Resilience

A Behavioral Health Bill

Michael Sefton, Ph.D. crisis intervention, Health Psychology, Human Behavior, Police officer behavior , ,

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 are protective factors in law enforcement: Ballistic vests notwithstanding

Michael Sefton, Ph.D. 12-step programs, Alcoholism, Childhood violence, CIT, Human Behavior , , , , , , , ,

vest.jpg
Officer wearing ballistic vest

A new paper was just published in the Journal of Police and Criminal Psychology that has to do with high rates of depression in some police officers. It is written by Emily Jenkins (2019) who is a biostatistician and epidemiologist at the National Institute for Safety and Occupational Health in Morgantown, WV.  Her co-authors include John Violante who himself is an epidemiologist and former New York State Trooper now researching police officer health and suicide.  Basically, the authors say there are factors in personality and behavior that serve to reduce the new incidence of depression in LEO’s and to reduce the associated physical debility that may be co-occurring in cases where a history of depression was previously reported. One might see this protection as a ballistic vest for emotional health and career hardiness. High resilience leads to career success, satisfaction, and reduced likelihood of developing depression. Resilience refers to adaptability and flexibility in dealing with stressful situations.  Resilience officers are able to tolerate highly stressful situations without becoming debilitated by stress and negativity.

I find the study interesting but it doesn’t connect with the troops in the field. For example, one feature listed as helpful against depression is “active coping” that includes things like agreeableness, conscientiousness, and having social support. Understanding protective factors leads to understanding who is most at risk of developing depression.  The goal is to reduce depression among LEO’s and lessen the long-term impact of depression once it has been diagnosed.  The paper cites links to depression and poor coping skills to personality features such a high neuroticism and low conscientiousness and low extraversion.  These variables may lead to higher risk for substance abuse, reduced hardiness, and a host of physical signs and symptoms.  These personality features are the biomarkers of chronic stress and its harsh consequences. They make sense to me but I rarely encounter a police officer, or anyone else for that matter that actively thinks about the core set of personality features that have defined them throughout life.

Officers across the country are being trained in peer support and crisis intervention training. At the Direct Decision Institute we are providing a variety of training programs designed for this same issue – increased officer hardiness and reduced risk of burnout, depression, and suicide. These are intuitive concepts and when talking with active duty LEO’s, I feel like the rank and file understand the words they hear but rarely will an officer offer up a personal example of times he or she may have had behavioral health issues. I have heard officers become very emotional when telling the stories of friends who have suffered with mental illness but rarely a personal story.

Two recent exceptions to this notion are Sergeant Mark DiBona, a recently retired sheriff’s department officer from Florida and Joe Smarro, an officer from Texas who is recently featured in an outstanding documentary entitled Ernie and Joe released in May, 2019 with great acclaim.  It should not be this way and there is still great secrecy behind the veil of police service.  It takes great courage to share personal struggles and one’s private experience.  Police officers are most uncomfortable with this. Officers who are signing up for CIT and peer support courses are carefully chosen and may be more open to personal self-disclosure exhibiting greater positive coping skills, hardiness, extroversion and emotional resilience.

In order to reduce stigma associated with law enforcement behavioral health issues all members of the police service need greater self-awareness, openness to self-disclosure, and understanding of the effects of repeated exposure to violence and its broad ranging vicissitudes. This is nothing new and is being taught in academy training. Police psychologists who provide pre-employment screening should analyze the test data carefully and avoid selecting men and women who are most at risk of developing depression and who are outgoing, confident, and emotionally sturdy.

From anonymity and stigma grows resilience

Michael Sefton, Ph.D. CIT, DVH, Human Behavior, Police officer behavior, use of force continuum , , , , ,
Today there is still a great deal of stigma associated with reaching out for peer support within police departments. Officers’ fear being misunderstood and seen as weak if they acknowledge their vulnerability years into the job. The blue line bleeds each time an officer takes his or her own life yet the silence within the ranks is stunning. An officer may act heroically in their efforts to save a child who isn’t breathing and fail.  An officer may be first-in to a call for domestic violence homicide and fail.  An officer may be dispatched to a horrific motor vehicle crash and come upon an overturned minivan with a shamble of entrapped human misery and death and still feel a failing.  These events create a chink in the armor and sometimes reveal gaping personal anguish that accumulates over time. The cumulative impact of trauma adds to the layers that belie the outward calm.  As a former police officer there are calls I covered that are painful to this day. Abject failure. Exposure to subclinical, traumatic events takes a toll of both physical health and emotional wellness and can lead to PTSD, secondary traumatic stress disorder, and burn out.
Prevention of law enforcement suicide is paramount.  As recently as early November, 2018 a former police chief died by police assisted suicide killed by his former officers after charging them with a kitchen knife.  And in Baltimore County, MD, School Resource Officer Joseph Comegna, a 21-year veteran of the force, took his own life at his desk in the public school.  “And unlike line-of-duty incidents, which tend to receive a great deal of media coverage, law enforcement suicides rarely get much press, says Al Hernandez, a 35-year veteran of the Fresno Police Department (FPD) in California. Hernandez helps connect officers to mental health care.” according to Jack Crosbie writing in Men’s Health about a suicide death of an NYPD officer who died in early 2018.
The impact of stress on the lives of LEO’s is well known and can have pervasive impact on officer well-being both in and out of uniform.  Hypertension, cardiovascular disease, substance abuse, and depression are just a few of the behavioral health consequences that may result from repeated exposure. Ongoing vulnerability to traumatic events can result in anger, resentment, strong negative emotions, and reactive embitterment that can erode job satisfaction and job performance (Sadulski, 2017). Critical Incidence Stress Debriefing plays an important role for police by helping LEO’s manage their trauma and post-traumatic stress. It should be provided as part of an integrated system of peer support. Most departments have officers trained in CISD whom provide peer support to brother and sister LEO’s who are in crisis. Key among these relationships is the hand-off to mental health professionals when indicated. Peer support is not treatment and the relationship between the peer support and psychological treatment should be clearly defined.
Each of us in law enforcement has a duty to reduce suicide among the men and women in blue whenever possible. This requires a substantive understanding of the risk factors associated with LEO self-destruction. Chief among law enforcement is the camaraderie that bonds officers together during times of stress. Peer support is a key factor in reduced emotional suffering among law enforcement officers. 
Risk factors for suicide increase when the conventional need for belongingness among law enforcement officers which is thwarted by the estrangement or isolation.  This comes with individual officer discipline, e.g. suspension, or some other factor pushing him/her out that can be isolating and evoke feelings of thwarted belongingness according to Thomas Joiner (2009). Social alienation is a powerful emotional dynamic that results from the experience of being estranged from a core group of supportive friends, colleagues, and immediate family. This occurs in many ways including change in social reciprocity and reduced exposure to primary interpersonal ties resulting in powerful feelings of loss and growing belief of being a burden. This may be the result of disciplinary actions toward the officer, on-the-job injury, or departmental requisite following officer-involved use of force. 
Embitterment has large implication on LEO productivity, career satisfaction, job performance, citizen complaints, and officer health. It grows slowly as a function of career experience perceived support, and critical incident debriefing and peer support are vital to officer longevity.  Mentoring in the field and supervisory support reduce officer isolation and sometimes powerful feelings of negativity that can fester over time according to Polizoti, 2018.  Ostensibly, resilience is the opposite of embitterment. Have you ever worked with someone who rolled with the punches – literally and figuratively?  They can have felony cases dismissed in court and remain nonplussed maintaining a positive attitude and a “better luck next time” belief system.  
Lethal Self-Injury – Acquired Ability
The final risk factor involves a gradual desensitization to pain and human suffering according to Joiner (2009). Over time, exposure to repeated violence, homicide, intimate partner violence, and other “salient fearsome experiences”, the self-preservation instinct gradually disintegrates into a residual fearlessness in the face of life threatening danger and an acquired capacity to ignore the horror and humility of violence with a higher tolerance of pain and substantive capacity for suicide (Joiner, 2007).
Joiner believes that the capacity for suicide is acquired over time from the repeated exposure to trauma such that the reaction to horrific traumatic events, e.g. domestic homicide, loses the ability to evoke a normal emotional response and habituates to a decreased emotional reactivity, a higher tolerance for pain, and a fearlessness in the face of death. Given this proclivity toward feeling “numb” in the face of high levels of violence, over time researchers look for protective factors such as reducing isolation and more frequent debriefing after every critical incident rather than wait until LEO coping goes the way of attachment and perceived support. 
References
Sadulski, J. (2017). Promoting Police Resilience through Peer Support. Law Enforcement. Blog post taken November 20, 2018
Joiner, T. (2009). The Interpersonal-Psychological Theory of Suicidal Behavior: Current Empirical Status. Science Briefs, APA, June.
Polizoti, L. (2018) Critical incident resilience training. Personal correspondence, September.
 



Officer resilience and career success with less burnout

Michael Sefton, Ph.D. CIT, crisis intervention, Human Behavior, Police officer behavior, psychological relevence , , , , , , ,

Mike Sefton photo
Michael Sefton, Ph.D. in Guangzhou, China

WESTBOROUGH, MA December 9, 2017 Resilience in police training is an added lesson designed to enhance the careers of officers-in-training. According to Leo Polizotti, Ph.D. resilience refers to professional hardiness that is protective against career burnout and raises both professionalism and job satisfaction.

It is essential to help individual officers through the tough times and enhances job satisfaction.  In the case of traumatic events – officer resilience is essential for a healthy response to a critical incident.  In the long run, physical health and well-being are the underpinnings of an emotionally resilient professional who will be there over and again – when called upon for those once in a lifetime calls that most of us will never have to answer.

Emotional resilience is defined as the 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. In its absence a police officer experiences irritability, brooding, anger and sometimes resentment toward his own agency and “the system” for all its failures.  The lack of emotional resilience leads to officer burn-out.

“Your biggest risk of burnout is the near constant exposure to the “flight or fight response” inherent to the job (running code, engaging and managing the agitated, angry, and irrational, or any other of your responsibilities that can cause you to become hypervigilant). Add the very real tension of the politics and stresses inside the office and a dangerous mix is formed. The pressures and demands of your job can take a toll on your emotional wellbeing and quality of life and burnout will often follow.” Olsen & Wasilewski, 2014

It is well documented that flooding the body with stress hormones like adrenaline and cortisol play a role in police officer health and well-being. “Stress and grief are problems that are not easily detected or easily resolved. Severe depression, heart attacks, and the high rates of divorce, addiction, and suicide in the fire and EMS services proves this” according to Peggy Rainone who provides seminars in grief and surviving in EMS. (Sefton, 2013). There are various treatments for stress-related burnout including peer support, biofeedback for reduced sympathetic dysfunction, and professional psychotherapy. “Being exposed to repetitive stress leads to changes in the brain chemistry and density that affect emotional and physical health.” (Olsen, 2014)  Improved training and early career support and resilience is essential for long term health of first responders including the brave men and women in blue.

Polizotti, L. (2017) Psychological Resilience: From Surviving to Thriving in a Law
Enforcement Career. Presentation. Direct Decision Institute

Olsen, A and Wasilewski, M. Police One.com (2014) Blog post: https://www.policeone.com/health-fitness/articles/7119431-6-ways-to-beat-burnout-in-a-police-officer/ Taken December 9, 2017

Rainone, P. (2013) Emergency workers at risk. (website) http://www.emsvilliage.com/articles/article.cfm?ID=176. Taken 12-1-2013

Sefton, M. Domestic Violence Homicide: What role does exposure to trauma play in terminal rage? Blog Post: https://wordpress.com/post/msefton.wordpress.com/505 Taken December 9, 2017.