disorder, the four-week mark is when a disorder would set in. it is to see whether they have clear ted that hoop of intrusive results from the trauma. it will be mandatory and not be different for each person. this is something that they would have to do and have to attend. it would not be punitive or fall into any fitness for duty. it would get them through the psychological services. we could follow through with them after critical incidents. since they do not fall into that place of discipline. >> at this point in time, there is only one mandatory visit

until we discussed the items. i know that you and the officer that is with us give us the timeline for that meeting. there was some chatter about our police officers being different. when they go to counseling, it is more a of a cognitive approach. we discussed this with a former member of the san francisco police department that teaches at a community college. police officers are problem solvers. they do not do well when they are called in to solve their problems. >> the police culture will not ask for help until they are in crisis. using something like their family or their job. making it mandatory, i do not believe it should only be mandatory for shooting

incidents. most critical incidents are critical in themselves. having a mandatory check in process makes it less of a stigma. it is a wellness check for officers. this could be a consistent process that you would be on board doing. they could get that up and running and get through that critical incident in a healthy way. >> how about the second item? >> advancing the officers to three hours instead of two. we find that we have enough time with the two-hour block. we are doing a lot more

presentations from volunteers. we have a person talking about his son, who was an officer. it was very moving for the officers. it was a very moving real-life story. we also do a scenario components so that the officers can talk about problem-solving among their peers. and what somebody in crisis may look like. you know what that looks like in the public. what does it look like when one of your peers is in crisis? how do we get them help so that it is from the ground up? >> my job is to know how to do it right there and then. they can start right when that crisis is in front of them.

they can educate them about what is available to them and their family members and their loved ones. >> you like to increase that to the audio-hour block to a three- hour block? >> there are so many issues that we could cover. we are focusing on crisis management or stress management. a little bit of suicide and depression. it is mostly about the resources. it would be easier to focus on some of those bigger issues and give them more information. that would help them to problem solve when they're confronted with it. in regard to the general rule 1111 which is our intervention policy are brown substance abuse and on alcoholism. i

maybe adding some language around anger management or behavioral management. it is specific toward alcohol and substance abuse. if we can figure out working and talking the language to include behavioral management, we have officers who have come across issues with anger management that come across or desk for disciplinary issues and our center was to get hooked into some of our clinicians to go through anger management programs, which we do. there are other issues about conduct unbecoming or gambling issues or sexual addiction or certain issues that do need intervention that they may be getting in trouble for. we need to stretch the language a little bit to include some of the other issues and not just alcohol and substance specific. it is a same process. we can get them put van to the get them plugged in.

we are a conduit for that. what is great is this agency does not keekick people to the curb. they realize there is an underlying problem. having us get involved earlier than later to make sure these officers can deal with that underlying problem so they do not end up getting in trouble. they do not end up getting fired or disciplined or retiring to sen. just to be involved earlier on most of the matter is treated we have somewhat of a connection to the command staff around when officers are in trouble. i do not need to know the details because of confidentiality. we want to know if we can offer help sooner. and plug them into the system center. >> we have done several dispositions. we have recommended the 1111 program. that is perfect.

>> i do what you to finish -- what you to finish. other than no. 4 on here, what is the required commission action -- what ones require commission action? >> none of them. >> that is the clarity for me. thank you. >> we are looking at instructing a block specific to suicide and addressing it because it is a real issue. during the specific course for officers, i do not know if we can mandate it. it would be great if we could mandate that. specific to post-trauma stress

and depression. that would be valuable if we could get everyone trained. also, presenting to command staff on all the resources. currently we have training that includes officers and sergeants. i think the command staff and the lieutenants and above do not get all the information they deserve. i am not sure if they know what is out there for them. they too can use it. it will be helpful to hand out a referral or let them know what is available. i think they deserve to hear it, too. so they do not get all that. all the goodies. >> you talked about this yesterday. we have had a conversation with the chief about these issues. the lieutenant and the rank of lieutenant above do not go to advanced officers training. the higher ranking officers or

commissioned officers are not getting this training. we taught -- talk to the chief about that, that will change. that is a great recommendation. and find out more. >> looking for some help. that would allow me to do more teaching. i want to do more construction and educating. this is such a necessity to educate. putting together classes around suicide is important. stretching out the officer's training and we also do the peer counseling training at the economy. and being able to do family- partner training where officers can bring in family members and partner so we can give them an overview of what to expect and how they are transitioning from civilian to cop and some of the things, the stressors they may

encounter coming into this. >> i appreciate that. one of the things you provide that goes to most of the officers -- emotional survival for law enforcement. it is a very interesting read. a lot of the officers have read it. it explains things, the evolution of a police officer when they join a police department, energetic, excited, ready to do things and changes happen. a lot of it is based on their training. how they handle other people. it is an incredible book. the commissioner has a copy. more training on this is incredible. it is very helpful. it talks about things do not even see or realize. they give simple examples and show a police officer and the officer tells you what they see.

the mental health of our officers is important. there are some great recommendations. >> this could be something that could be given out to the records on their first day at the academy. >> you -- this book would be something that each record could get. something they could offer with their family and learn together in the beginning. so they have something they know if changes occur, there is reasons for these changes. so they're not in such shocks sshocked when they find out things are changing. we also had the author, and give a presentation last year. he only was able to do a four- hour block.

he usually does and eight-hour block. we would love to have him come back. to do something for the entire department on an eight-hour block once or twice a year, something like that. we have phenomenal responses from it. >> something came up that i wanted to call attention. if you get a great explanation of the emotional responses the officer goes through after a critical incident, where sometimes -- when questions are answered, they are inaccurate. >> after an incident, what has happened is if you are exposed -- a dramatic event is considered anything that is exposure to horror, terror, or fear. it is one of those fighter flight incidents. noradrenaline forces your body

to still live or die. because of that adrenaline floods three system, it sort of disrupts all the perceptions. what makes it difficult or what i hear in debriefings when i hear the critical incident debriefings after shootings, the officers will say that there will come across different perceptions of the incident. i felt like i only shot twice or heard two bullets go off. so there is a physiological reaction to the stress that causes your perception to become diffused and disoriented. when you get that education, it normalizes what they are going through. and they may have sleep disturbances are flashbacks of the incident, or become hyper vigilant after witnessing something so horrific or being involved in someone -- where someone lost their lives. it is not necessarily the incident because they were able to take action. it becomes black and white. the incident is over. but then the hard part for the officers is the aftermath.

it is usually the administrative issues that popup that become -- force them to second-guess their performance or what they should or could have done better. or they are not sleeping or they're getting in fights with their families because they have mood swings. what my job is is to normalize those reactions and make sure that the understand they are normal. the problems they come in contact with when they're interviewed by homicide is the field interrogated by their own people. homicide is doing the job and they do it consistently as they're supposed to. the feeling they get is they keep asking the same questions, something must be wrong with me. i must be answering a wrong. part of the dramatic response for some could be psychogenic and asia. pieces are missing and her brain takes awhile to adapt to what is witnessing. if you are witnessing something

horrific or life-threatening, your brain does like a standstill. it becomes like in shock. when an officer goes to explain or tell the story afterward while they're being interviewed or interrogated afterward, it may sound like they are not telling the truth and it may sound like they start to question, did i do that, did i hear that or say that? sometimes the adrenaline flood causes you to have auditory exclusion. your ears stop the sound and you cannot hear anything. you can see people moving and talking but nothing is coming out. when officers explain this in the debriefing, they feel like they're going crazy. they say, i do not know what is wrong with me, i did not hear that or see that. you were right next to me but i did not hear you talking. there is a physiological answer and the reason and cognitive reasons as to what your body perceives those things -- what your body perceives those things. that is what they debriefing

does is educate them as to where your body and mind goes through when it is subjected to, or possible death. what happens is when you try to explain that and you deny get followthrough or they do not get to talk about it, their risk isolating, going through their head, wondering how come i am missing pieces or, how come i said i shot twice and the investigator said i emptied my gun? there is a missing piece between the investigation and what they are feeling, what they think happened. and so i think there needs to be a connection more with after of the debriefing and understanding between what they have learned and what they are to expect from the investigator or interview process afterwards. we talk about, i do know what -- do not know what homicide investigators learn about the psychological aspect of, but it would be great if they could connect in that same way and understand the physiological,

cognitive reactions to trauma so would make more sense when the officer says things that do not make sense to them. so the quicker you can do with an process some of -- a deal with an process some of the intermission after a trauma and normalize it, the quicker and officer will heal. it is good we do a 10-day investigative period because it allows the officer to take a break and feel safe. it is important they allow themselves to get some sleep, feel safe with their families, get some fluid. what happens with the adrenaline flood is it the edge the -- it dehydrates them extremely. the team can help to diffuse -- de-fuse some of that. they're trained to talk to the officer involved to let them know about some of these responses that make her so that they know in their mind they told me this was normal.

when they come to the debriefing, they get further education about it. and of course, we educate them on how to follow-up with the referral process but having the clinicians be involved early on. to do in private, confidential check and is something that is valuable. a debriefing can include several other people, dispatchers sometimes, chaplains, and they may not want to talk or share, but if we have a clinician check they can do that with privilege confidentiality. at the four week mark, they can check in to see if a disorder has set in. >> we're in the process of working out, we will have three come up -- collections, psychotherapists who will be available. >> to clinicians. we are to -- have two that are

on board and three chickens. thank you for your work on this. meeting with the chief and also commissioners mazzucco manchin. it is an important topic. the rippling effects of your work will be seen on a lot of different levels. the department wanted to clarify, no. 1. as it stands now and with your proposal on going forward, the mandatory check-in will only apply to officer involved shootings. that is the way it stands now? >> that is the way it stands now. >> i heard you possibly suggesting there are other critical incidents that he may recommend the same procedure applying to in the future, is

that? >> there are certain incidents that are just as critical. for now these are the ones we're focusing on to make sure we get this in place, if we think we need something later, we might be able to do the same thing or may not apply. just knowing that we look at critical incidents, shooting being the big one. it comes across your desk because there are so many entities involved. some of the other incidents you might not care of because they are one-on-one incidents that district stations. we also debrief incidents that are not shootings. we do as many debriefings as we can in critical incidents. i do not know of minatory chickens with the clinician is appropriate for every situation but that is something we can talk about at a different time. commissioner kingsley: we would find it interesting to hear about your thoughts as to other critical incidents that might

fall into this system in addition to the officer involved shootings. keep that in mind. >> i wanted to say that i appreciate the report this commission has for these matters. in the past, a lot of officers never felt that will support and care from the commission around these kinds of issues and this is the first time i have felt there was a lot of input and sincere commitment and care about these issues. the officers are recognizing that. i think it is good because it is time for change around that. commissioner dejesus: i am concerned about we're seeing depression and anger and alcohol

abuse. it is many months after c'mon not years after the incident. that is some of my concerns. some instances have been dramatic. we had the one in california and they come back and they are dramatic. i am glad you have the chickens and i am wondering toward the end, you can have some kind of test to see if they are depressed. -- i am glad you have the check- ins. those are issues that have to be looked at. those are what we're seeing. when you talk about the additional staff, we should talk about additional funding. the clinician's i hear are psychologists, are there sworn officers that are psychotherapists? >> we have already sort of

cleared this through who are currently licensed ph.d. is. we looked at 10 shootings a year, if there were used twice each time, they came out to three or four dozen a year. it is not that expensive. -- they came out to $3,000 or $4,000 a year. they're licensed clinicians. >> also if you could follow-up and see it is necessary to have a psychiatrist or doctor on board. to deal with the physiological changes, depression, they can give them treatment for depression. i know you would recognize it. or you could build on it. and build that area and put more resources into it. >> we do have a new police position that we did talk about, trying to make sure we combine efforts. if there is something we can

discuss together, we can use our same resources and pull them together. the conditions that would check in with the officers are also able to refer to psychiatrists and to recommend medication as necessary. we do have a group of clinicians and a psychiatrist on board that we can use as a resource. >> i am glad we're looking into the spotlight that is there and i hope we can take care of officers rather than having to deal with them in disciplinary actions. that is a bad place to be. >>commissioner chan: thank you r your presentation and being generous with your time. we spent time picking your brain on all these suggestions.

i was appreciative of the work that you do and the high volume of calls that you respond to, i do not know how you do it. i hope the commission can continue to support your work and i can say for all of us we would be glad to do that. looking at this worked, it does give us one facet -- looking at this work, it does give us one facet. the only main tools prosecution. discipline is often one of our main tools and looking at this we are able to see another tool and that is preventive and that looks at the issues. i appreciate we are looking at this angle. i wanted to also thank you. i appreciate that -- commissioners often make lots of presentations and for you to

follow through so quickly is impressive. i wondered if you are able to release a summary about -- of suggestions about officers needs. >> we could probably have that in a couple of weeks if that is ok. the ones we have gone over is really positive. most of the suggestions which have been similar, mostly around, can we teach more about depression, about suicide, can we talk about that? the other comment i wanted to make about ptsd, it is not necessarily the critical incident that triggers all that. it is usually the accumulative stress and it is many years of doing this job in dealing with victims in and out. that is usually what tears the officer down and the alcohol comes into play.

the stress is sometimes more serious than the one time incident. you get plugged into the commission -- clinician and you get all these resources. it is the stuff you do not always hear about. there could be a reaction to trauma and having to witness it over and over is what takes a toll and that is what i see as the falling into the abuse of alcohol or whatever it may be, falling into depression. the more exposure you have to trauma or some of the things you have to witness, usually, there is a low level of depression and some anxiety, if not in most officers. it may not be recognizable. it starts very early in their career and it is -- if it