Peer support

Professional M.H. Intervention: Making the hand-off

Michael Sefton, Ph.D. Human Behavior ,
Whenever there is a serious call of any kind, we review the incident..  We will attempt to weigh the seriousness and potential impact on law enforcement officers.  We will contact our CISM  Team members who may work in the district involved (they’d be more familiar with the officers) and obtain an assessment from them.  We will also contact supervisors that responded to get their impression of how the incident may have impacted their officers.  After a careful review, we will decide on whether or not we conduct a debriefing.  Sometimes (on rare occasion, we will contact the officers directly (the officers that were involved in the incident).  However, we try not to do that, because we don’t want them to try to debrief the incident over the phone (officers will naturally start talking about the incident over the phone and we don’t want that), but sometimes you need to go directly to the source.   Cumulative trauma extends beyond shootings and other “critical incidents,” however. Among cumulative trauma are the days and nights of being cursed and shouted at, listening to the screams, viewing dead bodies, and the momentary scares and fears that go along with law enforcement. These are the “bumblebee stings” that add up; one or two may be tolerable but, as they add up, the pain increases to the breaking point—and posttraumatic stress disorder (PTSD).
  • Line of Duty Deaths
  • Suicide of a colleague
  • Serious work-related bodily injury
  • Multi-casualty/disaster/terrorism incident
  • Incident with high degree of threat to personnel
  • Significant events involving children
  • Events in which the victim(s) are known to personnel
  • Events with excessive media interest or scrutiny
  • Events that are prolonged that end with a negative outcome (failed CPR)
Any significantly powerful, overwhelming or distressing event when any incident such as the above occurs, we will be notified by our Operations Division and or CISM Team members and or rank and file officers, soon after the incident.  These incidents will always elicit a response of some sort (these are all “Mitchell Model”events).  After investigating, we make a determination on how to proceed;whether it calls for a Debriefing, a 1 on 1 with a trained peer counselor, a critial incident diffusing, a recommendation for clinical services, OnSite Academy, McLean Hospital, sometimes no action will be taken at all, but there will definitely be a response (as in an investigation and careful thought), etc.  We take many criteria into consideration when we make our determination.  What other officers have informed us about the involved officer, how long the involved officer has been on the job, what other incidents the officer has been involved in, the officers personality, who was with him/her during the incident, how gory the incident may have been, any external issues etc.   We almost never make a final determination until we have consulted with one of our clinicians.

Police Stress Intervention Continuum: An empirical option for LEO’s and command staff to reduce officer suicide

Michael Sefton, Ph.D. Human Behavior, Police officer behavior, psychological relevence, Stress, use of force continuum , , , , , , , , , , ,
Scope of the Problem: Police Suicide and the goal to eliminate it – modified December 28, 2022
Police job-related stress is well-identified and reported in the media daily and the rates of suicide nationwide are being debated by Aamodt and Stalnaker. They are actually less than one is led to believe but even one law enforcement officer suicide is too much. During the week of Christmas 2022, 3 police officers took their own lives at Chicago PD. Some law enforcement officer deaths may be reduced by using a stress intervention continuum. This ties the continuum of calls into a stress reduction protocol that empowers resilience and recognizes the importance of stress mentoring and the soft hand-off for defusing the growing impact of high stress and high lethality exposure. The stress intervention continuum does not single out one officer but identifies all officers – including call takers, dispatchers, and supervisors for defusing particularly abhorrent events like mass shootings. This way, personnel who played a roll in a “bad call” will not be overlooked nor stigmatized for stress reduction defusing and/or debriefing.
Stress is defined as any situation that negatively impacts an officer’s well-being. The rate of suicide and divorce among law enforcement is approximately the same or lower than the general public according to a meta-analysis conducted by Professor Michael Aamodt.  But there are areas in the country and agencies that have higher rates of self-inflicted death.
When the suicide rate of police officers (18.1) is compared with the 21.89 rate for a comparable demographic population, it appears that police officers have a lower rate of suicide than the population according to Aamodt, 2008.
Incidence of suicide tend to be elevated in cities like Chicago, where chronic gun violence and a murder rate in the hundreds per year means cops see a staggering amount of traumatic events. As a result, they may gradually become numb to the exposure of pain and suffering (Joyner, 2009). A Department of Justice report found that the suicide rate in the Chicago Police Department is 60 percent higher than the national average.  According to the 2018 Chicago Sun Times, in a note to department members, former CPD Supt. Eddie Johnson said in 2018, “Death by suicide is clearly a problem in Law Enforcement and in the Chicago Police Department. We all have our breaking points, a time of weakness where we feel as if there is no way out, no alternative. But it does not have to end that way. You are NOT alone. Death by suicide is a problem that we can eliminate together” CST September 12, 2018.  Chicago PD is not alone with the problem of suicide among its men and women in blue. In fact, smaller departments with fewer than 50 officers often have high rates of suicide and lack the peer support and clinical resources that enable officers to find help during times of crisis.
Law enforcement officers (LEO’s) encounter the worst of all experience on a routine basis. The people who call the police may be society’s best upstanding citizens but on this occasion it could be the worst day of their lives and they seek help from police.  Many times it is not the pillars of society seeking help but those people in the fringes or margins of society now victims of violent crime or abuse.
According to Hartley, et.al., 2007, “repeated exposures to acute work stressors (e.g., violent criminal acts, sad and disturbing situations, and physically demanding responses), in addition to contending with negative life events (e.g., divorce, serious family or personal illness, and financial difficulties), can affect both the psychological and physiological well-being of the LEO population.” When these officers are identified there needs to be a planned response using a peer support infrastructure that provides for a continuum of service depending upon the individual needs of the LEO and the supports available. In many agencies, especially smaller departments lacking resources, officers’ languish and sometimes spiral downward without support and without somewhere to turn.  Police officers must have support available to them long before they are expressing suicidal urges.
As programs are identified and service continuum grows the risk of peer conflict over perceived betrayal of trust must be addressed. This must be addressed in the peer support training with emphasis on preservation of life over maintenance of confidentiality or the status quo of abject silence. “In itself, it’s a product of centuries of police culture in which perceived weakness is stigmatized. Cops know their brothers have their back, no matter what, but they still don’t want to be seen as the one who’s vulnerable.” according to a recent Men’s Health article written by Jack Crosbie in a report about suicide in the NYPD published during Mental Health Awareness month in May 2018.
The argument is made that the recurring uncertainty of police calls for service often leave LEO’s with low-level exposure to trauma of varying degrees. It is common that LEO’s move from one violent call to the next without time to decompress and process what they have seen.  The repeated exposure to trauma can slowly whittle away LEO resilience – defined as the capacity to bounce back from adversity. In a national media study published by Aamodt and Stalnaker, legal problems were a major reason for the law enforcement suicides yet no other study separately cited legal problems. In another study, relationship problems accounted for the highest percentage of suicides at 26.6% (relationship problems plus murder/suicide), followed by legal problems at 14.8%. In nearly a third of the suicides, no reason was known for LEO suicide.
Police suicide has been on the radar of advocates of LEO peer support for months or years.  The incidence of suicide has remained stable across the country but some agencies have higher rates of suicide.  Smaller departments – those with less than 50 officers in general have the highest rates of suicide.  This may be linked to the lack of availability of peer support programs and a paucity of local practitioners to provide professional service with knowledge in police psychology. “While police officers may adapt to the negative effects of chronic stress, acute traumatic incidents necessitate specialized mental health treatment for police officers (Patterson, 2001)”.  A referral to the department EAP often falls flat and makes it more difficult to make the hand-off when peer support is not enough.

Points of entry to Peer Support – Stress Intervention Continuum

  1. Exposure to highly stressful events in close sequence
  2. Change in work assignment, district/station, deployment undercover or return from deployment
  3. Increased absenteeism – over use of sick leave – missing court dates
  4. Increased use/abuse of substances – impacting job functioning, on-the-job injury
  5. Community – citizen complaint(s) for verbal abuse, dereliction of duty, vehicle crash
  6. Citizen complaints of excessive force during arrest, supervisory or peer conflict, or direct insubordination
  7. Abuse of power using baton, taser or firearm, recurrent officer involved use of force. Officers are sometimes strongly embittered and angry at this point in their career due to perceived lack of support and powerful feelings career disappointment and alienation – copyright Michael Sefton, Ph.D.
Real-time model of change
The use of force continuum is well described in the LEO literature and ongoing criminal justice narrative. What does that have to do with stress intervention in police officers? It sets the tone for officer behavior whenever they meet potential resistance and or increased aggression during citizen encounters. It may also be used for initiating peer support needs whenever an incident use of force has occurred.  LEO’s change the force response based on the situation they encounter in real-time in a flexible and fluid manner. In this same way, peer support programs can flexibly shift to the needs of a presenting LEO and intervene early on – rather than when an officer is at a breaking point. “This continuum (use of force) has many levels, and officers are instructed to respond with a level of force appropriate to the situation at hand, acknowledging that the officer may move from one point on the continuum to another in a matter of seconds.” NIJ publication.  Peer support too, must accommodate a law enforcement officer in real-time to begin the process of building a healthy, resilient response to sometimes horrific exposures and provide a continuum of unbiased employee assistance and when necessary professional consultation.
Protective Factors begin in Academy training
What topics should addressed while LEO recruits are in training?  Ostensibly, the resilience of LEO’s depends upon the opportunity for in-service training in topics of mindfulness, stress management, physical health maintenance, nutrition, and trust.
“Emotional resilience is defined as the capacity to integrate the breadth of police training and experience with healthy, adaptive coping, optimism, mental flexibility and healthy resolution of the traumatic events. In general, resilient people are self-reliant and have positive role models from whom they have learned to handle the stressful events all police officers encounter” according to Leo Polizoti, Ph.D. a police consulting psychologist (Sefton 2018).
Police programs for health maintenance
The Police Stress Intervention Continuum or P-SIC, involves a system of police support that varies in its intensity depending upon the continuum of individual needs of the LEO including physical debility or other significant components impacting career success and satisfaction. The intervention protocol is flexible and fluid as well. The entry point into the peer support continuum initiates from supervisory observations of LEO history and behavior, peer recommendations, and exposure to a range of traumatic events.
The cumulative stress associated with a career in law enforcement cannot be understated.  In the setting of police stress and stress support there is an intervention protocol that relates to the peer-support program continuum.  Depending on where officers enter the peer support network will impact the level of intervention they may require in the P-SIC program.  Peer support is not psychotherapy but officers occasionally must hand off the officer in trouble to a  higher level of care.  These hand-offs are key to linking at-risk LEO’s with range of professional support needed to keep them on the job. Yet fear of reprisal for acknowledging the cumulative impact of stress and its impact often derails the hand-off to the professional. The highest risk for suicide to a LEO is when he is denuded of badge and gun because he may be a threat to himself.
The career success they have may be directly related to the application of resiliency training to build and maintain physical and emotional hardiness that lasts a lifetime according to Leo Polizoti, 2018. Before this can happen the stigma associated with reaching out must be reduced.
NIJ Publication (2009). Use of Force Continuum. https://www.nij.gov/topics/law-enforcement/officer-safety/use-of-force/Pages/continuum.aspx. Taken November 17, 2018
Aamodt, M. G., & Stalnaker, N. A. (2001). Police officer suicide: Frequency and officer profiles. In Shehan, D. C, & Warren, J. I. (Eds.) Suicide and Law Enforcement. Washington, D.C.: Federal Bureau of Investigation.
Aamodt, M. (2008). Reducing Misconceptions and False Beliefs in Police and Criminal Psychology. Criminal Justice and Behavior 2008; 35; 1231 DOI: 10.1177/0093854808321527.
Patterson, G T. (200l). Reconceptualizing traumatic incidents experienced by law enforcement personnel. The Australian Journal of Disaster and Trauma Studies, 2.
Joyner, T. (2009) The Interpersonal-Psychological Theory of Suicidal Behavior: Current Empirical Status. Science Briefs, American Psychological Association, June.
Sefton, M. (2018). Police Training: Revisiting Resilience Blog post: https://msefton.wordpress.com/2018/07/27/police-training-revisiting-resilience/. Taken November 18, 2018
Sefton, M. (2018) Points of Entry to Peer Support and mentoring. Blog post: https://wordpress.com/post/msefton.blog/5269 – taken December 27, 2022
Hartley, T., et.al.(2007). Associations Between Major Life Events, Traumatic Incidents, and Depression Among Buffalo Police Officers. International Journal of Emergency Mental Health, Vol. 9, No. 1, pp.
John M. Violanti, Anna Mnatsakanova, Tara A. Hartley, Michael E. Andrew, Cecil M. Burchfiel. (2012). Police Suicide in Small Departments: A comparative analysis. Int J Emerg Ment Health. Author manuscript available in PMC 2015 Aug 14. Published in final edited form as: Int J Emerg Ment Health. 2012; 14(3): 157–162.