Trauma exposure and sensible care for LEOs

The expectation that we can be immersed in suffering and loss daily and not be touched by it is as unrealistic as expecting to be able to walk through water without getting wet.

Rachel Naomi Remen, MD

“You are going to get wet in this business, it is what you do with it and how you process the “wetness” that impacts how your brain is going to react over time, according to Jamie Brower, Psy.D. a Colorado Police Psychologist. Brower explains this concept to the LEO’s and first responder’s treats following years of exposure to critical incidents. Many officers believe they are handling things well but gradually experience the loss of purpose in life often seen in cases of trauma. The key to treating repeated trauma is to intervene routinely following traumatic high lethality events, such as death of a member, multi-casualty critical incidents, and others with routine defusing immediately following the incident. I believe this should include all members who were on the call including supervisors. I once conducted a critical incident review following a fatal automobile crash with multiple fatalities and injuries. All members who responded to the incident were present except the on-duty sergeant and the fire chief. When necessary, peer support, debriefing, and direct psychological intervention are a must for career well-being and resilience.

“Your resiliency is like an immunization or protective factors against what life will throw at you” according to Mike Grill, M.S., a counselor in Colorado. Resiliency refers not to survival of the fittest but to the species that adapts quickest to changes in the environment. So the resilient person who is exposed to a horrific event like a school shooting or the death of a child is going to say: “Hey this bothered me and I need to do something about it” not “I should be able to handle this on my own” according to John Nicoletti, Ph.D. How do you get balance back in your life because, if all you see is death than you are going to have a pretty weird perspective going forward in life said Dr Nicoletti, in a short, Lifelines documentary in association with Stories Without Borders shot to inform on PTSD and law enforcement, fire service, and first responders.

Post traumatic stress is an injury that occurs during the course of an event like a mass shooting, or cumulatively over the years of exposure during the career in law enforcement or other first responder service like fire or EMS. It is not a mental disorder. Children in the family can be the first responder’s lifeline back. You will still have a scar but the injury will heal said Dr. Daniel Crampton, a retired Ute Pass Regional paramedic and trauma specialist in Colorado. Dr Crampton is available for peer support and has been very responsive and ethical at times I’ve reached out to him.  In previous blog posts I have suggested that building resilience may be forged by having annual behavioral health “check-ups” and that in doing so, officers may earn extra payments for adhering to a behavioral health protocol each year that includes attending defusing and debriefing sessions following critical incidents. Just like the Quinn Bill in the 1970’s here in Massachusetts, where officers earned extra salary for attending college and earning their degrees, a similar incentive may be added for officers who attend annual behavioral health screenings and regular stress reduction trainings.  The obvious benefit is a healthier mind and body among front line police officers with enhanced job satisfaction and career resilience.

 

Covid-19 pandemic: No more important time for resilience

It has been frequently mentioned that exposure to death and uncivilized brutality has an impact on wellness and personal resilience. Not a surprise. Especially in these pages, I make an effort to point out that the cumulative impact of traumatic exposure slowly whittles away one’s capacity for mental health, empathy and emotional efficacy. “There is a relationship between the severity, frequency and range of adverse experiences, and the subsequent impact on mental health.” (Dillon, Johnstone, & Longden, 2012). The conundrum has always come down to just what constitutes a “traumatic” event in childhood? Sometimes there is no single identifiable event that a child brings forth that may later become a trigger of serious emotional instability later in adulthood.

The Covid-19 virus has the potential for creating traumatic events depending upon the degree of exposure and a child’s understanding of the narrative brought forth by parents and other trusted adults during the pandemic. “Over 30 percent of Americans know someone who has died or been infected by the virus. The fallout to mental health from the coronavirus is real. I see it in my own family as nerves become frayed 8 weeks on.” according to the blog post from May, 2020. Trauma informed therapy supports the model of early traumatic experience being the underpinning of many mental health outcomes we see later in life. The biopsychosocoial model identifies physical abuse, sexual abuse, exposure to violence, chronic substance abuse as the substantive reasons for many mental and physical illnesses years later. When we look in the rear view mirror at this virus we will see the litter of emotional wreckage that may leave its hooks in many people around the globe.

Coronavirus. Ise.ac.uk

There is a relationship between the severity, frequency and range of adverse experiences, and the subsequent impact on mental health.

(Dillon, Johnstone, & Longden, 2012).

“The more adverse events a person is exposed to in childhood, the greater the impact on physical and mental health and well-being, with poor outcomes including early death” (Anda, Butchart, Felitti, & Brown, 2010; Anda et al., 2006; Felitti et al., 1998). There was a time in my training that I collected data on childhood fire setting and the psychodynamics of pyromania. I saw 50 children in my fellowship year who came because of fire setting. Without a doubt, there was marked early instability in the childhood homes in these kids that likely germinated into fascination with fire play and perhaps more directly, physically aggressive behavior. Many of the children I assessed were suffering from early onset trauma.

Depending upon the age of onset using fire as an expression of internalized conflict suggests a serious emotional disorder in need of expert assessment and treatment. The interest in fire may appear normal but slowly interest foments in homes where a prevailing emotional vacuum permits – decreased emotional warmth, access to fire starting materials, an absent parent, and frequent domestic violence.  

The inconsistent and unpredictable exposure to violence contributes to excessive and unpredictable behavior as children become adults. Often without direct knowledge of a specific trigger, trauma activates brain circuits that drive fear and emotional behavior including substance abuse, domestic violence, and assault. What is more, these absorb community resources as psychological needs grow.

The coronavirus has profound impact on the emotional stability of people around the world because of its unpredictability and lethality. It evokes fear, and uncertainty as it spreads unchecked. Later, the virus can serve to trigger long hidden memories in a way that can sabotage healthy human development leading to vague anxiety, physical symptoms, loss, and deep despair.

Scott D. Jones of Arlington, MA was a decorated paramedic who responded to a mass homicide in 2000 in which 7 people were shot in an episode of workplace violence. He would go on to kill his second wife and 2 children 14 years after repeated episodes of severe depression and suicidal behavior and domestic violence toward his first wife.  These behaviors were the first red flags of an impending emotional breakdown and terminal rage. Paramedic Jones certainly had problems but the repeated exposure to trauma – especially the mass shooting, activated his fight-flight response intolerably and may have been one of the demons he faced in the end.

Michael Sefton, Ph.D.

Trauma can be triggered by loss due to Coronavirus in two ways. First, by direct contact with a family member who is hospitalized and may have died. Nearly every person who contracted the virus had someone left behind that was worried about their health and eventual recovery. Many had family members who communicated with patient via text messaging and FaceTime – until the loved one could no longer do so. Families relied on the updating calls of first responder nurses, chaplains, social workers, and physicians.

Next, through secondary exposure to similar cases and media coverage that assails efforts at closure and engrains the narrative of fear, guilt and shame by reporting ever increasing case numbers, hospitalizations and deaths survivors are left feeling numb and unable to mourn. Funerals were deferred or could not be held at all as some jurisdictions required the cremation of the remains of coronavirus victims. This has a negative impact on survivor health and well-being often evoking a religious and moral crisis of faith. Survivors have enormous guilt and sadness not being with a loved one who died from the virus or waiting to go for medical at the onset of symptoms. They mourn to mourn and are left feeling numb at the lack of closure.

So whether it is early trauma associated with domestic violence or trauma from repeated exposure to work-related experiences, there is a resilience that resides within most people that guides the rise from being overwhelmed again and again to move forward with courage and hope and feelings of hardiness. These are learned responses to high stress events like a pandemic, but people who are positive thinkers, optimistic, physically fit and emotionally insightful rise up, controlling the lives they lead.

We are offering a zoom platform event entitled The Psychological Impact of the Cornavirus Pandemic: Common sense answers on November 11, 2020 at 5:30 EDT and again in December 10, 2020 at 7 PM. It is free and to be sent the zoom link contact: jswiderski@whittierhealth.com or call the Whittier Rehabiltation Hospital at 508-870-2222 in the U.S. If you plan on attending the 12/10/2020 session please drop me an email at: msefton@whittierhealth.com

Michael Sefton, Ph.D.

Harlem domestic violence homicide calls for transparent psychological autopsy

The psychological autopsy is an individually designed case study that elicits a broad range of factual data regarding the behaviors of a decedent in the immediate day or days leading up to domestic violence homicide. The study is especially important when first responders and essential workers are involved all the while a pandemic ravages the city in which they live. Michael Sefton, Ph.D. Direct Decision Institute, Inc.

The recent domestic violence homicide in Harlem raises the specter of an essential city worker who killed his sister-in-law while his wife called for help. The police stopped the attack resulting in the death of Ubaldo Gomez but not before he shot and stabbed a women in the head with a kitchen knife. The fact is that domestic violence has increased during the pandemic as it does at other of life’s stress points. Did the fact that the alleged murderer was an MTA employee considered to be “essential personnel” have an impact on his mental health that may have been foreseen? What role, if any, did his role as an auxiliary police officer for the NYPD have in the terminal event? A psychological autopsy would answers these questions and establish a worst case scenario of frontline exposure to trauma and possibly offer insight into underlying history that may have been anticipated and stopped. Certainly the hierarchy at 1 Police Plaza will have an interest in this case. The Corona virus has added to risk of DV and DHV.

For too many women who are abused repeatedly during times of crisis there is no place to run and no one to keep them safe. Orders of protection are ineffective and without GPS monitoring and they are nearly impossible to enforce. In a 2011 domestic violence homicide in Maine, the protective order was violated 4 times by Steven Lake who killed his wife and children in Dexter before killing himself in June 2011. That alone was grounds to hold Lake without bail. No police agency removed access to his collection of over twenty firearms. The scene diagrams illustrate how Lake was armed with two firearms and a hunting knife. He murdered his children while forcing his estranged intimate partner to watch. It was thought that he planned a murder spree and he left 9 suicide notes. The final despicable act, as police arrived, was to attempt to light the bodies on fire.

In general, there is little interest in such a comprehensive post hoc psychological examination because there is no pending prosecution. Nevertheless, a psychological autopsy conducted on Lake in the Fall of 2011 revealed a clear timeline littered with red flag warnings that were missed or ignored. The research conducted in 2011 was done pro bono. It undertook over 200 hours of interviews and presented the Domestic Violence Review Board with over 50 recommendations for reducing high rates of domestic violence homicide in Maine (Allanach et al. 2011). The medical autopsy editorialized the case in its final report:

“Despite receiving some mental health counseling it is apparent, in retrospect that the degree of violence and anger possessed by the abuser was not realized.”                                                            Chief, Maine State Medical Examiner

This latest case in point involved an estranged wife, her sister, and the building manager in Harlem. The three were having dinner when someone armed with a firearm broke into the apartment. It was the estranged husband of one of the women. He was wearing his Metropolitan Transportation Authority uniform, and he had a gun according to the NY Post reports. In the meantime we have been told that the perpetrator was an auxiliary police officer and was licensed to carry a firearm. What triggered this paroxysmal violence? If it was foreseeable, then Mr Gomez should not have had access to his firearm.The psychological autopsy will address prior history of intimate partner violence, protection orders in place, work-related stress, recent health concerns related to the corona virus and Mr Gomez trauma exposure history, and his mental health in the days before the murder. 

Police officials said the transit worker, Ubaldo Gomez, shot his sister-in-law and stabbed her in the head with a knife, while his wife reached out for help. When Gomez refused to drop a 12-inch kitchen knife and tried again to stab the man, a police sergeant opened fire, killing him. In the end, there is always at least a single person who knows what is about to happen and often does nothing to stop it. A family member of Gomez suggested “he had some mental issue, something happened. He was always working day and night. He barely slept. He worked.” as quoted in the NY Post. Whether this duplicity and denial stems from cultural beliefs about the supposed “privacy” of DV, society must change the way in which law enforcement manages these cases. The buy-in from police, legislators, judges, probation, and the public-at large needs to be fully endorsed for real change to happen and for safety plans to work. Many states across America are planning to enact “red flag” rules that will remove weapons from individuals with a known history of domestic violence e.g. choking spouse during fight (Sefton, 2019).

Family members who may be in the crosshairs of these insidious events often see but lack the knowledge to stop the emotional and behavioral kinetics once they start. The fear of being murdered by an intimate partner creates emotional paralysis. In a large percentage of DV occurrences, financial and self-image influences as well as outright fear of the abuser by the victim limit moves toward safety. Therefore, a continuum of interagency cooperation is needed to effectively measure risk and understand the pre-incident red flags that are common manifestations of abuse and often forecast terminal violence, all of which occurred in this case. As the totality of these red flags comes into focus it becomes incumbent upon each of us to take action to prevent domestic violence threats from becoming reality (Allanach, et al. 2011).

It would seem to be vitally important that a transparent psychological autopsy be initiated to gain an understanding of the factual behavior that was observable and measurable in the days leading up to the murder especially given the likely unintended victim. Preliminary reports described Gomez as having a pattern of pathological jealousy and victim stalking. For her part, Gomez’ wife Glorys Dominguez called for help in the weeks prior to the terminal event seeking help.

Allanach, RA, Gagan, BF, Loughlin, J, Sefton, MS, (2011). The Psychological Autopsy of the Dexter, Maine Domestic Violence Homicide and Suicide. Presented to the Domestic Violence Review Board, November 11, 2011

Sefton, M (2019) Violence prediction: Keeping the radar sites on those who would do us harm. Blog post https://wordpress.com/block-editor/post/msefton.wordpress.com/5012 taken May 23, 2020.

Sheehan, K, Moore, T. Woods, A. NY Post May 21, 2020 https://nypost.com/2020/05/21/man-killed-in-nyc-police-involved-shooting-was-auxiliary-cop/?

Positive Policing and Purpose in Life

Purpose in life has been introduced as benefiting people, including law enforcement officers, to find a positive sense of purpose and personal satisfaction in their work product and in their lives. It was originally espoused by Viktor Frankl in 1946. Frankl, a physician, survived the German concentration camps and the deliberate extermination of 6 million Jews during WW-II. His wife and entire family were killed at Auschwitz and Dachau. How could he possible find purpose and meaning in life after this horrific experience. In the book Man’s Search for Meaning, first published in 1946, Victor Frankl shares the experience of seeing hundreds of people herded off to their extermination. People and members of his immediate family were horrifically gassed and sent to mass graves. Frankl’s theory holds that “there are three primary human capabilities, or, in his words, noological possibilities: self-detachment, self-transcendence, and the ability to “spiritually be in touch” with something or someone independent of spatio-temporal dimensions” according to McGann (2016) who reviewed Frankl’s book Man’s Search for Meaning.
Officer well-being is essential for career longevity. It becomes apparent that police officers grow and remain productive in an environment of support: both within the organization and within the community in which they serve. These attributes build a sense of personal meaning and career purpose. Leo Polizoti, Ph.D.
In Man’s Search for Meaning, Frankl described the daily demoralizing prisoners underwent both physically and psychologically. Survivors of the horrific images at concentration camp Auschwitz began to find meaning in their forced labor – even humor along with camaraderie. Many of us glean a significant sense of well-being from what we do personally and professionally. Most cops derive great personal meaning and purpose from the job of police officer at least for the first 3-5 years. Law enforcement officers’ derive much of their identity from the work they do on a daily basis and can experience wide ranging stress from call to call. As such, it has become well-known that police work requires special understanding of one’s community and a positive sense of personal responsibility, well-being and resilience for career success and hardiness (Polizoti, 2018).
Our tour guide at the West Bank in Israel in 2019 – Rami Nazzali found great purpose in teaching visitors about the plight of Palestinians on the West Bank and Gaza Strip – He strongly believes the plight of Palestinians in the Gaza Strip and West Bank are fighting for purpose and meaning in their lives. Rami Nazzali writes for The NY Times.
Purpose in life refers to an underlying belief that what you do for work has importance and purpose on a larger scale. Moreover, to diminish oneself as a result of career embitterment runs a risk of the erosion of purpose and loss of group membership. That is when one becomes marginalized and loses his purpose and the “why” for living. Viktor Frankl believed that once gone the purpose of life and the will to live cannot be restored. Mark Dibona previously was a patrol sergeant for the Seminole County Sheriff’s office in Florida, where he supervised nine officers, but the memory of the June morning where he was called upon to resuscitate and dying infant still haunts him. “Other stressful situations include, but are not limited to: long hours; handling people’s attitudes; waiting for the next call and not knowing what the situation will be; and even politics within the department. Then, on top of it all, officers are frequently criticized, scrutinized, and investigated for decisions they make” said Michelle Beshears on the faculty at American Military University. Among police officers between seven percent and 19 percent of police officers experience symptoms of Post-Traumatic Stress Disorder, compared to 3.5 percent of the general population. A colleague and friend, Sergeant Mark DiBona retired from law enforcement in 2019 has had some difficult times on the job in Florida that effect him in a profound way. He is an strong advocate for law enforcement mental health and suicide prevention. “Until this day,” said Dibona, who admits to having contemplated suicide several times before he began counseling, “I can feel the warmth of that baby on my arm.” A child Mark believed he could save.

A Behavioral Health Bill

In the 1970’s there was a bill that allowed police officers who earned their college degree to be paid extra money called the Quinn Bill. The Police Career Incentive Pay Program was enacted by the Massachusetts Legislature to encourage police officers to earn degrees in law enforcement and criminal justice according to the Massachusetts Department of Higher Education website. The funding for this ended in 2012 when the Commonwealth of Massachusetts stopped paying its share to cities and towns across the state. Officers hired after 2009 were not eligible for this program. In many cases, officers earned thousands of dollars on top of their base salary to continue their education. Many officers went on to earn advanced degrees and came to depend on this funding.

“Public safety is a priority, and it is essential that we have a highly trained and educated police force to keep our community safe.’’

Hon. Setti Warren, Mayor of Newton, MA

In Newton alone, the money to pay its police officers with earned an earned college degree amounts to an annual budget amount of 1.3 million dollars according to Mayor Setti Warren who believes it is worth it. Newton and many other communities in Massachusetts have continued payments to officers even after the state subsidies were no longer available. It is the right thing to do. In a similar way, reimbursing cops for “wellness training” should include subsidies for mindfulness and voluntary critical incident defusing sessions with peers following high lethality-high acuity events such as an active shooter incident.

Officer wellness is a vital component to resilient community policing. Officers who are resilient and mentally healthy provide better response to citizens in crisis. Just as it is important for law enforcement officers to be rewarded for continuing their education legislation may be enacted that provides funding for officers who undergo behavioral health and fitness training when it is associated with job-related trauma and mental illness. Peer support and crisis intervention training (CIT) teach LEO’s the skills needed to support fellow officers in need and deescalate people in the field who are in mental health crisis. By doing so, they avoid use of force and potential civil action against the police from use of physical force or incidents of officer involved shooting (OIS).

Officers are urged to sign up once they are released from formal field training and agree to be open to behavioral health follow-up moving forward. They do so after seeing the department psychologist to review incidents they have experienced in their early careers. Once cleared they agree to participate in regular defusing sessions in the aftermath of high profile incidents. At the same time, they may keep an electronic behavioral health profile with dates of traumatic cases and their role and response to each. If the LEO wishes to share these self-reports the department psychologist may have access to the case files and individual behavioral health responses. Family members would have access to the department psychologist if deemed necessary. There would be mandatory meetings with the department psychologist following OIS incidents and at other times depending upon department regulations and protocols.

Once a police officer opts to join the Career Behavioral Health Resiliency program he or she would receive a stipend that would be commensurate with the total time allotted to their participation wellness and resiliency programming. They can go all in and receive an annual incentive for both the resilience they achieve and for being part of the peer support network that might include mentoring another officer who is struggling with career embitterment or from the effects of repeated trauma. In some cases, an officer may choose not to mentor a fellow officer but agree to personal growth and mindfulness activities along with participation in educational offerings. The program would be a win-win all around by raising the behavioral health and emotional stamina of the troops in the field and the chain of command.

I suggest proposing a law enforcement version of “no man left behind” ethos espoused in the U.S. Military. There should be a path to recovery for most police officers who are willing to receive this current “best practice” standard of care leaving no man or woman behind. Dr. John Violante, a University of Buffalo research scientist and former N.Y. State Trooper believes “police officers have a moral duty to care for members of law enforcement who are in crisis”. This will put an annulment on the stigma associated with the human response to trauma that often leaves officers feeling alone and ostracized by the men and women with whom they serve. By using a robust peer support network and collateral police psychology model officers may develop a sense of normalcy for intervention following high acuity calls.

The International Association of Chief’s of Police (IACP) has a broad-based Mental Wellness program it is reporting on its website that highlights the importance of this kind of support. “The IACP, in partnership with the University of Pennsylvania (Penn) and the Bureau of Justice Assistance (BJA)’s VALOR Initiative, is customizing a program specifically designed to help officers and agencies by enhancing resilience skills. The cost of such a program will reap rewards in the form of career longevity, officer well-being, officer morale, quality of community policing, and greater faith and trust in law enforcement in general.

copyright 2019 Direct Decision Institute

What is involved in CIT and Jail Diversion?

“The important part of crisis intervention training comes in the interdisciplinary relationships that are forged by this methodology. Trust and respect between the police and its citizens builds slowly one person at a time. “

Michael Sefton, 2017

Police officers have historically been ill prepared to deal with people exhibiting signs of mental illness or severe emotional disturbance. Many were thought to be unpredictable and therefore resistant to the typical verbal judo officer’s are trained to use. The CIT programs provided training to police officers in an attempt to bridge the gap between myths about mental illness passed down from one generation of LEO’s to the next and actual training and experience in talking with citizens experiencing a crisis in their life, learning about techniques to manage a chaotic scene, strategies for enhanced listening, understanding the most commonly encountered disorders and role playing. For one thing some person’s afflicted with mental illness have difficulty following directions such as those suspected of hearing voices, paranoia or command hallucinations but this is not always the case. Many individuals CIT trained officers will encounter are normal human beings who are experiencing a high stress, crisis such as the death of a loved one, financial loss, failed marriage or relationship, or major medical illness. This adds a layer of complexity to the CIT model that officers soon experience.

Acuity increases with encounters of mentally ill who are both substance dependent and have some co-occurring psychiatric condition. The alcohol or drugs are often veiled in the underlying “mental illness” but in truth they are not mutually exclusive. The importance of treatment for substance dependence and mental illness cannot be understated as violent encounters between law enforcement and the mentally ill have been regularly sensationalized. The general public is looking for greater public safety while at the same time M.H. advocates insist that with the proper treatment violent police encounters may be reduced and jail diversion may be achieved. 

5 Stages of Police Crisis Intervention

  1. Scene safety – Assess for presence of firearms – obtain history of address from dispatch – have back-up ready
  2. Make contact with complainant & subject – express a desire to help; listen to explanation of the problem – ascertain what is precipitating factor?
  3. Establish direct communication with subject – attempt to establish trust; support for taking steps toward change; “why now?”; identify any immediate threats – sobriety, weapons
  4. Pros and Cons for change – ascertain how willing  is subject to begin change process, i.e. sobriety, counseling, detoxification
  5. Positive expectations for change = direct movement toward change – hospital program; rewards that will come with positive change

“A crisis event can provide an opportunity, a challenge to life goals, a rapid deterioration of functioning, or a positive turning point in the quality of one’s life”

(Roberts & Dziegielewski, 1995)

There is a high degree of stress in any call involving a person in crisis. Repeated exposure to trauma is known to change the fight/flight balance we seek for emotional stability. Excessive autonomic arousal poses a threat to cardiac functioning and damaging hypertension. After high intensity/high lethality calls I suggest a defusing session take place immediately after the shift or as soon as possible. Excess adrenaline from an abnormal stress response can have significant health effects on LEO’s. Defusing or debriefing sessions can help reduce the impact of these types of calls. Full critical incident debriefing should wait until the normal effects of such calls wear off.

Sefton, M. (2017) Human Behavior Blogpost: https://msefton.wordpress.com/2017/03/30/police-are-building-bridges-and-throwing-life-savers/ taken December 10, 2017

The Field Training Officer: Important things they may not know

Most departments has active field training protocols that recruits must pass after leaving the academy.  This means they ride along with the FTO until they are ready to function independently as LEO’s.  The specific time line for this depends on FTO daily observation reports during the phases of field training.  These begin with close supervision where the trainee does little of the daily work. In the latter phase of training the FTO may pull back and provide intervention only if needed by allowing the trainee to be the lead on all calls.

Officer resilience depends upon solid field training with adequate preparation for tactical encounters, legal and moral dilemmas, and mentoring for long-term physical and mental health.  Michael Sefton, Ph.D. 2018

Law enforcement officers begin their careers with all the piss and vinegar of a first round draft pick.  This needs to be shaped by supervised field training and inevitably will be effected by the calls for service each officer takes during his nightly tour of duty. Much like competitive athletes, law enforcement officers at all levels exhibit “raw” talents, including leadership abilities and the cognitive skills to go along with them.  Moreover, like competitive athletes, these raw abilities have to be honed, refined and advanced through a combination of modeling, coaching and experience in order for the officer to develop the skills needed to improve performance, as well as prepare them for career advancement according to Mike Walker.  This important task falls upon the field training officer (FTO) and is a critical phase in probationary police officer’s development.  “The FTO is a powerful figure in the learning process of behavior among newly minted police officers and it is likely that this process has consequences not only for the trainee but for future generations of police officers” according to Caldero and Crank (2011).  In 1931 the Wickersham Commission found over 80 percent of law enforcement agencies had no formal field training protocols for new officers entering the field of police work described by McCampbell (1987). In 1972, formalized field training protocols were introduced by the San Jose, CA police department that became a national model for post academy probationary field training.

Just before I was promoted to sergeant while working for a law enforcement agency, USCG Vice Admiral John Currier, a friend of mine said to me: “Michael, move up or move out”.  I wasn’t sure what he meant by that but given my 9 years as a patrolman, I started to lobby for a promotion to sergeant.  The agency at which I worked had little turnover in the middle ranks so I was never sure I would get a chance for promotion.

All law enforcement officers should have a career path when they graduate the academy that lays out a career path based on officer interest, career improvement goals, on-going training interests, and agency needs.  Training opportunities offer new officers the chance to gain experience in anything from specialized investigations i.e. sexual assault and child abuse, firearms instructor, domestic violence risk assessment to bike patrol and search and rescue.  Our chief believed strongly in incident command, active shooter response, and emergency medical technician training.  I went on to take the paramedic technician course at a local college in 2011-2012. In many ways my former agency was well ahead of the curve in training opportunities and tactics including use of body worn video cameras, taser training, stop sticks, and individually deployed patrol rifles.  I was encouraged by my chief to participate in a research opportunity I was offered in domestic violence homicide from a case in northern Maine, a community much like the one I served. From this research we introduced a risk assessment instrument developed by  Jacquelyn Campbell.

The chrysalis for me came in August, 2012 when I was appointed by the Select Board to sergeant at the recommendation of my chief.  Before this could occur, I had put in a significant amount of time developing a field training program, domestic violence awareness and lethality assessment protocols, and police-mental health encounter training. I learned the hard way that most police officers do not like working with citizens with mental illness and hate attending training classes on mental health awareness and crisis intervention training. I realized that I needed to become a leader and in order to do so I needed to become better in communicating with the troops and with those up the chain of command. In order to develop leadership I was sent to sergeants school but what I learned was the importance of being a role model for those in training and to teach by doing, teach by example. I also learned that field training is demanding, exhausting work if done with the precision needed to fully socialize the trainee and provide needed modeling while gradually offering greater independence for the trainee.

cropped-images.jpgField training involves months of practicing ‘what if‘ scenarios, learning the ropes of the police service, use of force, and writing reports. Early in the phase of training the tough discretionary decisions faced by a probationary officer are made by the senior training officer based on prior judgement, experience and what is most prudent for the specific incident and conditions on the ground.  “Agencies should thus maintain a greater degree of FTO supervision, not just trainee supervision. Such an effort would go a long way toward improving FTO programming and better informing the needed research base” Getty et al. (2014, pg. 16). Field training is often time limited with special consideration for officers who need additional training in specific skills or personal areas of concern. Some officers are put on career improvement plans and extended field training, when needed, and some probationers are discharged from the agency because of skills or behavior that are not compatible with police work. Law enforcement agencies want active police officers who represent the core beliefs of the agency and individual community needs.

Field training has perhaps the most potential to influence officer behavior because of its proximity to the “real” job according to Getty, Worrall, and Morris (2014).

Probationary officers can be taught the how and when of effecting an arrest but the intangible discretionary education comes from FTO guidance and socialization that takes place during the FTO training period.  Research has revealed that officers’ occupational outlooks and working styles are affected more by their FTOs than formal “book” training, Fielding, 1988.  The selection of who becomes an FTO is not well defined.  In a study at Dallas PD probationary trainees were exposed to multiple FTOs over 4 phases (Getty et al. 2014).  The study revealed a correlation between new officer behavior – in the 24 months after supervision, as measured by citizen complaints and the FTO group to whom they were assigned. It is conceivable that the results in the study may be due to the relative brevity of training at each phase may have stopped short of instilling good habits or extinguishing bad habits in many new police officers. I have worked in agencies where only the sergeants were the FTO’s by virtue of rank and supervisory acumen long before systematic field training programs were introduced.  In Dallas, results showing officer misconduct via high citizen complaints may too have been associated with unprepared FTO’s who were drafted to supervise the trainee and who were not prepared for that role.

“Bad apple” and/or poorly trained FTOs may thus have a harmful influence on their trainees. Getty et al. (2014)

Choosing successful FTO’s is of critical importance for new officer development and for future generations of law enforcement officers. The values espoused by the FTO have enormous impact on the behavior, habits, and professionalism of new police officers. It has been shown that the quality of this training belies post-supervision job behavior and success.  Haberfeld (2013) has offered a supportive assessment of the assessment center approach to FTO selection suggesting there are qualities that may be quantified in the selection process. This may be helpful in the selection of FTO’s who are professionally resilient and emotionally hardy as they lead the new probationary officer into his career. If officers are randomly assigned to provide field training without forewarning or preparation this may staunch career growth in the probationary LEO.  If this becomes the norm then FTO’s may have provide more of what probationary officers need such as correct values, discretionary wisdom, and perhaps less negative socialization that can lead to embitterment, misconduct, and citizen complaints.

At times of high officer stress when high lethality/high acuity calls are taken the probationary LEO is apt to require greater support and guidance from the FTO. It is during these critical incidents that post hoc peer support and defusing may take place.  Training LEO’s should be permitted to openly discuss and express the impressions they experience to calls that may be more violent, and outside of the daily norm for what he or she has been doing.  In doing so, the impact of these high stress exposures may be mitigated and emotional resilience may germinate. The responsibility of FTO’s to reassure and invigorate trainee coping skill and mindful processing of critical incidents cannot be under emphasized.  FTO’s understand that healthy police officers must be permitted to express horror when something is horrible and feel sadness when something leaves a mark. They will become better equipped in the long run if allowed to fully appreciate the emotional impact that calls for service will elicit in them.  The stigma of high reactive emotions from high stress incidents, i.e. homicide or suicide, is reduced when officer share the call narrative and its allow for its normal human response.

Michael Sefton, Ph.D.
2019

REFERENCES
Caldero, M. A., & Crank, J. P. (2011). Police ethics: The corruption of noble cause (3rd ed.). Burlington, MA: Anderson.
Fielding, N. G. (1988). Competence and culture in the police. Sociology, 22, 45-64.
Getty, R, Worrall, J, Morris, R. (2014) How Far From the Tree Does the Apple Fall? Field Training Officers, Their Trainees, and Allegations of Misconduct. Crime and Delinquency, DOI: 10.1177/0011128714545829, 1-19.
Haberfeld, M. R. (2013). Critical issues in police training (3rd ed.). Upper Saddle River, NJ: Pearson.
McCambell, M. Field Training for Police Officers: The State of the Art (1987). DOJ: NIJ, April.

Law Enforcement – M.H. encounters – New documentary April 27, 2019 in Somerville

A new documentary featuring the law enforcement CIT model of police-mental health response is being featured as part of the 2019 Boston Independent Film Festival.  This entry won a prestigious award the SXSW in its film debut.  As I retired from police work my interest in law enforcement mental health interactions deepened.  As a result I met these officers in San Antonio was was taken for some days of first hand observation of their work.  The documentary took 2 years to complete and gives the viewer a front row seat in the model from San Antonio PD and Bexar County that works. The film debuts here in Boston at the Somerville Theater in Davis Square on Saturday April 27, 2019.  I strongly urge readers in the area to attend.

In many police agencies the call volume for mental health encounters is at or above 50 percent. That means that every other call for service requires that officers dispatched to the call have an understanding about encounters with citizens experiencing a mental health crisis. Many LEO’s lack training and are uncomfortable with these calls. Importantly, this does not mean that 50 percent of all calls involve mentally-ill citizens but those individuals experiencing some behavioral health emergency – like a job lay-off or impending divorce or financial problems. They are not mentally ill and should not be treated any differently than any other 911 call for service. Police are often called when bad things happen to normal individuals who become emotionally overwrought often made worse by chronic use of alcohol or drugs.

Training for encounters with citizen’s experience a mental illness is part of the early career academy education. Many officers are provided 40 or more hours of crisis intervention training (CIT). In-service programs are being introduced across the country because of the importance of having expertise and understanding in basic de-escalation. Agencies around the country are playing catch up in learning how best to deal with abnormal behavior. Police in Albuquerque, NM are using a monthly supervision model where the department psychiatrist case conferences specific calls and officers learn techniques for de-escalation and process details about how better to respond to future calls.

Crisis intervention training teaches law enforcement officers what to expect and allows them to practice using role playing to see for themselves how to intervene with people in crisis using de-escalation techniques. “Law enforcement officers’ attitudes about the impact of CIT on improving overall safety, accessibility of services, officer skills and techniques, and the preparedness of officers to handle calls involving persons with mental illness are positively associated with officers’ confidence in their abilities or with officers’ perceptions of overall departmental effectiveness. ” Bonfine, 2014. “When a police officer responds to a crisis involving a person with a serious mental illness who is not receiving treatment, the safety of both the person in crisis and the responding officer may be compromised especially when they feel untrained” according to Olivia, J, Morgan, R, Compton, M. (2010).


Bonfine N, Ritter C, Munetz MR. Police officer perceptions of the impact of Crisis Intervention Team (CIT) programs. Int J Law Psychiatry. 2014 Jul-Aug;37(4):341-50. doi: 10.1016/j.ijlp.2014.02.004. Epub 2014 Mar 11.PMID: 24630739

Olivia, J, Morgan, R, Compton, M. (2010) A Practical Overview of De-Escalation Skills in Law Enforcement: Helping Individuals in Crisis. Journal of Police Crisis Negotiations, 10:15–29.
While Reducing Police Liability and Injury

Cumulative exposure to stress: The stigma of being human

The impact of cumulative emotional reactions and Post traumatic Stress Disorder (PTSD) has significant negative impact on law enforcement heartiness, job satisfaction and career success (Polizoti, 2018). Police agencies across the country are looking for ways to mitigate the impact of accumulated stress associated with exposure to the worst of the worst of all human experience. “Arguably, everything from unattended death, domestic violence, child abuse, and a fatal motor vehicle crash may show up on the call board of any dispatcher on any day or night.” Sefton, 2014. There is no doubt that police officers and first responders are exposed to experiences that are well outside of normal human experience. On top of this requirement many officers do not feel supported by the people they serve and worse, the leadership hierarchy within the agency.

Law enforcement agencies are looking for ways to reduce the human cost of the stress and trauma LEO’s experience on the job but eliminating this all together is likely impossible. This “roller coaster” ride is often why we sign up for the police service where one can have hours of boredom sprinkled with seconds of shear terror and exposure to viral human suffering.

It has been said that LEO’s keep their internal conflict and emotions to themselves always in check and under control. Some fear being perceived as weak and feel intimidated by seeking support for the behavioral health needs resulting from the job. Strength in silence is the archaic mantra lurking behind the blue line and may be the underpinning stigma at work. This stereotype has a significant impact on family relationships, work performance, and career longevity. It has changed in the past decade but very slowly and too many officers are suffering.

Just as we have seen in a subset of the returning member’s of the armed forces, LEO’s are taking their own lives as a result of the accumulation of stressful calls year after year coupled with an erosion of coping skills rendering them vulnerable to becoming hopeless, embittered, and angry. On top of that and perhaps most dangerous is a growing mistrust and perceived lack of respect and support from community leaders, citizens, and sometimes department leaders.

Bias refers to having expectations about a class or subset of people based on unrecognized and unsubstantiated prejudice. Among law enforcement there is a perceived threat of reverse bias associated with having an emotional reaction to the law enforcement experience – at least as far as the front line troops are concerned. There is sometimes an negative attribution associated with being on stress-related leave so many officers who need support do not seek help. Over time this takes a toll on officer well-being. The health risks from years of maladaptive coping to on-the-job calls for service can be insurmountable for some leading to substance abuse, depression, heart disease, and PTSD.

The upwelling of professional disdain toward the police and outright lack of support from the public arising from use of force and incidence of fatal officer involved shootings adds to the LEO “disidentification” with the police service. Once an officer has disidentified with the job he or she is vulnerable to a host of professional challenges associated with becoming at risk for career burn out and embittered.

“Pain is lessened by ceasing to identify with the part of life in which the pain occurs. This withdrawal of psychic investment may be supported by other members of the stereotype-threatened group—even to the point of its becoming a group norm. But not caring can mean not being motivated. And this can have real costs.” according to Steele (1999) who studied achievement in African American college students.

Whether one is speaking about academic achievement or career satisfaction and job performance in the police service “disidentification is a high price to pay for psychic comfort” according to Steele (1999).

The reason for this falls back to deeply held bias toward mental illness that cuts across all segments of society. But it hits particularly hard among law enforcement and first responders. This is especially true when a brother officer is silently suffering.

Elevated mental health distress includes suicidal ideation, anxiety, and depressive symptoms. Some LEO’s preferred to seek help from a chiropractor or physiotherapist rather than a clinician or mental health provider” which reveals the true extent of underlying stigma and bias (Berg et al., 2006).

Polizoti, L. (2018) Career resilience and hardiness. LEO presentation. Worcester, MA.
Steele, Claude (1999) Thin ice: Stereotype threat and black college students. The Atlantic Magazine.

Berg et al. (2006). Fighting Police Trauma: Practical Approaches to Addressing Psychological Needs of Officers

The Agony of Releasing a Murderer

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Albert Flick is led out of the courtroom following his initial appearance in the Androscoggin County Court house in Auburn Wednesday morning. (Russ Dillingham/Sun Journal)
 
There is no pleasure when a parole board must decide on whether to release or not a man who violently murdered his wife. Especially the case of Albert Flick – arrested in Westbrook, Maine in 1979 and convicted of the brutal murder of his wife. Mr. Flick asked not to be released perhaps out of some inner sense of foreboding and primal instinct of things to come – if such a thing exists among killers. He is a wolf in sheep’s clothing -underneath he is ravenous.
Fast forward to Sunday July 15, 2018 Albert Flick who had been released from jail for committing the violent murder of his wife again killed a woman with whom he had an infatuation. He had been stalking her for weeks prior to her murder.  He followed she and her two little boys from place to place in Lewiston, Maine.  She had an inner sense that he was dangerous but was fearful of going to the police at the time of her death. Yet she had spoken to friends about her worries. What may have prevented the victim from calling police when she first noticed Mr. Flick was stalking her? Why was she fearful of the very people charged with preventing violence? What may have happened if she had notified the officer on her beat? Or a police officer walking in her neighborhood?
The answer is that Mr. Flick would have had a visitor that in all likelihood would derail his infatuating behavior. If not, he would have had is parole revoked as it should have rightfully been done.  I was a police officer in Westbrook, Maine when Flick murdered his wife in 1979. I was on duty when the call came in to the station but as a junior officer was not dispatched to the scene. The scene was horrific even by todays standards of violence. Nevertheless, the case is well know to me as I later worked closely with the arresting investigator Ron Allanach and his partner Wayne Syphers – both exemplary career law enforcement officers.  Ron went on to earn his doctorate in counseling and was Chief of Police for 8 years at the end of his career in Westbrook. Both men were instrumental at convicting Albert Flick.  Flick is shown in the 1979 photograph below being taken to court in Portland by Detective Syphers who made a heroic effort to save the life of the victim. The female victim ultimately died in his arms in 1979.  Albert Flick should have remained in jail for life and many in law enforcement who remember the case are agonizing over  his release after serving 20 years.
“Clearly, probation is not working. … At this point, I just don’t know what else to do. I think there’s a huge safety risk to women and society when it comes to Mr. Flick.” Prosecutor Katherine Tierney, 2010
WayneSyphers and Flick
Albert Flick with Det. Wayne Syphers (right) at Cumberland County, Maine trial in 1979
Flick was known for a proclivity for violence against women. After being released from his murder conviction Flick was arrested for chasing an intimate partner with a screw driver with intent to due harm. There would be other charges and other arrests that were red flags for the underlying anger he felt toward woman.  A group of us will reach out to Mr. Flick in the coming months for a sit down.
The female victim, Kimberly Dobbie, in this 2018 Lewiston, Maine case had felt threatened by Flick. Her instincts were keen as it related to his potential for violence against her. But she told only her friend and no one else.  She was 30 years his junior and had spurned his love interest. She had twin children who were present during the despicable killing and are traumatized having witnessed their mother’s death. In his book “The Gift of Fear“, Gavin deBecker espoused the value of trusting our primal instincts as they pertain to our personal safety.
Flick had been in and out of prison for crimes involving intimate partner violence and intimidating female witness who were courageous in coming forward against Flick. At some point he himself reported asked to be kept in custody.
“You can’t say that nothing can be done, because nothing will be done,” said Michael Sefton, a former Westbrook police officer who now works in Massachusetts for the New Braintree Police Department.
Keep Me Current, 2011
The judge who authorized Flick’s release is retired from the bench but his stated opinion for releasing Flick was that “he had aged-out and was no longer criminally inclined” yet he himself asked to remain behind bars.  Why?
Technically this was true, Flick no longer fit the stereotypic picture of a repeat murderer.  He was older and physically growing infirm.  Most men who commit domestic violence homicide do not recidivate once released from prison especially those over the age of 70.  While researching a case of family murder-suicide, I have spoken to a man who served 18 years for strangling his wife who was released and became a model citizen and amateur photographer. He published a book of his photographs that were quite good – even sensitive.  This man was not a risk and was somewhat younger than Flick.  So by all reasonable judicial standards Flick was considered a low-risk release. Probation would keep him in line.  Not so fast, information was available from his first release that included repeated violence against women raising a red flag of potential violence in the future.  Plus the horrific nature of the stabbing murder in 1979 was not a factor in the release conditions once he had served his time. Finally, there is also information that suggested that Mr. Flick did not seek his own release as reported above. He may have been institutionalized with the simmering anger he himself expected would again leach from his despicable soul.