6 trauma management best practices for police organizations

By William Mazur and Joseph Collins

More than 80% of police and other first responders experience traumatic events on the job. [1] And for the estimated 30% of officers who are military veterans, this trauma may be layered upon past trauma suffered on the battlefield.

Incidences of child abuse, suicide, domestic violence, officer-involved shootings and more can be a regular part of an officer’s job. [2] In fact, our data found first responders experience 7-10 significant traumas in their first year on the job. By contrast, civilians may face just two in their entire lives.

While most police officers go into law enforcement knowing they will be exposed to horrific scenes, many are not prepared for what can happen emotionally, psychologically and physically. As former police chiefs who now work with law enforcement being treated at Sierra Tucson, a counseling and mental health facility in Arizona, we think of trauma as the proverbial death by 1,000 cuts: If untreated, it can result in emotional detachment, difficulty in relationships, depression, anger, complacency and, all too often, thoughts of suicide.

It’s our position that law enforcement leaders must not only provide support for first responders already facing trauma but also proactively put in place programs that help build resilience to the pressures of the job from Day 1 of every new recruit’s employment. One of the major responsibilities of law enforcement leaders is to mitigate risk. Strategic planning, scenario-based training, threat assessment and situational awareness exercises are all necessary components of solid risk mitigation. Ensuring your team’s mental well-being should be no different.

Trauma has negative effects on police

National Alliance on Mental Illness (NAMI) statistics show police officers report much higher rates of depression, burnout, post-traumatic stress and anxiety than the general population. In addition, almost 25% of police officers have experienced suicidal ideation at least once. [3] A key reason? Trauma.

Trauma is an event or circumstance that results in physical, emotional and/or life-threatening harm. It can have lasting adverse effects on the individual’s mental, physical and emotional health and social and/or spiritual well-being.

Trauma is prevalent within the law enforcement community, especially for those injured on the job. Police officers experience trauma in three ways:

• Acute trauma is a major traumatic experience such as a shooting that cuts through the survivor’s mental “armor,” overloading their system and leaving them feeling unprotected and dealing with more than they can handle.
• Layered trauma is the smaller, cumulative experiences that change an officer slowly. The figurative mental armor falls off over time – first an arm plate, then a leg piece – and after a few years there is no more armor left and seemingly no resources available to help the officer cope. The officer is essentially stripped of their ability to apply healthy coping skills in this type of scenario.
• Vicarious trauma is experiencing someone else’s trauma after hearing or relating to their stories of traumatic experiences.

There’s also a fourth category that significantly affects law enforcement: unresolved trauma. Unresolved trauma is complex trauma that has built up over time and has not been dealt with. For example, we’ve seen the effects of trauma in an officer who grew up in an abusive household and is then confronted with a call for abused children. The effect of that experience may force unresolved trauma to the surface.

The hyperarousal, re-experiencing and avoidance symptoms of trauma can make completing the most mundane tasks seemingly impossible. In many cases, those battling post-traumatic stress turn to drugs and/or alcohol as a means of coping. Unfortunately, self-medicating is like “saving the roof and shingles without dealing with the fire in the basement.”

Furthermore, should the symptoms of post-traumatic stress remain present in an individual’s life without alleviation, the anguish can worsen and trigger additional mental health concerns. Police officers experiencing trauma must do something to get the trauma out. Therapy may be the answer.

6 trauma management best practices for police organizations

Following are some best practices to enhance your officer wellness:

1. Destigmatize discussions around trauma and mental health

According to Walden University, stigmatization is a major factor that prevents police officers from getting help. An anonymous survey of more than 400 Dallas Police Department personnel identified four primary barriers to mental health service access: [4]

• Inability of officers to recognize when they are experiencing a mental health issue.
• Concerns regarding confidentiality.
• Belief that mental health professionals cannot relate to those working in law enforcement.
• The notion that those who seek mental health services are unfit to serve as officers in the criminal justice system.

Consequently, fewer than 20% of police officers with confirmed mental health issues sought services in the previous year.

This does not have to be the norm. “Police leaders need to lead by example. If they expect their officers to seek mental health treatment, then they, themselves must be willing to do so,” says Lewis Z. Schlosser, Ph.D., ABPP, managing partner of the Institute for Forensic Psychology in New Jersey. “Moreover, leaders should be transparent and honest about it, as this will normalize seeking mental health treatment.”

A department that openly talks about, supports and plans for the likelihood of mental health trauma is one that destigmatizes it and helps those who may be suffering in silence. Consider these best practices:

• Share articles on why mental health needs to be prioritized to demonstrate that leadership is invested in the conversation around resilience and strong mental health.
• Build a culture that defines strength as the willingness to admit there is something wrong and encourages talking about mental health.
• Eliminate the false premise that first responders are superheroes just because they wear a badge. They are human beings who need safe spaces to open up about their experiences.
• Another piece of advice from Schlosser: Introduce the police psychologist to department personnel to build trust and rapport before your officers need his or her services.

2. Help your first responders break through their armor

All first responders learn from Day 1 to put on their figurative armor as a means to protect their heart. They have historically been conditioned to hold the grim aspects of the job close to the vest, to tamp down their feelings. This protective armor, or coping effort, and a belief that compartmentalizing the job away from one’s home life will effectively keep them safe from the effects of trauma is, unfortunately, misguided.

First responders need safe spaces – at work and at home – to take the armor off. They need to understand that for a person to admit they may need help with their mental health is not a sign of weakness. It is not shameful. In fact, it is just the opposite. It takes nerve, introspection and emotional intelligence to ask for help. And the likelihood that someone will reach out for help increases exponentially when their colleagues and supervisors provide a safe space to break through the armor.

3. Invest in your team; hire a mental health coach

While performance and psychological coaching are common in the business and sporting industries, it is sorely lacking in the first responder community. Recently we encountered a second-generation first responder who asked for referrals for a wellness counselor to “stay ahead” of any mental health challenges she may face. This should become the norm.

While “choir practice,” or gathering with other officers to hash out the day at a local tavern, may be a way to release the angst of the job among friends, it can also be detrimental, as vicarious trauma may be exacerbated through these seemingly harmless conversations paired with the depressant of alcohol. Leaders should support healthy means of release – exercise, family and community time – and the first responder industry must work to get mental health resources in place before traumatic events happen.

4. Build organizational resilience

The U.S. Surgeon General reports putting mental health at the center of workplace policies is more important than ever as the nation grapples with financial stressors, pandemic shifts in workplace culture and growing concerns about stress. [5] This should be no different in first responder workplaces across the country.

According to Aduro, a provider of well-being support for workplaces, resilience is an important trait that helps prevent and heal burnout. Psychologists define resilience as the process of adapting in the face of adversity, trauma, tragedy, threats or significant sources of stress. Not only do resilient people adapt to difficulties, but they bounce back and grow from difficult times.

That is an important distinction. Resilience does not mean avoiding stress or difficult times. It means going through them and coming out having learned or grown. [6]

5. Give officers space

According to SAMHSA, one of the core risk factors for first responders is the pace of their work. First responders are always on the front lines facing stressful and risky calls. This tempo can lead to an inability to integrate work experiences.

For instance, according to a 2013 study, 69% of EMS professionals have never had enough time to recover between traumatic events. [7] As a result, depression, stress and post-traumatic stress symptoms, suicidal ideation and a host of other functional and relational conditions have been reported. [8] Workplaces need to fully support time away from the job to recover from traumatic events.

Repeat traumatic exposure to the brain is not normal. Police officers need and deserve to be able to give the brain time to heal. Often simply sleeping is key, but others may also need to understand how to down-regulate and shut off the adrenaline rush of the job.

6. Underscore that fitness-for-duty evaluations are not a worst-case scenario

Fitness-for-duty evaluations (FFDEs) are psychological examinations typically requested by the employer and common in many professions. While these evaluations are intended to determine whether officers can safely perform essential job functions after experiencing trauma, they, unfortunately, bear a harmful legacy. According to Schlosser, some FFDEs have been used inappropriately and “weaponized” to try to remove officers from duty.

When used legally and correctly and performed competently, FFDEs are a vital component of a comprehensive officer wellness program. [9] Many officers enter the FFDE assuming the worst: that they will leave the evaluation no longer employed. Leadership must stress that data shows between 94% and 96% of officers go back to work, either immediately or eventually. [10] “If an officer is not fit at the time of the evaluation, however, then the evaluating doctor should help the agency and the officer by providing recommendations for the officer to follow that will allow him or her, hopefully, to be restored to full duty,” says Schlosser. “It is important to understand that the FFDE should be seen as a career-saver, not a career-ender.”

Conclusion

Making mental health a priority within a police department is simply the right thing to do. Asking and answering questions like “How can I help my officers?” and “What can I do to break down long-held negative mental health beliefs?” are stepping stones to building a compassionate accountability and wellness program within your department.

Such a program works to protect your team. Just think, after seven or so years on the job, most organizations have invested nearly seven figures into employees via salary and wages, benefits, training and equipment. In addition, employees are typically hitting their stride in terms of their job expertise. Other data estimates a range of 7–10 traumatic events per year for an officer. Multiplied over a 20-year career, the impact of repetitive exposures to trauma could be devastating to individuals and their organizations.

Those individuals need to be protected. Knowing the cumulative effect of these traumatic events, it’s critical you prepare them for their career – not just for the physical and duty impacts, but for the mental health impacts as well. When they know about trauma and how it can drive behavior, people are better prepared to deal with it head-on.

Checklist: Is your agency ready for meaningful wellness measures?

Use the following checklist to determine if your agency is ready for meaningful organizational and officer wellness support. If you answer no or have difficulty answering these questions, consider building a program around these best practices. Complete the box at the top right-hand corner of this page to download a copy for your reference.

• Does your department have an employee assistance program (EAP)?
• Do you have peer-support resources for officers?
• Do your officers have an external, confidential source to go to for assistance?
• Are your supervisors trained to recognize signs of chronic stress or an adverse reaction to an event?
• What does your insurance cover in terms of substance use disorders and/or mental health issues?
• Are you self-insured? You may have more leverage securing treatment for a member than you realize.
• What are the out-of-pocket costs, if any, associated with treatment?
• Do you have resources (preventive measures) available that contribute to the physical/mental health of your members? Think resilience education and a culture that understands and promotes self-care.
• Do you have a mechanism in place for spousal support?
• Are you aware of the state regulatory guidelines with respect to first responders and mental health treatment?
• Do you have a best practices model in place to assist officers after critical incidents?
• Have you located, vetted and spoken with mental health professionals in your area who specialize in treating first responders?
• Are you disseminating information on a departmentwide level that reinforces your support of personnel seeking help, and are you doing that consistently? Conversation plus education equals reduced stigma.
• Do you have a chaplaincy program to assist with employee outreach?
• Are you making all this information available to recruits in the academy?

This checklist is a resource from Sierra Tucson. Find more information about its Red, White and Blue program for the first responder community here.

References

1. Klimley KE, Van Hasselt VB, Stripling AM. (2018.) Posttraumatic stress disorder in police, firefighters, and emergency dispatchers.” Aggression and Violent Behavior.

2. Walden University. 5 Reasons the Mental Health of Police Officers Needs to Be a Priority.

3. Law Enforcement. National Alliance on Mental Illness.

4. Jetelina KK, Molsberry RJ, Gonzalez JR, et al. (2020.) Prevalence of Mental Illness and Mental Health Care Use Among Police Officers. JAMA Netw Open.

5. Novotney A. (Oct. 21, 2022.) Why mental health needs to be a top priority in the workplace. American Psychological Association.

6. The Future of Well-being at Work: Strategies for HR Leaders in 2023. Aduro.

7. Bentley MA, Crawford JM, Wilkins JR, et al. (2013.) An Assessment of Depression, Anxiety, and Stress Among Nationally Certified EMS Professionals. Prehospital Emergency Care.

8. First Responders: Behavioral Health Concerns, Emergency Response, and Trauma. (May 2018.) SAMHSA.

9. Psychological Fitness for Duty Evaluation Guidelines. (2018.) IACP.

10. Schlosser LZ, Guller ME. (2016.) Unfit and Unfixable: A Closer Look at Officers Found Unfit for Duty with Little Chance of Recovery. New Jersey Police Chief Magazine.

About the authors

William “Bill” Mazur is a 25-year law enforcement veteran and retired from his department in 2017 as deputy chief of police. Bill holds a bachelor’s degree in criminal justice and a master’s degree in human resources training and development. He is a graduate of the FBI National Academy and a master instructor with the FBI National Academy Associates in their comprehensive officer resilience training program. As a Public Safety Liaison with Acadia Healthcare’s Treatment Placement Specialists Team, he provides specialized treatment guidance for public safety personnel, first responders and families in personal crises.

Joseph “Joe” Collins is a 35-year law enforcement veteran who retired in 2020 from the Two Rivers (Wisconsin) Police Department as chief of police. He is a graduate of the FBI National Academy and was the 2015-2016 president of the Wisconsin FBI National Academy Associates (FBINAA), where he served five years on the executive board. He previously served as cochair of the FBINAA’s Officer Safety and Wellness Committee and as a member of its Finance Committee. He is a master instructor with the FBINAA’s comprehensive officer resilience train-the-trainer program and serves as a subject matter expert consultant for the U.S. Department of Justice in officer resilience. As a Public Safety Liaison with Acadia Healthcare’s Treatment Placement Specialists Team, he provides specialized treatment guidance for public safety personnel, first responders and families in personal crises.

Complete the box at the top right-hand corner of this page to download a copy of the meaningful wellness measures checklist for your reference.