Can We Ever End the Stigma?

Certainly, the things we’ve talked about so far are definitely contributing to the problem of suicide in law enforcement, but the one thing that we really need to address that, unless we fix that, nothing else will really matter is:  the STIGMA associated with asking for help.

Our research shows that about 90% of all officers admit that they are affected emotionally by the things they see and do on the job.  So we have to ask, then, whey they don’t seek help, even when they know they need it.  In fact, in the research that we mentioned previously, we asked exactly that.  And in the over 900 open-ended responses we received, the one word used most frequently in those responses was the word “stigma.”

Further research shows that 80% of those responding believe that the stigma is perpetuated by their peers.  In other words, even though an officer knows that when he or she looks around at fellow officers, 9 out of 10 of them are experiencing some level of emotional impact from the job, they believe that 8 out of 10 of those same officers would tell them that they need to “suck it up” and keep going, and to NOT seek any kind of help or support to deal with the stress that they are experiencing.  Instead of acknowledging the effects of the stress of the job, and normalizing the need to address those effects, we keep insisting that people cram more and more stuff into their emotional trash can, and we never encourage them to take out the trash when they need to.

Also, 90% of those respondents said that the stigma is perpetuated by the department or agency they work for.  The don’t believe the administration will have their back.  They believe they will be punished in some way if they admit they need help, and they’ve developed that perception because they’ve seen it happen far too many times.

WHAT EXACERBATES THE PROBLEM OF LE SUICIDE

            Kind of continuing our current thought here, officers simply don’t have confidence that their leaders actually care about their mental and emotional well-being.  According to our research, department leaders only average 2.5 out of 5 stars on the following statements:

  • “Leaders in my department care about the mental wellness of their personnel.”
  • “Leaders in my department believe mental wellness is as important as physical wellness for a resilient and healthy workforce.”
  • “Leaders in my department know how to recruit and hire resilient personnel.”
  • “My department has institutionalized its belief in mental wellness through a set of well-written policies and practices.”
  • “My department has a well-trained peer support team consisting of personnel trained in some form of psychological first aid.”
  • “My department utilizes mental health practitioners who are familiar with emergency services culture and work, and who are trust by personnel within the department.”
  • “Leaders in my department know how to communicate with personnel suffering from emotional distress in ways that are supportive rather than threatening.”

Another issue is that officers are not always as resilient as they think they are.  They do their best to maintain a tough exterior, and they think they are doing themselves a favor by trying to disassociate from the mental and emotional strain, but as they get pushed into a condition of stress overload, you start seeing a progression of problems, such as:

  • Persistent irritability
  • Persistent anxiety
  • Periods of high blood pressure
  • Grinding teeth at night
  • Insomnia
  • Forgetfulness
  • Heart palpitations and/or unusual hearth rhythms
  • Inability to concentrate
  • Headaches

Unmanaged stress at that level can lead to worsening signs of distress that would include:

  • Persistent tardiness or absenteeism
  • Procrastination, turning work in late
  • Decreased sexual desire
  • Persistent tiredness in the mornings
  • Social withdrawal
  • Cynical attitudes
  • Resentfulness
  • Increased consumption of alcohol, caffeinated drinks
  • Apathy

Further unmanaged stress at that level pushes people farther into stress overload, and can result in:

  • Chronic sadness or depression
  • Chronic stomach or bowel problems
  • Chronic physical and/or mental fatigue
  • Chronic headaches
  • The desire to “drop out” of society
  • The desire to move away from work, friends, perhaps even family
  • The desire to commit suicide

Finally, police officers don’t really trust mental health professionals and they are looking for alternatives to help address their needs when it comes to mental wellness, especially after critical incidents, but as a matter of routine as well.  Long story short, here’s what our research has told us:

When asked whether they would prefer a mandatory annual appointment with a mental health professional hired by their department or voluntary participation in an effective peer support program, 7 out of 10 officers said they would prefer to talk to a peer first.

Trust me, there is plenty of room on the continuum of care for both an effective peer support consisting of well-trained and dedicated officers, and the work of licensed mental health professionals for those cases that cannot be fully addressed by peers.  But I do strongly believe that peer support should always be the beginning point on the continuum of care.  In nearly every case when a peer needs to refer someone to a mental health professional, that person is more open to accessing that level of care, and more compliant with the recommendations of the therapist than if they are told by their administration that they must go see a clinician “or else.”

This is Part 4 and the last article of a series of articles on Confronting the Issue of Suicide and we want to thank you for taking time to read them. Meanwhile, if you are struggling with the stresses of the job or of life in general and are looking for some resources for help, please reach out to us at m.me/callforbackup.org and one of our peer support specialists will be happy to help. If you are in crisis now and need immediate help, please text the keyword BADGE to 741741 to be connected to a trained crisis counselor 24/7/365 – always free, always confidential.

All “Stressed Up” with No Place to Go

Next, let’s talk about the cumulative effects of chronic stress – the day-to-day tasks and responsibilities of doing the job that can eventually take a heavy toll on our personnel.  In our research, we’ve utilized a couple of tools to help us find out what police officers believe is causing them the most stress in their job.

The Operational Stress Questionnaire asks respondents to score 20 items relating to the tasks associated with police work according to the amount of stress they perceive as caused by each item.  Here are the top five most stressful tasks based on results we have received:

  • 5: Paperwork
  • 4: Feeling like you are always on the job
  • 3: Upholding a “higher image” in public
  • 2: Shift work
  • 1: Fatigue

The Organizational Stress Questionnaire asks respondents to score 20 items relating to the administrative and bureaucratic aspects of police work according to the amount of stress they perceive as caused by each item.  Here are the most stressful aspects based on the results we have received:

  • 5: Feeling like you always have to prove yourself to the organization
  • 4: Dealing with co-workers
  • 3: Inconsistent leadership style
  • 2: The feeling that different rules apply to different people
  • 1: Staff shortages

Then, of course, police officers also have to deal with critical incident stress.  It is said that between 50% and 60% of adults in the U.S. will suffer one traumatic event during their lifetime.  Truth be told, 100% of police officers will experience multiple traumatic events over the course of a career, including:

  • Line of duty death
  • Suicide of a colleague
  • Serious work-related injury
  • Multi-casualty / disaster / terrorism
  • Events with a high degree of threat to personnel
  • Significant events involving children
  • Events in which the victim is known to personnel
  • Events with excessive media interest
  • Events that are prolonged with a negative outcome
  • Any significantly powerful, overwhelming distressing event

            We also need to talk a little bit about trauma and stressor-related disorders.  There are a number of stress-related conditions that can show up, either because of the cumulative effects of chronic stress or in the aftermath of an especially traumatic event such as a critical incident on the job.  These include post-traumatic (critical incident) stress, Acute Stress Disorder, Post-Traumatic Stress Disorder, and Adjustment Disorder.

            Let’s start by talking about post-traumatic stress, otherwise known as critical incident stress.  Here are the basics that you need to know:

  • Notice here that I did not say “post-traumatic stress disorder.”  It is important to understand the difference between post-traumatic stress and post-traumatic stress disorder.
  • About 95% of people experiencing a traumatic event will experience symptoms of post-traumatic stress, and those symptoms will show up with changes in their mental status, their emotions, their physical condition, their behavior, or even in how they view the world in the aftermath of the traumatic incident.
  • Evidence does show, though, that the majority of those people, through their own natural resiliency, will recover without any type of formal psychological intervention if they receive some form of early psychological intervention.  This is one of the reasons, of course, that we advocate so strongly for a peer support program in every public safety agency with a team of people that can provide that kind of intervention either for their own personnel, or to help personnel from other agencies around them.
  • Symptoms in the aftermath of a traumatic event will typically show up within the first 3 days and will typically be gone within 1-2 weeks.  Recovery may be gradual, but with the right kind of supports in place, recovery does happen.

Next, let’s take a look at Acute Stress Disorder (ASD).  If recovery in the aftermath of a critical incident has not happened within the 1-2 week time frame, if new symptoms come up, or if existing symptoms become more intense, then the individual should be evaluated by a mental health professional for Acute Stress Disorder (ASD).  About 30% of individuals experiencing post-traumatic stress will go on to develop this disorder.

  • Acute stress disorder has a specific set of symptoms that are listed in the DSM-5.  We’re not going to go into detail about those symptoms here, but again, duration of symptoms after a critical incident is the key to deciding whether someone should be evaluated by a clinician.
  • The good thing about acute stress disorder – if it’s possible to believe that anything is good about having a disorder – is that it is acute, meaning that the symptoms will go away, usually within about a month.

Next, we come to a discussion about the condition most believe is the worst stress-related disorder of all, Post-Traumatic Stress Disorder (PTSD).  According to the American Psychiatric Association, about half of the people who develop Acute Stress Disorder will go on to develop Post-Traumatic Stress Disorder (PTSD).  This can include family members who have been indirectly exposed to trauma, although in those cases that individual would likely be diagnosed with what is known as Secondary Traumatic Stress Disorder versus receiving a diagnosis of PTSD. 

  • In addition to being caused by direct exposure to a specific traumatic event, PTSD may also develop in some cases due to repeated exposure to critical incidents on the job as a first responder
  • A key factor in the diagnosis of PTSD is that a legitimate diagnosis of PTSD cannot be made until at least 30 days have passed since the traumatic event that triggered the stress-related symptoms.
  • The symptoms may only include those from the specific list of symptoms in the DSM-5 and occur with the required frequency and intensity, otherwise a diagnosis of PTSD is not appropriate.  And the precipitating event MUST involve death, the threat of death, sexual assault, or the threat of sexual assault, otherwise a diagnosis of PTSD is not appropriate

Finally, we come to a condition known as Adjustment Disorder (AD).  This is another stress-related disorder that is sometimes diagnosed when a diagnosis of PTSD is not appropriate.  We may refer to this sometimes as “stress response syndrome.”  With this condition:

  • Stress related symptoms may not appear for a few weeks up to about 3 months in some people after some type of trigger event, and after a long period of time dealing with the same type of stressor.
  • The only 2 conditions under which the symptoms of adjustment disorder will go away are 1) if the underlying stressor is removed, or 2) if the sufferer learns more effective coping skills for managing the underlying stressor.
  • One of the reasons we believe this is such a serious condition is that research indicates that a person with a diagnosis of adjustment disorder is 19 times more likely to die by suicide than a person without that diagnosis.  For more information on our suicide awareness and prevention efforts, I would encourage you to visit our website at callforbackup.org.

There we have an overview of these common trauma and stressor-related disorders and the impact they can have on those who suffer from them. 

This is Part 3 of a series of articles on Confronting the Issue of Suicide and we encourage you to visit again for more installments in this series. Meanwhile, if you are struggling with the stresses of the job or of life in general and are looking for some resources for help, please reach out to us at m.me/callforbackup.org and one of our peer support specialists will be happy to help. If you are in crisis now and need immediate help, please text the keyword BADGE to 741741 to be connected to a trained crisis counselor 24/7/365 – always free, always confidential.

Is the Culture the Culprit?

Well, let’s start by talking about the culture of law enforcement and how both the positive and negative elements of that culture may be contributing to the mental wellness issues suffered by our personnel.  And we’re going to use a fairly simple definition of culture: “The way we do things around here.”

First, one way the culture can be described as positive is by the expectations that characterize both the agency and the people who choose to work in emergency services.  Meeting those expectations is critical to the success of the organization and ultimately to protect the lives and property that we are sworn to protect.  Those expectations include:

  • Having a strict sense of discipline and understanding that there are going to be rules, regulations, policies, and procedures that must adhered to.
  • Working in any of the emergency services requires a strong work ethic, and having a high regard for, and the personal capacity for, physical and mental toughness.
  • Being a protector is part of the job.  It goes without saying that those working in emergency services should be protective of their own families, but also of civilians, and they will come across as being chivalrous and altruistic in their approach to serving the public.
  • Finally, there will be a code of conduct that provides a framework for an organizational culture that reflects well-defined and strongly supported moral and ethical principles.  In other words, people who are willing to put on the uniform and serve others are, first and foremost, just good people.

Another way to describe the culture as positive is by taking a look at the leadership structure.  Every successful organization needs principled leaders, and those leaders need to be effective at inspiring the members of the organization to follow (and for the followers to ultimately to be developed into leaders themselves).  Here’s what this looks like in a good organization:

  • The organization is highly structured, and by nature must also be very authoritarian.  Not dictatorial, but authoritarian.  Someone has to be in charge, and while good leaders will listen and gain input from others, the decision of the leader must ultimately be followed.  The lives of people working in these organizations depends on this.  You may recall the line from the movie A Few Good Men when Col. Jessup says, “We follow orders, son.  We follow orders or people die!” 
  • Which leads to the second statement about leadership, which is that leaders expect loyalty from their subordinates and from their allies.  Everyone should want the leader to succeed, because if the leader succeeds, the organization succeeds.
  • Leaders, and followers of course, must be mission focused and goal-oriented.  Goals and objectives are clear, there become a right way and wrong way to accomplish the task, and leaders understand how to communicate those goals and objectives so that the mission at hand is accomplished. 

Finally, a positive aspect of emergency services culture is the nature of the personal commitment demonstrated by everyone in the organization.  In a great emergency services agency:

  • There is a warrior culture that is characterized by some of the most praiseworthy traits imaginable – bravery, duty, honor, loyalty.  In a successful organization, we are going to see every member displaying those traits.
  • There is the feeling of loyalty to comrades.  Everyone is in it together, and everyone will be concerned about building others up, and everyone is going to make sure that they are watching out for one another before, during, and after any incident to which they are called upon to respond.  They will never leave anyone behind!
  • And finally, the mission comes first above all else.  I’m reminded of the motto made famous by the Army’s 1st Infantry Division: “No mission too difficult, no sacrifice too great.  Duty first!”

That covers the positive aspects of the culture that is prevalent in law enforcement as well as in the military and other emergency services.  There are plenty of good reasons to do things a certain way, but a lot of the negative consequences that people working in emergency services may experience are caused by some of the very things that make that culture as successful as it is.

            There are, for example, some personal realities associated with the culture.  People working in emergency services come from a variety of backgrounds, and even though they are willing to commit to the same rules and regulations, the same sense of order, the same chain of command, and so on, they still bring with them their own personalities and their own unique life experiences.  Learning to conform to the common cultural expectations of the job will often mean:

  • That the level of commitment required to learn the job and do the job well may make the individual feel as though he or she is “married to the job.”  They often end up spending more time doing and thinking about the job than spending time doing things they personally enjoy or that their friends and family members wish they could do together.
  • It also may mean finding it difficult to juggle between the department and home life.  Whether that’s finding the appropriate and necessary balance in answering the question, “how was your day?” or whether that’s deciding not to volunteer for an extra detail or overtime shift in order to spend time with the family, those choices often become more difficult.
  • Many times, the job ends up becoming the identity.  It starts that way because we are so proud of what we do.  It ends that way because we don’t know how to do anything else.  Not surprising, it is believed that 80% of emergency services retiree suicides happen within the first 2-3 years of retirement.  Why?  One reason could be because they have lost their sense of identity to the job.

There are also some professional realities associated with the job.  The harmful effects of some of these things will vary from person to person, but here are some of the most common professional realities:

  • People working in any of the uniformed services end up feeling as though they should be able to control the outcomes of the situations they respond to, and they end up “keeping score” and keeping a record of their wins and losses.  While some of the wins can be exhilarating, the losses can be devastating.
  • They also suffer from problems associated with things like sleep deprivation.  Study after study has been done to determine what the “best” shift schedule would be, but there is still a lot of disagreement on that subject.  No matter the duration of the shift, many people working in emergency services realize they have too much to do and not enough time to do it, and many times the stress of the job as well as some of their personal habits can make it difficult for them to get the sleep they need to be recharged and ready for the next day.
  • In many cases, the job also comes with a lot of public scrutiny and criticism.  No matter which service you work for, there will always be that.  Firefighters shouldn’t be going to the grocery store; they should be at the fire station.  Police officers need to stop hunting and killing innocent people.  There’s the ever-famous, “I pay your salary!”    And when one is injured or dies in the line of duty, we hear, “that’s what they signed up for.”  We could go on and on.  And to make matters worse, the government officials we work for will often take the side of the complaining public instead of standing by the public safety employees.

And we can’t end the discussion of the negative aspects of this culture without talking about some of the psychological realities, which include things like:

  • Personnel are taught to compartmentalize their experiences and to suppress their emotions.  Our research tells us that about 91% of first responders agree that the things they see on the job affect them emotionally, yet they don’t seek help in dealing with those emotions
  • Their sense of personal bravado, their self-confidence, and the sense of comradery within the culture reinforces what they have learned to do; hence, they continue to pack more trash into the trash can instead of emptying it when they need to.
  • We hear conflicting statements like: “We don’t need this stress stuff.”  “I just go home and have a drink and forget about it.”  “Suck it up, buttercup.”  “There must be something wrong with me.”  “I can take care of myself.”

This is Part 2 of a series of articles on Confronting the Issue of Suicide and we encourage you to visit again for more installments in this series. Meanwhile, if you are struggling with the stresses of the job or of life in general and are looking for some resources for help, please reach out to us at m.me/callforbackup.org and one of our peer support specialists will be happy to help. If you are in crisis now and need immediate help, please text the keyword BADGE to 741741 to be connected to a trained crisis counselor 24/7/365 – always free, always confidential.

Answering the “Big Question”

Just how many law enforcement suicides are there each year?  That’s the “big question,” and the answer is that no one knows for sure.  There are a number of organizations that have been trying to track the numbers of both active and retired officers for some time.  I have no intention of saying anything disparaging here, but let me name of few of the organizations that I’m talking about (and you will have heard of most of these):

  • Blue H.E.L.P.
  • Badge of Life
  • The Ruderman Family Foundation
  • The National Law Enforcement Suicide Mortality Database

The one thing that these organizations have in common is that they have basically nothing in common.  They don’t have the same number of suicides that have been tracked, they don’t have the same method of validating the information they receive, some are adamant that law enforcement suicides should always be treated as a line of duty death while others do not support that idea, and so on. 

            So, the answer to the question as to how many law enforcement suicides are there every year is that we don’t have an accurate number, and in my mind, there is little hope that we will ever have an accurate number.  But I’ll have more to say about that as the article continues.

            Meanwhile, there is information available that I believe still helps us understand the severity of the problem of suicide in law enforcement.  We did a survey through Humanizing the Badge asking police officers about the topic of suicide, and here is what we found from the 3,892 responses we received:

  • 41% said they would consider suicide as an option if they were to find themselves in one or more of the following circumstances:
  • Loss of a spouse, life partner, or child as a result of death
  • Loss of a spouse, life partner, or child as a result of divorce or separation
  • Recent diagnosis of a major/terminal illness
  • Feeling responsible for the death of a coworker
  • Killing someone accidentally or out of anger
  • Feeling isolated or alone
  • Being accused of sexual misconduct
  • Fear of losing their job due to being convicted of a crime or facing incarceration
  • Fear of losing their job due to receiving a mental health diagnosis
  • 43% said they had personally known another officer or former officer who had died by suicide
  • 78% said they were personally aware of another department or agency that had lost an officer or former officer to suicide

Other numbers that we know, for example, is that back around 2015-2016 when the suicide rate in the general population was around 12 per 100,000 the Department of Justice released the results of a study that showed the suicide rate in law enforcement to be about 18 per 100,000 and another study in 2017 showing that the rate of suicide in Chicago PD was about 60% greater than the average of law enforcement agencies across the country for a rate of about 29 per 100,000.  The number of suicides in NYPD in 2019 translates to a rate for them of about 30 per 100,000.

Is there any doubt that suicide in law enforcement is a problem?  Of course not.  Even if we don’t know the exact numbers from across the country, the numbers that we do know are (or should be) enough to cause us to want to take action and to do better.

Now, here’s the thing that had given me hope that we might actually have accurate numbers to report one day: The Law Enforcement Suicide Data Collection Act.  This Act passed on June 16, 2020, and here are the basic things you need to know about it:

  • It requires the Attorney General, through the Director of the Federal Bureau of Investigation, to establish the Law Enforcement Officers Suicide Data Collection Program within one year of the passage of the Act
  • It requires the Attorney General, through the Director of the Federal Bureau of Investigation, to deliver a report to Congress detailing the information that is collected through that data collection program beginning two years after the passage of the Act.
  • The only problem is that, while the Act requires the program to be established, the Act also says that this is a program “. . . under which law enforcement agencies may submit to the Director information on suicides and attempted suicides within such law enforcement agencies . . .”

The FBI has a similar data collection program for collecting data on the number of officers each year who are assaulted, injured, and killed in the line of duty.  There are almost 18,000 law enforcement agencies in the United States, and yet fewer than 10,000 of them reported information to that data collection program last year.  Hence, I no longer have hope that we will ever have accurate numbers of the law enforcement suicides of both active and retired personnel that take place each year, simply because if agencies aren’t absolutely required to report the information, there is probably only around a 50% chance that they will.

Still, people feel like they have to be able to report a number.  During his training programs, Lt. Col. (Ret.) Dave Grossman says that it is his belief that between 200 and 450 active police officers die by suicide each year.  That’s quite a wide range of numbers, and he may very well be right, but that’s like going to the gun range to qualify and only having to hit the proverbial “broad side of a barn” in order to pass!  The only thing I’m fairly comfortable saying when it comes to the numbers is that, in my opinion, we lose more officers to suicide each year than the number of officers who are feloniously killed in the line of duty.

This is Part 1 of a series of articles on Confronting the Issue of Suicide and we encourage you to visit again for more installments in this series. Meanwhile, if you are struggling with the stresses of the job or of life in general and are looking for some resources for help, please reach out to us at m.me/callforbackup.org and one of our peer support specialists will be happy to help. If you are in crisis now and need immediate help, please text the keyword BADGE to 741741 to be connected to a trained crisis counselor 24/7/365 – always free, always confidential.