Law enforcement officers manage and experience a variety of stressful encounters on a regular basis. Common critical incidents can include traffic accidents and fatalities, adult and child injuries and deaths, house and building fires, robbery, assault, rape victimology, SWAT callouts, and individuals in crisis, to name a few. After years of exposure, some law enforcement officers report experiencing intrusive memories, sleep challenges, nightmares, substance usage and abuse challenges, family conflict, anger impulses, catastrophic perceptions, and an overall negative outlook on life.
To make matters worse, stigma may become a factor that prevents law enforcement officers from seeking help. Stigma within law enforcement can be described as a negative perception regarding others seeking behavioral health treatment as being “weak” or “untrustworthy,” which coupled with trauma-based exposures can cascade into an “ultimate storm” via feelings of being trapped, suicidal, hopeless, and helpless. Not having outlets can then lead the law enforcement officer to suicide completion.
Having a robust wellness program can help alleviate such challenges and provide the infrastructure for hope and improving one’s quality of life. Wellness programs that have peer support officers and a mental health component (i.e., an external and/or internal behavioral health clinician or group of clinicians) governed by confidentiality, can help formulate a preventative maintenance model in mitigating such concerns. The success of such a program can be based on adherence to federal and state mental health and/or peer support confidentiality laws and rules, practices, principles, and guidelines.
Law Enforcement Peer Support Officers
Peer support law enforcement officers can be trained in understanding behavioral health issues and crisis prevention principles. Law enforcement peer support officers are peers who can help law enforcement personnel (both sworn and police civilians) with lending an ear for support to help with stress management, suicide prevention, and overall officer safety and wellness. They can be instrumental through giving positive recovery-oriented messages, decreasing barriers to seeking behavioral health services, normalizing help-seeking behaviors, strengthening healthy coping skills, including resiliency and connectedness, and providing support following a suicide loss or suicide attempt in an agency.1 Law enforcement peer support officers can also act as a conduit for referring another law enforcement officer or police civilian to a licensed behavioral health clinician trained in a particular clinical treatment method.
Licensed Behavioral Health Clinicians and EMDR Treatment
The importance of having a licensed behavioral health clinician as either an internal or external clinician providing clinical treatment for the law enforcement officer or police civilian is significant due to not only the opportunity for clinical interventions and treatment, but also trust building for channeling the unique “stress” from the job. The outlet is based on confidentiality for such trust building. Informed consent during the intake process (e.g., during the first therapeutic contact regarding the limits of confidentiality) is where that trust building can develop significant momentum for growth. It can establish the genesis for a solid therapeutic blueprint of an outlet for the law enforcement personnel.
One such evidenced-based, clinical treatment method is Eye Movement Desensitization and Reprocessing (EMDR). EMDR is a form of psychotherapy treatment that was developed to relieve distress associated with traumatic memories.2 It was developed by Dr. Francine Shapiro in the late 1980s and has become one of the premiere treatment methods to treat trauma.3
During EMDR therapy the client focuses on distressing memories while simultaneously focusing on external stimulation directed by a licensed behavioral health clinician trained and certified in performing EMDR. The clinician provides direction for lateral eye movements, hand-tapping, and audio stimulation.4 Dr. Shapiro hypothesized that EMDR therapy helps the client tap into their traumatic memory “bank.”5 This represents that the information processing is improved with new associations developed between the traumatic memory and the way that the memory is stored in the brain (i.e., elimination of triggers). These new associations are thought to result in complete information processing, new learning, elimination of emotional distress, and development of healthy cognitive thoughts and perceptions. EMDR therapy uses a three-pronged protocol: (1) the past events that have laid the groundwork for dysfunction are processed, which develop new associative links with adaptive information; (2) the past events target the current circumstances that initiate distress, and the way internal and external triggers are soothed; and (3) a potential new “blueprint” for future events are incorporated to assist the client in developing the skills needed for healthy functioning.6
In one study, 62 police officers were randomly assigned to either EMDR or a standard stress management program (SMP), each consisting of six hours of individualized contact. At completion, police officers in the EMDR program provided lower ratings on measures of post-traumatic stress disorder (PTSD) symptoms, subjective distress, job stress, and anger, and they reported higher marital satisfaction ratings than those in the SMP. The results of EMDR were maintained at the six-month follow-up, indicating persistent growth from a relatively brief treatment regimen for this small sample of officers who were experiencing some level of stress from their job.7
The Importance of Wellness Programs
Wellness in police departments, especially law enforcement, has become a popular discussion among police leaders, administrators, and first-line supervisors. Wellness that focuses on “mind, body, and spirit” and a sense of “balance” to facilitate an improved quality of life has the potential for not only a healthier law enforcement employee, but also a healthier police department. Having healthy outlets may help to channel the unique “stress” from the job such as heightened and accumulative exposure to critical incidents, administrative stress, staffing shortages, generalized negative criticism, and the pressure to make split-second decisions. Untreated and inconsistent treatment for such accumulative stress may be correlated to heightened anxiety and depression. Nutrition, physical exercise, and strength conditioning, along with mental wellness such as resiliency cultivation, are beneficial variables that can positively affect law enforcement health over time.
Suicidality and the Importance for Suicide Prevention in Law Enforcement
Suicidality encompasses both suicidal ideation and actual suicide attempts. Suicidal ideation refers to thoughts of death. The severity of suicidal ideation can vary, from transient and unwanted thoughts to a fixation with death that may involve comprehensive planning.8 Untreated and ineffective treatment for those who suffer from anxiety and depression can contribute to suicidality.
The challenge is that stigma for seeking help can contribute to cascading symptoms for the officer where time runs out and the officer may be at greater risk and complete suicide. It is crucial to establish a culture of wellness and normalize a culture for seeking help without being viewed as “weak” or “untrustworthy.” Part of that establishment can be creating internal policies for training midline supervisors to identify, intervene, and refer personnel for assistance upon recognition that there may be a specific employee who needs help. Examples of signs for midline supervisors to be aware of may include high frequency in uses of force, absences from work, excess substance consumption, workplace conflicts, and mistakes on the job to name a few.
Police departments embrace the concept for preventive maintenance regarding their equipment and vehicles. Consideration for a similar model of preventive maintenance for officers to facilitate suicide prevention through behavioral health and physical wellness may also help. Providing ongoing training regarding how to intervene with personnel who experiences suicidality, developing a vetted list of behavioral health resource professionals who are culturally compatible with law enforcement, developing standard operating procedures for peer support teams and in-house psychological services programs, cultivating wellness coordinators, and the implementing physical exercise regimens and nutritional programs can be the pathways for such preventive maintenance. Creative expressions such as “Chief Challenges” where law enforcement personnel participate in competitions for running, weightlifting, swimming, sit-ups, push-ups, and so on, can not only be healthy and fun, but also develop the intangibles for strong teambuilding, resiliency cultivation, rapport, and solidarity as a department.
Conclusion
Having a healthy police department encompasses having behavioral health resources for employees without fear of demotion, loss of employment, and carrying the stigma of being “weak” and “untrustworthy” and should be a goal of police leaders in today’s police force. The trauma-based exposures that law enforcement personnel experience over a 25- to 35-year career are unimaginable. Without assistance to process their experiences in a safe, competent, and confidential setting, law enforcement personnel can undergo an array of behavioral health challenges, affecting not only the police officers themselves, but also the police departments collectively. Legal challenges and lawsuits, dysfunction and scandals, and fiscal challenges can be some of the problems for police departments who struggle and don’t adopt a prosocial and preventive maintenance model for behavioral health wellness. Budgetary challenges, stigma, prioritization, and denial can be some of the ongoing impediments to police leaders’ considering making these resources available to their personnel. Asking police leaders if they know an active law enforcement or retired officer who died by suicide may be the first question to starting the conversation within respective departments. Many police departments in the world have experienced a police officer, either active or retired, who has died by suicide. Other questions one might ask are “Were there any behavioral health signs that were missed?” “Was help offered?” “Was seeking behavioral health help promoted within the culture of that police department?” “Were situations leading up to the officer’s suicide handled from a disciplinary perspective as opposed to a wellness framework?” and “Were family or personal matters, or a lack of work-family balance, contributing factors leading up to the officer’s suicide?.”
Police leaders of today are faced with an array of multitasking challenges to consider. A preventive maintenance model for behavioral health wellness as a top priority and goal to foster balance, resiliency development, and acceptance for behavioral health assistance provides a platform for help. For years there has been an emphasis on defensive tactics, firearms training, and defensive driving techniques to name a few, but very little on behavioral health wellness. A simple question could be considered for police leaders of today: How much behavioral health wellness is taught and provided in the police academy or block training for established personnel? Many police departments across the globe are experiencing staffing shortages, consideration for technology evolvement and advancement, complex problem-solving demands, and accumulative stress on the job in an ever-changing and evolving world. Will police leaders offer a comprehensive behavioral health preventative maintenance model to help their personnel impacted by such challenges? d
Notes
1International Association of Chiefs of Police (IACP) National Officer Safety Initiatives (NOSI), Peer Support as a Powerful Tool in Law Enforcement Suicide Prevention (2020).
2Francine Shapiro, “Efficacy of the Eye Movement Desensitization Procedure in the Treatment of Traumatic Memories,” Journal of Traumatic Stress 2,no. 2 (April 1989): 199–223; Francine Shapiro, “Eye Movement Desensitization: A New Treatment for Post-Traumatic Stress Disorder,” Journal of Behavior Therapy and Experimental Psychiatry 20, no. 3 (September 1989): 211–217.
3EMDR International Association website.
4Francine Shapiro, “Eye Movement Desensitization and Reprocessing Procedure: From EMD to EMD/R a New Treatment Model for Anxiety and Related Traumata,” The Behavior Therapist 14, no. 5 (May 1991): 133–135.
5Francine Shapiro, Eye Movement Desensitization and Reprocessing: Basic Principles, Protocols and Procedures, 1st ed. (New York, NY: Guilford Press, 1995); Francine Shapiro, Eye Movement Desensitization and Reprocessing: Basic Principles, Protocols and Procedures, 2nd ed. (New York, NY: Guilford Press, 2001).
6EMDR International Association website.
7Sandra A. Wilson et al., “Stress Management with Law Enforcement Personnel: A Controlled Outcome Study of EMDR Versus a Traditional Stress Management Program,” International Journal of Stress Management 8, no. 3 (July 2001): 179–200, https://doi.org/10.1023/A:1011366408693.
8Ashley Borders, Rumination and Related Constructs: Causes, Consequences, and Treatment of Thinking Too Much (Cambridge, MA: Academic Press, 2020).
Please cite as
Robert J. Cipriano Jr., “Preventative Behavioral Health: A Maintenance Model of Wellness for Law Enforcement Personnel,” Police Chief Online, May 11, 2022.
