DANGERS OF LAW ENFORCEMENT STRESS

by

Gary Lee Taylor

A project

submitted in partial

fulfillment of the requirements for the degree of

Master of Criminology

in the College of Social Sciences

California State University, Fresno

December 2015

APPROVED

For the Department of Criminology:

I, the undersigned, certify that the project of the following student meets the required standards of scholarship, format, and style of the university and the student's graduate degree program for the awarding of the master's degree.

Gary Lee Taylor Project Author

George Kikuchi Ph.D. Criminology

AUTHORIZATION FOR REPRODUCTION

OF MASTER’S PROJECT X I grant permission for the reproduction of this project in part or in

its entirety without further authorization from me, on the condition that the person or agency requesting reproduction absorbs the cost and provides proper acknowledgment of authorship.

Permission to reproduce this project in part or in its entirety must

be obtained from me. Signature of project author:

DEDICATION

This work is dedicated to the many law enforcement, corrections officers,

and any other first responders that sacrifice for the greater good. To my brothers

and sisters in blue, I want to remind them of this poem written by an unknown

author. For the public, this poem is meant to acknowledge our sacrifice and

remind them of the cost it takes for their safety. There is a flip side to this poem.

For officers, this poem is a reminder of those sacrifices and the cost of that

sacrifice which can lead to mental health concerns or suicide. Let this poem be a

reminder to not be afraid to get beyond the stigma within our culture and to seek

help.

The Police Officer’s Life

I have been where you fear to be

I have seen what you fear to see

I have done what you fear to do

All these things I’ve done for you.

I am the one you can lean upon

The one you cast your scorn upon

The one you bring your troubles to

All these people I’ve been for you.

The one you ask to stand apart

The one you feel should have no heart

The one you call the officer in blue

But I am human just like you.

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And through the years I’ve come to see

That I am not what you ask of me

So take this badge and take this gun

Will you take it? Will anyone?

And when you watch a person die

And hear a battered baby cry

Then do you think that you can be

All these things that you ask of me?

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ACKNOWLEDGMENTS

I would like to express my sincere gratitude to all the professors of the

Criminology Department at California State University, Fresno. I enrolled at

CSUF with a goal in mind for this project. I had great support and guidance from

each professor during this period of growth. Many of you were there to answer

questions outside of class, and provide sound advice. Additionally, members of the

CSUF Graduate Writing Studio who helped me fine-tune this work of art.

Marcus Tafoya, a friend, fellow military veteran and police officer that

understands the turmoil of this job. Thanks for your support and guidance

throughout this project, and for the times we walked down memory lane

discussing the funny things that happened on the job.

Thank you to my parents, grandmother, brother and his family, and my

extended family for their undying support throughout this tumultuous time of my

life. To my parents and grandmother, your love and support is a model to live by.

Thank you to my children, Colin and Katherine for their love and understanding.

Both of you are the reason for my existence.

For my wife, Jeanie, I love you. Your strength helped me overcome

weakness, and you made my life easier with your support. You are unselfish and a

very caring person. I could not have done this without you. I am excited about

where this project is taking me, and how it will positively affect our lives together.

It’s hard to find the words for the police psychologist who wishes to remain

nameless. You saved my life. No one understands the law enforcement officer

better than someone like you. I don’t know where I would be without your

guidance and expertise to help me overcome the disorders that ended my career. I

believe that in helping me, you have helped many other officers. I will be the

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spearhead to help improve their lives as I move forward. When you touch one life,

you touch many.

TABLE OF CONTENTS Page

LIST OF TABLES .................................................................................................. xi

LIST OF FIGURES ............................................................................................... xii

CHAPTER 1: INTRODUCTION ............................................................................. 1

Introductory Statement ...................................................................................... 1

Stress Relationship ............................................................................................ 1

California Commission on POST ...................................................................... 4

Personal Background ........................................................................................ 6

CHAPTER 2: Literature Review ............................................................................ 15

Police Officer Duties ....................................................................................... 15

Case Studies & Personal Communications ..................................................... 19

Stigma and the Administrative Breakdown .................................................... 25

Captain Mellon’s Story ................................................................................... 28

Deputy Seifert’s Story ..................................................................................... 29

Officer Harless ................................................................................................ 30

Assistance Programs ....................................................................................... 31

LEOKA Statistics ............................................................................................ 33

Department Statistics ...................................................................................... 36

Depression, PTSD, and suicide ....................................................................... 37

Positive Side of Seeking Help ......................................................................... 40

Formations and Solutions of PTSD ................................................................. 43

CHAPTER 3: Methodology ................................................................................... 53

CHAPTER 4: Project Design ................................................................................. 56

Workshop Design & Learning Objectives ...................................................... 56

Page

x x

Workshop Design ............................................................................................ 57

Stigma in the Police Culture ........................................................................... 58

Stress 59

Sleep Deprivation ............................................................................................ 61

Fight-or-Flight Syndrome (Adrenaline/Cortisol) ............................................ 65

Anxiety ............................................................................................................ 68

Depression ....................................................................................................... 69

Post-traumatic Stress Disorder (PTSD) .......................................................... 72

Psychologist Responsibility to officer/agency ................................................ 73

CHAPTER 5: Discussion and Conclusions ............................................................ 76

Summary ......................................................................................................... 77

REFERENCES…………………………………………………………………..79

LIST OF TABLES

Page

Table 1. Mayo Clinic Stress Symptoms ................................................................. 60

LIST OF FIGURES

Page

Figure 1. 48 Hours of Sleep Deprivation demonstrating the degredation in performance. ........................................................................................... 63

Figure 2. 72 Hours of Sleep Deprivation demonstrating the degredation in performance. ........................................................................................... 64

CHAPTER 1: INTRODUCTION

Introductory Statement

This is an examination of the traumatic effects that the law enforcement

occupation has on a police officer. We will understand many of the duties related

to the job description and how shift work combined with odd hours can lead to

sleep deprivation. Studies will show the physiological and psychological effects

on officers as a result of these schedules and their duties. These schedules

combined with the violence related to police work lead to more stress. Further

studies show the negative effects of intense and chronic stress on the body and

mind. There are mental health systems in place for officers, but due to stigmas or

fears, they are not always used to their full potential. Chronic stress can lead to

disorders such as depression and posttraumatic stress disorder (PTSD). Untreated

or misdiagnosed these symptoms can eventually lead officers to suicide.

Additionally, breaking down the walls of the police culture (stigma) will allow

officers the opportunity to get the help they need to combat these issues, and

reduce suicide. Finally, research by the Badge of Honor/Life has shown staggering

numbers of law enforcement suicides during the last few years.

Stress Relationship

Policing is a stressful occupation due to the many ways stress can be

imposed on officers from critical incidents, shift-work, administrative issues,

violence, and observing types of death. Stress can accumulate over many years or

manifest after one critical incident. This build up of trauma can lead to familial

problems, poor physical health, and suicide for the officer (Violanti, 2013).

Chronic stress leads to various physiological and psychological problems such as

2 2

depression, PTSD, high blood pressure, and cardiovascular disease (CVD).

Officers suffering from stress or other related issues have trouble performing their

duties and become health risks, have potential disciplinary problems, become early

retirees, and have mental health disorders and/or substance abuse problems

(Austin-Ketch, Violanti, Fekedulgen, Andrew, Burchfield, & Hartley, 2012).

These psychological issues can become a problem for officers when dealing with

workers’ compensation rules. People with presumptive claims go through the

workers’ compensation process faster than those with mental health claims.

Mental health claims can take over two years to complete. The anxiety and stress

during this process may be compounded on the individual and their family during

this period.

Officers find maladaptive coping mechanisms in alcohol or other

substances, which exacerbate the problems at work and with their families

(Menard & Arter, 2013). Using substances as coping mechanisms may lead to

suicidal behavior. Real life examples of this behavior can be found in a recently

published book, Public Safety Suicide (Van Haute & Violanti, 2015). According to

a national study of police suicides conducted by ‘The Badge of Life’ “in 2008, 141

officers committed suicide, in 2009, 143 committed suicide, and in 2012, 126

committed suicide” (Clark & O’Hara, 2013, para. 3). There is a stigma in the law

enforcement culture not to ask for help, and distrust toward the administration

regarding psychological concerns is commonly felt. This is not just an American

problem. In Ottawa, Canada, they have recorded twenty-six suicides by first-

responders, which include police, firefighters, and paramedics in a six-month

period. Twelve of those suicides were police officers (Yogaretnam, 2014).

According to Allen, Jones, Douglas, and Clark, (2014), “The law enforcement

culture values strength, self-reliance, controlled emotions, and competency in

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handling personal problems” (p. 35). It is crucial for supervisors to identify these

problems early to implement appropriate treatment for the officer.

Although many law enforcement organizations have mental health

programs in place to help officers, the culture of law enforcement continues to be

an obstacle in preventing treatment for physiological or psychological health risks

of officers. Stigma appears to be the biggest obstacle preventing officers from

receiving the help they need. Stigma is embedded in all of our lives, “…stigma

decays the ability to hold on to what matters most to ordinary people in a local

world, such as wealth, relationships and life chances” (Kleinman & Hall-Clifford,

2009, p. 418). As in any other culture, police culture is a set of shared values with

common behavioral norms, rules, and actions. Police have developed this culture

from their shared respect for each other due to the constant potential for life-and-

death contacts they make, and stresses suffered from this environment. Sharing

these risks increases solidarity, which causes this culture to be extremely resistant

to change (White & Robinson, 2014).

The International Association of Chiefs of Police (IACP) has only recently

initiated efforts to break down the cultural walls within law enforcement to

improve the understanding of mental health issues related to this occupation

(Allen et al., 2014). Until we can break down this wall, the number of

mental/physical health retirements or deaths for law enforcement is likely to

maintain current trends or increase the number of early retirements, deaths from

suicide and/or heart attack. A need for change should likely start in police

academies. California Commission on Peace Officer Standards & Training

(POST) learning domains were reviewed.

4 4 California Commission on POST

The California POST is comprised of forty-three Learning Domains (LD).

The LD’s are composed of the material required for cadets to know in order to

become police officers; such as, laws of arrest, various types of investigative

training, use of force, search and seizure, evidence collection, sex crimes, report

writing, etc. California POST has over 800 hours of mandatory training, which is

the most of any state. All academies are required to meet the minimum amount of

hours for these LD’s to be taught, and they are allowed to add additional hours for

any other training they deem necessary.

LD 32, version 4.2 is titled, ‘Lifetime Fitness’ and is comprised of four

chapters. Chapter one deals with personal fitness programs. Chapter two deals

with nutrition for life. Chapter three covers common medical concerns for police

officers, and chapter four covers recognizing and managing stress. An area of

concern was found in chapter three, under the heading of cardiovascular disease

(CVD). Chapter three states that, “research indicates that cardiovascular problems

are becoming more prevalent among younger officers, possibly due to eating

habits”(California Commission on Peace Officer Standards & Training, n.d.,

chapter three, p. 4). This statement suggests that if you change your eating habits,

one will be healthier, and not have to be cognizant of any other medical issues,

such as sleep deprivation. The problem with this training is that it does not show

how sleep deprivation or depression can play a significant role in a person’s eating

habits.

In chapter four on page twenty, “Caffeine Abuse” is discussed. Some of the

symptoms POST claims are related to caffeine abuse, are symptoms typically

found in anxiety, sleep deprivation, and PTSD. This training suggests to a cadet,

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who might have these symptoms; they need only to stop abusing caffeine to

remove the symptoms. A medical professional is more suitable to explain the ties

between the various health risks. It should be important to know the various links

between these symptoms. An officer with more awareness as to these links should

be able to recognize they could be suffering from more than one issue, or they

have misdiagnosed their issue.

Stress is often mentioned in chapter four, but there is no mention of

depression symptoms or other related mental health concerns. Much of the writing

shows officers how to reduce stress, but it does not cover the seriousness of this

problem or the importance of seeking mental health professionals. POST

acknowledges the stigma by advising officers to, “Seek counseling regardless of

the stigma” (California Commission on Peace Officer Standards & Training, n.d.,

Chapter 4, p. 7). This is significant because POST acknowledges the stigma, but

does not define what it is or how it affects officers. The lack of education or

discussion on this stigma suggests there is a need for awareness on this issue.

Kevin M. Gilmartin Ph.D. was instrumental in increasing awareness with

the publication of his book, Emotional Survival for Law Enforcement, at the IACP

1993 conference. Since then, he has toured the country lecturing to officers on

how to survive the pitfalls of the law enforcement profession. He explains how an

officer begins their career idealistically and how over the years becomes more

cynical. Gilmartin’s research defined how emotional changes to the officer could

lead to physical changes. He identified that law enforcement spends more time on

physical training for officer safety than on emotional survival for the officer

(Gilmartin, 2002). Dr. Gilmartin’s work was one of the first major steps toward

awareness and education on mental health for law enforcement.

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This awareness, supported by scholars like Dr. Gilmartin, has slowly

increased over the years. Within the last decade, mental health professionals have

started noticing that law enforcement professionals are suffering from PTSD just

like military combat veterans. The most recent push to educate on the issue of

stigma, mental health, and police suicide was done by the IACP in their 2013

national symposium. This is a dramatic step forward for law enforcement by the

IACP bringing further recognition to this problem.

Personal Background

In addition to the research I have done in this area, I can contribute a

considerable amount of personal experience. I was a police officer for nineteen

years between two different police agencies. Beginning in 1994, I spent over ten

years with Fresno Police Department (FPD), Fresno, California. I made a lateral

move in 2004 to Clovis Police Department (CPD), which is a smaller neighboring

agency, and stayed there until I was medically retired in December of 2013 for

PTSD and depression.

FPD is the sixth largest agency in California, and the twenty-sixth largest in

the country. For a number of years, Fresno was number one in the country for

auto-theft. Due to the auto-theft problem, and gang violence, the chief of police

had done something no other agency in the United States has done. He placed the

Special Weapons and Tactics (SWAT) team on the street full-time, which lasted

for approximately 4 years. I was an instructor for force options (choices officers

make when using all types of force from verbal to lethal), driving, report writing,

and I created a class for search and seizure to new recruits in orientation. Also, I

was a Field Training Officer (FTO), and defensive tactics instructor at FPD, and

later at Clovis Police Department (CPD).

7 7

One of the reasons I made the move to CPD is that I wanted a change to get

away from the routine violence I was constantly dealing with, and had become

accustomed to in Fresno. There were many violent and traumatic cases I was

involved in, but three important investigations I believe were key in mental health

issues I later suffered due to delayed onset PTSD.

October 30, 1997, in the early evening hours, six-year old May Ka Lee

exited a vehicle her parent was driving. She was sent across the basketball courts

at Melody Park to retrieve her brother. Gang violence erupted when a rival gang

member began shooting at his intended victim through the crowded court area.

May Ka Lee was shot and lay on the court until officers could arrive. I followed

the ambulance to the emergency room (ER). As I stood there, I watched the ER

staff quickly strip this little girl’s clothing off in an attempt to save her life. Within

a matter of minutes the child was pronounced deceased.

I hadn’t had any of my own children as yet, but it was traumatizing

nonetheless to watch and experience what I saw in the ER, and see the reckless

disregard for life the shooter had to shoot into a crowd. Over the years, I have had

periodic dreams of that night, seeing myself tucked back into the corner of the ER

looking down at May Ka Lee, and her lifeless body. Officer B. Twedt was the first

officer to arrive at the shooting, and he began performing cardio pulmonary

resuscitation (CPR). During a personal contact with Officer Twedt in May 2015,

this incident came up while we were discussing my trauma.

After all the years we worked together, this was the first time Officer Twedt

informed me that he had trouble dealing with this call as well. Officer Twedt had

three young daughters at the time. Twedt said all he could think about were his

daughters while he was trying to save May Ka Lee, and he was never offered a

visit to mental health. During my time with FPD, the only time mental health was

8 8

contacted was after a critical incident, which usually was an officer involved

shooting (OIS) or a violent attack on an officer. This like many other calls that

followed were just part of the job. But a much worse incident was yet to come.

January 23, 1999, I responded to a fully engulfed apartment fire at

Maple/McKinley Avenue to assist fire with traffic control. When I arrived, fire

personnel advised me that there were three bodies inside the apartment. The

mother (Galina) shortly arrived on-scene and gave me the following details. She

and her husband were immigrants from Russia; she had suffered mental and

physical abuse from him over the years. Galina was living at another location, and

had won full custody of the children. Galina was on her way here to pick up the

children at her scheduled time. The children, Alexi, Alexander and Peter were

nine, six and two years old. Words can’t express how I felt when I observed

Galina dropping to the ground, breaking down with emotion, and hearing her

screams of anguish, when she realized her children had just been murdered by

their father.

There was a trail of blood that left out the front door of the apartment. It

was believed that the father had left the apartment after trying to commit suicide,

but likely failed or changed his mind. The father was later found dead the next

block over. I needed to see the corpse of the man who had committed this horrid

crime. He was white as a ghost from the blood loss from his self-inflicted wounds

with a knife. A regret that I have today is that I approached the window of the

apartment once the fire was out so I could see the children.

The ash and water filtered away most of the burnt flesh odor. The images

that have stuck with me are the children laying on the floor and bed. They were

burnt beyond recognition; their throats were cut from side-to-side, with body

fluids that had exited through the neck from the heat. The fluid had bubbled up,

9 9

and solidified through the lacerations. It was just another call for service to handle

without concern about trauma.

I went home at the end of that shift around 2 a.m. Ten months earlier my

son, our first child was born. I stood over his crib and broke down as I stared at

him peacefully sleeping, and trying to understand how a father could do such a

thing to their child. Seeing my son always reminds me of this incident, and due to

his age, I will always know how many years ago that incident occurred.

On January 23, 2009, a local newspaper, The Fresno Bee, brought back

memories of that night. They printed a front-page in-depth article about the

mother, Galina (Loseva) Messmer. The title, “10 years later, Visiting Memories.” I

made the mistake in reading that article. It brought me back into the emotions of

that night. So much so, that I wrote a lengthy email to the editor/author explaining

to him that there was an unknown person that was severely affected that night. I

explained my role, and how that incident affected my life. It was frustrating to me

that the author had little concern to reach out and talk with me. I have kept the

article with me since it’s release.

July 21, 2001, an armed robbery at a liquor store was broadcast with a

license plate number to the van, and a suspect description. Within minutes, the van

was found parked along a curb, and occupied within a few blocks of the registered

owner’s address. The suspect was non-compliant, and made the decision to flee in

the van. There were many issues regarding the use of lethal force that I had

processed, and without going into details, this incident had numerous issues that

justified the use of lethal force.

I was first to fire my handgun at the threat as he tried to flee the scene.

There were many onlookers (some of them children) that had placed themselves in

a dangerous position just to watch the police work. I feared they could get run

10 10

over, which is one reason I chose to engage the threat. The van crashed at the end

of the block into a police car, and I heard several shots fired from a shotgun blast,

and handgun. I ran down the block and assisted officers that had moved patrol cars

up for safety for the arrest of the suspect. I was lethal cover for an officer that used

a beanbag shotgun to shoot out the rear window so we could see inside.

The role of lethal cover is to be ready to immediately engage a threat while

covering an officer using a less lethal tool, such as the beanbag shotgun. There had

been no movement at this point by the suspect. The beanbags did not clear the

window enabling us to see inside. I approached and swept the glass with my arm

suffering minor scratches. I could see the suspect slouched over the steering

wheel.

I made my way along the driver side always being ready to engage the

threat, and believing that I was going to be the first one shot once I got to the door.

Officers opened the side door on the opposite side of the van to get a view inside.

As I approached the driver door, I became scared that the suspect was faking

injury, and holding the gun in his hand. I was afraid when I opened the door, he

would fire from that position. I always wore a vest for protection, but the angle he

was at would likely strike me below the vest. To add to the intensity, officers that

cleared the other side were yelling at me to get him out. I have memory loss as to

how I pulled him out.

I would have had my gun ready to engage when I opened the door, but I

don’t remember how or when I holstered my gun. All I can remember is quickly

opening the door, grabbing him with both hands, and throwing him to the ground

for handcuffing. I know I used both hands to pull him out because both hands were

covered in his blood. He was deceased at the scene, and I remember walking over

to some sprinklers that came on so I could wash the blood off of my hands.

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Additional stress came when I was secured away from other involved

officers because I was going to be transported downtown to headquarters for a

later interview. The primary supervisor that was involved in the entire incident

approached me, and asked about my role. I knew from my police officer bill of

rights (POBR) that there are certain things I have to answer. I started to explain to

the sergeant where I shot from because I had forgotten what my rights required me

to divulge during this stressful time. She immediately interrupted me and said

something similar to, “I don’t want to hear all of that. I don’t want to go to court

when you go.” An experienced officer was standing there with me; he

immediately pulled me away from her and told her to step away from me. The

problem with her statement is that I could have taken it out of context. That

statement could make an officer think he did something wrong, and would be

criminally prosecuted.

FPD had a peer support program at that time. My peer support officer came

down to headquarters to be with me during the time I had to wait for my interview.

I had been up for approximately twenty-two hours before I was interviewed the

next morning about my role in the OIS. I was released after the interview and went

home. Unknown to me my wife had called my parents who lived over an hour

away. They were there when I arrived home. As soon as I saw my wife and

parents, I broke down with emotion. I was called later that day, and given an

appointment to meet with the psychologist during the standard three days off after

a shooting.

I never knew or understood how fight-or-flight worked within the body. I

couldn’t sleep; I had dreams reliving the shooting, having the blood on my hands,

and I felt like I had the energy to break through walls. The psychologist broke

down how the body reacts during fight-or-flight, which helped me understand my

12 12

symptoms. There was a serious concern for me, and the other officers involved in

the OIS due to threats made by gang members wanting retaliation. I was feeling

stress due to the threats being generated toward us. I was having trouble sleeping,

and the press was also pressuring the department for the names of the involved

officers. These issues caused me to stay home for over a week before returning to

work. More stress followed because my OIS became a big news topic, and later a

federal lawsuit was filed.

I had to endure the stress of dealing with the lawsuit for the next three years

before it was finally dropped. During that time, I had periods where I relived parts

of the OIS. One specific incident occurred while I was driving with my wife on the

freeway. I don’t know how I kept the car on the road during this flashback. It was

midafternoon; I was seeing the darkness of that night, then the flash from the

discharge of my firearm going off. My wife gently grabbed my forearm, which

snapped me out of the dream. I asked how she knew something was wrong. She

said she could see my forearms tense up, and my knuckles where white from me

clinching the steering wheel.

While conducting this research in 2014 - 2015, it became apparent that I

had been showing many of the discussed symptoms since 2001. I had dreams

where I would sit up in bed, and yell at someone to get on the ground while

simulating I was pointing a gun. I was chasing a suspect in one dream, and kicked

the man when he fell. I woke up hearing my wife scream because I kicked her on

the back of her calf, which caused visible injury. I had several occasions where I

jumped out of bed trying to catch my breath. My symptoms were so severe that on

a couple of occasions I thought I was going to need an ambulance. I never knew

these breathing issues were panic attacks. It wasn’t until my contact with the

psychologist at the end of my career that my symptoms were explained. This

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relates to a lack of awareness, as did my sleep deprivation and eating habits. I had

gastro-intestinal problems, which increased over the years, and were likely stress

induced. During the last three years with CPD, I started noticing my behavior

changing. I found myself later questioning things I did on calls or how I dealt with

people. I was restless, sleep deprived, had a lack of motivation, irritable,

depressed, I had angry outbursts, and social withdrawal.

One of my angry outbursts came during a shift briefing before we go out on

patrol. I yelled at the supervisor over a discussion we were all having regarding

our pursuit policy. I lost my tempter with him in front of my coworkers, and an

administrator who was there immediately corrected my behavior. However, there

was no contact or follow-up to discuss my behavior. I jeopardized my safety on

two occasions. I was angry while handling a call by myself around midnight. I

searched a building by myself because I wanted something to happen. I emailed

my supervisor about my feelings. He contacted me a few hours later at the end of

our shift. He was concerned about me searching without back-up officers. I went

home after the talk, and there was no follow-up by him to check on my status.

I believe the lack of awareness for officers regarding mental health issues

did not allow the supervisor to do what he likely should have done. He should

have had me contact mental health due to that incident being such a dangerous

thing that I had done. Roughly a year later, I was angry again and attempted to

serve an arrest warrant at a house without requesting assistance. The standard on a

warrant arrest is six officers, but four is what was normally used. These and other

behavior issues led to an internal affairs investigation regarding my conduct.

Administrators took my badge and gun, and recommended I see a police

psychologist because the behavior that they are/were seeing is not like the person

they know. I am thankful they recommended the contact with the doctor. I would

14 14

have likely dealt with the disciplinary issues on my own without knowing my

disciplinary issues were brought on by my mental health issues. My behavior

could have led to termination or far worse. During the time of me being on

administrative leave, I had issues with suicidal thoughts, but was able to overcome

them. I felt at the time that my life situation was hopeless. The psychologist helped

me understand the symptoms of PTSD. Because I put my trust in the psychologist,

it helped me move forward with my life, and gave me the strength to know there is

more than being a police officer.

CHAPTER 2: LITERATURE REVIEW

Police Officer Duties

There are many duties in the job description for a police officer. They

protect life and property through the enforcement of laws and regulations. They

also maintain a working knowledge of laws as they change. They protect life and

property by patrolling the streets and responding to calls for service from the

public or contacting persons on the streets in a proactive manner. Officers have

irregular working hours, must work during adverse weather conditions, holidays

away from their families, and are subjected to public and administrative scrutiny.

Officers handle many types of investigations to include gruesome traffic collisions

with fatalities, sexual assaults of women and children, murder scenes, suicide,

death investigations, gang violence, family violence, and mental illness. Officers

have to testify in court related to these investigations. If you are not a day-shift

officer, being called into court to testify is during off-duty time, and for graveyard

officers, during their sleep time. Heightened risks within the job are during arrest

procedures, searching dwellings for wanted persons, parolee contacts, traffic stops,

robberies, narcotics sales, vehicular pursuits, suicide by cop, and combative

subjects (Federal Bureau of Investigation, 2013). Decisions to use deadly force or

other force options during many of these incidents can happen several times

during a shift.

There are typically three types of shifts that officer’s work, day shifts,

swing shifts and graveyard shifts. Swing shifts overlap graveyard shifts with this

shift ending sometime between 1:00 am to 2:00 am. Beginning the job as a police

officer, one will likely start their career working on a graveyard shift. Most

officers work these shifts overnight on an 8, 10, or 12 1/2-hour shift. Typical hours

16 16

of a graveyard shift officer are likely to end at 6:30 am or 7:00 am. Officers work

schedules can change when officers get called into work during an emergency

situation or forced overtime due to shift shortages. Officers being called into court

after working a swing or graveyard shift are likely to lose sleep and be expected to

return to work that same day. Circadian rhythm is our internal clock.

Abnormalities arise when a person is unable to fall asleep at normal bedtimes.

According to Barbadoro, Santarelli, Croce, Bracci, Vincitorio, Prospero, and

Minelli (2013), “shift-work has been related to disrupted sleep/wake cycle and

chronic desynchronization between endogenous circadian rhythms and behavioral

cycles, thereby leading to endocrine and metabolic alterations, such as

hypertension, glucose intolerance and lipid profile disturbances” (p. 1). As a result

of their findings, there is evidence of obesity found in shift workers.

A study conducted by the United States Army on sleep deprivation showed

personnel abilities lessened with the lack of sleep. Four groups of soldiers tested

during a twenty-day test showed significant performance drops for each group.

Group one performed at 98% efficiency with seven hours of sleep a day. Group

two performed at 50% efficiency on six hours of sleep a day. Group three

performed at 28% efficiency on five hours of sleep a day, and group four

performed at 15% efficiency on four hours of sleep a day (Grossman &

Christensen, 2004, p. 24). As years pass, police officers are likely to become less

efficient in performing their duties if they are not getting enough sleep. This not

only poses a health concern, but poor decisions by officers when it comes to

officer safety, and making force option choices, can lead to injury and/or

civil/criminal problems. Fatigue and insufficient sleep can be a factor in

predisposing an officer into being a casualty of stress. Constant stress from the

various types of contacts an officer is exposed to for the many types of

17 17

investigations or negative contacts they handle on a daily and yearly basis can lead

to risk factors of stress (Violanti, 2013).

A natural stress response is when a person perceives a threat whether it is a

barking dog or gang member that is fidgeting with his hands when an officer

contacts him. The hypothalamus gland acts as the body’s thermostat and sets off

an alarm system in your body. This system prompts the adrenal glands to release a

surge of hormones as discussed later in the fight-or-flight syndrome (Endocrine

Awareness Center for Health, n.d.). A retired Army Ranger, Lt. Col. Grossman

(2004), produced a chart to follow as a guide. “Condition White” is a place where

the average person is helpless, vulnerable, and in denial that anything can happen.

A normal heart rate is 60-80 beats per minute (BPM). Basic alertness and

readiness is a place a police officer operates on any given day, and this is

“Condition Yellow”. Grossman states this condition is at 100 BPM. In this

condition, officers are psychologically prepared for combat. “Condition Red”

respectively begins around 115-145 BPM, which brings an officer to his optimal

combat performance. Operating in yellow and red increases stress. As an officer

makes contacts or life/death decisions when confronted with threats, he moves into

the Condition Red category. Energy becomes important during this reaction, and

the brain provides the body with the necessary things it needs to confront the

threat. This is known as the “Fight-or-Flight Syndrome”.

According to Sharps (2013), during fight-or-flight the body releases

adrenaline and cortisol into the body as fast as it can while your heart rate is going

up. Cortisol causes the liver to elevate the blood sugar and enhances the

metabolism of fats and protein. This causes excessive wear on the heart and the

blood vessels. The body stops digesting food, muscles are hardened for a

confrontation and blood flow is restricted to the extremities in case of injury.

18 18

Many years of this occurring to the body can lead to digestive problems. Muscle

tissue degrades because the higher metabolism prevents removal of toxins.

Cortisol for long periods is caustic to muscle tissue, but a larger problem is

cortisol damage can affect the brain structure that is responsible for new

memories. Long-term activation of this stress-response system can lead to

overexposure to cortisol, and other stress hormones, which increase the risk of

anxiety, depression, digestive problems, heart disease, sleep problems, weight

gain, memory and concentration impairment (Mayo Clinic, “n.d.”).

Police officers can get into this Condition Yellow/Red many times in one

shift. Making a traffic stop on a vehicle at night with multiple subjects in the car

wearing gang attire, chasing a person on foot or in a vehicle pursuit, violent

confrontations, responding to shots fired or an officer needing help, breaking up a

bar fight or seeing children victims of abuse during a domestic violence

investigation, or drawing their weapon and making a decision to use lethal force.

An officer perceives a threat and adrenaline is released for a short time during the

initial contact on the traffic stop. Once the contact is over, the officer moves on to

the next incident but his body is still in recovery from the stress (Sharps, 2013).

The body might not recover before the next threat occurs and dumps more

adrenaline into the system. According to Solana, Extremera, Pecino, and Fuente

(2013), “Enduring high levels of stress continuously can culminate in burnout” (p.

488). Their study revealed high levels of stress in 32% of Spain’s National Police

that participated in the sample. What happened at an out of control pool party in

McKinney, Texas is a good example of an officer who may be suffering from high

levels of stress.

19 19 Case Studies & Personal Communications

According to a Washington Post article written on June 10, 2015, Corporal

Eric Casebolt made national news for his behavior while trying to deal with

approximately 100 juveniles causing a disturbance at a private pool party in,

McKinney, Texas. This case suggests that Corporal Casebolt is suffering from one

or more symptoms discussed within this project. Statements from his attorney

confirm he had some mental health issues due to prior calls before this incident,

and his behavior in the video suggests this to be true.

These 100 juveniles did not live in the area, and responded to a twitter

invitation by a person that had no authority to invite people to this neighborhood

pool. Police were called when a resident and security guard were assaulted.

Casebolt was one of the officers that responded to this disturbance. Casebolt is

seen on a viral video shouting profanities to juveniles, running from place to place,

using hands-on force, and pulling his gun. Eleven other McKinney officers were

on scene and had no complaints against them. The department began an internal

affairs investigation regarding Casebolt’s behavior when violators or their parents

complained about how Casebolt acted during the contact. Corporal Casebolt was

placed on administrative leave while they were going to investigate the complaint.

The day after the incident Casebolt, a ten-year veteran resigned. Experts discuss

his actions and state his behavior appears to be out-of-control, but not criminal.

Casebolt’s attorney provides a statement to show a potential reason for his out-of-

control behavior, which was due to two suicide calls he responded to back-to-back

directly before the pool party incident.

Corporal Casebolt began his shift by responding to a man who had shot

himself in the head poolside in front of his wife, children, his family, and other

20 20

children and friends. Casebolt worked the scene and spent a considerable amount

of time consoling the family. From there, Casebolt responded to a juvenile who

was on a second story roof threatening to jump. Corporal Casebolt was able to

calm her down without her jumping. Through his attorney providing his statement,

Casebolt states he was not emotionally ready to deal with the pool party

disturbance when the call came out, and was going to let other officers handle the

call. According to Captain J. Hall, Porterville Police Department, Porterville, CA,

this is standard in police work. Many times an officer is finishing up a call by

talking to a citizen or sitting in their car adding notes, and/or entering information

in a report. Officers will make a decision to stay on the call or break for the radio

traffic depending on the seriousness of the call, if other officers are available, and

for many other reasons (personal communication, August 20, 2015).

Officers take pride in handling calls that come out in their beat (area of

responsibility). Unless the case they are investigating is not complicated, they will

break to take charge of the dispatch call. When a call is dispatched that is not

serious in nature, and not in their beat, the officer may wait to hear if other units

take the call. This exception is likely only after an officer is decompressing after

some traumatic incident. If units take the call, then the officer can sit on his/her

current call for a few minutes to enter notes or information in a police report. Or

the officer needs a few minutes to decompress from a stressful call as in Corporal

Casebolt’s situation. Police agencies have different policies on when officers are

to write their police reports. Some agencies allow officers to write felony arrest

reports before coming back into service, while others dictate you come back into

service when the suspect is booked, and you write the report at a later time. This

can sometimes lead to the stigma created by officers.

21 21

There is pressure by your peers if they notice you are not handling the same

workload they are during the shift. This can cause an officer to clear a call before

he is ready so he can be involved or become the primary officer in the next call for

service. The primary officer will be the one conducting the investigation and

writing the report. Officers that succumb to this pressure will likely be backlogged

with reports to write, and no time to write them. This handling of ‘your’ beat or

calls for service is part of the shared value system in law enforcement (White &

Robinson, 2014).

Corporal Casebolt was content in letting the other officers handle the pool

party, which had been dispatched as a non-emergency trespass call. Casebolt

changed his mind when he heard the call was upgraded to a violent assault, he felt

it was his duty to respond (Holley & Izadi, 2015). Casebolt’s behavior during this

incident, and his rash or quick decision to resign for what appears to be

department violations suggests he may be suffering from one or more forms of

stress. This appears to be a great example of an officer that needs help. Corporal

Casebolt dealt with a bloody suicide with a man who shot himself in the head, and

immediately thereafter, a juvenile who wanted to jump off a two-story building.

Corporal Casebolt gets to the pool incident where his adrenaline has likely

spiked on top of his other emotions when you can see from the video that

numerous juveniles are showing no respect for law enforcement by not complying

with his orders to leave the area. This behavior by the teens compounded with the

previous calls and no time to decompress may have pushed Casebolt into losing

control of his emotions, and poor judgment as it applies to his police training

(Barbadoro et al., 2013; Grossman & Christensen, 2004).

Additional stress added to the situation comes in the form of the national

media, anti-police activists, public outrage, and death threats that Casebolt has

22 22

consistently received against he and his family. Casebolt resigned the day after the

incident citing that he let his emotions get the better of him, and he was resigning

with the hopes that the city and agency can heal (Holley & Izadi, 2015). Although

this is his statement, his resignation comes so fast that it may be a knee-jerk

reaction to the negativity directed at him. Corporal Casebolt could be suffering

symptoms of depression, anxiety, insomnia and irritability (Mayo Clinic, 2014).

Some or all of these symptoms could have been a result of his behavior during this

pool party incident, which was likely brought on by the suicide calls he handled,

and compounded when the juveniles refused to follow his commands at the pool

incident. The lack of respect for the officer may have caused Casebolt’s emotional

reaction as seen on the video.

Consider the statement of McKinney police department Chief Greg Conley,

about Corporal Casebolt’s actions. The Chief said his actions were, “indefensible”.

One might ask, how does a ten-year veteran who made officer of the year in 2008,

and is a defensive tactics instructor, get to this point in his career. Casebolt’s

actions do not appear to be criminal, but departmental violations regarding

professional conduct. These circumstances demonstrate that Corporal Casebolt

should maintain his position as an officer, and seek psychological counseling or

treatment. The lack of understanding by the general public of what officers go

through, and the stigma that is likely preventing this officer from getting

assistance could lead to more problems for Casebolt. By resigning, Casebolt will

not have an income, and likely lose health care coverage, which could lead to

further depression, family problems, self-medication, and a potential for suicide.

With regard to Casebolt resigning, one needs to consider the issue of him drawing

his firearm during the incident, which was likely related to the fight-or-flight

syndrome.

23 23

Corporal Casebolt removed his weapon for unknown reasons, but a trained

expert can see that he had it in the low-ready position. One such expert is Captain

John Hall. According to Captain Hall, the low ready means the gun was

unholstered to confront a perceived threat, but not pointed at someone. The

position of the gun is low (pointed toward the ground) and ready to come up if

there is an eminent threat to engage (personal communication, August 20, 2015).

Captain Hall has been in law enforcement for twenty-one years, and a member of

his SWAT team. He is a current firearms and tactics instructor. Captain Hall has

instructed cadets in two different police academies, officers within his own

organization, and for law enforcement and private citizens at ‘Gunsite Training

Academy’ for up to sixteen years.

As can be seen in the video, Casebolt holstered his weapon when he likely

realized there was no threat; however, this threat perception possibly caused

adrenaline to release into his system. An officer that discharges his firearm in a

confrontation is likely to experience a large dose of adrenaline into their blood

stream. It normally takes 72 hours for a large amount of adrenaline to filter

through the body (Sharps, 2013). Police officers are typically placed on three days

of administrative leave after a critical incident of this mass to allow the endorphins

released into the body to dissipate, and give officers time to recover emotionally,

physically and to meet with a psychologist. Being provided an appointment to

meet with a psychologist provides the officer psychological help. The police

psychologist role varies based on the needs of the department. In order for the

psychologist to be effective, a trust relationship needs to be established with the

officer (Allen et al., 2014). Additionally, the problem here lies with the officer

trusting the psychologist. The psychologist must approve that the officer is fit to

return to duty before the officer is allowed to return to work. This is a healthy

24 24

benefit for officers, but as seen in Allen et al., (2014), the stigma will likely

interfere with this opportunity. Furthermore, Wester, Arndt, Sedivy, and Arndt,

(2010) research links similarities in military and police training. The police

academy takes a regular citizen, and resocializes them just as drill sergeants do in

military boot camp. The academy as in the military breaks down a police cadet’s

self-identity to teach them to become self-reliant, restrict weakness, and to place

an emphasis toward toughness, and aggression. This type of training is about

survival during life threatening confrontations. It is a mindset that is instilled

during their academy training, and throughout the rest of an officer’s career.

This stigma officers have can increase stress because they are not likely to

seek help when they need it because it suggests they are weak and are failures

(Wester et al., 2010). Additionally, seeking help from a mental health professional

would mean that an officer recognized they need help, which runs contrary to what

they were taught to be self-reliant, tough and aggressive. Years of chronic stress

from this work environment with or without being involved in a shooting and

taking human life can cause the body to be in a state of fight-or-flight syndrome

on a routine basis. The overexposure to cortisol and other stress symptoms can

disrupt the body and put the officer at an increased risk of numerous health

problems. Some of these health problems include, depression, anxiety, insomnia,

and irritability (Mayo Clinic, 2014). Of these symptoms of depression that affect

an individual would be mood, fatigue or loss of energy, feelings of worthlessness,

impaired concentration, indecisiveness and insomnia to name a few. The

circumstances surrounding Officer Stan Smith during his career as a police officer

is one such example of the police culture or stigma, and how stress affected him.

25 25 Stigma and the Administrative Breakdown

Officer Smith has extensive law enforcement experiences, and they have

involved multiple shooting incidents, which distinctly illustrates the stigma in the

police culture (personal communication, July 7, 2015). Officer Smith wants to

remain anonymous due to the police stigma, current legal issues with his agency,

and his claim for an industrial injury retirement with workers’ compensation.

Officer Smith has been a sworn police officer for ten years, with two

additional years served as a reserve police officer. He is currently employed by a

metropolitan police agency in California, and out on stress waiting for his stress

retirement (industrial injury) to be accepted through workers’ compensation.

Officer Smith had worked in a patrol style special (tactical) unit. He has been in

four officer-involved shootings (OIS). His first shooting, in 2007, was fatal; his

second, which was non-fatal, was in 2010; his third shooting, in 2012 was fatal,

and he has a pending law suit from the third OIS; his fourth was in 2012, four

months after his third shooting. Officer Smith recalls hiding his stress from the

police psychologist due to stigmas he felt within the police culture, which was

compounded by his immediate supervisor (sergeant) and his area commander.

Officer Smith recalls the department policy after an OIS changed early in

his career. He relates that officers would get the automatic three days off after a

critical incident, which typically was an OIS because nothing else was really

treated as critical. If the psychologist thought the officer needed more than the

three days to decompress before coming back to work, they could do that without

losing any sick time. The policy changed to where any time needed after the

original three days had to come out of the officer’s sick time, then the officer had

to get the time back through a workers’ compensation request. It was not worth

26 26

fighting with workers’ compensation to get those days, and he would have likely

not taken those days if needed because of the current policy in addition to the

stigma. However, his supervisors compounded his problems after his second

shooting.

Officer Smith’s sergeant and district commander checked on him in the

aftermath of his second OIS. They advised him not to take more than the normal

three days off, because it would leave a negative stigma on him within the

organization. They expressed to him that he could lose his special unit position

due to how the administration viewed how Officer Smith handled the outcome.

They advised Officer Smith to be careful when talking to the psychologist, and

keep it to a minimum. His sergeant told him that if he has issues, Officer Smith

could come talk to him in private. He was also advised that he was doing a really

great job, and they would hate to see him get reassigned. This put pressure on him

at the time, but he followed through with not being truthful with his feelings when

speaking to the psychologist. Officer Smith was reminded by these same people

how to handle the situation after his third and fourth shootings.

Officer Smith recalls during team briefings that his district commander

would sometimes talk to the team about taking time off. The commander would

speak about an officer by name from another district that took more than the three

days off. According to Officer Smith, this was said in a negative way about the

other officer, or at least he took it that way. The commander complimented his

guys by calling them, “Warriors” for not taking more than the standard three days

off after a critical incident or OIS. The commander elaborated that the chief of

police was upset at the officers that took the extended time off. Looking back, he

said this was a subtle way to promote a negative culture or stigma within an

organization that would not allow officers to get the help they needed.

27 27

Officer Smith believes this behavior allowed his PTSD, anxiety, and

depression to grow. He never told the psychologist the truth out of fear of

termination for a mental health issue. He believed that if he had told the truth

about how he felt at certain points in each of his shootings, the psychologist would

inform the administration, and he would have to take a fitness for duty

examination. Smith knew if he failed a fitness for duty examination, he would lose

his job and career, which would leave his family with nothing.

Officer Smith believes it’s not just the sworn police officers that do not

understand the problems with mental health concerns. His chief put out a

memorandum later in his career that officers should be allowed to decompress

before being interviewed. The idea is the decompression time is to help them calm

down so they can give a better interview. This helps the officer and the agency if a

future civil/criminal suit is filed. After his fourth shooting, a legal defense attorney

was contacted for him to talk to before his interview. This is common procedure at

his agency to have legal defense after an OIS for the involved officers. Officer

Smith advised the attorney that he had already been up/awake for approximately

nineteen hours, he was having trouble concentrating, keeping his thoughts, and he

was never allowed to decompress. Officer Smith wanted to move the interview to

a different day. The attorney said the detectives were ready; and for him to, “just

do the interview.” He did the interview and claims it was a, “shitty interview.”

Officer Smith states the interview was, “shitty” because it is an official

record of a critical incident. Being tired and having mental health concerns over

the stressful incident caused him to provide a terrible statement that could hurt

him, and/or the agency at a later date. This was an important interview for the

officer and the administration. Members of the district attorney’s office were

listening and checking to make sure the officer followed the law. An interview like

28 28

this is intended to determine if an officer will be criminally cleared from any legal

wrongdoing with the force he used. If an officer were to try to change their

statements later, it would look as if he/she were trying to cover up for a mistake.

Civil suits are common after police shootings, and attorneys would likely use a

poor statement to make the officer and/or agency look bad. Officer Smith believes

he could have provided a more articulate statement as to the events of the OIS if

his attorney, and the organization, would have provided him time to rest after such

a stressful event.

Captain Mellon’s Story

Police officers are not alone in this struggle; they share these same issues

with correctional officers. According to statistics published by (Kevin E. Bedore,

2012), correctional officers (CO’s) have the second highest mortality rate of any

occupation. Approximately one third of prison inmates have committed assaults

against staff. Correctional officers rarely live past their 58th birthday, and are likely

to be assaulted at least twice during a twenty-year career. The young age of 58

suggests stress or like symptoms is a key factor in their deaths. Correctional

officers also have a higher rate of suicide than any other occupation with that

being 39% (Bedore, 2012). A tragic example of these statistics is the story of CO

Captain Mellen.

Captain Mellen was a 22-year veteran of the prison system. Surprisingly, he

came home one day and said to his wife, “I can’t go back there one more day”

(Owen, 2014, p. 1). Mellen retired shortly thereafter-in early 2010. Mellen

struggled with symptoms of depression, likely PTSD, and was withdrawing from

his family and friends. According to his wife, she had noticed his problems by

29 29

seeing warning signs, but never thought it was serious enough that he would take

his life by August of 2011. Captain Mellen’s 21-year old daughter wanted to know

why her loving father completely changed one day (his unexpected departure from

the job), then shot himself in the head with a shotgun over a year later. Another

tragic example relates to Deputy Sheriff John Seifert.

Deputy Seifert’s Story

In early December 2008, Deputy Seifert responded to a 911 call where a

man that he knew had shot and killed a manager at the local ski lodge in Colorado.

Deputy Seifert’s tragic story illustrates how quickly alcoholism, PTSD, and likely

depression can overcome a law enforcement official.

After a short pursuit with the suspect, deputy Seifert engaged the suspect in

a fierce gun battle with several rounds being fired. Seifert struck the suspect with

some rounds, but it was believed the suspect shot himself to end the confrontation.

After the incident, Seifert began drinking heavily, and struggled for the next two

years with PTSD. Seifert left the department in 2010-2011, and committed suicide

with a gun in early December 2013. Ironically, he took his own life just 20 days

before the anniversary of his shooting (Wasilewski & Olson, 2014).

According to the Sheriff, his office worked with Seifert by trying to get him

the help he needed. Deputy Seifert’s tragic story drew attention to the problem

which caused the Colorado state legislature to create a bill that would provide

workers’ compensation to police officers suffering from job-related PTSD.

Unfortunately, the bill faced opposition by state leaders and the Colorado

Association of Chiefs of Police (CACP), and never got out of committee. The

likely concerns of most states are that these benefits would strain budgets and lead

30 30

to frivolous claims for workers compensation. The CACP believe PTSD to be a

real issue; they are against the wording in the original bill, and want to make sure

officers and organizations are both covered ("Police Unions Push for PTSD

Coverage," 2014). Currently, there are ten states that deny any compensation for a

mental injury, fourteen states allow it only if stress is unusual, seven allow it, but

are undecided if stress needs to be unusual, ten states allow compensation whether

stress is unusual or not, and eleven states are undecided whether stress injuries are

compensable (Mann & Neece, 1990). Officer Daniel Harless of Canton, Ohio is a

great example of an officer likely suffering mental health issues related to the job,

and this condition led to his termination.

Officer Harless

Officer Harless was fired regarding his conduct during a traffic stop that he

conducted. He was seen on patrol car video shouting profanities at the driver, and

threatening that he should have shot him. Harless had other similar complaints

about this behavior. He was terminated for his conduct, but he was involved in a

life-and-death struggle with a suspect seven to eight years earlier (Katz, 2012).

Officer Harless may be suffering from delayed onset PTSD from the old incident.

A health and wellness program could have likely helped him before it reached this

critical point. If Harless’ behavior is found to be related to PTSD, he could be

reinstated and given treatment. It’s unknown what kind of program the Canton

Police Department has, but there are agencies that have different styles of

programs to help officers.

31 31

Assistance Programs

Los Angeles Police Department is one such agency that has an internal

program to help officers. Their Behavioral Science Services (BSS) bureau

provides counseling assistance to officers and their spouses, training in suicide

prevention, stress management, anger management, and many other health

beneficial issues for their officers ("Behavioral science services," n.d.).

Psychologists who specialize in law enforcement related issues staff their

program, and they continually conduct research in areas of law enforcement that

relate to their mission. Fresno Police Department (FPD) in Fresno, California is

another such agency taking steps to aid officers.

In 2011, FPD Chief Jerry Dyer defined in a department memorandum to his

front-line supervisors what a critical or traumatic incident is for his department

members. Chief Dyer acknowledges in the memo key incidents that officers come

across are not always treated as critical or traumatic events. The memo states the

importance to offer support to an officer immediately even if they appear to be

fine. Unlike LAPD, FPD does not have a section with psychologists working

within the department. FPD contracts with outside health services. However, FPD

has an internal wellness program under their Employee Services Bureau (ESB).

The goal of the ESB is to educate officers regarding stress, how to manage stress,

and maintain confidentiality. To quote the mission statement, “The goal of the

ESB is to create content, healthy and balanced people who effectively address

professional and personal challenges by seeking support in a confidential and

trustworthy environment, equipping and enabling them to better serve the

32 32

community.” Programs such as LAPD’s and FPD’s show administrations are

making steps to help their officers’ combat this problem of mental health.

Just as law enforcement agencies are making steps forward, so is the

California Department of Corrections and Rehabilitation (CDCR), which has also

created a program within the Office of Training and Professional Development

(OTPD). CO’s face the same stigmas that law enforcement officers’ face. In the

instructor guide, version 1.0; page iii, they inform the instructor the, “…class is

intended to encourage employees to reach out for help, and to erase the stigma of

employees who seek help.” The learning objectives of their program cover

awareness, self-care, prevention and intervention to name a few. The guide covers

awareness in correctional officer fatigue, which is not that different from police

officers.

Correctional officer fatigue is defined in three categories. First, officers’

health begins to fail, and their performance declines due to “depressed mood,

PTSD, depression, anxiety, and declined work performance.” Second, “a

dysfunctional/ideology behavior, ‘us against them’ mentality, cynicism,

indifference, and workplace alienation.” Thirdly, “negative personality changes,

declined empathy/compassion, social isolation, and negative emotions such as

anger, guilt, and shame” (Office of training and professional development, n.d., p.

12). The most important thing to remember is both these occupations lose people

to suicide because indicators were not identified early, support was not offered

when it was observed, or possibly the stigma created an obstacle.

According to the National Institute of Mental Health (n.d.), depression is a

disorder of the brain that is likely caused by a combination of factors to include

genetic, biological, environmental, and psychological. Areas of the brain involved

affect sleep, mood, thinking, appetite, alcohol, substance abuse, and behavior. Let

33 33

us assume a police officer after many years of service and much exposure to the

traumatic events we have already covered suffers depression from the environment

and psychological effects. Some observable symptoms can include difficulty

concentrating, remembering details, making decisions, irritability, isolationism,

cynicism, declined work performance, fatigue and decreased energy, insomnia,

and feelings of hopelessness. As an example, you might see an officer having

trouble concentrating during an interview and later remembering details when

having to testify in court or making poor decisions and becoming angry when

using force on a person. This behavior can cause unnecessary injury to the officer

and/or the individual or lead to disciplinary action likely due to the officer’s

conduct. This behavior is an example of what happened to Corporal Casebolt,

Officer Harless, Deputy Seifert, correctional officer Captain Mellen, and many

others. By looking at the Federal Bureau of Investigation (FBI) statistics, and local

statistics from three agencies I reviewed, we can begin to see the violence and/or

potential stressors officers deal with on a daily basis.

LEOKA Statistics

The Federal Bureau of Investigation gathers statistics from law

enforcement agencies yearly using the Uniform Crime Reporting system (UCR).

The UCR was conceived in 1929 by the IACP to meet the need for reliable crime

statistics for the nation. The FBI has been collecting this data since 1930. These

statistics provide another picture of the dangers of law enforcement and potential

stressors. The data is analyzed and posted under Law Enforcement Officers Killed

and Assaulted (LEOKA) (Federal Bureau of Investigation, 2010-2013). The data

34 34

collected is on officers feloniously killed or assaulted in the line of duty

(Accidental deaths were left out of these statistics).

The data in 2010 show 11,108 police agencies reported the following.

Fifty-six officers killed in the line of duty, and 53,469 assaulted. Of those killed or

assaulted, 33% were responding to disturbances, 14.7% were in arrest situations,

and 12.9% were handling, transporting or maintaining prisoners. 61.9% were in

one-unit patrol cars, and 19.2% were in two-unit patrol cars. The rest were

detectives and special unit operations. The average age was thirty-eight years old,

and the average years of service was ten.

The data in 2011 show 11,944 police agencies reported the following.

Seventy-two officers killed in the line of duty, and 54,774 were assaulted. Of those

killed or assaulted, 33.3% were responding to disturbances, 14.7% were in arrest

situations, and 12.6% were handling, transporting or maintaining prisoners. 63.8%

were in one-unit patrol cars, 17% were in two-unit patrol cars, and the rest were

detectives and special unit operations. The average age was thirty-eight years old,

and the average years of service was twelve.

The data in 2012 show 11,759 police agencies reported the following.

Forty-eight officers killed in the line of duty, and 52,901 were assaulted. Of those

killed or assaulted, 32.5% were responding to disturbances, 15.2% were in arrest

situations, and 13.6% were handling, transporting or maintaining prisoners. 64%

were in one-unit patrol cars, 16% were in two-unit patrol cars, and the rest were

detectives and special unit operations. The average age was thirty-eight years old,

and the average years of service was twelve.

The most recent data published was for 2013. This data shows 11,468

agencies reported the following. Twenty-seven officers were killed, and 49,851

were assaulted. 31.2% were responding to disturbances, 16.3% were arrest

35 35

situations, and 12.8% were handling, transporting or maintaining prisoners. 62.7%

were in one-unit patrol cars, 17.3% were in two-unit patrol cars, and the rest were

detectives and special unit operations. The average age was thirty-nine years old,

and the average years of service was 13 years.

By examining the last four years, a pattern can be seen developing. Over

50,000 officers are assaulted each year with an average age of 38.25 years, and

they average 11.75 years of service. Eighty percent or more of these assaults are

against uniform patrol officers. Researchers suggest that officers become

complacent after a few years of mundane calls or boredom in between the high

intensity calls. They believe this complacency leads to mistakes, which get the

officers hurt or killed (Ashton, 2015; Moore, 2014; Sheets, 2014). Although there

is good evidence in support of the complacency theory, these researchers may not

have taken into account the mental health aspect that can be culprit in some of

these complacency concerns.

According to Captain J. Hall, the general belief in law enforcement is that

officers become complacent after seven years. The expectation is that they have

seen so much of what has been discussed, that they make mistakes. He was never

provided any training, nor had it ever been discussed that the complacency issues

would or could be related to mental health. Many times agencies will provide

firearms or use-of-force training thinking this to be the reason for mistakes made

or for injuries sustained by officers (personal communication, August 20, 2015).

Currently, the national narrative within the media through political and

social experts is that law enforcement officers need more training. This narrative

comes from all the national attention related to law enforcement shootings. The

problem with this narrative is that these non-law enforcement experts believe this

training to be of a tactical nature (use-of-force) or humane in nature (sensitivity

36 36

training). The national narrative suggests that no thought has been given or at least

suggested that mental health issues could have led to these mistakes or errors in

judgment; if in fact they are errors or mistakes. Statistical data for three different

policing agencies was examined as an example of what officers struggle with on a

daily basis.

Department Statistics

Fresno police department in 2013 had 748 sworn personnel to service a

population of 508,453 citizens from January through December. However, the

United States Census Bureau estimates Fresno’s 2013 population to be 956,102.

Patrol officers responded to 405,800 calls for service. Of those calls, officers

investigated or were exposed to 25,319 Part 1 crimes, which include, homicide,

rape, robbery, aggravated assault, burglary, larceny/theft, motor vehicle theft, and

arson. Officers made 39,696 arrests, and 25 officers had been assaulted during this

year. The second city reviewed was Los Angeles, LAPD.

In 2011, LAPD had 9,808 sworn officers to service a population of

3,792,621 people. LAPD has four bureaus. Officer rankings are PO I-PO III,

which are typically patrol officers under the rank of sergeant. Between the four

bureaus, they were authorized 6,719 officers in rank PO I-PO III. Of this number,

the bureaus only deployed 5,410 to handle the calls for service with a shortage of

1,309 officers. Officers handled 3,630,743 calls for service that included 104,996

Part 1 offenses, with 146,065 arrests. 651 officers were assaulted during this year,

and 496 of these officers were working in patrol. During 2011, 803,613 hours of

sick time was used, and 535,720 hours was used for on the job injury (traumatic

and non-traumatic) through workers’ compensation. 43,114 disciplinary actions

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were taken against officers. The last agency examined was Chicago police

department (CPD) in their 2009 report.

The U.S. Census Bureau estimates Chicago’s population to be 2,695,598 as

of April 1, 2010. At the end of 2009, CPD had approximately 13,136 officers,

which does not include high-level command staff. Officers responded to 4,495,714

emergency calls for service, 554,733 non-emergency calls, and 132,303 alarm

calls for service. Officers made 181,669 total arrests, and 28,625 were for Part I

offenses. There were 4,613 allegations of misconduct investigated on officers, and

285 were sustained. Of those, twelve for alcohol abuse, eighteen for

drug/substance abuse, 194 for verbal abuse, and 183 for criminal misconduct. 726

allegations were made for unreasonable use of force. There were 3,298 assaults on

officers.

The statistics examined from LEOKA, and these three agencies give us an

idea of the workloads, and violence that officers deal with, and how potential

stress or burnout can invade an officer’s life.

Depression, PTSD, and suicide

Depression is common in people who have posttraumatic stress disorder

(PTSD). According to police psychologist, Dr. J. Price-Sharps (personal

communication, September 9, 2015), PTSD includes a depression component; but

to have a diagnosis of depression besides the diagnoses of PTSD, the symptoms of

depression must be severe enough to warrant a second diagnosis of depression.

Psychologists typically see symptoms of PTSD stemming from a person going

through a serious traumatic event such as natural disasters, combat, horrific or

violent crime, or serious accidents. A study found that, on average, officers

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experience more than three traumatic incidents for every six months they are

working (Patterson, 2014). Symptoms of PTSD include re-experiencing the event,

avoidance of the event location, panic attacks, severe anxiety, flashbacks, hyper

arousal, trouble sleeping and uncontrollable thoughts to name a few. With a lack

of awareness, many officers are not likely to recognize some or all of these

symptoms as being an issue for concern.

There are three types of PTSD that exist, acute, chronic and delayed-onset.

Symptoms that last under three months are acute. Symptoms that last a minimum

of three months are chronic and symptoms that manifest after six months or even

years are classified as delayed-onset (Elements Behavioral Health, n.d., para. 2).

According to Hartley, Sarkisian, Violanti, Andrew, and Burchfiel (2013), “Higher

PTSD symptomatology has been associated with higher waking cortisol measures

in police officers.” (p. 242). Additionally, Violanti et al. (2006) believe there is

evidence that links cardiovascular problems to PTSD. Of the numbers of police

officers measured, “76% had elevated cholesterol; 26% had elevated triglycerides;

and 60% elevated body fat composition” (p. 542). These elevated symptoms can

lead to heart attack, stroke and/or death.

Officers that suffer from chronic stress, depression, PTSD and other related

conditions are susceptible to suicide. As stated earlier in the Badge of Life

citation, police officer suicide is high. The United States in 2008, there were 141

police suicides, in 2009 there were 143 police suicides and in 2012 there were 126

police suicides. The average age of the officers in 2012 was 42 years old. The

average number of years on the job was 16, and 15-19 years were the most at risk.

A study was conducted in 1996 to determine the number of misclassified police

suicides as non-suicides (Violanti, 2010). Violanti’s study found there is likely a

17% increase in misclassification of police suicide.

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Unchecked stress after critical incidents can lead to physiological and

psychological problems for police officers. Many years of this problem lead to

chronic stress, depression, physical health problems, and likely PTSD and/or

suicide. The mission of the International Association of Chiefs of Police (IACP) is

to “advance professional police services; promote enhanced administrative,

technical, and operational police practices; foster cooperation and the exchange of

information and experience among police leaders and police organizations of

recognized professional and technical standing throughout the world” (IACP, n.d.,

para. 1). The problem is serious enough that in 2013, the IACP hosted, “Breaking

the Silence: A National Symposium on Law Enforcement Officer Suicide and

Mental Health.”

The barriers need to be broken from the administrative level down to the

patrol officer. There are many programs in place to help officers, but the stigma or

lack of awareness on these health issues continue to slow the learning process. A

study conducted by the Badge of Life found that 96% of the departments they

contacted did not notice any warning signs that led to their officers committing

suicide (O’Hara, Violanti, Levenson, & Clark, 2013). This likely supports the idea

of the stigma in law enforcement. More awareness of the problem, peer support, or

improved mental health programs within departments is likely to help prevent

suicide and/or catch other illnesses. O’Hara et al. (2013) suggest that officers

should undergo a health screening every year because this is just as important as

getting the required flu shot every year. This would allow officers to get help

before they need it, not after.

A recent study done in the Netherlands to treat officers with PTSD and

prepare them for a return to work showed more than a 90% recovery rate (Plat,

Westerveld, Hutter, Olff, Frings-Dresen & Sluiter, 2012). Their treatment

40 40

followed a strict protocol to prepare officers for a return to work status. Using the

O’Hara et al. (2013) yearly plan would help to identify officers with physiological

and psychological problems. By combining types of treatment as conducted in the

Netherlands, officers could get the necessary treatment to prevent family and

disciplinary problems, early retirement for medical reasons and substance abuse

problems. In the long run, this would likely reduce workers’ compensation claims,

disciplinary problems, civil/criminal lawsuits, sick leave abuse, divorce, and most

importantly, reduce suicide. As seen within the story related to deputy Seifert,

agencies are likely concerned with frivolous reports related to mental health,

which lead to economic concerns with workers’ compensation. The following two

personal communications provide examples of the positive side of recognizing the

need for help, and the destructive side when the stigma prevents reaching out for

help.

Positive Side of Seeking Help

Sergeant S. Crawford has extensive law enforcement experiences with

being involved in numerous critical incidents, which include an OIS, but him not

being a shooter, gang violence, and violent crime investigations to include death.

Sergeant Crawford’s story illustrates the benefits to overcoming the police stigma,

and seeking mental health treatment on his own (personal communication, August

18, 2015).

Sergeant Crawford was a Military Police officer (MP) in the United States

Army for seven years, many of those years as a criminal investigator. After

leaving the service, he became a police officer with Fresno Police Department

(FPD) where he has been an officer for 19 years. I contacted Crawford because he

41 41

was my partner in a double-unit (two-man patrol car) up until the time of my OIS.

I recalled many years ago Crawford coming to my house to inform me that he had

depression, and was taking medication for it. I always respected his courage for

doing that due to the stigma of our culture, and that he trusted me enough to give

me this personal information. Also, his is a positive outcome for someone that was

not afraid to ask for help.

Crawford said he recognized he was suffering from sleep deprivation,

which impacted his attitude. This was approximately five to seven years on the job

with FPD. After recognizing this behavior change, Crawford tried healthy things

to correct this issue, such as, taking trips to the coast to relax, exercise, and fine

tuning his eating habits. After two to three months, his behavior did not change,

and his symptoms worsened. Crawford approached his supervisor and explained to

him his symptoms and concerns. The supervisor put him in contact with the police

psychologist on contract with the department at the time.

The psychologist did not give Sergeant Crawford a diagnosis, but gave him

medications to help him sleep, and deal with the depression. After three months,

Crawford said he was back on track, and able to get off the medications. He keeps

a prescription in case he needs it in emergency situations. I asked about his

perceptions of the stigma in the police culture, and if it was a concern at the time

he spoke to me. Sergeant Crawford said he understands there is a stigma in our

culture, but his personal beliefs allowed him to overcome those stigmas to get

help. One thing he believes should stand out to people if they are informed is that

Crawford has attended four funerals in the last five years of police officers that

have retired and committed suicide. He believes common sense should tell you

they had issues on the job. He also agrees that there is difficulty in tracking these

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suicide rates when officers retire. They will not show a connection to the

department or their job.

Sergeant Crawford says doing the right thing should not be hard. He knows

that the culture frowns upon perceived weakness or mental health issues, but he

was not afraid because he is stronger than that. He believes his upbringing gave

him the attitude or strength to overcome the stigma to get the help he needed.

Simply put, if it’s broke, then you have to fix it. Of course, not all of us have the

same backgrounds or education to be in a position I was in at the time. Education

for future officers over the next few generations will likely help reduce these

stigmas if it becomes more accepted.

Crawford promoted to the sergeant position in 2006. He believes his

experience with his issues have helped him recognize symptoms in other officers.

He chooses to not ignore those observations and to get involved in their business

to help them. However, he states you have to find specific ways to approach these

officers in need so not to have them become defensive. As a supervisor,

administrator, regular officer or friend, Crawford states it is a leadership issue to

recognize and help each other when symptoms are recognized. The act of doing

nothing to help someone is like being culpable for his or her later actions.

Establishing trust in employees opens the doors for officers to approach him or

anyone else to seek help. This is how to break down the stigma in this culture.

Sergeant Crawford is also a POST Advanced Leadership Instructor. He

believes the academy training on this material to be minimal. The only way to get

this training in more detail is through department members that have gone to some

training opportunity, the agency programs if they have any to put on, if the agency

brings in a lecturer on the topic, or the agency sends officers to this kind of

training. It was important enough for the IACP to have their symposium on this

43 43

subject in 2013, it should be important enough to include training in the academy

curriculum to help future officers overcome this stigma, and/or not be afraid to ask

for help. This interview shows the positive impact the mental health professionals

have on this culture if used in a timely manner. The last personal communication

will demonstrate what happens when most, if not all of these issues affect an

officer’s life.

Formations and Solutions of PTSD

Retired officer M. Tafoya has extensive military and law enforcement

experiences. Tafoya has been involved in military combat, and multiple police

shooting incidents. His story vividly illustrates a stigma in the military and police

culture; and how severe stress, anxiety, substance abuse, depression, and PTSD

can harm an officer. Lastly, the key role a police psychologist played in saving his

life (personal communication August 7, 2015).

Tafoya was a reserve officer with FPD for approximately two years before

becoming a sworn officer with FPD. Tafoya recalls his mental health issues began

pre-law enforcement with his time in the United States Marine Corps, and

continued into his time as an officer.

Tafoya was in the Marine Corps from 1989-1999. He was exposed to

combat in various parts of the world, and his first time killing a person came in the

Philippines’ at age eighteen. Tafoya recalls his sergeant checking on him after the

incident. Tafoya advised him he was not doing well. Tafoya had feelings of guilt

because his reaction to taking a human life was not the way he had perceived it

happening. His sergeant told him to get a bottle of alcohol to deal with his

emotions. More emotional problems occurred in the coming years with him being

44 44

exposed to suicide. His only training on how to deal with these emotional issues

were to drink.

Tafoya had a friend in his unit commit suicide in his living quarters on

base. The Marine used a 44 magnum and shot himself in the closet. During a unit

formation, the unit commander asked for the Marine’s friends to identify

themselves. After raising their hands, Tafoya and the other friends were directed to

clean up the bloody mess. Five months later, Tafoya’s roommate shot himself with

a 357 magnum. Tafoya did not identify himself as his friend so he would be

excused from the cleanup, but he was nonetheless tasked due to being a roommate.

Tafoya chose to leave the Marine Corps in 1999 as his unit was deploying

to Somalia. Tafoya recalls one of his closest friends was killed by sniper fire three

days after Tafoya had left the service. Tafoya focused on the fact that his friend

was the first Marine killed in action (KIA). Tafoya said he began suffering

survivor’s guilt for not being there to stop that from happening. Tafoya wanted to

become a police officer, and soon started as a police cadet with FPD. Tafoya

worked a forty-hour week as a cadet, and would change clothes into his reserve

uniform, then would work upwards of 40 more hours of reserve time during the

same workweek. He worked hard in this fashion for approximately two years

before becoming a sworn officer. Tafoya had a personal goal of working in patrol

for five years before applying to any special units.

Tafoya had his first officer involved shooting (OIS) in 2004 while he still

worked patrol. He recalls two volleys of gunfire during the incident. Tafoya knew

he would be given three days off for administrative leave, standard in police

shootings, and be sent to a police psychologist. Tafoya believed that psychologists

could get you fired if you talk about emotional stuff. Tafoya had a personal plan to

tell the psychologist he was fine so he could return to work. Tafoya acknowledges

45 45

there is a stigma within the police culture just as in the military. Tafoya was taught

to suck it up and move on both in the military, police academy, and during his

time as an officer. It was a perception; at least at FPD that the more days off you

take after a shooting, the weaker people think you are as an officer.

During his first contact with the psychologist, Tafoya wanted to maintain

control. The psychologist would not accept certain answers, and wanted to ask

more personal questions, which he refused to discuss. The contact became

confrontational when the psychologist made statements about her concerns over

his evasive behavior, and made statements that she believed he was not ready to

return to work. Tafoya became confrontational with the psychologist because she

kept saying that his shooting occurred because he had repressed feelings of

abandonment over his daughter. This confrontation led to Tafoya getting a

different police psychologist, and him immediately returning to work.

During his time as an officer Tafoya suffered physical injuries as well as

emotional. Tafoya was taking prescription medications such as vicodin, oxycontin,

and norco. Tafoya began taking the medications when he got home from work to

numb his physical and emotional issues, as well as drink alcohol. Eventually,

taking the medications became a habit, and Tafoya moved from taking the

medications after work to all the time. Nearing his five-year mark, Tafoya was

moved into a tactical unit.

Tafoya had joined this tactical unit in a part of the city that was considered

one of the most violent. Shortly thereafter was an incident that he wanted to

describe in general terms due to the length and complexity of this loud party

incident. In short, Tafoya responded to a loud party disturbance that went wrong.

There were over fifty people in the front of the house. Family and gang members

were physically fighting while the majority watched. Tafoya recalls his partner

46 46

advising him that someone was trying to get his gun. As more officers arrived, the

crowd began to push into the house.

Tafoya was pushed/forced into the house during the chaos. He was

prevented from leaving, and assaulted during his few minutes being inside waiting

for assistance. Tafoya was extremely stressed after the incident was over, and said

he would have welcomed the opportunity to see the psychologist so he could get

three days off to decompress. Due to the stigma, Tafoya did not ask for help, and

allowed it to be handled by the department, which never happened. This is an

example of how agencies typically view OIS’s as critical incidents, and not other

circumstances that can affect an officer. Three months later, Tafoya was involved

in his second OIS.

This OIS was non-fatal. He was sent to the same psychologist that replaced

the one in his first OIS. He continued to be treated by this same police

psychologist for all his shootings, and beyond. He credits her treatment style as to

the reasons he is where he is today. Tafoya recalls having a better relationship

with her, but he did not trust her to open up about his true feelings. Tafoya talked

the psychologist into letting him return to work within the three-day time limit.

The only reason she released him is because he was going to be in a training class

on that third day of his administrative leave. What Tafoya did not tell the

psychologist is that the training was for simunitions. This training is where

firearms are used with paint bullets to provide the most realistic training in tactical

situations such as, building searches, and many other types of aggressive and

stress inductive types of training. Tafoya recalls at some point after this shooting

he began having problems holding down food. He increased his self-medicating

around this point, and would finish off a bottle of scotch to numb the pain. By

September 2005, he was involved in his third OIS.

47 47

Tafoya’s third OIS was a fatal shooting. Tafoya suffered a lot of guilt after

this shooting when he found out the suspect he shot did not have a weapon on him

as he had believed. The man’s parole agent informed officers that the suspect told

him that a cop would be dead or he would be dead, because he was not going back

to prison. Tafoya said he began, ‘Monday morning quarterbacking’ himself about

the shooting. Tafoya asked his area commander for permission to leave the unit

and take a day shift detectives position because he needed to decompress. The

commander said he would help him, but asked that it wait until the end of the

fiscal year, which were several months away. The commander said Tafoya’s unit

was showing good numbers in crime reduction, and he needed him to continue

making arrests. Tafoya knows that in FPD, the area commanders receive bonuses

in pay for reducing crime statistics in their areas, and he believes the commander

put his financial wants before Tafoya’s personal needs. Six weeks later, Tafoya

was in his fourth OIS.

The fourth OIS was fatal. This shooting and the way many of his team

members acted created a lot of stress and anxiety. Tafoya and his partner engaged

a vehicle identified by team members trying to leave the scene of their stop after

pointing a gun at the officers. Tafoya and his partner used the precision

immobilization technique or PIT maneuver to stop the car. Tafoya said the bigger

threat was in the car, not the person on a bike that his team members focused on.

Instead of backing up Tafoya and his partner, many of his team members chose to

stop a man on a bicycle they thought could be involved. The PIT maneuver caused

the suspect vehicle to spin around bringing the passenger side of the car toward

Tafoya’s door. Tafoya engaged the armed passenger while exiting the car. Tafoya

recalls his hands shaking so much that his partner had to help him holster his gun.

Tafoya was and still is, “pissed’ off at his team members, and refers to them as

48 48

cowards for not backing him up. My team is supposed to have my back, and they

were worried about something insignificant. This was the first time that he

realized that law enforcement was not really a family.

Tafoya always knew law enforcement was not really a family, but this was

the first time that it struck him. He always believed they were not a family because

of the way he observed officers treating each other, and how the administration

treated the officers. His team members played a sick joke on his partner that also

created more stress/anxiety for Tafoya after this shooting. Tafoya was on

administrative leave when he found out what happened.

The police psychologist saw Tafoya’s partner as well, due to him being

intimately involved in the fatal shooting. The psychologist typed up a form letter

for his partner to take back to his commander to show he was cleared for normal

duty. His partner never read the letter, and placed it in the commander’s

department mailbox, which is accessible by any employee. As a joke, one of his

team members intercepted the letter, and used his computer skills to fabricate

some statements in the letter. The wording made it sound as if Tafoya had made

derogatory statements about his partner, and that he was a coward. The letter was

likely used to make fun of his partner. His partner began calling Tafoya’s cell

phone and leaving messages that were angry and profane. Tafoya had not been

checking his phone for a day or two after the incident. When he got around to it,

he saw around seventeen messages from his partner. The last message his partner

was apologizing and telling him to forget about what he said. Within a week or so,

Tafoya was moved out of his unit and into a plain-clothes night detective unit slot.

The issue of the letter was brought to the attention of a high-ranking administrator,

but no disciplinary action was taken on the misconduct of the involved officer. In

hindsight, this is an example of the stigma within the culture. The lack of

49 49

disciplinary action to correct this egregious act that could have caused sever

problems for Tafoya, if not his partner shows the lack of leadership and/or

understanding of mental health issues that officer’s face.

The loud party incident he handled a few years back became a lawsuit and

criminal case against him. This issue created much more stress by how the agency

and district attorney’s office treated Tafoya, but this was not something Tafoya

was going to describe in detail. In the end, Tafoya was medically retired in July

2007, and was diagnosed by independent psychologists as 85% disabled with

PTSD. His battle with his agency and workers’ compensation lasted over five

years before he received his benefits. Tafoya recalls his fatal shootings were hard

on him because he remembers the twisting and turning of their bodies as their

souls left their bodies. He is thankful for the police psychologist that stuck with

him through this, and got him back into school as a distraction, and a means to a

better future.

Tafoya started working toward his bachelor’s degree in the fall of 2007,

and completed his doctorate (Psy.D.) in May of 2015. At the beginning, Tafoya

battled his addiction to pills and alcohol, and attempted suicide six times. It is still

emotional for him, and he chose not to discuss this issue in detail. Looking back,

Tafoya said the myths about how police perceive mental health is wrong. The

stigma prevents officers from getting the necessary help, and it is compounded by

members of the organization that lack understanding or the proper education in

this field. The fears he had, and of his co-workers is that mental health is for the

weak, and the doctors and/or organization will screw you over if you show you

can’t perform the job. The belief in law enforcement is that it’s a family, but in

reality it’s a business, and everyone is expendable.

50 50

Tafoya believes if he was more open early on in his career, things would

have likely been different or his transition to better health would have been easier.

One thing Tafoya remembers is what an older veteran police officer told him when

he first started. It will take three to five years to learn how to be a cop, and it will

take twenty to twenty five years to learn how to survive within the agency. Tafoya

believes the cliques within the organization, and the internal politics create the

stigmas within the police culture.

I asked Tafoya how his condition affected his family. Tafoya has a

daughter from his first marriage. He recalled when she was 15-16 years old; she

told him that she felt Tafoya was buying her love. This was due to him never

being around as a father because of all the work he was doing. When Tafoya was

there for her, he would buy her gifts to make up for lost time. At that age, she was

able to notice changes in Tafoya’s behavior.

Tafoya would lie to her about physical injuries she observed after

altercations he had during arrests. He did not want her to worry, but she knew he

lied about the injuries. She observed him drinking alcohol regularly, and would

recognize an increase in his consumption after an OIS. His daughter heard him at

times yelling in his sleep from nightmares. She loved the fact he was a police

officer due to the respect for the badge, but hated it because he was never around

for her.

Tafoya was remarried in 2007 to his wife Tracy, a fellow officer. They

were partners as a double-unit for nearly two years. There was no intimacy during

this time, but this allowed them to get to know each other on an intimate level.

They began dating after his first OIS. Tracy was on-duty every time Tafoya was in

an OIS. Tracy knew the issues Tafoya was having, and she had concern for him.

An issue for Tafoya that relates to stigma came after his fourth OIS.

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Tracy contacted her sergeant to request time to go be with Tafoya at

headquarters. Her sergeant refused to let her go down there stating she is not his

wife, and for her to keep working. A fellow veteran officer heard of this, and

contacted a lieutenant. The lieutenant was sympathetic to the need and released

Tracy from work the rest of the night to be there for Tafoya, and he allowed her to

use her compensation time to take the next few days off to be with him while he

would be off on administrative leave.

Tafoya believes his marriage with Tracy survived because of her being a

police officer, and understanding the behaviors. However, he believes his PTSD

would have eventually destroyed his marriage if he didn’t break away from the

stigma within this culture. This would not have happened if he didn’t get to a point

where he could trust the police psychologist. It took him five years to go through

the process of trusting the psychologist.

Tafoya found hope with the help of the psychologist. She recommended he

go back to school to focus on his education. In hindsight, it was to keep his mind

off of other things so he could survive as he went through counseling. Tafoya went

to a local junior college to occupy his mind; he had no intentions of going further

with his education. While in college, Tafoya continued with his therapy and

coaching. Therapy helped him understand everything he was going through was a

normal reaction, and the coaching helped him set goals. During this time, the

department had fired him for his alleged misconduct during the loud party call

discussed earlier, and a criminal case was brought against him for that incident. He

continued using school as an escape from the trial and his PTSD. He was now

attending California State University, Fresno when he was acquitted of the charges

in the case.

52 52

As he went through this process, Tafoya realized he was more than a police

officer. Looking back, he knows he would not have made it without his support

group, psychologist, wife, family, and college instructors who knew his plight.

Tafoya credits the compassion of the instructors taking the time to work with him,

as he sometimes would struggle with school. If he did not have this kind of

support, Tafoya states he would have eaten a bullet years ago. While finishing his

bachelor’s degree, Tafoya made the decision to get a doctoral degree in

psychology so he could help fellow officers not go through what he went through.

Tafoya found a class on life coaching while working on his doctorate. He

was impressed with the course, and joined a life coaching training program that

would last for one year. He completed this course while finishing his doctoral

degree. The life coaching has helped him understand the walls that people put up

to protect themselves, which relates to the stigma in the police culture. This

training has helped him work through his issues by goal setting, and it is working

for his current clients.

CHAPTER 3: METHODOLOGY

This program was created from a need for me to give back to my fellow

officers. I do not want them or their families to go through the things I went

through during my career by having a lack of understanding, awareness or

education on the various stress related issues, which can lead to suicide.

Additionally, this workshop is designed to break down the police stigma within

the culture that many times prevents officers from receiving help. The goal is to

use current research, personal experience and experiences of others to promote

more awareness of these issues. The target population will be law enforcement

officers and their families. However, this training would serve other related fields

to include, corrections, dispatchers, military, any federal law enforcement

organization as well as first responders such as, any law enforcement officer with

a patrol function, firefighters, and paramedics.

Becoming a member of the Society for Police and Criminal Psychology

(SPCP) has allowed me the opportunity to network with police psychologists

across the United States and other countries. I was invited to the SPCP national

conference to present this project in September 2015. After the presentation, I was

approached by several members who were interested in the possibility of me

speaking more about this issue to officers in their respective cites. A psychologist

who is a member of In Harm’s Way: Law Enforcement Suicide Prevention

suggested that I consider going on speaking engagements to get this message out.

In Harm’s Way provides training in crisis intervention, peer support, and

stress management. They also provide resources and publish articles on related

issues that promote more awareness, and offer a hot line for emergency help. This

federally funded program offers training seminars and workshops nationally.

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Other groups that can assist with this outreach goal are the National Alliance of

Mental Illness (NAMI), IACP, the Department of Veteran Affairs (DVA), and the

publication, PoliceOne.com.

NAMI offers national resources to help provide awareness on mental health

and suicide prevention. The IACP provides training to law enforcement

organizations through their national conferences, training, and research archives.

DVA has been working in support of veterans for decades regarding issues related

to PTSD, depression, and suicide. Working with any of these groups will likely

assist in reaching more people in need of this type of support. PoliceOne.com is a

law enforcement magazine reporting on national/international issues related to law

enforcement. Seeking publication of articles in PoliceOne.com is another way to

increase awareness. As an example, their latest issue on October 20, 2015, states

one of their goals is to discuss major issues facing law enforcement in this modern

era. Their topics include the political climate and modern threats to law

enforcement to include, ambushes against officers, less public support, strains on

mental health and dealing with PTSD.

This proposed workshop will benefit its attendees by creating more

awareness on these issues and it is a step toward breaking down the police stigma.

Attendees will be provided the knowledge on how to deal with themselves or

loved-ones suffering from untreated stress that can lead to many health related

issues and/or result in suicide. Additionally, administrators having this training

will likely be more alert to symptoms they might see in their officers. Having the

ability to catch these symptoms will allow supervisors a way to help their officers

before disciplinary issues, or other special circumstances, arise.

If this training is POST approved, officers can get credit for attending. If

the various state POST’s, and all law enforcement agencies, will utilize this

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research in building programs to help officers in this area or improve on programs

they have in place, we can reduce mental health issues/concerns and/or law

enforcement suicides.

CHAPTER 4: PROJECT DESIGN

Workshop Design & Learning Objectives

This training program was designed to benefit law enforcement agencies,

their administrators, supervisors, officers, and family members in furthering their

understanding of the physiological and psychological effects of long-term chronic

stress, and how it impacts their lives. This program will show the seriousness of

the health risks involved in police work, and connect the effects of long-term or

chronic stress to behavioral changes. This program was designed from personal

experience and an extensive literature review to ensure understanding of the

impact stress can have on the individual, agency, and family members.

The program has been created as a means to break down the law

enforcement stigma, and further the training of the IACP’s 2013, “Breaking the

Silence: A National Symposium on Law Enforcement Officer Suicide and Mental

Health.” The impact of increased understanding and knowledge can alter this

culture, their expectations when it comes to asking for help, reduce early

retirements, minimize disciplinary actions, improve family relations, and reduce

the number of police suicide. Breaking down the stigma will allow more

opportunity to deal with the physiological and psychological concerns. The

processes and procedures for this workshop are outlined and discussed in this

chapter. The topics include police stigma, stress, sleep deprivation, fight-or-flight

syndrome (effects of cortisol and adrenaline), anxiety, depression, posttraumatic

stress disorder, legal/non-legal psychiatric responsibilities, and the workers’

compensation process. This program was designed to be delivered over a two-day

period of time. Non-sworn family members are encouraged to attend. Depending

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on the number of participants, it can be held in a classroom, small or large

auditorium, conference room, or at a local agency.

Workshop Design

Each session (Day 1/Day 2) was designed as an eight-hour module. The

following section is an overview of the content used in each module, followed by

a table that illustrates the syllabus. The table identifies five (5) elements included

in the design: time, topic, objective, materials, and activities.

Day 1/Session 1: The objectives of day one are to: 1) Establish an

environment of openness and comfort for the participants, 2) Build trust and show

credibility, 3) Define stress, and show how it’s linked to related topics, 4) Enhance

understanding of stigma in the police culture, 5) Increase awareness and

understanding the culture has on the officer, organization, and family, 6) Show the

effects of sleep deprivation/fatigue, both psychologically and physiologically, and

7) Increase awareness on how cortisol and adrenaline can negatively affect the

body during Fight-or-Flight.

In this initial session, the presenter will provide his/her history related to

these topics (if there is one), interest, background, the need for this class, and the

benefits for education on this topic. Participants will be required to introduce

themselves, share their interest in attending this class, and all sworn law

enforcement will be asked how many years of service they have to enable the

instructor and class to know the level of experience in attendance. The instructor

can draw on personal experience from the attendees as their experiences relate to

the material. Following introductions, participants will be asked for their

interpretations or perceptions on these issues, and allowed to ask questions for the

instructor to address throughout the course as it pertains to specific material. The

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following is an overview of the stigma in police culture, and how it effects the

desired change within this group.

Stigma in the Police Culture

The stigma in police culture is unique because the law enforcement

occupation is very different from any other civilian occupation. The average

person is not trained for their careers or jobs as law enforcement officers are

trained. The average person gets their training from college courses or trade

professional schools, which does not typically include life saving techniques,

dealing with combative people, high-speed driving, firearms training, crowd

control, how to safely search buildings, control techniques of violent people

during arrest procedures, and much more.

The average person learns functions of their job skills without being

threatened, attacked or placed in a dangerous situation. Law enforcement goes

through this training and much more. “The law enforcement culture values

strength, self-reliance, controlled emotions, and competency in handling personal

problems” (Allen, et al., 2014). This training teaches officers just like soldiers to

be tough, and to fight through pain whether it is physical or mental.

Police officers rely on each other to help keep them alive during violent

confrontations or from life-and-death contacts they make. This reliance has

created a mutual respect between officers due to the constant potential of these

types of contacts and stress suffered from this environment. (Furthermore, officers

tend to hang out with other officers and their families during their off-duty time.

This reduces the personal interaction with the average person not involved in law

enforcement. By limiting social interaction with non police officers the stigma in

this social context is allowed to fester.

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The social network of law enforcement compounds the police stigma

problem because the officers within this network recognize what they believe to be

accepted behavior, and as a group they devalue what they believe to be non-

essential, and thus place labels on the problem or people. The stigma is

interconnected through this social network (i.e. officer, supervisor or

administrator) (Kleinman & Hall-Clifford, 2009). The officer(s) that are on the

outside of this belief or social network succumb to this inappropriately nurtured

way of thought that leads them to believe that mental health issues are a sign of

weakness. These people do not want to be labeled as a, “head case” or treated as

an outsider (Yogaretnam, 2014).

This training or fear of being devalued by your peers is the stigma that

prevents officers from getting the necessary help they need. In order to change this

stigma there has to be a change of heart, a change of mind, and these changes need

to be profound.

Stress

Stress is something every person feels on a daily basis, whether it’s public

speaking, driving a car in heavy traffic, shopping in packed malls during the

Christmas season, and/or dealing with agitated or aggressive persons. Stress

symptoms can affect one’s body, thoughts, mood, feelings, and behavior. A person

that is able to recognize common stress symptoms is able to manage them in order

to prevent health problems such as, high blood pressure, heart disease, obesity and

diabetes (Mayo Clinic, n.d.).

As seen in Table 1, the Mayo Clinic defines common effects of stress, and

lists them in the following categories:

60 60 Table 1. Mayo Clinic Stress Symptoms

On your body On your mood On your behavior

Headaches Anxiety Overeating

Muscle tensions or pain Restlessness Undereating

Chest pain Lack of motivation or

focus

Angry outbursts

Fatigue Irritability or anger Drug or alcohol abuse

Change in sex drive Sadness or depression Tobacco use

Stomach upset (acid

reflux)

Social withdrawal

Sleep problems

© Mayo Clinic 2015

Many times the stigma of the police culture prevents officers from seeking

help at the earliest signs of stress. The stigma felt by officers is likely the biggest

threat they face in getting assistance. The other issue preventing officers from

getting help is education and/or awareness that there is a problem. As previously

stated, POST has minimal training for academy cadets regarding more detailed

information on stress, anxiety, depression, and PTSD related symptoms. Without

more training in the academy, the only training or education on this subject

officers get with regard to mental health concerns will be if their agency sends

them to a training course on this subject, the agency brings in a professional to

train them, or like some agencies they have an internal program or unit to provide

these services. Without this training or education, officers are likely to educate

themselves on rumor, their observations/misperceptions of what/how other

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officers dealt with similar circumstances or how these officers were treated in

similar circumstances.

Sleep Deprivation

The amount of sleep a person gets depends on many factors, which in this

case depends on age. The recommended hours for most adults is 7-9 hours,

although some can need as few as 6 hours or as much as 10 hours. Getting too

little sleep in previous days can lead to a sleep debt. The body requires this debt to

be repaid. Our bodies can become trained to function with less sleep, but our

judgment, reaction time, alertness, and other functions will be impaired (Belenky

et al., 1994). A person’s performance declines, and this can become critical in law

enforcement occupations. Insufficient sleep and exhaustion is a likely factor in

predisposing a person to become a stress casualty.

According to Belenky et al., 1994, sleep deprivation is dangerous. Sleep

deprived people have been tested to measure their hand-eye coordination. Results

show these people performed poorly, and their performance was similar to people

that were intoxicated. Additional tests show that alcohol magnifies the effects on

the body. Sleep deprivation leads to problems in decision-making; i.e. when to use

force or what type of force to use, performing required tasks, such as driving,

shooting, or dealing with verbal disputes without losing your temper.

According to the DSM-5 desk reference, there are several sleep-wake

disorders. Officers having difficulty sleeping for any reason should seek out a

medical professional to determine if they might be suffering from one of these

many disorders which include, insomnia, hypersomnolence, breathing-related

sleep, sleep apnea, circadian rhythm, sleep arousal, and nightmares to name a few.

Many of the symptoms involved within these disorders cover “same day” issues or

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recurring symptoms at least three days a week, and lasting up to three months.

Awareness is important due to the number of variables involved with these

symptoms. Officers without proper understanding of these symptoms are likely to

not understand changes in their mood or behavior as a result of any of these

disorders. Seeking a medical professional about these symptoms will likely help

the officer resolve this potential problem from escalating.

Military studies have shown that a person loses their ability to perform

simple tasks by 25% for every successive 24 hours of being awake. During the

tests, group one performed at 98% efficiency with seven hours of sleep (Belenky

et al., 1994; Grossman & Christensen, 2004). A significant drop in performance

came with group two on only six hours of sleep. Their performance was rated at

50% efficiency. Group three performed at 28% efficiency with five hours of sleep,

and group four performed at 15% efficiency on four hours of sleep each day. Each

night of being deprived of sleep showed a systematic decline in performance. An

example of this concern can be found in an after action report taken by one of the

authors, G. Belenky (Belenky et al., 1994). Belenky debriefed personnel involved

in this friendly fire attack of United States Army forces on each other during a

combat operation in Iraq, during Operation Desert Storm.

This after action report illustrates how sleep deprivation affected the

cognitive abilities of the involved combatants. After forty-eight hours plus of

continuous operations, a Bradley platoon of six fighting vehicles engaged an Iraqi

column of combatant vehicles. Two Bradley’s believed they were firing a certain

direction when in fact they were not, they were firing into their own line and

destroyed two of their own vehicles. The ability to hit their targets was not lost

with the sleep deprivation; it was orientation and the ability to grasp the tactical

situation (Belenky et al., 1994). For a police officer suffering sleep deprivation in

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any of these capacities is likely to lose some or all of these abilities. Under these

conditions an officer could make a mistake by using unreasonable force with their

hands or all the way up to lethal force. This is one of the many problems when it

comes to sleep deprivation. Figures 1 and 2 illustrate how sleep deprivation

degrades cognitive performance.

Figure 1. 48 Hours of Sleep Deprivation demonstrating the degredation in performance. From “Sleep, Sleep Deprivation, and Human Performance in Continuous Operations,” by Col G. Belenky, 1997, Joint Services Conference on Professional Ethics (JSCOPE), Volume 97, p. 2. Copyright 1997 by Col G. Belenky. Reprinted with permission.

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Figure 2. 72 Hours of Sleep Deprivation demonstrating the degredation in performance. From “Sleep, Sleep Deprivation, and Human Performance in Continuous Operations,” by Col G. Belenky, 1997, Joint Services Conference on Professional Ethics (JSCOPE), Volume 97, p. 2. Copyright 1997 by Col G. Belenky. Reprinted with permission.

This study concluded that 7-8 hours of sleep is necessary for a person to

maintain peak performance. Lack of sleep resulted in reduced mental abilities that

sustain situational awareness, and having a grasp of a tactical situation. To

reinforce his theory, Dr. Belenky also conducted an 85-hour study where the

subjects were allowed one 30 minute nap each day. This determined that any

amount of sleep reduced the cognitive degradation (Belenky, 1997).

Consequences of sleep deprivation include, memory problems, depression,

a weakening of your immune system, increasing your chance of becoming sick,

and an increase in perception of pain. As one can see, it can be dangerous to be

sleep deprived, whether it is your safety or you can become the risk to other

people. The effects of alcohol on a sleep-deprived person are magnified.

Additionally, caffeine and other related stimulants will not overcome the effects of

sleep-deprived people. The important thing to remember for law enforcement is

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that decision-making and task awareness are of the utmost importance in this

occupation.

Studies have shown the negative effects of sleep deprivation on cognitive

tasks, data analysis, decision-making, alertness, and mood (Belenky, 1997). Many

of the involved subjects studied did not recognize their level of impairment and

believed they were performing at peak levels when they were not. Others showed

problems in assimilating new data and they became less innovative in their

problem solving.

Most important is the potential effects sleep deprivation has on the immune

system. According to a recent article in Scientific American (Stickgold, 2015), two

studies have shown that certain immunizations are not effective on those that are

sleep deprived. In a 2003 experiment, scientists tested the standard hepatitis

vaccination on a small group. Those that had slept normally showed they had 97%

higher antibody levels than those that were sleep deprived (Stickgold, 2015).

During the second study, researchers measured the results of the hepatitis B

vaccine over a six-month period. Their results showed that subjects with less than

six hours of sleep a night during the week around the first vaccination, were seven

times more likely to have low antibodies in their system than those that had sleep.

This group was not considered to have been protected against future infection with

the hepatitis B virus. This research suggests that sleep deprived officers are still

susceptible to health risks when they believe they are immunized against certain

illnesses (Stickgold, 2015).

Fight-or-Flight Syndrome (Adrenaline/Cortisol)

The body is designed to react to stress in ways meant to protect you from

perceived threats, such as predators and other aggressors. These threats are rare in

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modern times for the average person, but not for law enforcement officials. The

hypothalamus sits at the base of the brain. It is designed to set off an alarm system

for the body to react to a potential threat (Sharps, 2013). This is done through a

combination of nerve and hormonal signals, which prompt your adrenal glands to

release a surge of hormones, which include adrenaline and cortisol to deal with the

threat. This puts the body into the fight-or-flight syndrome.

According to the Mayo Clinic, adrenaline will increase the heart rate,

thereby elevating the blood pressure, which in turn boosts energy supplies to the

necessary parts of the body during this crisis. Adrenaline allows these supplies to

move quickly through the body. This can cause muscles to tense, breathing faster,

potential sweating, your attention to become more focused (tunnel vision), and it

increases energy to run away from a dangerous situation. Additionally,

norepinephrine works similarly to, and in conjunction with adrenaline (Klein,

2013). This helps with your awareness during this crucial time. Norepinephrine

will shift blood away from areas of the body that will not need the blood, such as

the skin, and direct it toward the muscles. This keeps minor cuts or lacerations

from severe bleeding, and gives the muscles the strength/energy to, “fight”

through the threat or, “flight” run from the threat.

Cortisol is the primary stress hormone. Cortisol increases the sugars

(glucose) in the bloodstream; it enhances our brain’s use of glucose and increases

the availability of substances that repair tissue. Cortisol also curbs nonessential

functions in this situation such as altering the immunity system responses,

suppresses the digestive system, the reproductive system (sex drive hormones) and

growth responses for tissue repair. This complex system also communicates with

parts of the brain that control mood, motivation and fear. Cortisol release shuts

down these functions or limits them in order to deal with the threat/stress at hand.

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The release of cortisol to deal with this threat/stress is supposed to be short-

lived, long enough to deal with the threat (Bennington, n.d.). Think of early

mankind (hunters) who brought food (meat) into the village. They would release

cortisol when they engaged large prey. They quickly killed their prey, and returned

to the village with meat. After the engagement, their bodies could quickly return to

normal levels. A police officer is dealing with much more than our early ancestors.

Officers are not just dealing with one target; they have to be alert to other threats

while combating one or more individuals (Sharps, 2013). They don’t go home

after one incident to relax, they go back into service and likely head to another

cortisol dumping situation. This constant rise/fall in fight-or-flight throughout a

shift likely leads to physiological and psychological issues.

When stressors are always present as in the functions of law enforcement,

an officer is likely to feel under attack, and the fight-or-flight systems can stay

turned on. This leads to numerous health risks such as anxiety, depression,

digestive problems, and heart disease, sleep problems, weight gain, memory and

concentration problems. The shutting down of our immunity system enables

people to become more susceptible to illness. If stress isn’t managed properly, the

production of cortisol may not function properly within our system.

Day two/Session 2: The objectives of day two are: 1) Define anxiety, and

show how it can interfere with our daily lives, its symptoms (physiologically and

psychologically), causes, relationship to other conditions, and risk factors, 2)

Define depression, discuss the symptoms (physiological and psychological),

causes, relationship to other conditions, complications and risk factors, 3) Define

posttraumatic stress disorder, discuss the symptoms, causes, emotional effects,

psychological changes in emotional reactions, physiological issues, and risk

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factors (suicide), 4) Legal/non-legal issues regarding a police psychologist role in

the treatment of officers, 5) Workers’ compensation role in this industry.

Anxiety

Anxiety is normal in our daily lives as is stress in proper doses. Unchecked,

anxiety can become a disorder where a person has intense and excessive feelings

of worry and fear about every day situations. The Mayo Clinic defines symptoms

of anxiety as;

• Feeling nervous,

• Feeling powerless,

• Having a sense of impending danger, panic or doom,

• Having an increased heart rate,

• Breathing rapidly (hyperventilation),

• Sweating,

• Trembling,

• Feeling weak or tired, and trouble concentrating or thinking about anything

other than the present worry.

Some of these symptoms are similar to symptoms of stress, depression,

sleep deprivation and post traumatic stress disorder. For this reason, it would be

imperative for an officer to seek professional help to determine what category their

symptoms are related; then the officer could get the proper treatment to overcome

the issue. Awareness is important regarding these symptoms so people know if

these are physiological or psychological symptoms.

Causes for anxiety vary and certain anxiety disorders are not fully

understood. Some health issues linked to anxiety are heart disease, diabetes,

thyroid problems, drug abuse, irritable bowel syndrome, and acid reflux (Mayo

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Clinic, 2015). Also, anxiety can be a side effect of certain medications. The police

stigma will likely interfere with officers seeking assistance for these medical

issues and/or the other problem is that with a lack of awareness regarding these

symptoms, some officers are not likely to realize they need medical attention even

if they were to overcome any stigma. Either way, this will create risk factors if

untreated Dr. J. Price-Sharps (personal communication, August 18, 2015).

According to Dr. J. Price-Sharps, critical incidents such as shootings, riots,

violent acts against an officer, and certain types of crime scenes can lead to any of

these medical concerns. As previously stated, chronic or long-term exposure to

these events, especially without treatment, will likely allow the opportunity for

anxiety to build from stress. This can lead to depression, PTSD, family problems,

disciplinary actions, termination, and/or suicide (personal communication, August

18, 2015).

Depression

The Mayo Clinic defines depression as a mood disorder that causes a

person to persistently feel sad and lose interest in activity (Mayo Clinic, 2015).

Depression affects how one feels, thinks, behaves, and can lead to a variety of

emotional and physical problems. It can make one feel as if life isn’t worth living,

which can lead to suicide. More specifically, the DSM-5 lists various types of

depressive disorders.

The DSM-5 is the guide that psychologists use to diagnose what mental

health condition a person might have. The DSM-5 defines the following disorders.

“Disruptive Mood Dysregulation Disorder, Major Depressive Disorder, Persistent

Depressive Disorder, Substance/Medication-Induced Depressive Disorder, and

Other Specified Depressive Disorders” (American Psychiatric Association, 2013,

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p. 93-107). According to Dr. J. Price-Sharps, many of these mental health

disorders have overlapping symptoms. Therefore, mental health professionals need

as much information as possible in order to make a correct diagnosis. Information

needed should include, onset of symptoms, context, length of symptoms, and

severity (personal communication, September 23, 2015).

Depression can require short or long-term treatment. Most people feel

better with medication, psychological counseling or both. Depression is easily

treatable once someone recognizes the symptoms through awareness or evaluation

(Mayo Clinic, 2015).

The Mayo Clinic defines the symptoms of depression as:

• Feelings of sadness

• Tearfulness

• Emptiness or hopelessness

• Angry outbursts

• Irritability or frustration, even over small matters

• Loss of interest or pleasure in most or all normal activities, such as sex,

hobbies or sports

• Sleep disturbances to include insomnia or sleeping too much

• Tiredness and lack of energy, so that even small tasks take extra effort

• Changes in appetite-often reduced appetite and weight loss, but increased

cravings for food and weight gain in some people

• Anxiety

• Agitation or restlessness

• Slowed thinking, speaking or body movements

• Feelings of worthlessness or guilt

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• Fixating on past failures or blaming yourself for things that aren’t your

responsibility

• Trouble thinking, concentrating, making decisions and remembering things

• Frequent or recurrent thoughts of death

• Suicidal thoughts and/or suicide attempts

• Unexplained physical problems, such as back pain or headaches.

Most importantly, for many people with depression, these symptoms may

be severe enough to cause noticeable problems in day-to-day activities.

According to Dr. J. Price-Sharps, depression is often not identified. It often

goes undiagnosed and/or untreated; likely due to the way people misdiagnose their

symptoms. Some of these symptoms include memory difficulties, personality

changes, physical aches and pains, fatigue, loss of appetite, wanting to stay home

instead of going out to socialize, and suicidal thoughts (personal communication,

September 23, 2015). For law enforcement, many of these physical symptoms are

likely to be misdiagnosed by the individual as common injuries sustained over the

years. The memory effects are just as likely to be misdiagnosed due to people

thinking that age has something to do with their memory loss, fatigue, etc. The

DSM-5 desk reference shows, on pages 93-95, that one or more of these

symptoms are related to time. The desk reference asks psychologists to look at

whether symptoms are occurring most of the day, nearly every day, three or more

times per week, have been present for twelve-months or longer, and/or are

observable by others.

One of the problems for police officers is that they are not always around

the same co-worker or supervisor. Therefore, the officer’s pattern of behavior that

begins to develop is not likely to be recognized by these co-workers. Increased

awareness will help supervisors and co-workers understand these symptoms if

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they see a certain or unexpected behavior in a fellow officer. More importantly,

family members are more likely to see the symptoms or a pattern of behavior

develop. This is why it is important to have family attending the workshop along

with first responders previously mentioned.

Post-traumatic Stress Disorder (PTSD)

There are three types of PTSD that exist, acute, chronic and delayed-onset.

Symptoms that last under three months are acute. Symptoms that last a minimum

of three months are chronic and symptoms that manifest after six months or even

years are classified as delayed-onset (Elements Behavioral Health, n.d., para. 2).

The criteria for PTSD is, “exposure to actual or threatened death, serious injury, or

sexual violence in one (or more) of the following ways:

1. Directly experiencing the traumatic event(s).

2. Witnessing, in person, the event(s) as it occurred to others.

3. Learning that the traumatic event(s) occurred to a close family

member or close friend. In cases of actual or threatened death of a

family member or friend, the event(s) must have been violent or

accidental.

4. Experiencing repeated or extreme exposure to aversive details of the

traumatic event(s) (e.g., first responders collecting human remains;

police officers repeatedly exposed to details of child

abuse)(American Psychiatric Association, 2013, p. 143)”.

According to the DSM-5, a psychologist is looking for the presence of one

or more intrusive symptoms related to the event. Some of these symptoms include:

• Recurrent and involuntary memories

• Flashbacks

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• Intense or prolonged distress related to the event

• Persistent avoidance of thoughts or feelings related to the event, as well as to

places, conversations, activities, etc. that remind a person of the triggering

event

• Changes in cognition and mood associated with the event

These changes include a loss of memory to aspects of the event, negative

beliefs about people or about oneself (i.e. No one can be trusted or I’m a bad

person), distorted views about the cause of the event, persistent emotions of fear,

anger, guilt, shame, diminished interest in activities, and feelings of detachment

from friends and family.

The psychologist needs to look for two or more of the following marked

changes in a person’s behavior (American Psychiatric Association, 2013, p. 145):

• Irritable behavior and angry outbursts (with little or no provocation) typically

expressed as verbal or physical aggression toward people or objects.

• Reckless or self-destructive behavior.

• Hypervigilance.

• Exaggerated startle response.

• Problems with concentration.

• Sleep disturbance (e.g., difficulty falling or staying asleep or restless sleep).

Lastly, the psychologist is looking to see if any of these symptoms have

lasted over a month, if the symptom(s) have caused distress in the individual’s

social, occupational, or other important areas of functioning.

Psychologist Responsibility to officer/agency

According to police psychologist, Dr. J. Price-Sharps (personal

communication, August 18, 2015), there are a number of variables involved in

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treating officers, and multiple roles the psychologist can play. Psychologists

involved in pre-employment examinations have an ethical obligation to the

agency. The agency/organization is their client during this instance, and there is no

confidentiality during this process. The role of the psychologist is to keep the

agency/organization safe from civil liability in hiring a potential problem. There is

similarity in the other role when they are involved in a fitness-for-duty

examination.

The similarity in a fitness-for-duty examination is that the officer is already

an employee of the organization. An officer having problems will be sent to the

psychologist, and hopefully the psychologist will be provided all necessary

information regarding the problem. The idea behind this is to see if mental health

is an issue for concern regarding the officer being able to continue working.

Sometimes agencies don’t know the criteria required to send an officer to a

fitness-for-duty examination, or in Dr. Price-Sharps experience; due to this

misunderstanding regarding the legal aspects of a fitness for duty they may refer

an officer for an evaluation when there are no overt signs of mental illness.

According to Dr. Price-Sharps there are three outcomes that can occur after

the fitness for duty examination. The diagnosis could be that the officer is fit for

duty, and can immediately return to work; the officer needs treatment with the

assumption they can become fit again, and return to work; or they are unfit and no

expected treatment will help them return to work, and this gets an officer fired or

terminated. This last diagnosis is what leads into workers’ compensation issues.

Dr. Price-Sharps states that a good use of mental health treatment is when

the agency identifies signs of a mental health disorder being present or causing

impairment to the officer. The goal of the psychologist is two-fold. First, to

determine if the officer shows signs or symptoms of a mental health issue; second,

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determine if the officer can continue working while they are provided treatment.

Not all mental health concerns mean that an officer needs to be placed on

administrative leave with their gun, badge, and police authority being stripped

away.

There is confidentiality when an officer seeks out the psychologist for help.

As an example, Dr. Price-Sharps said that an officer could be going through

disciplinary actions with their department regarding the officer’s conduct. An

officer that is not formally sent to the department-contracted psychologist could

have a right to confidentiality. Officers need to ask the psychologist if their session

will be confidential. There are a number of factors that determine whether or not a

psychologist can maintain confidentiality with the department. Even as a

department psychologist there are times when it is confidential. It is a complicated

issue, officers need to ask the psychologist what, if any, information will be shared

with the department.

CHAPTER 5: DISCUSSION AND CONCLUSIONS

There are some methodological challenges due to a variety of concerns.

Some of these challenges include: health issues being multi-faceted, organizations

not willing to participate, and officers not always being open to discuss these

problems. All of which are likely a part of the stigma. A person can have PTSD

without a diagnosis of depression because they are closely related. As previously

stated by Dr. J. Price-Sharps, PTSD includes a component of depression, but to

have a diagnosis of depression in conjunction with the diagnosis of PTSD, the

symptoms of depression must be severe enough to warrant a second diagnosis of

depression. In essence, this means a professional mental health expert needs to

thoroughly evaluate the individual to ensure a proper diagnosis due to the many

symptoms one can have and how some of these symptoms can overlap with other

disorders.

Depression affects the body in many ways. Depression can increase the risk

of several diseases and other conditions to the body. A medical pre-screening

would help identify certain issues prior to officers participating in a study. Some

of these issues could be genetic and not related to work experience, such as

insomnia, obesity, cardiovascular disease, acid reflux and diabetes to name a few.

This is key in a pre-screening because these symptoms can arise from the job,

which would create a workers’ compensation issue. Furthermore, there are

individual differences in people and it is hard to parse the causation.

An additional limitation can be the supervisory response during critical

incidents. Their lack of training or understanding can affect certain outcomes. For

example, according to Officer Smith’s account, a supervisor and administrator had

directed him away from mental health treatment so he could keep his special unit

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position. Officers not understanding their symptoms and exhibiting unwillingness

to be honest with their feelings, i.e. denial, are additional limitations. Officers have

pre-judgments on how other officers were treated during similar incidents. Lastly,

there are competing male and female stigmas, cultural differences, a variety of

religious beliefs, and workers’ compensation laws.

Summary

This project was initiated to benefit law enforcement agencies, and their

sworn personnel, in furthering their understanding of how traumatic incidents

affect the individual officer as well as their family and the public. The duties of a

police officer may lead, over time, him/her to succumb to stress. This can lead to

physiological and psychological changes such as, depression, anxiety, PTSD, and

suicide to name a few. These behavioral changes can lead to disciplinary action,

civil/criminal lawsuits, sick leave abuse, and destruction of a family. Examples of

these issues were discussed by observing the cases of Corporal Casebolt, Deputy

Seifert, Officer Harless, and corrections officer Captain Mellen. Further examples

were provided within the personal contacts of Officer Smith, Sergeant Steve

Crawford, and Officer Tafoya.

Statistical data taken from the FBI, as well as the Fresno, Los Angeles, and

Chicago police departments, demonstrates the physical and mental pressures that

officers endure. This data suggests that there is a pattern with long-term or chronic

stress that affects officers at 15-19 years of service. As reported by the IACP in

their 2013 national symposium, the police stigma is a significant problem as

officers are taught to be self-reliant, restrict weakness, and to be tough and

aggressive. The California Commission on POST acknowledges this stigma

problem as well. The stigma can increase stress for the officers because they are

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not likely to seek help when they need it, because they likely perceive themselves

as weak and/or failures (Wester et al., 2010). Given the psychological implications

of stress for law enforcement officers, their families, the agency, and the public

they serve, it is imperative to provide necessary support to manage stress, and

prevent or reduce the behavioral affects that lead to disciplinary actions, such as:

excessive force, violence, substance abuse, civil/criminal lawsuits, destruction of

the family unit, and suicide. Benefits to these changes would prolong the

contentment of officers that could have a better family life, longer careers and

healthier lifestyles. The agency then benefits from having healthier employees,

better public relations, less disciplinary related issues, and cost reduction in

workers’ compensation claims.

A two-day workshop to educate law enforcement personnel will likely

assist officers and their respective agencies in taking steps to break down the

stigma within the culture. Since 1993, people like Dr. Gilmartin have been

discussing these mental health issues. When IACP conducted their 2013 national

symposium, “Breaking the Silence: Law Enforcement Officer Suicide and Mental

Health,” the problem was given the opportunity to be acknowledged by a larger

audience. This workshop is designed to continue the efforts of organizations such

as the IACP, Department of Veterans Affairs, and In Harm’s Way by educating

officers, their families and law enforcement agencies.

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