Police Stress and Trauma Paper

Running Head: TRAUMA & LAW ENFORCEMENT

Concealed Wounds:

The Effects of Trauma on Law Enforcement Officers

Meghan Mohon

Flagler College

25 April 2016

TRAUMA & LAW ENFORCEMENT 2

Abstract

Law enforcement officers (LEOs) work in a field where they are constantly made to face

incomparable situations that can often lead to incomparable suffering. From being

involved in shootings, to dealing with the dark side of humanity day in and day out, the

stress of being a LEO can prove too much for many--and those that begin to feel the

weight of that stress or those traumatic situations can sometimes feel abandoned and

alone as they struggle with things like Posttraumatic Stress Disorder (PTSD), leading

many to take their own lives. This paper will be broken into various sections in order to

explore key issues of this topic, including: The definitions and science of stress and

trauma, the psychological, emotional, and physiological effects exposure to trauma can

have on a police officer, the effects of police culture on support and policies involving

PTSD and suicide, and the possible treatments and courses of action that may help those

LEOs left struggling with any of these work-related issues.


Introduction

"We carry these things inside us that no one else can see. They hold us down like

anchors, they drown us out at sea." (Sykes, 2016). For law enforcement officers (LEOs),

safety is a top priority. Between months of training teaching LEOs how to react to

situations and complete physical tasks, and constant updates in bulletproof vests and tools

they may need to stay safe, departments emphasize getting officers home in one piece,

and taking care of them when they are injured. But what about when there are no physical

injuries, no visible scars or wounds to patch up, and yet the officer is still suffering? What

happens when years of chronic work-related stress, like dealing with constant physical

strain and verbal abuse, and exposure to sudden traumatic experiences, like officer-

involved shootings, take their toll on the minds of LEOs?

The mental health of police is an issue receiving more and more attention as the

effects of Posttraumatic Stress Disorder (PTSD) and the growing number of police

suicides gain research. Although not all that experience trauma develop PTSD,

approximately 7-19% of current on-duty LEOs report symptoms of/ have been diagnosed

with PTSD, with 20-30% developing some sort of posttraumatic stress reactions in their

lifetime (Neylan, 2002). This is substantially higher than in the general population, and

even more LEOs may go undiagnosed or not report symptoms due to the stigma still

attached to mental illness (and responses considered “emotional”) within the police force

(Marmar, et al., 2006). In addition to this, police also have an increased risk for

developing depression and attempting, or committing, suicide—with an average of 125-

150 police suicides per year—well above the national average (national average:


11/100,000, police average: 17/100,000) (Badge of Life, n.d.; O’Hara, Violanti,

Levenson, & Clark, 2013).

Unfortunately, departments often lack the tools and the mindset to help officers

with psychological issues, or to react properly to officer suicides—mainly due to tight

budget constraints, and an enduring police culture that vilifies any show of ‘weakness.’

While medication, therapy, and critical incident stress management (CISM), among other

options, are available to officers living with PTSD, many of those options are under

utilized (again often due to police culture and a lack of support and funding from

departments.) And most, even when diagnosed, go with little to no treatment—which can

lead to an increased likelihood of suicidal ideation. This comprehensive research paper

will give an overview of the effects work-related stress and trauma can have on LEOs,

with a focus on police PTSD and suicide. It will also discuss the implications of police

culture on struggling officers, as well as possible courses of action and treatment options

that may help not only improve mental wellness among LEOs, but also work to eliminate

the lingering stigma associated with mental health issues in police.

Defining Terms

This section will look at the general definitions of key terms that will be

referenced throughout the paper, including stress and trauma, PTSD, and suicide. The

terms stress and trauma are often confused as interchangeable—however, Badge of Life

(BOL) (a site focused on police suicide prevention programs) highlights the importance

of differentiating between the two. BOL states that stress is best described as something

that happens everyday, to everyone—not just police (BOL, n.d.). This stress can be

eustress (beneficial stress that can motivate and excite) or distress (negative stress that


causes anxiety and leads to mental and physical problems) (Brock University, 2010).

Stress can come in many forms, and if stressors persist overtime, usually due to a

chronically stressful environment or job, that stress then turns into cumulative stress,

which can lead to depression, higher likelihood of falling ill, lack of sleep and appetite,

and many other issues (McSteen, 2012).

Then another type of stress that will be discussed is critical incident stress, which

can be brought on by seeing events (such as emergencies or disasters involving tragedy

and death) or being put in threatening situations and which can have a range of effects

depending on how it is managed. These critical incidents include essentially any situation

in which a person may experience extreme fear, vulnerability, and loss of control in

witnessing or experiencing a threat or horrific event—many of which can also cause

trauma (Solomon, 2016). BOL describes trauma, then, as something that “happens to

you,” an event that “runs over you like a bus or compiles over time to make for an

unbearable burden…” (2015). Trauma results from intense experiences of distress (such

as critical incidents) that overwhelm a person’s coping abilities, and can result in long-

lasting and severe, mental and physical repercussions—fitting, as the origin of the word

comes from the Greek word literally meaning ‘wound’ (Sharpe, Noonan, & Freddi,

2007).

Two things that can be connected to stress and trauma are Post Traumatic Stress

Disorder and suicide. PTSD is a mental disorder, outlined in the Diagnostic and

Statistical Manual, which occurs after an individual experiences a traumatic event and

symptomatic reactions (such as flashbacks, avoidance of stressors, isolation, agitation,

and nightmares) result (American Psychological Association, 2013). Suicide, then, can be


defined as the intentional killing of oneself. These self-inflicted deaths can be carried out

by a range of methods (i.e. hanging, intentional drug overdose or poisoning, shooting),

and mental illnesses (such as PTSD) are often a key predictor in who may be more likely

to attempt suicide or have persistent suicidal ideation (suicidal thoughts or fixations)

(World Health Organization, 2016).

Stress and Trauma

Police typically have more exposure to a variety of stressors that are often of the

distress variety: extensive physical tasks and training, receiving verbal abuse from

civilians they may be dealing, receiving criticism from the media, constantly having their

performance monitored by body cameras or by the public, pressure from leadership or

higher-up authorities to manage their work in a certain way, and lack of rewards. These

stressors can usually be managed by modifying habits, finding outlets in hobbies or

exercise, meditating, or therapy. However, chronic exposure to distress (which many

LEOs have) can lead to a variety of mental and physical problems if not properly

managed.

Negative Effects of Stress

According to the American Psychological Association (APA), stress can affect

the body in a multitude of negative ways. When a person is stressed, muscles tend to

become tenser as a means of guarding against injury or pain, and if this tension is

prolonged, it can create painful aches in the neck, shoulders, and head. As a result of

constant increases in heart rate, high levels of stress hormones, and elevated blood

pressure, chronic stress can lead to an increased risk of heart attacks and strokes.

Digestion is effected as stomach ulcers may develop, nausea may become more common,


and nutrients may not be properly absorbed. There is also an increase the likelihood of

alcohol or tobacco use. Stress can also cause rapid or hard breathing that may trigger

hyperventilation and panic attacks, and the constant release of stress hormones can lead

to changes in mood and sexual desire. All of these can create a drain on the body, which

leads to strains on a person’s mental and emotional state—and are especially important

for LEOs (who are constantly put in positions that cause high stress levels) to understand

and manage (APA, 2016).

Negative Effects of Trauma

Despite all of these negative effects, stress alone is typically not the sole source of

PTSD or suicidal ideation in police; those are more often due to trauma. Trauma can

result from a single experience (critical incident) or an accumulation of trauma resulting

from a range of experiences and incidents over time. For LEOs, experiences that fall

under this heading are all too common, and considered a principal part of the job. Critical

incidents police may experience can include: witnessing the aftermath of violent crimes

(including murders, sexual assaults, and child abuse) and working with those victims,

being involved in potentially life-threatening situations such as car chases and shoot-outs,

and witnessing/ aiding people during natural disasters and automobile accidents (Marmar,

et. al., 2006).

The scars these critical incidents leave on a person’s mind cannot be managed in

the ways that stress can, and devastate the person’s ability to cope. They can leave stress

reactions, or emotional aftershocks, that may appear immediately, or even months after

the critical incident occurred (Virginia Law Enforcement Assistance Program, 2008).

More than that, trauma can leave actual physical damage on the brain.


Effects of Trauma on the Brain

The brain areas that are most affected by trauma include the hippocampus (which

shows signs of shrinking), the amygdala (increased activity), and the prefrontal cortex

(decreased function); these parts of the brain, as well as the body as a whole, is also

affected by the increased release and lack of regulation of chemicals such as cortisol and

norepinephrine, both of which are neurochemical responses to traumatic stressors. These

chemical reactions in the brain are often referred to as “fight or flight” reactions—which

originate in the hypothalamus—meant to help us survive potentially life-threatening

events by firing nerve cells and chemicals to prepare to fight or flee a threat, and re-

directing blood flow to extremities to aid with this. Without getting into too much detail,

chemicals such as cortisol have many features facilitating survival instincts, such as fear-

related behaviors, and also aid in triggering sets of neurons that are associated with

increasing vigilance and coping behaviors when one is faced with an acute threat. These

changes to circuits of the brain can cause alterations in memory, along with a number of

physiological responses such as increased heart rate, tunnel vision, lightheadedness, dry

mouth, quickened breathing, and tenseness in muscles—all of which can effect a LEOs

ability to perform and think comprehensibly when in a traumatic situation, as well as

potentially lead to emotional aftershocks and further problems occurring in their futures

(Bremner, 2006; Martin, 2015).

Post Traumatic Stress Disorder (and Other Diagnoses)

After a critical incident or a build up of traumatic experiences has occurred, many

LEOs find the “fight or flight” feelings lingering, even once the threats have all

disappeared. When symptoms of stress and heightened fear persist for longer than a few


weeks after a traumatic event, they begin to tell the tale of a larger issue at hand (National

Institute of Mental Health, 2016). The Diagnostic and Statistical Manual (DSM),

provides the current list of criteria accepted as a standard for diagnosing someone with

mental disorders such as PTSD.

The criteria for PTSD in the DSM-5 are as follows: The first section articulates

that there must have been some sort of stressor experienced—via direct exposure,

witnessing it in person, indirect exposure (via a close relative or friend having directly

experienced it), or repeated indirect exposure to details of traumatic events, usually in the

course of professional duties (LEOs being a good example of this). The next section

focuses on the symptom of re-experiencing the traumatic event—there must be intrusive

memories, nightmares, dissociative reactions (such as flashbacks), prolonged distress

when exposed to reminders of the trauma, or physiological reactivity (such as elevated

heart rate and rapid breathing) when exposed to stimuli relating to the trauma. The third

category is focused on avoidance symptoms; essentially when the person actively avoids

thoughts or feelings relating to the trauma, or any potential external reminders (people,

places, smells) of the trauma. The fourth section discusses negative changes in mood and

perceptions, including amnesia about key features of the event, distorted negative beliefs

about oneself or the world, persistent blame of self or others for causing the trauma/

outcome, trauma-related emotions (such as fear or anger), diminished interest in

activities, feelings of detachment or alienation, and an inability to experience positive

emotions. The next section looks at symptoms of reactivity, such as aggressive behaviors/

irritability, recklessness, hypervigilance, startled responses, concentration issues, and

disturbances in sleep. The last few sections discuss the duration (symptoms must persist


for more than one month—though symptoms may start immediately after a trauma), that

the symptoms must cause distress or impairment, and that they must not be due to other

illnesses or substances (APA, 2013).

There are many potential risk factors and predictors that may help decipher which

LEOs are more susceptible to developing PTSD, and who may be more resilient.

Variables such as demographical characteristics (i.e. race, gender), genetics, the personal

coping style of the officer, as well as the traumatic event itself (i.e. how life threatening it

is and the psychological and physiological responses immediately after or during the

experience), can all contribute to the development of PTSD later on (Marmar, et. al.,

2006). The effect of perceived gender roles and the differences in how male versus

female officers handle different types of trauma could also factor in (Hartley, Violanti,

Sarkisian, Andrew & Burchfiel, 2013).

However, even those that do not develop PTSD may still struggle with other

mental health issues, such as the shorter-term acute stress disorder (ASD), which includes

many of the same symptoms as, and is a decent predictor of, PTSD in the future, but is

only diagnosed within the first month after a trauma (Gibson, 2016). There are also many

cases where the stressors and pressures experienced by LEOs (though not necessarily

traumatic events) can lead to symptoms of Depression/ Major Depressive Disorder

(MDD). Depression is categorized primarily by symptoms such as mood changes, loss of

interest and pleasure in activities, sleep problems, guilt and fatigue, and suicidal ideation

—all of which LEOs may experience and struggle with in silence, receiving little help or

recognition (APA, 2013).


The commonly circulated symptoms of PTSD such as the hypervigilance, the

nightmares and flashbacks, the isolation, and the irritable behavior, only just scratch the

surface of what can be experienced, and how LEOs may react to traumatic stress.

Because of the clear changes in the function of the brain, and because the cause of PTSD

is external, not internal, many state that PTSD would be better defined as a psychological

injury, as opposed to a mental illness. As one common quote states: “PTSD is not about

what’s wrong with you, it’s about what happened to you.” (Ouimet, 2012). The

complexity of PTSD is still being explored and researched, as are the effects it may have

on the performance and wellbeing of LEOs. However, this re-branding of the disorder as

an injury could potentially help fight the stigma and allow more LEOs to be comfortable

in talking about their experiences, as well as about mental health in general.

Suicide

For law enforcement, suicide is one of the most pressing and complex issues—not

only because of the especially high rates of officers still committing suicide each year,

but because of how taboo speaking about emotional stress and suicide still are within

police departments—despite the clear problem. There are often a number of reasons

behind an individual committing suicide, and the same goes for LEOs when they do so.

Problems at home or with finances, a build up of stress from home and work, or the more

serious underlying problem of PTSD can all contribute to officers suffering to the point

of becoming suicidal. In fact, in the 2012 BOL National Study of Police Suicide

(NSPOS), researchers found that some 83% of those officers that committed suicide had

some outside personal problems going on as well, with 11% having pending legal issues

(BOL, 2013). It is noted in a study done by Violanti, et. al. (2008), that depression and


posttraumatic stress are considered strong risk factors for suicide in police. In addition to

this, the same study looked at the possible connection of police shift-work, and suicidal

ideation—with results that showed there were increases in contemplations of suicide

among officers with certain types of shifts, and the lengths of shifts, worked (for women

it was more prevalent with increased depressive symptoms, while with men it was more

so with higher PTSD symptoms) (Violanti, et. al., 2008). In a separate study, Violanti, et.

al., (2009), found that depression, marital status, and gender were all solid potential

influences on police suicide ideation—with unmarried female officers that had depressive

symptoms reporting the highest amount of suicidal thoughts. With all of these

possibilities, there are also factors such as genetics and religion that may play a part in

finding who is more susceptible to suicidal ideation.

The demographics of who commits suicide more among police are somewhat

debated. It is estimated, however, that the average LEOs that succeed in committing

suicide are white males (though the rates of female and male officers are actually similar

given the smaller percentage of female officers), just over half were single, with highest

rates presenting in those 40-44 years of age with 15-19 years of service/ on the job (BOL,

2015). In the book Police Suicide: Epidemic in Blue, Violanti (2007) concludes that

(contrary to popular belief) retirement does not necessarily make an officer more likely to

commit suicide. In 85% of cases, however, reports stated that no one expected the suicide

(O’Hara, Violanti, Levenson, & Clark, 2013).

As to the method used, gunshots were utilized approximately 91% of the time.

There is also a particular type of police suicide Violanti (2007) discusses, which is called

“suicide by suspect,” (essentially the opposite of suicide by cop) where suicidal officers


may intentionally put themselves in harms way or provoke dangerous suspects to the

point of getting themselves killed. Also highlighted by many studies is the important role

police subculture plays in how suicide is viewed and handled by departments, and most

stress the steps that should be taken to prevent LEO suicide (both topics will be discussed

in later sections of the paper) (BOL, 2015; O’Hara, Violanti, Levenson, & Clark, 2013).

Police Culture, Leadership, and Support

Phrases such as “get over it” and “move on” are still used all too often in police

departments when faced with emotional or traumatic distress among officers. There are

countless stories of LEOs that have risked their lives, paid the ultimate price, or made

incredible sacrifices for their job; yet many with trauma disorders, or for whom the stress

was too much, are treated as pariahs—cast from the good graces of their departments and

turned on by fellow officers that were meant to be like family. This can leave officers

feeling isolated and betrayed, stigmatized because of their mental health in a world where

emotion is still perceived as weakness, and talking about feelings is never the norm. As

Malmin (2012) stated in an FBI Bulletin article: “Law enforcement’s subculture poses

one of the most significant risks to the health and wellness of its personnel…this toxic

environment inhibits wellness training and therapeutic intervention despite officers’

routine exposure to debilitating, traumatic incidents of stress.”

The deeply rooted police subculture still seen today centers around some positive

things like fraternity and justice, but is primarily about strength and maintaining a “tough

guy” image. The ideas of being macho, fearless, and resilient to all emotional woes are

seared into the minds of recruits from the moment they begin training. This continues as

they progress through their careers, as leadership continue not to put focus on mental


health issues and perpetuate the police culture. In the video “Breaking the Silence:

Suicide Prevention in Law Enforcement,” one police chief, John Morrissey, stated that he

had known about suicide being an issue but never made it a priority until there were two

officer suicides within 5 months, which forced him to prioritize it (Spencer-Thomas,

2015). There is an expectation set by leadership, and perhaps by society as well, that

officers should be oblivious and immune to emotional suffering, which may be helpful

whilst on the job, but is extremely detrimental to the officers overall, especially when

they feel they must turn to avoidance or maladaptive coping strategies (O’Hara, Violanti,

Levenson, & Clark, 2013). Mental health issues and threats of suicide are still considered

“dirty little secrets” that most refuse to speak openly about because they are considered

signs of weakness and failure—the cardinal sins of police culture (Malmin, 2012).

Departments are still so stuck in these old-fashioned ideals that they typically

deny any workers compensation or paid assistance/ therapy for officers with PTSD,

despite many considering it an injury more than anything else (Solomon & McGill,

2015). There are even falsifications of officer suicides—with agencies misreporting the

cause of death—because they do not want the shame and embarrassment of suicide to be

put on the families or the law enforcement agencies (Solomon & McGill, 2015). The

same goes for therapeutic approaches to treating PTSD or other mental health problems.

The book Counseling Cops highlights the difficulties of helping officers overcome

negative police values and the association of therapy with weakness; pushing for officers

to get the help they need, despite a culture that says they should not need help

(Kirschman, Kamena, & Fay, 2014). However, as stated in an article by the International

Association of Chiefs of Police (IACP) (2014), the issue of mental health is actually one


of officer safety, and emphasizes that if departments have policies for LEOs’ physical

safety (i.e. body armor and self-defense training) then they should do the same to protect

and promote mental and emotional safety and health—including supporting and assisting

any officers in need. While officers are trained on how to help others through trauma,

they rarely give themselves or their fellow officers the same assistance—this harmful

perpetuation of police culture causes officers to feel alone, and to further any mental and

emotional problems they may experience (Malmin, 2012). However, in an interview with

Deputy Neil Bronner of the St. John’s County Sheriff’s Office, who has worked as a LEO

for over 20 years and experienced multiple critical incidents, he says this is slowly

getting better: “It used to be that if you showed weakness or emotion, people would look

at you like you had three heads. It’s more accepted in the culture to be bothered by it

now.” (N. Bronner, personal communication, 6 April 2016).

Psychological and Emotional Consequences

“Officers are simply human beings performing a service, one that happens to

involve the darker side of life. They are not immune to emotional pain…they function in

the same ways as you or me…”(Solomon & McGill, 2015, pg. 24). 90% of LEOs will be

affected by a critical incident at some point in their career (Moad, 2011). Of those, an

estimated one third will develop some symptoms of PTSD (BOL, 2015). Many might

think that the fact that LEOs are human would provide the obvious conclusion that they

are not immune to pain—emotional or physical—and their mental health should be

treated with the same respect and dignity as the victims they help. The Price They Pay, a

book that gives personal accounts of officer experiences with critical incidents that have

resulted in struggles with PTSD, demonstrates real-life examples of just how debilitating


and consuming the stress LEOs experience can be. The book highlights the types of

horrific things LEOs may be exposed to, and details the range of emotional and

psychological distress officers may go through following that exposure. Examples of the

stories include officers that were involved in shootings who end up tossed aside by their

departments, left confused and struggling to understand and overcome their symptoms,

officers feeling powerful emotional repercussions after receiving physical injuries, and

officers that felt there was no way to escape their suffering but to end their own lives

(Solomon & McGill, 2015).

LEOs are faced regularly with the worst members of society, and must confront

things most could not imagine living through—and their coping skills, as most peoples’

would, diminish over time. Deputy Bronner commented on this, citing that after fatally

shooting a suspect, he became a completely different person. “There’s your life before

the shooting, and your life after the shooting…After, I took risks, I didn’t care if I died, I

didn’t care about anything…I realized I was nothing more than just another warm body in

a uniform that they could easily replace.” (N. Bronner, personal communication, 6 April

2016). Many officers begin to feel numb, discouraged, and experience burnout after a few

years of experience or after critical incidents. This burnout can cause the officer to lose

faith and enjoyment in their career, and opens the door to symptoms of PTSD and

depression (which LEOs have a significantly high rate of) (Brown, 2003). The changes in

their psyche: the guilt over certain events, shame about having a mental illness, and all

the emotions and symptoms that accompany PTSD can lead to changes in how LEOs

approach life in general, as well as how they approach their job.


Physiological/ Health Implications

Law enforcement is known for being a fairly active and physically

demanding occupation. Officers are put through tests of strength and endurance, as well

as trained to respond to a variety of straining, potentially harmful, situations. Not only

does this substantially increase the probability of on-the-job injuries (simply from

training or from carrying out duties), but also increases long-term stress levels overall—

which can play a huge role in creating or increasing the severity of a range of health

issues. Officers are often exposed to situations that have a higher potential of causing

them immediate bodily harm, even death (such as being around explosives, exposure to

narcotics, being involved in fights, chases, and auto accidents.) And those physical

injuries, while often treated with more diligence and funding than mental health injuries,

can alter the course of an officer’s career, and cause psychological harm as well

(Solomon and McGill, 2015).

In addition to the more conspicuous and immediate physical injuries, stress and

trauma can strain and individual’s body beyond its normal limits, creating a range of

health problems. Insomnia/ sleep deprivation is one of the most pressing and widespread

health issues in police—with approximately 45% experiencing sleep issues consistent

with those of people involved in sleep studies, and officers being nearly four times as

likely to sleep less than six hours a day than the general population (Neylan, 2002;

Hartley, Burchfiel, Fekedulegn, Andrew, & Violanti, 2011.) This can lead to hindered

mental and physical performance as well as a range of cognitive issues (i.e. concentration

and memory). One study also reported that LEOs showed a higher rate of obesity and an

overall significantly higher risk for cardiovascular disease than the general population


(Hartley, Burchfiel, Fekedulegn, Andrew, & Violanti, 2011). All of these severe issues,

paired with the negative consequences and symptoms chronic stress can cause, create

very impactful and potentially dangerous strain on officers’ bodies, and can lead to

psychological issues, or even early deaths (Violanti, 2015).

Effects on Life

Officers suffering from PTSD endure a psychological injury that can change

every aspect of their lives—from personal experiences to their work. Their interactions

with loved ones, how they treat themselves, and their performance on the job can all

become distorted after a trauma has occurred. In addition to that, there is the concept of

collateral damage resulting from critical incidents. Even if an officer, or the loved ones of

an officer, do not directly experience a trauma, they can still be deeply affected by it. If,

for example, an officer is shot in the line of duty—that may create emotional aftershocks

that spread through an entire department, even reaching the families of other officers,

which can create widespread psychological and emotional harm if not handled properly

(Solomon & McGill, 2015).

The personal lives of officers and their families are heavily affected by their

career, with family being one of the first layers to feel the changes. While many cite that

the divorce rates of LEOs are substantially higher than those of civilians—resting at

about 60-75% (to the national average of 50%), there are also many that conclude that

there is not yet enough support to confirm those significantly high rates (Khan, 2013).

While there is little argument that LEOs face different stressors in marriage and family

life than most (with shift work, police culture, trauma, etcetera), there still needs to be

more up-to-date research done on the subject to confirm differences in divorces and the


reasons behind familial issues. This all being said, there is an abundance of information

pertaining to how work-related stress and trauma (especially when serious mental health

problems result) can create suffering and strain on family and friends of those officers

effected. The isolationism and other symptoms that accompany PTSD can be difficult for

loved ones to understand and cope with. Pair that with the long hours LEOs spend on the

job (including being frequently scheduled on holidays and during important events),

constant fear of a their loved one being injured or killed, and having their loved one shut

off emotionally/ lose proper communication, and it is easy to understand how couples or

families may drift apart.

Because police subculture dictates that seeking help for emotional issues is

viewed as weak, officers often pursue their own means of coping, many of which are

maladaptive. LEOs suffering from the stress or trauma of the job often find themselves

self-medicating—with alcohol especially—which can add a whole layer of psychological

and physical issues, not to mention disrupt their personal lives and the lives of their loved

ones (Violanti, 2015). Critical incidents have been linked to LEOs having negative

experiences with their emotions, their personal lives, as well as with the system overall,

and it is reported that 35% of officers will leave their respective departments within a

year of being involved in a shooting (Moad, 2011). This complete shift in career or

departments due to a traumatic incident can devastate many LEOs (especially those that

truly love being cops, and center their identity around their career) and create even more

suicidal thoughts. However, for their own well being, as well as for their families, many

officers see leaving the job as the only option left when they cannot receive the treatment

or aid they need following a trauma.


Courses of Action

Treating psychological injuries can be a difficult task, especially when

departments continue to hold onto traditional subculture beliefs, leading them to avoid

funding or helping prioritize the creation of treatment programs for officers. The first

steps to helping LEOs with PTSD and preventing officer suicides must happen at the

departmental and administrative levels first. Police departments as a whole must being

breaking down the stigma attached to mental illness, stop perpetuating the negative ideals

of police subculture, and all officers (from administration down) must work towards

being more accepting and vocal about dealing with issues of trauma and emotion before

anything can change about how officers are treated. The utilization of programs and

increasing the availability/ access to various prevention programs before a trauma, and

treatments for officers after a critical incident is the first step to moving to decrease

stigma, and getting LEOs the help they need to maintain better mental health.

Department-Wide Programs

Many of the department-wide courses of action that may help with prevention and

breaking stigma focus on both education prior to critical incidents, and creating a more

nurturing/ supportive environment for officers immediately following those incidents.

While there are typically a certain number of mandatory counseling sessions required of

officers after a critical incident, because of the police culture being what it is, most

officers are not forthcoming or honest about the type or amount of distress they are in,

and will likely not seek to continue treatment afterwards (Warren, 2015). There is also an

issue with the type of counselor/ therapist they are seeing—as a bad experience with a

counselor who does not understand law enforcement or does not want to spend too much


time on officers may result in worse officer coping, and officers being cleared to return to

duty when they are still suffering (Kirschman, Kamena, & Fay, 2014). However,

psychologist Dr. George Everly, who works to create treatment programs for officers

with PTSD, states that having more mandatory counseling programs in police

departments would help remove some of the stigma officers feel, and allow them to

become more comfortable asking for help as more go public with their own struggles

(Policeptsd.com, 2016). Beyond limited amounts of therapy, most departments do not

sponsor or fund an officer to attend peer support groups or alternative opportunities with

organizations (such as Hunting for Heroes, which focuses on recreational therapy for

LEOs, or other resources such as therapy dogs and programs for support) despite their

seeming success in helping many officers (Hunting for Heroes, n.d.; Manke, 2016).

One of the biggest and most promising movements in departments across the U.S.

is that of Critical Incident Stress Management (CISM). CISM and Post Critical Incident

Seminars (PCIS) not only provide officers with an opportunity to share experiences and

receive support and aid after traumatic incidents, but also help prevent symptoms of

trauma from developing by utilizing programs to prepare officers before incidents, and

management to help officers cope immediately after a critical incident occurs (VALEAP,

2008; ICISF, n.d.). It gives officers the direct psychological support that many need after

a critical incident—for example, through Critical Incident Stress Debriefing (CISD),

which is a multi-phase crisis intervention process that provides a place for discussing

traumatic events among a small group of peers and facilitators, officer distress can be

lowered, and it can give them a supportive officer-based environment to feel more

comfortable with asking for help and still being ‘part of the team’ (Mitchell, n.d.).


Personal Treatments

While there are many departmental courses of actions and options that could be

utilized more to change stigma and help all officers, there are also many personal

treatment options that the individuals themselves may seek out. From medication, to

therapies, to finding outside support—receiving actual treatment for PTSD, or any mental

disorder, is a crucial part of recovery. Processes such as Cognitive Behavioral Therapy

(CBT—talk therapy that works to change unhelpful thinking and thus maladaptive

behaviors), Prolonged Exposure Therapy (PET—focuses on re-experiencing traumatic

events and working to engage it, not avoid it), Cognitive Processing Therapy (CPT—

works on how trauma changed the individual’s thoughts and making them aware of those

thoughts to try and change negative beliefs) and Eye Movement Desensitization and

Reprocessing (EMDR—which involves processing and discussing traumatic memories

while in a calm state to actually ‘heal’ the mind) have all shown much more promise in

being effective treatments for trauma and PTSD than medications have. However,

medications such as selective serotonin reuptake inhibitors (SSRIs) (i.e. Zoloft and Paxil)

and serotonin and norepinephrine reuptake inhibitors (SNRIs) remain popular treatments

for PTSD, along with the use of various other drugs to target specific symptoms (i.e.

insomnia) (Jeffreys, 2016; Solomon, 2012).

While treatment differs in effectiveness for every individual, support after trauma

and training before are always key factors to helping officers. It is important officers

know what options are available to them so they avoid self-medicating with alcohol or

drugs, and so they have someone to turn to as needed. For Deputy Bronner, it was a

friend and fellow deputy (who had been through a shooting himself) that gave him the


greatest support; Bronner says he does not know how he would have ended up if it had

not been for that one person who understood him and was there when he needed help. He

also emphasized that departments “teach you to shoot a gun, not to deal with the

aftermath,” and that it is often up to new officers to seek out their own training and

mentally prepare themselves in whatever ways they can—as well as finding a solid

support system should something happen (N. Bronner, personal communication, 6 April

2016). Officers, as well as civilians, can better understand and prepare for critical

incidents and their effects simply by watching things like the documentary “Code 9:

Officer Needs Assistance,” reading books like Copshock or The Price They Pay, or doing

research into hotlines like “COPLINE” and “Safe Call Now” and prevention programs

such as those done by BOL and IACP. All of these can help defeat the stigma and the

negative aspects of police culture, as well as providing insight into the issue and what can

be done about it.

Conclusion

“Out of suffering have emerged the strongest souls; the most massive characters

are seared with scars.” (Gibran, 2016). LEOs continue to attempt to conceal their

suffering due to deep-rooted stigmas, and many end up losing their health, careers, and

often their lives, because of it. To fight for better treatment and aid for those officers

affected by PTSD and the traumas they are made to face everyday, the subculture of

police must be changed first. Leadership and departments overall must prioritize the

mental health of their officers, make moves to change the system for the better, and begin

teaching and training a new way of thinking, so that all will be able to receive the help

and support they need without fear of being cast out. “For every officer that commits


suicide, 700 have PTSD. These are the officers that have risked their lives to help

strangers.” (R. Clark, personal communication, 23 February 2016). Police departments,

loved ones, civilians, and fellow officers all have a duty, a moral obligation, to help the

officers who are made to suffer because of the career they chose and the horrors they

experience in the effort to help others. There is no shame, no dishonor, no disgrace in

feeling pain as any human would, in developing PTSD, or even in suicide—there is only

shame in how those that suffer are treated at the hands of those around them, and there is

only hope in those that are willing to work to change the system, and make it safer and

more supportive for all of the heroes still concealing their wounds.


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