Officer Wellness

October 3 marked the start of this year’s National Community Policing Week. First held in 2016, the week of engagement is meant to highlight efforts at “building stronger relationships between law enforcement and the communities they serve.”

In a White House proclamation this year, there was a particular emphasis on health and wellness, acknowledging that “Working in law enforcement today is harder than it has ever been. Officers are expected to be everything all at once — from rescuing citizens from natural disasters, accidents, and crime to serving as counselors to people experiencing a mental health or substance use crisis”.

Officer health and wellness are a major topic in police research and funding priorities and a featured aspect of programming at this year’s IACP Conference in Dallas. What follows is a look at some of the most significant challenges to officer health and wellness and what can be done to address them.

Fatigue

Fatigue presents a range of symptoms that includes feelings of tiredness, depression, other mood disorders, and reduced mental and physical capacities. A lack of sleep can also lead to memory impairment, irritability, and stress-related illnesses like obesity and hypertension. Startling statistics show that more than 90 percent of law enforcement officers report being routinely fatigued, and 85 percent report driving while drowsy.

Beyond the health impacts, persistent fatigue creates real-world dangers for officers and the communities they serve. More officers are killed by unintended events, like auto collisions, than events related to the commission of felonies. In recent years, up to a third of officer deaths have involved automotive accidents. Research into officer fatigue and auto collisions indicates that as many as 46% of officers have nodded off while driving. The danger doesn’t stop with the end of a shift either, as many officers endure substantial commutes to reach their homes.

Burnout

A manifestation of trauma-induced stress is burnout, which is defined by chronic exposure to these stresses. It can manifest as excessive cynicism, detachment from one’s work, emotional exhaustion, and feelings of low professional achievement, to name just a few of the most prominent examples. A newly conducted review from 2020 analyzed 108 research studies to better understand operational stress and burnout among officers. The need to increase understanding of officer burnout is evident, with 56% of officers reporting in Pew Research Center’s 2017 Behind the Badge survey that they have become “more callous” since taking the job. The same study found that the feeling of burnout is linked to generally negative feelings toward the job.

PTSD

An officer’s work can often involve traumatic and intense situations during a shift. The Department of Justice estimates in a recent publication that roughly 15% of officers nationwide experience Post Traumatic Stress Disorder (PTSD) symptoms, which have the potential to impair decision-making and an officer’s ability to do their job. The paper highlights scientific research looking at the effects of PTSD on brain function, notably studying police officers themselves and not a general population sample group.

The long-term effects of untreated PTSD are not fundamentally different in police officers compared to the general public. Sleep quality is often affected, conditions related to anxiety and depression occur at a higher frequency, and there is generally a higher rate of drug and alcohol abuse among those experiencing the disorder. In some instances, there can also be effects on decision-making ability, especially under stressful circumstances.

There is research suggesting that PTSD affects the ability of police officers and other first responders to assess risk in stressful situations. This is especially critical in calls potentially involving the use of deadly force, in which officers must make split-second decisions informed by the perception of risk. A new study incorporates sophisticated EEG sensors to measure brain activity in officers during simulated police work. While the results are preliminary, they show “disruptions in rapid decision-making by an officer who has PTSD may affect brain systems due to heightened arousal to threats, inability to screen out interfering information, or the inability to keep attention.” In potentially life-or-death situations, the implications of these impacts are evident.

Resilience

Why do some officers “bounce back” from repeated exposure to traumatic events while others struggle, becoming less effective in their work and potentially turning to self-destructive behaviors like excessive drinking and self-medication? The answer likely lies in practicing resilience.

Even in peer-reviewed articles, academics and researchers admit there is not a broad consensus on a working definition of resilience. In its generalized sense, resilience is explained more as a concept that includes “positive adaptation, or the ability to maintain or regain mental health, despite experiencing adversity.”

The American Psychological Association identifies three primary facets of resilience that are essential in how people respond to stress and trauma:

The ways in which individuals view and engage with the world:

At its core, this aspect of resilience is inwardly focused and understood to be influenced by social, biological, and behavioral factors. The ability to understand stress responses and regulate one’s emotions has been shown to be an important factor. Foundational research underscores the importance of self-esteem, self-efficacy (a person’s belief in their capacity to act in ways necessary to reach specific goals), risk reduction, and openness to opportunities.

The availability and quality of social resources:

Social support is a critical component of both physical and mental health. At its most basic, these are social ties that can be relied upon for emotional, spiritual, physical, and financial support. These can take many forms, with family structures, social or professional networks, clergy, neighbors, and so forth being primary sources of social support.

Coping strategies:

These are conscious strategies used to counter negative emotions that come from stressful situations. These are, by their nature, adaptive methods with no one-size-fits-all approach to deploying specific strategies to specific stressors. There are also, of course, negative coping strategies like drug and alcohol abuse that can diminish the availability and efficacy of other support structures.

Taking Action

Undoubtedly, the challenges to officers’ health and wellness are as diverse as they are profound. To meet these challenges, law enforcement leaders will need to use every tool available to them to build resiliency and confront the inherent difficulties of working in law enforcement. National Community Policing Week underscores the need to seriously address officer wellness as a component of broader and demonstrably effective community policing efforts.

Benchmark Analytics is guided by the belief that data science and analysis are vital to personnel management strategies that build resilience and promote officer wellness. To learn more about our work, visit us at IACP 2022 in Dallas, booth 8201.

Work-related trauma is, unfortunately, an unavoidable reality of police work, as are the day-to-day organizational stresses inherent in working within a command structure. Unchecked, these stressors have been linked to everything from early retirements and resignations to performance issues driven by a deterioration in physical and mental health. Resilience – the ability to cope with stress in healthy ways and grow from difficult experiences – is critical in confronting and managing these unavoidable aspects of police work.

As discussed in our previous blog, there is no one static definition of resilience. Instead, it is an interdependent system of assets, characteristics, and support structures that contribute to an officer’s ability to positively adapt in the face of adversity and practice strategies that help them maintain or regain their health. As such, there is also no one set of prescriptive policies that can be replicated across departments but rather it is a question of understanding resilience’s mental, physical, and social dynamics. What follows is a look at the research on the subject and what actions can be taken to address these three areas of need.

Growth Through Resilience

Using a sample group of police officers that experienced trauma in the line of duty, researchers have documented that exposure to traumatic events can cause changes in brain function that can be detected using functional magnetic resonance imaging (fMRI). The variables in this study also produced neurophysiological evidence of resilience in action. Subjects who participated in exposure-based therapy and cognitive restructuring showed a measurable effect in helping “…attain psychological growth on the basis of their negative experiences”. Simply, this is finding ways to adapt while maintaining a generally positive outlook on life

These research findings, in part, support theories surrounding post-traumatic growth (PTG) – a process in which people who have encountered trauma experience profound and positive changes in their outlook after the event(s). The study of PTG is largely theoretical and without broad consensus, though it has been suggested in research that police officers may experience it differently than the general population. Based on the evidence produced by one such study examining officer-involved shootings, researchers have pointed out that post-incident debriefings and required counseling sessions are useful in helping officers unpack a traumatic event and experience psychological growth in its aftermath.

Meaningful Peer Support

A common thread throughout the research exploring resilience in police officers underscores the value of professional and interpersonal support structures. It is often said that no one knows policing like fellow officers and that the level of trust inherent in a peer relationship makes it a valuable asset in promoting resilience. Recent survey data showed that nearly 90% of officers reported peer support as “helpful to very helpful” in managing stress associated with their work. The same survey showed that even among officers who had not engaged in peer support, nearly 60% of respondents said they would be “very likely” to seek such support if they felt they needed it.

Though peer support is demonstrably important, it is not a substitute for qualified mental health professionals in times of extreme stress. Whether they’re colleagues of officers, departmental leaders, retired officers, or chaplains, trusted peer resources have an essential role to play in breaking down the stigma associated with mental health care in policing. Recommendations and studies routinely indicate that a culture shift is necessary to combat an unwillingness to seek professional and specialized help after traumatic events, which significantly hinders long-term resiliency.

Mind/Body Connection

There’s no doubt police work involves physical strength to withstand the rigors of duty and the demands of apprehending a suspect, for example. Physical health and fitness have also been shown to have a close correlation with resilience and the overall well-being of officers. Furthermore, programs designed to enhance fitness show tangible results in lowering the level of perceived stress specifically involved with policing.

Strategies to promote physical fitness can take a variety of non-traditional forms. A case study examining a yoga and mindfulness program piloted by the Bend (Oregon) Police Department (BPD) showed measurable improvements in participants’ sleep quality, fatigue, and physical strength. Traumatology: An International Journal published a research guide examining training and police resilience, which affirmed the value of “non-traditional” wellness practices such as guided relaxation sessions, breathing exercises, and journaling – some of which can be conducted in private, avoiding any potential for stigma among peers.

The key to implementing innovative practices is creating meaningful ‘buy-in’ by ensuring they are culturally relevant to policing and supported by leadership. In the case of the BPD’s yoga program, instructors were either former police officers or had an in-depth knowledge of policing. This was thought to lessen the social pressure surrounding a non-traditional program and create a more meaningful – and ultimately effective – experience for officers.

Leadership Matters

Put simply: the recommendations are out there for building and maintaining resilience in policing via papers, research studies, best-practices guides, and conferences all dedicated to the subject. The common impediment to wide-scale implementation is a cultural one. The stigma associated with mental health and avoiding the appearance of weakness is hard to overcome.

The culture shift, in part, begins at the top of an agency. Evidence shows that leaders, whether by rank or social influence in a department, play a critical role in the cultural evolution needed to implement these types of programs successfully. Leaders who understand active listening and basic counseling skills substantially contribute to the conditions for resiliency.

Data Science and Leadership

Technology is a powerful complement to these core leadership skill sets that promote resilience. Benchmark Analytics and our First Sign® Early Intervention system utilizes the same type of research that’s advancing the understanding of officer resilience and combines those insights with advanced data science – giving departmental leaders the information they need to spot and support officers with off-track patterns of behavior.

Why do some officers “bounce back” from repeated exposure to traumatic events while others struggle, becoming less effective in their work and potentially turning to self-destructive behaviors like excessive drinking and self-medication? This is the fundamental question in research concerning resilience — a complex subject that involves putting research concerning wellness into practice. There are no easy answers, and resilience is not a fixed attribute inherent to an officer’s personality, nor is resilience a state that renders a person impervious to stress or trauma. Instead, it is a series of characteristics and support structures that contribute to the wellness of an individual officer and the agency they serve.

What characterizes resilience?

Even in peer-reviewed articles, academics and researchers admit there is not a broad consensus on a working definition of resilience. In its generalized sense, resilience is explained more as a concept that includes “positive adaptation, or the ability to maintain or regain mental health, despite experiencing adversity.”

The American Psychological Association identifies three primary facets of resilience that are essential in how people respond to stress and trauma. Like much of the discourse around mental wellness, these factors are frequently interconnected, contributing to a system of resilience rather than operating as independent variables.

• The ways in which individuals view and engage with the world

At its core, this aspect of resilience is inwardly focused and understood to be influenced by social, biological, and behavioral factors. The ability to understand stress responses and regulate one’s emotions has been shown to be an important factor. Foundational research underscores the importance of self-esteem, self-efficacy (a person’s belief in their capacity to act in ways necessary to reach specific goals), risk reduction, and openness to opportunities.

• The availability and quality of social resources

Social support is a critical component of both physical and mental health. At its most basic, these are social ties that can be relied upon for emotional, spiritual, physical, and financial support. These can take many forms, with family structures, social or professional networks, clergy, neighbors, and so forth being primary sources of social support.

• Coping strategies

These are conscious strategies used to counter negative emotions that come from stressful situations. These are, by their nature, adaptive methods with no one-size-fits-all approach to deploying specific strategies to specific stressors. There are also, of course, negative coping strategies like drug and alcohol abuse that can diminish the availability and efficacy of other support structures.

Intersections with Officer Wellness

Much, but not all, of the resilience research, is focused on people exposed to exceptional levels of stress: frontline medical personnel, soldiers, and corrections officers, to list just a few. Police officers are uniquely positioned in this arena due to the transdisciplinary nature of the profession. Officers must deal with the inherent stressors of their job, such as the physical dangers of patrol and repeated exposure to trauma. Just as pervasive are the organizational stressors involved with working in a command-structure hierarchy and dealing with the rigors of court appearances. The work requires them to be at the “top of their game,” displaying professionalism and efficiency 24/7 when dealing with a broad range of stakeholders ‑ victims, suspects, investigators, media, and many more with different needs and expectations.

Physical health and fitness have been consistently found to influence resiliency significantly. In the general population, regular exercise is shown to reduce stress, improve mood, and enhance one’s resilience to mental health issues like anxiety and depression. In policing, long hours, mandatory overtime, and associated fatigue are hard to avoid, as are the physical demands of patrol — making the physical aspect of resilience in policing a high priority when addressing resilience in policing.

A Plan of Action

In terms of its relationship with officer wellness, strategies to improve resilience can be thought of as wellness in practice. Resilience strategies are a way of closing the gap between theory and practice. Officers have faced escalating challenges to their mental and physical wellness in an era of decreasing public trust in the police as well as violence and mass-casualty events, some of which have specifically targeted police. These trends were the catalyst for the Department of Justice (DOJ) to investigate the problem to create best-practices recommendations. One of the key outcomes of the research was the assertation that support services and strategies cannot be built in the middle of a crisis and instead require forethought and planning on the part of departmental leaders.

Those recommendations from the DOJ stress the need for effective change management strategies in building meaningful programming designed to improve resilience. Leaders are advised to avoid simply creating new, top-down initiatives and instead emphasize building consensus and modeling behaviors.

Real-world resilience strategies from an International Association of Chiefs of Police (IACP) report draw from the three themes of resilience references earlier in this post and emphasize the need to be aware of an officer’s personal needs, the needs and capacity of the department as a whole, and then tailoring professional development offerings accordingly.

First and foremost, officers must be able to assess their own performance and shortfalls and recognize when they may need assistance with their physical, mental, or social wellness. In policing culture, an outdated stigma around seeking assistance can lead officers to avoid seeking help and instead turn to negative coping strategies that have the potential to damage relationships, both personal and professional, vital to maintaining resilience.

When addressing group dynamics, the report states, “…a resilient culture is a direct reflection of the amount of respect the officers inside a department have and show for one another”. Enacting meaningful peer-support programs is vitally important, and fostering an atmosphere of engagement builds a healthy internal culture that promotes resilience.

Lastly, departmental leaders must make professional development opportunities readily available to officers. Departments across the country are trying various evidence-based and innovative approaches to boosting resilience through strategies like physical fitness programs, science-based shift scheduling, and leveraging strong relationships in the broader law enforcement community.

Confronting the Challenge

It is well-understood by most that policing isn’t easy work. The profession is inherently dangerous and mentally taxing, and there is evidence to suggest that those problems are likely becoming more intense nationally. At such an important moment for policing, resilience to the age-old and emerging challenges of the profession is key to meeting these challenges. When considering plans to bolster resilience, departmental leaders must be aware that resilience is not a state that can be “attained” but is an evolving process of continual improvement and cultural shifts centered around building wellness.

Key to implementing strategies for resilience is understanding what officers need additional support and when. Off-track behavior pattern can be an early indication of struggles with maintaining resilience. First Sign® Early Intervention is the only early intervention system that uses research-based data science to produce exceptionally accurate and meaningful insights into officer behavior, spotting problematic behavior patterns sufficiently early for meaningful and effective intervention. Learn more about First Sign here.

Heading into 2022, officers and leaders in the corrections sector of law enforcement find themselves at the intersection of many familiar issues to the profession and law enforcement as a whole – recruitment and retention, officer wellness and readiness, and working conditions. While these intersecting issues in corrections have been documented and studied for decades, it is the second year of a global pandemic that has brought renewed attention and, in the best cases, an urgency to address these issues. In this article, we’ll look at how research into how these issues intersect and how unpacking those connections contributes to a more holistic understanding of corrections officers’ needs and experience on the job.

Retention

Retaining current staffers is a perennial top priority throughout law enforcement. Retention in the field of law enforcement has been studied and discussed for decades but, due to a combination of interconnected factors, including the so-called Great Resignation, there is evidence that the problem is growing. While potential causes of staffing shortfalls will continue to be investigated by researchers, it is clear now that turnover rates in some regions are approaching a crisis level. As of the publication of this article, some corrections departments are seeing annual attrition rates greater than 50%.

The need to retain corrections officers bears a lot in common with arguments for retaining law enforcement officers generally – training is costly and time-intensive, and there is an additional, implicit cost to knowledge and experience “walking out the door.” Much like in other law enforcement fields, corrections officers often leave the profession seeking better pay and working conditions, along with greater access to opportunities to develop skills and career advancement opportunities. Retention challenges also contribute substantially to staffing shortages which are a primary source of stress among corrections officers (more on that later), creating a cycle that is difficult to “break.”

Recruitment

Difficulties in retention and recruitment contribute to an oft-cited problem in the world of corrections: issues with staffing levels. A study from the RAND Corporation and the National Institue of Justice published in 2018 showed that surveyed corrections officers ranked recruitment as the top issue facing their profession. At the federal level, staffing shortfalls are an issue, but the most dramatic examples of shortfalls can be seen in states across the country. These gaps in staffing and shift coverage lead to the kind of working conditions that increase attrition and endanger the safety of corrections staff and prisoners.

Like many issues in government and public policy, additional funding would likely go a long way to improving corrections officers’ salaries, benefits, as well as access to training and career advancement opportunities. Research-driven tactics for improving recruitment, much like retention, are centered on better understanding the needs of potential recruits. The same RAND Corporation study identified establishing and promoting competency standards for recruits, supporting those standards with practical and evidence-based training, and involving corrections officers in decision- and policy-making as proactive steps the corrections sector can take to improve recruitment outcomes.

Burnout & Officer Wellness

Burnout is a complex set of symptoms and circumstances involving one’s occupation that generally involves feelings of exhaustion caused by chronic stress that isn’t well-managed. Research suggests that burnout affects anywhere from 9 to 30% of working adults. Among corrections officers, that figure is as high as 37%. This can lead to diminishing organizational commitment and counter-productive attitudes around safety, security, and inmate rehabilitation, as well as feelings of callousness.

Though burnout is a known issue in law enforcement, evidence suggests the problem is especially acute among corrections officers. In one Florida-based study, researchers examined differences in stress levels among police and corrections officers and found stark differences in how the two groups experienced workplace stress. A particularly dramatic example occurred when the two groups were asked about staffing shortages. 26.4% of police officers reported it as causing a high level of stress, whereas 73.3% of corrections officers said it contributed to high levels of stress.

Overcrowded Facilities

Prison overcrowding is another issue at the intersection of many of corrections officers’ challenges. A recent Pew Research Center study shows that, while the US prison population has receded slightly from a historic high, it remains quite large. Tightened budgets, policy decisions, and often inadequate facilities contribute to overcrowding at many prisons, especially at the state level. Though consistent data from states is somewhat difficult to obtain, the most recently published federal statistics show that as many as 36% of prisoners are currently being held in facilities operating at more than their rated or design capability.

The effects of overcrowded prison facilities on corrections officers are felt throughout the profession. Increased incidence of assault and riots are correlated with overcrowding, putting officers in greater danger. The Corrections Officer Association of Delaware, for example, estimates overcrowding combined with understaffing leads to a 57% attrition rate of officers over a three-year span.

COVID-19

The COVID-19 global pandemic has further revealed many of these structural issues and added greater urgency to the need to address long-standing challenges in the corrections profession. Corrections facilities, especially those operating beyond their capacity, are ideally suited for spreading highly transmissible diseases. Like police officers, corrections officers have seen COVID emerge as the leading cause of duty-related death since the pandemic began.

The additional strain caused by the global pandemic has contributed to ever-growing rates of attrition and retirement. Though it will likely take another year or two for comprehensive academic studies to reach publication, there is plenty of anecdotal evidence to point out that systems and corrections officers are approaching a breaking point.

Research-Driven Solutions

Though the issues facing corrections officers and leaders are substantial, other law enforcement sectors have shown there are evidence-based tactics to confront what can seem like intractable problems. At the root of many of these overlapping issues are needs expressed by corrections officers that are not being adequately met by their work conditions. Agencies find that employing research-based early intervention and officer management solutions can create meaningful change for officers by giving leaders the knowledge and tools to manage their workforce effectively while mitigating risk.

Over the last fifty years, the understanding of post-traumatic stress disorder (PTSD) has undergone a radical transformation. What was once thought of as fatigue, nervousness, or even cowardice in the face of danger is now understood to be a multi-dimensional set of interlocking symptoms that can persist for years after exposure to trauma. This growing understanding of the disorder and increased awareness of its symptoms and effects have created greater urgency among law enforcement agencies to confront PTSD with support and treatment.

This growing awareness is shown in initiatives like the recent passing of SB57 in Missouri. The bill recognizes the impact of PTSD on law enforcement officers and creates funding and programmatic support for routine check-ins with mental health professionals every three to five years. It also provides crisis support for officers and departments after critical events.

This is just one example. Across the country, law enforcement leaders and policymakers are ramping up efforts to confront PTSD in the law enforcement community. What follows is a look at some of the impediments to effective treatment and the methods departmental leaders have developed to break down those barriers.

Overcoming barriers

Though police culture is not monolithic, there are common elements expressed throughout the profession – especially the notion that officers act as protectors for the rest of society. This notion can engender a cultural belief among officers that they “need to be stronger and braver than ordinary civilians” to fulfill their mission of service. Moreover, many in the profession see law enforcement as a kind of family unit subject to the highest levels of trust. In the most intense situations, a fellow officer may be the difference between survival and a far-worse outcome while on duty. While this is useful in maintaining unit and agency cohesion, it can also lead to an “us versus them” mentality when dealing with outsiders.

Staff psychologists and mental health professionals are frequently seen as outsiders within a department. In many agencies, they work on a part-time basis or are contracted from an outsider provider. Furthermore, the relationship between officers and mental health professionals can often begin as a negative experience. In most cases, a recruit’s first encounter with mental health staff is in a pre-employment psychological evaluation which can be thought of as a potential impediment to the recruit’s career goals (disqualifying them from service). After the academy, subsequent encounters with mental health staff often come from a referral from a supervisor or Internal Affairs (IA), contributing to the feeling that the interactions are punitive and a “blocker” in an officer’s career path.

PTSD Treatment That Works

Organizational and cultural changes are beginning to break down some of these barriers, and, with increased awareness, many officers now voluntarily seek help for PTSD symptoms. Evidence-based treatment options (EBT) are, by definition, the most effective means of confronting PTSD. Researchers and mental health professionals have studied these methods showing demonstrated and, importantly, repeatable patterns of efficacy in proactively addressing PTSD and offering viable treatment options that serve the unique needs of law enforcement officers. The American Psychological Association strongly recommends four specific PTSD treatments:

Cognitive Behavioral Therapy (CBT)

CBT examines relationships between thoughts, feelings, and behavior. For instance, by exploring one’s patterns of thoughts and better understanding them, a patient can see improvements in emotions and behaviors.

Cognitive Processing Therapy (CPT)

This therapy seeks to help a person challenge and modify unhelpful beliefs about the trauma they experienced. By creating a new understanding of the trauma itself, CPT can reduce its ongoing negative impact.

Cognitive Therapy

An offshoot of CBT, this treatment involves “modifying the pessimistic evaluations and memories of trauma, with the goal of interrupting the disturbing behavioral and/or thought patterns that have been interfering in the person’s daily life.”

Prolonged Exposure

A person incrementally approaches the memories, feelings, and stimuli associated with their trauma using this therapy. By retelling their experience with guidance in a supportive environment, the patient confronts the fear and anxiety associated with the experience.

These techniques represent recommended PTSD treatment for the broadest segment of the population. Research suggests that law enforcement officers have needs that can be different from that of the general public. Recognizing that, departmental leaders can enhance their efforts at combatting PTSD with the following strategies:

Peer-support

When discussing what is shown to address mental health and wellness among officers, the conversation often turns to the necessity of peer-support networks. No one “gets” the stress of policing like fellow officers. This inherent rapport can break down some barriers to seeking help for a mental health challenge like PTSD. These were typically informal networks of more senior officers providing advice and guidance to their more junior colleagues in the past. In many departments, these networks have become more formalized and are being incorporated into the mental health programming offered by departments.

Becoming an insider

Mental health professionals are not powerless when countering the “outsider” narrative that can hinder their work. They can and often do attend police social functions, making themselves part of the fabric of the department’s community. Ride-alongs have also shown results in increasing rapport and trust between mental health providers. The Bend, OR Police Department’s mental health staff has participated in ride-alongs since 2015, and the NYPD has an established program for embedding members of the public with officers, to name just a few.

Changing the Narrative

A police officer’s work increases their likelihood of experiencing traumatic events that can lead to PTSD. Though the disorder is not inherently different in law enforcement officers compared to the general population, their profession and culture create unique needs. By better understanding those needs and how they may be addressed, law enforcement leaders and policymakers can potentially change the narrative of how PTSD is confronted and treated within the law enforcement community.

The public debate around policing has only increased in volume in recent years, with opposing sides struggling to see eye to eye on many of these issues. Funding, mission, purpose, and other concerns, both practical and ethical, are in play. One distinct point of agreement between opposing sides is that the profession involves inherent dangers not seen in most other job categories. These dangers are often traumatic and, by definition, put police officers at a higher risk for developing Post Traumatic Stress Disorder (PTSD).

The understanding of PTSD has advanced rapidly in the last 100 years, primarily through the study of law enforcement officers, first responders, and military personnel. What once was thought of as a character deficiency is now understood as a complex set of intersecting psychological conditions brought on by abrupt or repeated exposure to trauma. As a part of a series on this blog, this post looks at how this understanding has evolved and how PTSD specifically affects police officers.

Historical Perspective

Though PTSD can result from any sort of traumatic event, understanding it as a psychological condition is historically associated with war. From biblical references to mentions by Shakespeare, the potentially debilitating trauma has long been well known if not always well-understood. Though there was discussion of “combat hysteria” or “battle hypnosis” in medical texts beginning in the 19^th century, it was the first World War that led to the first recognition of what we now know as PTSD symptoms. Shell shock was a term used to describe a debilitating condition distinct from combat fright or “malingering”.

As the 20^th century moved forward, there was progress in understanding the effects of acute or traumatic stress related to military or combat experience. However, they were often framed as moral or psychological failings when discussed outside of clinical settings, suggesting a fundamental weakness in those experiencing such symptoms. These notions contributed to the stigma of seeking help for PTSD that persists.

The United States’ involvement in the Vietnam War led to significant advancements in understanding trauma stress. As many as 700,000 returning war-zone veterans, nearly 25% of all who served, required some kind of psychological help after their service. With such a large population to work with and study, the understanding of PTSD broadened considerably during this period. In 1980, the condition was formally termed Post Traumatic Stress Disorder and added to the Diagnostic and Statistical Manual of Mental Disorders (DSM), a publication of the American Psychiatric Association considered to be the benchmark in classifying mental health disorders.

A Formalized Definition

PTSD was added as a diagnostic category with the publication of DSM-III and has remained a part of the guide through the fifth and most current edition. It was included in this edition as part of a new category of “trauma and stressor-related disorders.” To be diagnosed with PTSD, doctors follow a set of guidelines to rule out other psychological conditions. To be diagnosed with PTSD, a person must meet the following criteria:

• Exposure to trauma, whether direct or indirect.
• Intrusion symptoms in which the traumatic event is persistently re-experienced. Flashbacks and nightmares are examples.
• A pattern of avoidance related to external reminders or thoughts and feelings.
• Negative alterations of cognition and mood such as being unable to recall details of the trauma, feelings of isolation, and decreased interest in once enjoyable activities.
• Alterations in arousal or activity. These include nut are not limited to a heightened startle reaction, aggression, hypervigilance, and difficulty concentrating or sleeping.

These symptoms must last more than one month, create distress or functional impairment, and are not caused by medication, substance abuse, or another illness.

How PTSD Effects Police

Police work can be an intense profession with officers called to respond to situations potentially involving violence, abuse of children, and other traumatic occurrences. Additionally, however remote, there is always a chance that an officer will be required to use less or less-than-lethal force on a call. Research suggests that police officers can experience as many as three traumatic events every six months, compared to the broader population in which someone may experience only a few of these events over an entire lifetime.

This exposure to trauma predictably leads to higher instances of PTSD among law enforcement officers. Mental health professionals estimate that as many as 15% of police officers experience PTSD symptoms. This is more than double the rate at which the general population experiences them. In large part, due to stigma and negative stereotypes associated with the condition, it may be impossible to determine the actual population size of officers living with PTSD.

The long-term effects of untreated PTSD are not fundamentally different in police officers compared to that of the general public. Sleep quality is often affected, conditions related to anxiety and depression occur at a higher frequency, and there is generally a higher rate of drug and alcohol abuse among those experiencing the disorder. In some instances, there can also be effects on decision-making ability, especially under stressful circumstances.

There is research suggesting that PTSD affects the ability of police officers and other first responders to assess risk in stressful situations. This is especially critical in calls potentially involving the use of deadly force, in which officers must make split-second decisions informed by the perception of risk. A new study incorporates sophisticated EEG sensors to measure brain activity in officers during simulated police work. While the results are preliminary, they show “disruptions in rapid decision making by an officer who has PTSD may affect brain systems due to heightened arousal to threats, inability to screen out interfering information, or the inability to keep attention.” In potentially life-or-death situations, the implications of these impacts are evident.

Looking Forward

While the scientific understanding of PTSD has expanded rapidly over the past half-century, there is still much to learn. Reluctance amongst law enforcement officers to discuss mental health and seek treatment when necessary make PTSD a persistent challenge to readiness and overall health in the profession. As new therapies and treatment strategies are devised and tested, researchers continue to inform their work with the experiences of those at greater risk of experiencing trauma.

In our next post, we’ll be examining strategies law enforcement agencies and leaders are using to address PTSD among their officers.