The following is excerpted from Occupation Under Siege: Resolving Mental Health Crisis in Police Work by John Violanti, Ph.D. The book offers a mixed approach that includes research and some practical suggestions from practitioners on how best to deal with the police health crisis.
AN EXPERIMENT TO INCREASE RESILIENCE IN POLICE OFFICERS
Proactive training in resilience is important in police work to help reduce the impact of future stress and trauma.
An example of a resilience intervention was conducted by Arnetz et al. (2009, see below for complete study). This intervention was based on combining structured relaxation methods and rehearsal of skills for dealing with known police work stressors with the goal of achieving “optimal focus, effective weapons management, and navigating novel environments during a critical incident” (Arnetz et al., 2009).
The purpose of the Arnetz experiment was to prepare officers to successfully cope with job-related stress and trauma. This prevention program was unique because it:
- Targeted primary prevention, i.e., before professionals develop mental health symptoms.
- Combined emotional skills regulation training with improved operational and tactical skills to handle professional-derived trauma and challenges.
- Demonstrated sustained benefits over a 2-year follow-up period, substantially longer than any prior controlled trauma-prevention study.
Components of the Arnetz et al. (2009) sessions:
- Relaxation training,
- Guided imagery training to facilitate imaginal exposure to potentially stressful events,
- Mental practice of police tactical skills,
- Adaptive coping strategies for the different scenarios,
- Educational presentation that included discussion of the theory of stress,
- Impact on health and performance,
- Muscle relaxation technique,
- Homework to practice the relaxation technique daily was assigned.
Participants met once per week in small groups with their police group leader for 90-minute sessions for nine consecutive weeks. The leader began each session with a review of the previous week’s session and homework assignment.
Over the next 60 minutes, two police-relevant stress scenarios were presented. The presentation included exposure to critical incident police work scenarios via narrated, pre- sent-tense scenarios and guided imagery that was read aloud by the group leader. The group then practiced an abbreviated, 15-minute version of the relaxation techniques.
Officers not only had exposure-based preparation for potential duty-related incidents but also learned job skills and increased predictability of their job in order to promote successful adjustment to future trauma exposures.
Examples of scenarios:
- A threatening situation while alone in a room
- Active robbery with gunshots
- Domestic violence where children are adversely affected
- Death involving a child
- Facing a threatening situation not really knowing what a suspect is carrying in his hands
- Meeting an armed suspect with a gun face-to-face
- High-speed car chase
- Traffic accidents with multiple car involvement and with severely injured persons
- Experiencing another police officer in a life-threatening situation
Each scenario was described in great detail with vivid imagery to ensure that participants developed vivid, lifelike mental images during the scenario, were emotionally engaged and physiologically aroused. The imaginal training was designed to increase participants’ familiarity with potential future trauma and stressors, which is expected to increase their cognitive processing efficiency when applying their skills to similar situations on the job.
Officers had lower levels of negative mood after the simulated critical incident and lower autonomic reactivity, as measured by increase from baseline heart rate, during the simulated critical incident. Objective observations of police performance during the incident were higher for the training group (Arnetz, 2009).
BUILDING RESILIENCE IN POLICE OFFICERS: ORGANIZATIONAL STRATEGIES
What are some problems with establishing resilient police organizations?
- No indication of an organizational culture of readiness or resilience.
- Resilience does not have a high priority for leadership or is not supported.
- Officers not feeling heard or not feeling like an integral part of the organization.
- Trust is fractured throughout the department, including trust in leadership and trust in the organization as a whole.
- Officers not aware of the resources or programs available to them, do not use them, and do not feel that policies to support them are in place.
- Communication is lacking in many ways. Best practices are generally not discussed or shared within or among components. There is a lack of communication about resources and programs available to staff, their input is not sought, and their accomplishments are not celebrated.
What does a resilient police department look like?
- Trained with the knowledge, skills and attitudes required to perform the mission.
- Properly equipped with tools and protective assets to support the mission.
- Healthy and fit to endure the environmental conditions required in the mission.
- Guided by strong and effective leaders.
- Is ready to perform its roles and missions.
- Withstands and copes with stress.
- Adapts and adjusts to challenging conditions.
- Rebounds and grows from experience (Institute of Medicine, 2013).
What can be done?
The Officer Safety and Wellness Group formed by the Office of Community Oriented Policing Services (COPS) held a meeting in 2017 to formulate ideas for increasing resilience among police officers (Spence, 2017). Maintaining health was a key factor. Dr. Jon Sheinberg at the COPS meeting proposed the following pillars should be given high priority in every law enforcement agency as the building blocks of resilience:
- Tactical trauma care: Law enforcement agencies must have standardized equipment, including trauma care kits, and training in tactical trauma care such as hemorrhage control. When an officer is shot, the first responder to the scene is often a fellow officer.
- Cardiac screening: The risk of heart disease appears higher among police officers than the general population and may be exacerbated by the acute surge of adrenaline that officers experience in critical incidents. Screening for potential heart problems is necessary, relatively inexpensive, and likely to save money in the long run.
- Fitness: Lack of fitness is a health risk for officers and a liability for their agencies. Every agency should have fitness standards for all of its officers. In addition, agencies should have consequences – though not necessarily punitive – for failure to meet the standards and a benefit or reward structure for those who meet or exceed them.
- Overweight and obesity: The risk of shift work and having a sedentary job places law enforcement officers at higher risk of being overweight or obese, both of which increase the risk of heart disease and stroke and make the law enforcement officer less successful in certain job-related performance measures.
- Emotional or mental health: On a daily basis, law enforcement officers see small traumas that, over time, can have as significant an impact as a major incident. This can lead to a higher risk of self-medicating behaviors such as alcohol use.
The COPS meeting (Spence, 2017) also suggested the following organizational strategies:
- Don’t just launch new initiatives: Inventory what the agency has and assess what it needs. This also includes educating everyone in the agency on key facts and data about officer health and wellness. For example, talk about the rates and circumstances of officer suicides, heart attacks, obesity, line-of-duty injuries and deaths, vehicular crashes, and other basic awareness facts that everyone in the profession should know.
- Involve the whole agency in establishing wellness programs. The best programs involve management and rank and file working together and include education, screening, and service provision. Wellness does not need to be a chore, and programs can include incentives and competition to help inspire self-care.
- Provide a variety of options to help officers address their emotional health needs effectively. Formal counseling services are one avenue but so too are chaplaincy programs, peer support programs, mentoring, and information on other venues for assistance.
- Model good behavior and take ownership of initiatives. Agency leaders need to be clear that nothing is more important than the wellness of officers; this realization includes leaders’ own wellness. Show a commitment to diet, fitness, physical and emotional health screenings, body armor, and seatbelts when asking officers to do the same.
- Make fitness fun. Building teams and a sense of community within the agency can not only improve individual health but also make fitness enjoyable. Remember that the common use of push-ups as discipline in the academy may work to influence behavior during training, but that method also likely ensures that those officers will never do a push-up again once they graduate.
- Provide officers with annual fitness evaluations, regular information on the health risks of inadequate sleep, ongoing nutritional counseling, and periodic cardiac screening. Although providing a full cardiovascular risk assessment for all officers would be the ideal approach, even small steps can help. An agency should consult with knowledgeable experts to ensure the agency uses good, validated tests; otherwise, the money is not well spent.
- Talk about trauma as an experience shared by community members and law enforcement officers. This trauma-informed approach could help improve trust between the community and officers. Making agencies trauma-informed does not mean making officers feel like victims; rather, it is about recognizing and validating the trauma officers’ experience.
- Collect and analyze national data to identify the characteristics of successful officers to help define the characteristics associated with resilience. For example, one attendee said that individuals who succeeded at his workplace were more likely to have played team sports in high school and college. The more we understand about individual resilience, the more we can do to promote and protect it.
- Remember the influence survivors can have on current officers. Messages like “take care of yourself” hold a lot of weight when they come from survivors.
- Create a system to collect resilience research results and use the research to build effective programs. Currently, law enforcement experts recommend wellness programs without having the data to show if the programs are effective.
- Create comprehensive officer safety and wellness toolkits. These tool kits should include resources that cover issues such as the long-term effects of doing law enforcement work and how officers can take care of themselves to counteract those effects. There should be toolkits for agencies as well as for individuals. Resilient agencies empower officers to take ownership of their own health and wellness.
Resilience intervention research:
Trauma Resilience Training for Police by epraetorian on Scribd