Mental Wellness and Suicide Prevention for Law Enforcement Officers

A correlation between officers’ high levels of exposure to traumatic events and mental health issues has been shown in the wake of two significant events in recent years. Specifically, police stress and related challenges were exacerbated by an unanticipated worldwide pandemic and social unrest. The COVID-19 pandemic had a profound impact on public safety personnel and highlighted the need for behavioral health services in law enforcement (Rodriguez et al., 2023). Police officers were assigned to enforce health officials’ response measures, which included organizing local shutdowns, promoting social distancing, and enforcing stay-at-home orders, in addition to their regular responsibilities (Rodriguez et al., 2023). Police were also at higher risk of contracting the virus, considering their close contact with the community. Nearly 500 law enforcement officers lost their lives to COVID-19 between 2020 and 2021 (Barr, 2021).

The social unrest that resulted from the global pandemic greatly increased the stress that comes with being a police officer. Defunding efforts, frequently hostile communities, media perspectives, and scrutiny of law enforcement have all been linked to low morale, early retirements and resignations, and challenges associated with finding qualified candidates for police positions across the country (Rodriguez et al., 2023). According to a U.S. Marshals Service survey, more than 5,000 police officers reported experiencing hostile media coverage of their line of work (86%), worries about being exposed to COVID-19 (75%), unfavorable public perceptions (72%), low morale (60%), and threats against them or their coworkers (14%) (Blalock et al., 2022). The “thin blue line” has become even thinner because of these circumstances, and working in law enforcement presents substantial physical and mental health difficulties (Rodriguez et al., 2023, p.2).

To protect and serve their communities, along with maintaining their own physical and mental wellbeing, law enforcement needs to be trained through effective mental health and suicide prevention programs. Critical incident stress management and peer support programs are policy options that have shown favorable results. Police culture, limitations in confidentiality, and lack of available services are three main barriers law enforcement officers face when seeking help. This paper aims to highlight the ways that mental illness and suicide are affecting law enforcement officers, along with identifying possible solutions.

Previous Research Findings

There has been limited research that focuses on police mental wellness and suicide prevention (Allen et al., 2014; Krishnan et al., 2022; Thoen et al., 2020). However, the existing prior studies have consistently shown that the law enforcement community has higher than average rates of mental health issues, including anxiety, depression, posttraumatic stress disorder, and suicide (Rodriguez et al., 2023). Additionally, they are more vulnerable than civilians because of continuous exposure to trauma that is far more severe and frequent (Rodriguez et al., 2023).

Ramchand and colleagues (2018) conducted a statewide survey of 110 police agencies and categorized the suicide prevention programming that was supplied into four categories (minimal, basic, proactive, and integrated), depending on the level of service provided. Using the same criteria as developed for suicide prevention programs delivered to United States military personnel, the authors also assessed the efficacy of the programs that were presented. It was noted that not many programs were proactive in nature. The authors also noted that existing programs typically were not evaluated for effectiveness, nor was the level of care provided by agencies’ own clinicians evaluated. Overall, suicide prevention programming often is not funded as a priority, because many public organizations have thin operational budgets (Ramchand et al., 2018).

Contemporary Research

The results of recent studies have shed light on the advancements, or lack thereof, that police departments have made. Osteen et al. (2020) addressed the need to understand officers’ use of suicide prevention strategies in the community and factors that might impact those prevention endeavors. Law enforcement officers frequently encounter people struggling with mental health issues, including those who are at risk for suicide. A set of anonymous online surveys was completed by a nonrandom sample of 476 law enforcement officers (of the 844 invited, a 56.4% response rate occurred) (Osteen et al., 2020). The surveys measured the officers’ experiences of encountering suicidal individuals in the community, their prior training in suicide intervention, their level of knowledge and self-efficacy for participating in intervention activities, their attitudes toward suicide intervention, and their use of seven community-based intervention activities specific to law enforcement. Most participants were male (82%), white (84%), police officers (63%; 30% were sheriffs), with an average age of 37 years, 6 years of law enforcement experience in their current job, and 11 years of overall law enforcement experience. Participants represented 17 states, with most from two states in the southeast (69%).

To investigate law enforcement officers’ experiences with coming across suicidal people in the community, the study assessed participants’ knowledge, attitudes, self-efficacy, and behaviors regarding suicide prevention and intervention through a series of survey questions (Osteen et al., 2020). Questioning also included estimating the possibility that law enforcement officers would have these interactions with community members and how frequently they would occur over the course of their career. Inquiries concerning prior suicide intervention training and knowledge of agency procedures were also provided to the participants.

The Knowledge of Suicide Warning Signs and Intervention Behaviors scale, a standardized 14-item self-report created by Wyman et al. (2008), previously had been utilized primarily in educational settings. This measure evaluates the accuracy of responses regarding experiences, probability of encounters, frequency of encounters during one’s career, prior training in suicide intervention, risk factors for suicide, and familiarity with departmental procedures (Wyman et al., 2008). Additionally, participants were asked to complete the Suicide Prevention, Exposure, and Awareness Knowledge Survey (SPEAKS) subscale on suicide myths and facts (Osteen et al., 2020). There are 28 items on the subscale that have true or false responses. SPEAKS has been widely utilized by a variety of suicide prevention gatekeeper groups (Osteen et al., 2020). To measure attitudes around stigma on suicide and self-assessment of preparedness, the Attitudes Toward Suicide Prevention Scale (Herron et al., 2001) and the 8-item Perceived Preparedness for Gatekeeper Role scale (Wyman et al., 2008) were used.

The results of this study showed that participants who have been trained in some form of suicide prevention and intervention training scored high in knowing how they would help someone in a crisis. The difference in training between officers who had previous training and those who had not was substantial and statistically significant (Osteen et al., 2020). Additionally, on every item on the self-efficacy scale, officers with prior training scored noticeably higher. Outcome examples included encouraging someone to get help, asking pertinent questions about suicide, and reacting appropriately when someone discloses having suicidal thoughts. Most participants reported having received prior on-the-job suicide intervention training (64%) and being aware of the department’s suicide prevention procedures (84%). About 89% of those who knew about those protocols had read them, 98% of thought they were useful, and 65% of participants thought it was likely that they would encounter someone who was suicidal (Osteen et al., 2020). Almost 82% of participants said they had already dealt with suicidal people in their line of work. When asked how many suicidal people they had encountered, participant answers varied wildly. Although the average was 58 people, encounters with 15 people was a more realistic representation, considering the limitations of the data (Osteen et al., 2020). When asked whether it is appropriate to seek professional assistance for a suicidal person (84%), or to take someone who discusses suicide seriously (97%), a sizable portion of participants gave desirable answers (Osteen et al., 2020). However, most police officers believed that mentioning suicide would encourage individuals to think about it (61%).

Although statistically significant, a low correlation was found between years of experience and encounters, suggesting that factors other than years spent in law enforcement are linked to the number of suicidal people that officers come across (Osteen et al., 2020). A large percentage of participants (90%) felt that suicide intervention was an integral part of their job, which is a positive attitude toward suicide intervention. The least positive result was that only 52.6% of participants felt that most or all suicides are preventable. The fact that more sheriffs (97.5%) than police officers (78.1%) reported prior encounters was an intriguing finding, which could be because there are more sheriffs in the southeast (Osteen et al., 2020).

In this study, independent sample t-tests were employed, and bivariate relationships were examined using correlations (Osteen et al., 2020). Despite having low factual knowledge scores, law enforcement officers evaluated their perceived knowledge as being high. Positive attitudes toward prevention and self-efficacy were prevalent. The findings of Osteen et al. (2020) align with comparable research conducted in other nonclinical populations. The best indicators of participation in suicide intervention activities were self-efficacy and suicide intervention training (Osteen et al., 2020). Overall, the findings support the call for law enforcement to be provided efficient suicide training.    

In a second piece of contemporary research, the purpose of Thoen et al. (2020) was to gain a better understanding of the use of police officer wellness promotion and suicide prevention programs implemented in the United States, along with an understanding of the perceptions of program effectiveness (Part A). The study also sought to determine whether differences exist in the mental wellness and perspectives of programming of officers from agencies who utilize suicide prevention and wellness programs, as compared to those agencies who do not (Part B).

A stratified random sample of city police departments and sheriff’s offices nationwide was used, based on the most recent Census of State and Local Law Enforcement Agencies (Theorn et al., 2020). The number of full-time, sworn officers classified the areas into three strata: small (5–20), medium (21–100), and large (101+). Agencies were required to have a minimum of five full-time sworn officers to be included, to ensure the availability of departmental resources. The reason for this minimum was to guarantee that a police department would have the financial and human capital to provide wellness or suicide prevention programming (Theorn et al., 2020).

A total of 135 agencies were contacted to participate. In addition, 11 intentionally targeted agencies elected to participate, which were selected for their outstanding wellness programs. The final sample included 14 small (31.1%), 16 medium (42.1%), and 25 large (48.1%) agencies, totaling 47 police departments and 8 sheriff’s offices (Theorn et al., 2020). The association between response rate and agency size was investigated using a chi-square test of independence, and these variables were not significantly associated (Theorn et al., 2020). The final sample included 55 agencies for Part A of the study and 144 officers for Part B. Part A data were collected directly from police departments and sheriff’s offices, while Part B entailed completion of online surveys by individual officers from agencies participating in Part A (Theorn et al., 2020).

Interviews were accomplished via telephone by a trained graduate student research assistant, which presented challenges for agencies to identify the best respondents (Theorn et al., 2020). Anyone with knowledge about wellness training for the department or mental health coordination was asked to participate in the survey. The interview times lasted from 20 minutes to about an hour. Some agencies objected to participation, citing policies that restricted engagement in research, disclosure of information to the public, and/or a lack of officers or time available to complete the interview (Theorn et al., 2020).

The findings indicated counseling services or employee assistance programs were the most frequently provided programs at the agency level (Theorn et al., 2020). Programming also was reported to be either hurriedly or poorly planned. Nearly 25% of responders at the officer level were unsure if their organization offered programming, while 35% of respondents said their organization did not support the mental health of its officers (Theorn et al., 2020). Officers who felt that their overall well-being was supported also reported a considerable reduction in stress. Over 12% of police respondents said it was very probable or rather likely that they would attempt suicide at some point, and nearly 11% of agencies reported no wellness or suicide prevention programming (Theorn et al., 2020). Other programs identified were peer support groups and critical incident response teams. Only the availability of a peer support program showed a significant relationship with agency size, with larger agencies being more likely to have these programs than smaller and medium agencies. Sometimes programs were offered only to officers in leadership (commanding staff), mental health teams within agencies, or in training academies (Theorn et al., 2020).

It should be noted that most responding agencies lacked documented goals pertaining to officer wellbeing, and that program planning was poorly defined. Only 14 agencies indicated formalized programs with written goals (Theorn et al., 2020). There was no difference between targeted and nontargeted agencies. Only seven agencies indicated tracking effectiveness or outcome data. Almost 44% of agencies reported they were not interested in implementing any additional or different programs, usually stating that they wanted to enhance the current selection (Theorn et al., 2020). Finally, over 83% of small or medium agencies that did not offer any programming had no interest in implementing such programming (Theorn et al., 2020).

To reiterate, the main point of Part A was to better understand what types of suicide prevention and mental health programming, if any, are implemented by agencies nationwide (Theorn et al., 2020). While almost all agencies provided access to counseling services in some capacity, most small departments did not offer any extra resources, including reading materials or online resources. Some programs were required at a police department, but rarely for all officers of that agency (e.g., limited to command staff or specific mental health teams). Consequently, the potential benefits of these programs were limited to the selected groups. Also, some programs were noted to be labeled “required,” but it was unclear how this would occur (Theorn et al., 2020). Peer support programs were common, especially with large departments, and were reported to be well received by officers and recommended for other agencies. However, not all programs were helpful to respondents, as the stigma associated with asking for assistance hinders the introduction of new programs or the utilization of existing programs.

One of the greatest challenges of this study was defining mental wellbeing and programs that prevent suicide (Thoen et al., 2020). As the researchers in this study were also advocates of mental health, they were surprised and saddened that respondents were not familiar with their agency’s offered programming (Thoen et al., 2020). It was also mentioned that there is no one-size-fits-all strategy to choosing wellness programs for officers. This is especially true for rural agencies, who may find it more difficult to offer suitable services due to the lack of mental health professionals in their areas (Thoen et al., 2020). This study also highlights the fact that community wellbeing, as opposed to an officer’s personal wellbeing, is the primary focus of mental wellness.

Policy Implications

Critical Incident Stress Management (CISM) is a comprehensive, multi-part intervention system used after a potentially traumatic event or critical incident has occurred, such as an officer-involved shooting (Everly & Mitchell, 1999; Everly et al., 2002). CISM also includes small group debriefing of the incident, individual counseling, and referral if needed for additional services (Everly et al., 2002). There are also additional elements of CISM such as precrisis preparation, family crisis intervention, and follow-up procedures (Rodriguez et al., 2023). CISM is usually recommended to be carried out by certified CISM mental health professionals and peer support members under the supervision of a licensed mental health provider (Rodriguez et al., 2023). It is possible for a person’s typical coping mechanisms to become overwhelmed after being exposed to a critical incident, which could result in symptoms of distress, impairment, or dysfunction (Klimlet et al., 2018). A meta-analysis of CISM research indicates its success at reducing the risk of psychological distress (Everly et al., 2002). Furthermore, the model makes it simple to identify and refer individuals who are struggling to reintegrate after their exposure to more intensive psychological care (Everly & Mitchell, 2000). Since CISM is not exclusive to use inside police departments, mental health professionals who are willing, able, and culturally competent to work with police officers are in great demand. Research has noted that police officers debriefed using CISM reported less symptoms of depression and post-traumatic stress disorder (Everly et al., 2000).

Peer support is a concept by which people who share common experiences or face similar challenges provide emotional support to each other (Rodriguez et al., 2023). When a crisis arises, a police officer is typically more comfortable asking another officer for help rather than someone outside of their line of work (Rodriguez et al., 2023). Peer support teams work by allowing an officer in crisis the opportunity to vent or discuss their issues with another officer who is taught in active listening skills (Rodriguez et al., 2023). A peer support officer can also assess an officer’s risk level and refer a peer to a higher level of care, if needed (Rodriguez et al., 2023). The idea behind peer support is that people who have recovered from the effects of traumatic and stressful situations are in a unique position to help others going through similar things by being more aware of their surroundings and providing personal validation. It is crucial to remember that peer supporters are not qualified mental health specialists. As such, their services do not replace those of a licensed behavioral health provider. However, peer support has emerged as a useful, additional tool in preventing a variety of negative consequences. Peer support offers a behavioral health component, such as an internal or external behavioral health clinician or group of clinicians constrained by confidentiality, which are features of wellness programs that can aid in developing a preventative maintenance model (Rodriguez et al., 2023).

Although both programs discussed have shown promise, there is currently little empirical evidence to support their effectiveness with police officers. This field is still in its early stages of these kinds of exploration. Police officers need to feel comfortable asking for help from their fellow officers without fear of jeopardizing their jobs. For every police officer, especially those who are dealing with a traumatic event both on and off duty, police departments must have intervention programs in place. Critical incident stress management systems and peer support teams can enhance relationships within law enforcement agencies, offer general support, and lessen the stigma associated with seeking assistance. It remains obvious that more research and program implementation are required to determine the effectiveness of different prevention and intervention methods in police departments (Rodriguez et al., 2023).

Suggestions for Future Research

There are many reasons that can prevent individuals from seeking mental health services. Police culture, limitations in confidentiality, and lack of available services are significant barriers that can discourage police officers from seeking help to improve their health and wellness. Police culture is characterized by stigma surrounding mental health intervention, therapeutic relationship confidentiality, and service usefulness (Rodriguez et al., 2023). Police who receive therapy or counseling services could feel vulnerable and powerless, which subsequently makes them feel inadequate (Rodriguez et al., 2023). For a police officer, meeting with a mental health clinician can be viewed as detrimental to one’s career (Rodriguez et al., 2023). Building trust and a positive rapport with the mental health professional is essential for police officers to feel at ease during counseling or therapy (White et al., 2016). If their fellow officers find out that they were receiving mental health services, police officers who are undergoing treatment might also worry about being deemed unfit for duty (White et al., 2016).

Unfortunately, in the past, seeking necessary services has been hindered by worries about confidentiality and being seen as weak or untrustworthy by coworkers (Rodriguez et al., 2023). The boundaries of confidentiality need to be clearly explained (White et al., 2016), especially for police officers to understand what could lead to a breach of confidentiality (Rodriguez et al., 2023). The degree of trust between a mental health professional and the officer may be impacted by this limitation (Rodriguez et al., 2023). For instance, the department could receive more information from an officer candidate’s pre-employment assessment or physical fitness test, which would provide more insight regarding the potential new police officer (Rodriguez et al., 2023). Rumors and punitive actions, such as demotions or denial of promotions, for seeking mental health services both on and off the job can prevent people from seeking and/or continuing to receive care (Rodriguez et al., 2023). A healthy police department can foster positive change by having command and leadership staff embrace the idea of wellness for their police officers, rather than viewing service access as a sign of a weak or incapable officer (Rodriguez et al., 2023).

Lastly, law enforcement organizations might find it difficult to access certain services. For example, there might not be many providers in a rural area, and the public might find out that an officer needs assistance (Rodriguez et al., 2023). Historically, fear of administrative retaliation, confidentiality breaches, and investigations has prevented law enforcement from receiving necessary mental health services (Rodriguez et al., 2023). Some of these issues can be avoided by educating and encouraging police administrators about the advantages of offering available and confidential services (Rodriguez et al., 2023). It would also be beneficial to offer and promote involvement in early intervention and prevention programs (Rodriguez et al., 2023).

Along with suicide prevention and treatment for police officers’ own wellness, it is important that police departments have access to high-quality, continuous training that prepares them for interactions with individuals who display suicidal behavior in their community (Osteen et al., 2020). There are currently no standardized mandates for all police officers in the United States to receive training in mental health assessment and intervention strategies (Osteen et al., 2020). However, state legislatures have enacted intensive suicide prevention training mandates for licensed mental health professionals and elementary school teachers to use when encountering patients, clients, and students who are experiencing suicide behavior (Osteen et al., 2020). The number of suicide deaths could be decreased and law enforcement officers’ ability to connect at-risk individuals with appropriate mental health services could be strengthened by enacting a national mandate, model, or policy, led by law enforcement, requiring all officers to complete suicide intervention training (Osteen et al., 2020).

Conclusion

Law enforcement administrators have two crucial responsibilities in improving the perceptions about mental health care: upholding officers’ rights to confidentiality and privacy, and modeling stigma reduction by promoting and supporting the use of mental health resources (Rodriguez et al., 2023). Considering the high levels of stress and trauma police officers face on the job, research supports the need for preventive health initiatives. (Rodriguez et al., 2023) Police officer’s mental health may be impacted by these high stress levels, which can also increase the prevalence of reported depression. This contributes to not just how police officers carry out their duties but also the populations that they are tasked to serve.

COVID-19 and social unrest between 2020 and 2021 are the two recent traumatic events that affected the mental wellness of law enforcement officers. Previous research is limited on mental health and suicide prevention efforts for LEOs, and the few intervention and prevention programs in place do not appear to be very effective. Current research suggests that some progress has been made in providing support. However, this improvement was mostly limited to providing the opportunity for command staff and mental health teams to be trained in community intervention strategies. Critical Incident Stress Management and peer support groups are two promising programs for LEOs, but there is a need to offer more effective programming. Lastly, addressing barriers to mental health care for LEOs, such as police culture, limitations to confidentiality, and lack of available services are in need of future research. Police officers who protect and serve our communities deserve the necessary support, resources, and assistance to protect their own mental health wellness.

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