Mental Health Triage: Tools for LEOs, Pt. 1
The negative effects of the daily grind might be much greater than most realizeBy David J. Thomas, Ph.D, LMHC | Dec 21, 2017
In the world of law enforcement, the most noted form of trauma is an officer-involved shooting. But from a psychological standpoint that may not necessarily be the case. So-called normal or routine calls, over time—very often, in my experience—weigh heavily on officers and can lead to trauma. That’s the bad news.
The good news is that it seems the profession finally recognizes that exposure to major traumatic events requires some form of psychological triage. Most law enforcement agencies provide Employee Assistance Programs; Critical Incident Stress Management or Debriefing after such incidents; and/or have a contract with a mental health provider. However, most often agencies limit the nature and type of mental health services they provide for officers.
Furthermore, from an organizational standpoint and among officers, mental health is not seen as problem. I’ve heard it said: “To see the shrink is a sign of weakness. Warriors can handle anything.” Braziel, Straub, Watson, & Hoops (2016) completed an analysis of the San Bernardino, Calif., terrorist attack and the law enforcement response. In that analysis, the authors noted mental health counseling varied depending on the agency, a stigma is associated with those who seek therapy, and a co-worker openly teased those who sought therapy. Finally, a supervisor stated: “It’s almost seen as a ‘badge of discourage’ if you speak out and have problems. We need to show some degree of empathy for these people” (Braziel, Straub, Watson, & Hoops, 2016, p. 48).
The goal of this article is to examine psychological trauma, individual coping mechanism, and offer suggestions to remain mentally healthy. Before you move on, please review these questions and ponder them as you read.
- As an officer, do you recognize the differences between critical incidents, the routine and the impact of both on your psychological well-being?
- Have you taken the time to evaluate your coping skills? Are they healthy or destructive?
- Is your lifestyle one that is isolated or sharing?
- Finally, do you believe that the only people that you can trust are police?
Police are taught to be in control and never let anyone know that they’re personally hurting emotionally. The need to be—or at least to seem to be—in control is often why officers overlook or ignore the signs and symptoms of psychological trauma. It is important to note that today the police culture is primarily male, associated with the police culture are the male ego/machismo. Any sign of pain from trauma is a sign of weakness (Arrigo and Shipley, 2005; Bonifacio, 1991; Slovenko, 2002; Blau, 1994).
Clark and White (2003) note that police view themselves as problem solvers, not as problems: invulnerable to the daily grind of the job and trauma they experience, and so over time they become emotionally numb. The police personality is what can be described as biphasic. The biphasic personality allows an officer to adapt to stressful situations. Essentially, every officer has two (2) personalities: the work personality, who is capable of handling and adapting to stressful situations, and the off-duty officer who has a personal life (Siebert, 1994; Seaward, 2009).
When the working personality can no longer be contained and an officer’s coping mechanisms fail, the end result is often alcohol/substance abuse, bouts of anxiety, depression, sleeplessness, and, ultimately, suicide.
Herman (1997) argues that the there are two causes of psychological trauma: natural disasters and interpersonal conflict. Regehr and Bober (2005) offer that for first responders trauma and distress are directly related to the following incidents: the death of a child; exposure to mass casualties; witnessing a violence; being personally assaulted while on duty; first responder’s life threatened while on duty; and the death of a co-worker (p.13). It is important to note that neither definition addresses the daily grind. This, I believe, is a shortcoming.
Defining Your Routine
It’s often said that nothing in law enforcement is routine with the understanding that every call can result in serious injury or death. Law enforcement officers are routinely exposed to domestic violence, child abuse, traffic accidents, disturbances, dealing with the mentally ill, robberies, shootings, and dealing with people at their worst, which are all considered the norm.
To most officers, the aforementioned incidents are all in a day’s work. Most officers respond to these calls without ever thinking of the toll or psychological impact that they have on an officer’s mental health.
The question that is impossible for anyone to answer is: How much is too much?
In its simplest form, an officer’s brain is similar to a computer’s hard drive. The brain processes billions of pieces of information in a lifetime, retaining some information and deleting others (Richards, Clark and Clarke, 2007; Scott, 1995; Carter, 1998). For many officers, repeated exposure to trauma, and failing to resolve those traumatic events in a healthy manner, will impair an officer’s ability to function normally. The tipping point to an officer’s downward spiral is unknown. It could be an officer-involved shooting, investigating a murder suicide, investigating a natural death, or a simple car crash without injury.
Although officers are exposed to trauma on a daily basis what is rarely considered—at least as fare as mental health goes—is the status of the officer’s personal life, which is no different than the average citizen. Some of the well-publicized personal issues which have impacted an officer’s life are: finances, divorce, domestic violence, substance abuse/alcoholism, health concerns, depression, anxiety, and issues with anger management (White and Honig, 1995).
Often questions never asked are: Has the job created the problems in the officer’s personal life? Is the officer’s personal life impacting their job performance? Finally, what happens when an officer’s personal and professional lives collide and cannot be reconciled?
More to come in the second installment! Until then, take care of yourself and each other.
Arrigo, B.A. & Shipley, S.L. (2005). Introduction to forensic psychology, 2nd ed. Burlington, MA: Elsevier Academic Press.
Blau, T. (1994). Psychological services for law enforcement. New York, NY: John Wiley & Sons.
Bonifacio, P. (1991). The psychological effects of police work. A psychodynamic approach. New York, NY: Springer Publications.
Braziel, R., Straub, F., Watson, G., and Hoops, R. (2016). Bringing Calm to Chaos: A Critical Incident Review of the San Bernardino Public Safety Response to the December 2, 2015, Terrorist Shooting Incident at the Inland Regional Center. Critical Response Initiative. Washington, DC: Office of Community Oriented Policing Services.
Carter, R. (1998). Mapping the mind. Berkeley, CA: University of California Press.
Clark, D.W. &White, E.K. (2003). Clinicians, cops, and suicide. In D.L. Hackett & J.M. Volanti (Eds.) Police suicide tactics for prevention, pp. 16-36. Springfield IL: Charles C. Thomas Publishers.
Herman, J. (1997). Trauma and Recovery. New York, NY: Basic Books.
Regehr, C. & Bober, T. (2005). In the line of fire: Trauma in the emergency services. New York, NY: Oxford University Press.
Richards, D., Clark, T., & Clarke, C. (2007). The human brain and its disorders. New York, NY: Oxford University Press.
Scott, A. (1995). Stairway to the mind: The controversial new science of consciousness. New York, NY: Springer-Verlag.
Seaward, B.L. (2009). Managing stress: Principles and strategies for health and well being, 6th ed. Sudbury, MA: Jones and Bartlett Publishers.
Siebert, A. (1994). The survivor personality. New York, NY: Berkley Publishing Group.
Slovenko, R. (2002). Psychiatry in law: Law in psychiatry. New York, NY: Brunner-Routledge.
White, E.K. & Honig, A.L. (1995). Law enforcement families. In M.I. Kure and E.M. Scrivner (Eds.) Police psychology into the 21st century, pp. 189-206. Hillsdale, NJ: Lawrence Erlbaum Associates.