Scope of the Problem: Police Suicide and the goal to eliminate it
Police job-related stress is well-identified and reported in the media daily and the rates of suicide nationwide are being debated by Aamodt and Stalnaker. They are actually less than one is led to believe but even one law enforcement officer suicide is too much.
Stress is defined as any situation that negatively impacts an officer’s well-being. The rate of suicide and divorce among law enforcement is approximately the same or lower than the general public according to a meta- analysis conducted by Professor Michael Aamodt. But there are areas in the country and agencies that have higher rates of self-inflicted death.
When the suicide rate of police officers (18.1) is compared with the 21.89 rate for a comparable demographic population, it appears that police officers have a lower rate of suicide than the population according to Aamodt, 2008.
Incidence of suicide tend to be elevated in cities like Chicago, where chronic gun violence and a murder rate in the hundreds per year means cops see a staggering amount of trauma and may gradually become numb to the exposure of pain and suffering (Joyner, 2009). A Department of Justice report found that the suicide rate in the Chicago Police Department is 60 percent higher than the national average. According to the Chicago Sun Times, in a note to department members Wednesday, CPD Supt. Eddie Johnson said, “Death by suicide is clearly a problem in Law Enforcement and in the Chicago Police Department. We all have our breaking points, a time of weakness where we feel as if there is no way out, no alternative. But it does not have to end that way. You are NOT alone. Death by suicide is a problem that we can eliminate together” CST September 12, 2018. Chicago PD is not alone with the problem of suicide among its men and women in blue.
Law enforcement officers (LEO’s) encounter the worst of all experience on a routine basis. The people who call the police may be society’s best upstanding citizens but on this occasion it could be the worst day of their lives and they seek help from police. Many times it is not the pillars of society seeking help but those people in the fringes or margins of society now victims of violent crime or abuse.
According to Hartley, et.al., 2007, “repeated exposures to acute work stressors (e.g., violent criminal acts, sad and disturbing situations, and physically demanding responses), in addition to contending with negative life events (e.g., divorce, serious family or personal illness, and financial difficulties), can affect both the psychological and physiological well-being of the LEO population.” When these officers are identified there needs to be a planned response using a peer support infrastructure that provides for a continuum of service depending upon the individual needs of the LEO and the supports available. In many agencies, especially smaller departments lacking resources, officers’ languish and sometimes spiral downward without support and without somewhere to turn. Police officers must have support available to them long before they are expressing suicidal urges.
As programs are identified and service continuum grows the risk of peer conflict over perceived betrayal of trust must be addressed. This must be addressed in the peer support training with emphasis on preservation of life over maintenance of confidentiality or the status quo of abject silence. “In itself, it’s a product of centuries of police culture in which perceived weakness is stigmatized. Cops know their brothers have their back, no matter what, but they still don’t want to be seen as the one who’s vulnerable.” according to a recent Men’s Health article written by Jack Crosbie in a report about suicide in the NYPD published during Mental Health Awareness month in May 2018.
The argument is made that the recurring uncertainty of police calls for service often leave LEO’s with low-level exposure to trauma of varying degrees. It is common that LEO’s move from one violent call to the next without time to decompress and process what they have seen. The repeated exposure to trauma can slowly whittle away LEO resilience – defined as the capacity to bounce back from adversity. In a national media study published by Aamodt and Stalnaker, legal problems were a major reason for the law enforcement suicides yet no other study separately cited legal problems. In another study, relationship problems accounted for the highest percentage of suicides at 26.6% (relationship problems plus murder/suicide), followed by legal problems at 14.8%. In nearly a third of the suicides, no reason was known for LEO suicide.
In many cases the presence of law enforcement adds to the chaos and danger placing LEO’s in the Police suicide has been on the radar of advocates of LEO peer support for months or years. The incidence of suicide has remained stable across the country but some agencies have higher rates of suicide. Smaller departments – those with less than 50 officers in general have the highest rates of suicide. This may be linked to the lack of availability of peer support programs and a paucity of local practitioners to provide professional service with knowledge in police psychology. “While police officers may adapt to the negative effects of chronic stress, acute traumatic incidents necessitate specialized mental health treatment for police officers (Patterson, 2001)”. A referral to the department EAP often falls flat and makes it more difficult to make the hand-off when peer support is not enough.
Real-time model of change
The use of force continuum is well described in the LEO literature and ongoing criminal justice narrative. What does that have to do with stress intervention in police officers? It sets the tone for officer behavior whenever they meet potential resistance and or increased aggression during citizen encounters. It may also be used for initiating peer support needs whenever an incident use of force has occurred. LEO’s change the force response based on the situation they encounter in real-time in a flexible and fluid manner. In this same way, peer support programs can flexibly shift to the needs of a presenting LEO and intervene early on – rather than when an officer is at a breaking point. “This continuum (use of force) has many levels, and officers are instructed to respond with a level of force appropriate to the situation at hand, acknowledging that the officer may move from one point on the continuum to another in a matter of seconds.” NIJ publication. Peer support too, must accommodate a law enforcement officer in real-time to begin the process of building a healthy, resilient response to sometimes horrific exposures and provide a continuum of unbiased employee assistance and when necessary professional consultation.
Protective Factors begin in Academy training
What topics should addressed while LEO cadets are in training? Ostensibly, the resilience of LEO’s depends upon the opportunity for in-service training in topics of mindfulness, stress management, physical health maintenance, nutrition, and trust.
“Emotional resilience is defined as the capacity to integrate the breadth of police training and experience with healthy, adaptive coping, optimism, mental flexibility and healthy resolution of the traumatic events. In general, resilient people are self-reliant and have positive role models from whom they have learned to handle the stressful events all police officers encounter” according to Leo Polizotti, Ph.D. a police psychologist consultant (Sefton 2018).
Police programs for health maintenance
The Police Stress Intervention Continuum or P-SIC, involves a system of police support that varies in its intensity depending upon the continuum of individual needs of the LEO including physical debility or other significant components impacting career success and satisfaction. The intervention protocol is flexible and fluid as well. The entry point into the peer support continuum initiates from supervisory observations of LEO history and behavior, peer recommendations, and exposure to a range of traumatic events.
Generally speaking, a police officer’s behavior change is a function of the resilience they develop throughout their careers. Greater attention to physical health and emotional well-being are now being espoused in police academies across the country. Greater awareness of the correlation with the recent trauma and frequency of exposure to trauma such as the death of a child, exposure to dead bodies, suicide of a colleague, etc. have negative impact on officer well-being. Perceived support from supervisors and the organization hierarchy builds resilience.
Career success requires that officers learn stress tolerance and healthy habits to manage the daily challenges of police service. Physical exercise and healthy routines often afford the stressed officer an outlet for reduced risk of stress-related physical afflictions in addition to the emotional and health effects of repeated exposure to unpredictable violence.
The cumulative stress associated with a career in law enforcement cannot be understated. In the setting of police stress and stress support there is an intervention protocol that relates to the peer-support program continuum. Depending on where officers enter the peer support network will impact the level of intervention they may require in the P-SIC program. Peer support is not psychotherapy but officers occasionally must hand off the officer in trouble to a higher level of care. These hand-offs are key to linking at-risk LEO’s with range of professional support needed to keep them on the job. Yet fear of reprisal for acknowledging the cumulative impact of stress and its impact often derails the hand-off to the professional. The highest risk for suicide to a LEO is when he is denuded of badge and gun because he may be a threat to himself.
The career success they have may be directly related to the application of resiliency training to build and maintain physical and emotional hardiness that lasts a lifetime according to Leo Polizoti, 2018. Before this can happen the stigma associated with reaching out must be reduced.
Points of entry to Peer Support – Stress Intervention Continuum
copyright Michael Sefton
Exposure to highly stressful events in close sequence
Change in work assignment, district/station, deployment undercover or return from deployment
Increased absenteeism – over use of sick leave
Increased use/abuse of substances – impacting job functioning, on-the-job injury
Community – citizen complaint(s) for verbal abuse, dereliction of duty, vehicle crash
Citizen complaints of excessive force during arrest, supervisory or peer conflict, or direct insubordination.
Abuse of power using baton, taser or firearm, recurrent officer involved use of force. Officers are sometimes strongly embittered and angry at this point in their career due to perceived lack of support and powerful feelings career disappointment and alienation.
NIJ Publication (2009). Use of Force Continuum. https://www.nij.gov/topics/law-enforcement/officer-safety/use-of-force/Pages/continuum.aspx. Taken November 17, 2018
Aamodt, M. G., & Stalnaker, N. A. (2001). Police officer suicide: Frequency and officer profiles. In Shehan, D. C, & Warren, J. I. (Eds.) Suicide and Law Enforcement. Washington, D.C.: Federal Bureau of Investigation.
Aamodt, M. (2008). Reducing Misconceptions and False Beliefs in Police and Criminal Psychology. Criminal Justice and Behavior 2008; 35; 1231 DOI: 10.1177/0093854808321527.
Patterson, G T. (200l). Reconceptualizing traumatic incidents experienced by law enforcement personnel. The Australian Journal of Disaster and Trauma Studies, 2.
Joyner, T. (2009) The Interpersonal-Psychological Theory of Suicidal Behavior: Current Empirical Status. Science Briefs, American Psychological Association, June.
Sefton, M. (2018). Police Training: Revisiting Resilience Blog post: https://msefton.wordpress.com/2018/07/27/police-training-revisiting-resilience/. Taken November 18, 2018
Hartley, T., et.al.(2007). Associations Between Major Life Events, Traumatic Incidents, and Depression Among Buffalo Police Officers. International Journal of Emergency Mental Health, Vol. 9, No. 1, pp.
John M. Violanti, Anna Mnatsakanova, Tara A. Hartley, Michael E. Andrew, Cecil M. Burchfiel. (2012). Police Suicide in Small Departments: A comparative analysis. Int J Emerg Ment Health. Author manuscript available in PMC 2015 Aug 14. Published in final edited form as: Int J Emerg Ment Health. 2012; 14(3): 157–162.
After a spate of bomb threats and mass shootings there are still many myths about the attribution of these events and the underpinnings of violence. The knee jerk reaction is to attribute the recent Thousand Oaks, CA nightclub shooting to a “crazed gunman” but that would unfairly place the blame on the mentally ill. 12 people were left dead in a despicable sequence of events during which the shooter Ian David Long posted that he had no reason for doing it except boredom. In truth, most people with mental illness are not dangerous, and most dangerous people are not mentally ill.” Liza Gold, 2013. But Long had a history of violence and aggressive behavior that may have been linked to his service as a decorated US Marine. Published information suggests Long’s mother was terrified of making him angry out of fear that he would harm or kill her. Was Long’s terminal behavior attributable to mental illness or the result of traumatic events he experienced in the service of his country?
“Fact is I had no reason to do it, and I just thought….(expletive), life is boring so why not?” Ian David Long via social media post (now removed)
Psychological experts believe mentally ill persons lack the higher order planning to execute the complex steps necessary for anything more than petty crime – more often associated with co-morbid substance abuse. It is the co-occuring illness of drug or alcohol addiction that is a confounding variable in all police-mental health encounters. “Doctors and scientists know that the perpetrators of such violent behavior including incidence mass shooting events are frequently angry young men, who feel they have been mistreated by society and therefore seek to exact revenge” described in a BBC the report Criminal Myths published in November.
“Confounding variables such as a history of childhood abuse or use of alcohol or drugs can increase the odds of violence.” according to a BBC report debunking the belief that people who commit mass murder are mentally ill by Rachel Newer in November, 2018. The vast majority of cases are committed by a person or persons without mental illness. In fact, people with mental illness are more likely to be victims of crime and are not prone to violent behavior. The Thousand Oaks killer refused any mental health support and was not driven by demons
The interaction of substance abuse and mental illness is complex. Persons with drug and alcohol addiction must be expected to become sober with the help of substance abuse treatment and family support. The risk of violence and suicide declines when sobriety can be maintained. This is essential and will help to reduce officer involved use of force against the mentally ill substantially. What to do?
Red flag indicators are often demonstrated in behaviors that are observable and measurable sometimes for weeks and months before the terminal event according to Michael Sefton, 2015.
The incidence of mental illness leading to mass shooting may be illustrated in the 2007 Virginia Tech shootings. The Virginia Tech shooter Seung-Hui Cho had been treated for depression and was hospitalized on an involuntary basis prior to the rampage in 2007. Cho exhibited a life-long pattern of withdrawal from interpersonal relationships. He was often nonverbal and did not respond to people who reached out to him including direct family members. His mother prayed for God to transform her son.
I strongly believe that mental illness does not mitigate citizens from responsibility for crimes they commit. I agree that alternative sentencing may be a powerful tool to bring these individuals into treatment. The substantive goal of streamlining encounters between police officers and citizens who suffer with untreated emotional problems belies the mission of these gifted officers and can teach others the role of discretion in mental health encounters.
Ostensibly, building relationships with network psychotherapists, physicians, addiction specialists, court judges, and other support service like Child and Family Services is essential. This is the area of most vulnerability. When LEO’s fully buy-in to the mental health – police intervention model including the use of de-escalation techniques there must be receiving facilities available to initiate treatment and keep patients and citizens safe. The development of a fully integrated infrastructure for jail diversion, intake, and providing for the needs of the mentally ill is certainly a work in progress.
“And when it comes to mass shootings, those with mental illness account for “less than 1 % of all yearly gun-related homicides” a 2016 study found. Other studies indicate that people with mental disorders account for just 3-5 % of overall violence in the US” – Paul Appelbaum, M.D. taken from BBC by Rachel Newer 11-1-2018
Nuwer, Rachel (2018) http://www.bbc.com/future/story/20180509-is-there-a-link-between-mass-shooting-and-mental-illness taken 11-10-2018
Sefton, M. (2017) https://wordpress.com/post/msefton.wordpress.com/4561
Mentally ill American’s and their proclivity to act out against authority.
Washington Post (2007) Rescue and Recovery: A story of resilience that began with the scene in this photograph, Blog post: taken on April 16, 2007. https://www.washingtonpost.com/graphics/local/virginia-tech-five-years-later/?noredirect=on&utm_term=.cd170ba2ac09 taken 11-10-2018
Sefton, M (2017) Police as crisis interventionist: CIT as it is meant to be. Blog post: https://wordpress.com/post/msefton.wordpress.com/3653 Taken 11-10-2018
Sefton, M. (2015) Unappreciated Rage: The Dissembling Impact of those living in the Margins. Blog post: https://msefton.wordpress.com/2015/08/27/unappreciated-rage-the-dissembling-impact-of-those-living-in-the-margins/ Taken 11-10-2018
There is much to be said about all the good that comes from being alone. Aloneness and loneliness are completely different. Aloneness is a feeling of aliveness and emotional freedom. It is a positive and emotionally energizing place. It’s not the mere concept of being by oneself that defines being alone more the understanding that being alone requires both self-reliance and emotional sustainability. People who enjoy being alone have higher self-esteem and emotional maturity. There is a significant difference between being alone and being lonely.
Loneliness refers to feelings of being incomplete and sometimes empty. You can be surrounded by people and still experience feelings of loneliness and the range of emotions associated with insecurity, dependence and unmet needs. Some people feeling that without another person or companion that there is something wrong and missing in their lives. Loneliness is a negative emotion that quietly robs self-esteem and can errode one’s capacity to feel complete and connected to others. Lawrence Wilson suggests that loneliness may actually be a driving force that helps people look for connection in others to fulfill emotional need (2011). Wilson asserts that loneliness may be seen as a state of suffering over loss of connection or long felt abandonment. The difference between the two feeling states is important. Aloneness is a pleasant feeling whereas loneliness is unpleasant and can lead to chronic isolation and sadness. Aloneness can bring about creative energy while loneliness brings about brooding rumination.
Think about what that means. The two concepts are almost opposing emotions yet most of us are them as synonymous. Too many people either fear being alone or depend on others to complete them by making the whole. There was an old adage that we come into this world alone and so we go out. Emotional grown and emotional development require being alone and not total dependence on another person to feel complete or whole.
A good friend and co-author of our published Psychological Autopsy (2011) told me that if I “want to be a leader that I need to be more concise”. I had recently promoted to sergeant in the Police department from which I am now retired. At the time he was angry at me because I had promised him I would give my decision about travel plans we had discussed.
“If a man is solely judged on his moment of weakness there will be not leaders in the world” said a 91-year old man with skin cancer seated at a bar in Florida
Eventually, I called my colleague to say I was ‘all in’ when he let me know he had made other plans. Okay, my bad. I remembered at once him telling me that if I wanted to have followers I needed to be more concise and communicate more clearly. How true his remarks ring to this day and I hear it often from other friends and family.
He had given me a deadline and I failed to let him know of my intentions and he decided he needed to move on or risk losing air fare, hotels, etc. He was right, I was vague and noncommittal. I was hurt by his gruff response but it taught me an important lesson. If I want to have followers I need to be concise. Since then these words resonate with my belief system but I’d say I still remain uncertain when given too many choices.
“The genius of leadership lies in the manner in which leaders see, act on, and satisfy followers’ values and motivations as well as their own” and I can fully relate to this and attribute my leadership to a model of shared responsibility and collateral command.
Institute of Medicine (US) (2004). Committee on the Work Environment for Nurses and Patient Safety; Page A, editor.
Washington (DC): National Academies Press (US)
I am preparing for an upcoming presentation at the annual Society of Police and Criminal Psychologists in Sarasota, Florida held in early October each year. So far I have offered several police departments an opportunity for free in-service training in the area of risk assessment and domestic violence. No interest. I can even say that one of the chiefs I approached is a friend of mine and still there was no interest in hearing about updated issues in domestic violence and the risk associated with intimate partner abuse. This has been both a surprise – given my passion about the topic and self-ascribed expertise, but also because it brings up great anxiety when I think about the expectation for my presentation at a national conference consisting of my peers. This post is all about how to deal with the flood of anxiety associated with presenting one’s ideas to an audience that may not be interested in what I am selling.
“If we perceive our available resources to be insufficient, along comes the ‘threat’ mindset. When threatened, stress has a catastrophic effect on our ability to perform. We receive an enormous sympathetic surge (adrenaline/noradrenaline dump), and our HPA axis pumps out cortisol. High cortisol levels have a very detrimental effect on higher cognitive processes – decision-making and prioritisation” or triage as described in a blog written by Robert Lloyd and physician in the U.K.
Lloyd goes on to say “that breathing is the only autonomic process that we can consciously control (other than blinking – less useful). By doing so, we access the ‘steering wheel’ of our sympathetic nervous system, and can regain a feeling of self-control in a moment of extreme stress. Heart rate and blood pressure come down when practiced. The process of deliberately controlling ones breath in the midst of a stressful moment that is key to lowered autonomic overdrive and greater physiologic homeostasis. Mindfulness and reslience training converts a ‘threat’ to a ‘challenge’ mindset by building resilience to a controlled stressful stimulus.” It arms you with prophylaxis against condition black when the organism is fighting for its life.
Stress has undeniable impact on all human functioning and public health. Not enough is being done to infuse knowledge and understanding into the emotional maelstrom created by chronic stress (Sefton, 2014). Healthy coping and productivity breaks down when uncontrolled stress occurs over and over. According to Leo Polizoti, Ph.D., the primary author of the Police Chief’s Guide to Mental Illness and Mental Health Emergencies stress can lead to a breakdown in adaptive coping. “Learned resilience can be taught and leads to reduced stress and psychological hardiness rather than psychological weariness. Psychological weariness is a drain on LEO coping and adaptation to job-related stress and the efficiency for handling everyday calls for service. As the demand for police service becomes more complex, officers must adapt their physical and emotional preparation for service or risk premature career burnout” according to Polizoti. Resilience and career satisfaction are important components of law enforcement and individual officer training, behavior and longevity. Positive resilience will reduce officer burnout.
In its absence police officers and their agencies are at greater risk for conflict both internally and with the general public in the form of civilian complaints of police officer misconduct.
So in anticipation of my own decrease in internal homeostasis and elevated production of stress hormones, I will breath and adjust my thinking for a positive outcome and not be hurt by the buyer beware myth my topic may evoke. I will take a few moments to relax and breath slowly in anticipation of the quiescence it will bring and my belief in learned resilience.
“You can’t say that nothing can be done, because nothing will be done,” said Michael Sefton, a former Westbrook, Maine police officer who is a psychologist and former police sergeant in Massachusetts at the New Braintree Police Department.
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