The stressful lives of police officers — Mental Health Matters
In recent weeks, several police officers have been killed in the line of duty.
Policing is demanding and dangerous work. In 2014, 126 police officers were killed in the line of duty. More than virtually any other occupation, law enforcement is an emotionally taxing and physically dangerous job.
Law enforcement officers experience rare, low frequency, but high impact events such as disasters or violent mayhem and high-frequency, low-impact events like routine traffic stops: Both cause stress response problems.
Police officers unpredictably, but routinely, face situations that can turn lethal in an instant. They are exposed to traumatic events ranging from the mildly disturbing to the apocalyptic.
Exposure includes aggression, violence, rape, child abuse, murder, accidents and disasters. Gruesome scenes of scorched and/or battered bodies including infants and young children can be part of the job.
I first became aware of the stresses involved in police work early in my career as a psychiatrist. An unimposing fellow in his mid-50s was referred with a recent history of nightmares, intrusive recollections, hyper vigilance, anxiety and depression, all of which began immediately consequent to a traumatic event.
The story: My patient was a 25-year employee of the Bank of America in San Francisco, where he worked as a security guard. During all those years, he never drew his weapon until the fateful day when he shot and killed a man attempting to rob the bank.
He believed he had done what he had to do, the “right thing,” and was supported by thankful bank staff. Nonetheless, he developed nightmares about the death, daytime intrusive images of the killing, and other associated emotional symptoms typical of acute post traumatic stress.
He was off work, disabled for some three months. His symptoms gradually receded while in therapy and he successfully resumed employment.
Another story: A sheriff’s deputy in his late 30s, employed for some 10 years with a rural sheriff’s department, was chasing a suspect when the man suddenly turned, shot the deputy in the shoulder, and took off.
The deputy’s physical wounds healed uneventfully. However, he developed bad dreams about being shot or shooting someone, along with crippling anxiety that he would be shot again. He could not work and was eventually found to be permanently disabled for police work.
A third story: A sheriff’s deputy in a rural police department responds to a police bulletin about shots being fired in a neighborhood home.
He arrives at the home. All quiet. He enters the home and is confronted with this scene — a mother, a father, and an infant child- all dead. The father had put a bullet in his wife’s brain, virtually blew the head of his infant child off, and then killed himself.
The deputy, a father, could not shake the image that confronted him when he entered the house. He developed symptoms of post-traumatic stress and was temporarily disabled while his symptoms gradually abated.
These are not rare stories in police work. In the United States, some two-thirds of officers involved in shootings suffer moderate to severe emotional problems; nearly 70 percent of them leave police work within seven years of the shooting (see “Post-Traumatic Stress Disorder in Law Enforcement,” Nov. 2003, Criminal Justice Institute).
Other facts: Police are admitted to hospitals at higher rates than the general population and rank third among occupations in premature death rates.
In New York City, the suicide rate of police officers is more than double the rate in the general population.
In rating the most stressful jobs, police work comes in fourth, just behind firefighters, military work, and airline pilots.
In one paper, “Dying from the Job,” John Violanti, Ph.D., writes that 25 percent of police officers are alcohol-dependent, and 40 percent smoke tobacco. These drugs cause elevated risks of esophageal cancer and cirrhosis of the liver.
Beverly Anderson, writing in 2002 about police work, states that the stress of police work leads to, “elevated and alarming levels of alcoholism, divorce, domestic violence, heart attacks, cancer, depression, and suicide.”
Unfortunately, police culture, mirroring the larger culture — but more so — stigmatizes emotional and substance abuse problems as evidence of weak or deficient character.
Officers with problems frequently avoid seeking assistance, correctly inferring that such labeling may cause job loss or failure to be promoted.
Consistent with the stigmatizing label of mental problems, while high stress levels are part of police work, many states, including Nevada, make it very difficult to obtain worker’s compensation benefits for disabling job stress, even as they, by law, provide benefits for physical injuries.
What can be done to improve the odds that the police can return home at night, secure in their own beds? And that their families will attend fewer funerals and endure fewer broken lives?
The police as an occupying army of armored personnel vehicles and other surplus military grade equipment have succeeded only in stoking community, and particularly inner-city, rage and mistrust of policing, surely not the hoped for outcome.
The President’s Task Force on 21st Century Policing, May 2015, has better ideas: They emphasize expanded and more effective training to promote critical public confidence in the police and more effective policing.
High on the list of priorities are crisis intervention and de-escalation training, instruction in the disease of addiction, bias awareness training, and interpersonal and communication skills training.
Full implementation of these programs would go a long way to secure improved policing outcomes.
Incline Village resident Andrew Whyman, MD, is a clinical and forensic psychiatrist. He can be reached for comment at firstname.lastname@example.org.