What if police officers need help? Who would they confide in about troubling thoughts or persistent nightmares? Too often, they don't turn to anyone at all.

The law enforcement culture has typically rejected the notion that officers may need help in coping with stress and trauma in order to prevent or treat depression and avert suicide.

"Police officers do not want to be seen as weak. So if they have depression, or any other mental illness, they are extremely unlikely to get help" (Suicide.org). Groups such as Badge of Life (BOL) are trying to change that culture. They have conducted research on police suicides to begin to get a handle on the issue.

GOOD NEWS: The 2012 BOL study found 12% fewer suicides among law enforcement officers than they did in their 2009 study.

BAD NEWS: In 2012, the BOL still found 126 reported suicides among law enforcement officers, and the actual rate may be much higher (Policesuicidestudy.com).

The improved numbers are being attributed to an increase in peer counseling programs and an increase in the willingness of officers, especially younger officers, to seek professional help. "Suicides can happen in any profession, but they occur 1.5 times more frequently in law enforcement compared to the general population" (Officer.com).

"As we learn more through research and study, however, it becomes obvious that suicide is merely the tip of the iceberg in comparison to the more important issue of mental health in law enforcement" (Policesuicidestudy.com). Since depression is the leading cause of suicide, it cannot be ignored.

"Depression is 90% curable and, with the proper treatment interventions, those thoughts can go away. Eating your gun is not an option; treatment is" (LawOfficer.com).

Risk Factors for Depression

• Relationship difficulties
• Shift work
• Alcohol or other substance abuse
• Personal legal troubles
• Facing prosecution
• Negative public image
• Financial problems
• Physical pain/illness
• Inconsistencies in the criminal justice system
• Shame/humiliation
• Unrealistic expectations of self or by others
• Instant access to highly effective means of suicide (96+% use firearms)

Other possible causes of depression: genetics, critical incident trauma, cumulative trauma, and even repeated adrenaline dumps.

During an emergency situation, adrenaline dumps into a person's system and allows him/her to respond with speed, strength, and focus. "However, too much and too often, it's poison to your body that has negative effects on a person's physical and emotional well-being" (LawOfficer.com).

Post Traumatic Stress Disorder (PTSD) may be caused by a single critical event or cumulative trauma. Officers who suffer from PTSD may become depressed or even suicidal. "There's no excuse for law enforcement administrators not to (be) making sure officers are followed closely for at least two years after an incident" (AAETS.org).

Like depression, PTSD is treatable. Affected officers will need both a knowledgeable physician/psychiatrist, and a therapist who understands how to work with police officers (AAETS.org).

"So why don't officers simply go to their departments for help? Because they not only do not want to be seen as weak, but also do not want to be put on leave, reassigned to desk duty, have their gun taken from them, have other officers talk disparagingly about them, or be passed up for promotions in the future" (Suicide.org).

Officer.com presented a podcast interview of Ron Clark, the Chairman of the Board of Directors of The Badge of Life. He talked about the 2012 BOL study and how to promote mental wellness and prevent suicides. "The scandal in law enforcement is that not one department has ever said...the job has caused the officer to commit suicide" (Officer.com/podcast).

In the moving video, "Police Suicide, Where is the Piper?" BOL shares the words often spoken at law enforcement memorials: "It is not how they DIED that made them heroes, it is how they LIVED."

Despite these words, there is no big ceremony for a fallen officer who took his own life. No place on the National Law Enforcement Memorial. For an officer who commits suicide, it suddenly becomes a matter of how he/she died that matters. This appears to be another symptom of the unhealthy view many in law enforcement take toward mental illness and mental wellness.

The BOL suggests that police tend to their mental health as they do, hopefully, to their physical health. In a second video, "Police Suicide and HOPE," the BOL recommends annual mental health checks. They want officers to tend to their mental wellness before they have an issue.

These are signs that someone may be suicidal and in need of help:

• Talks about suicide
• Makes statements related to hopelessness or helplessness
• Has a preoccupation with death
• Shows a loss of interest in things he/she once cared about
• Makes detailed arrangements related to insurance and finances
• Gives away valued or prized possessions

Hopefully there are resources within a department that officers feel safe to turn to for help. Otherwise, direct them to local or national help lines.

National Suicide Prevention Lifeline:  1-800-273-TALK [8255]

Janice McCarthy lost her husband, a Massachusetts State Trooper, to suicide. She now addresses police groups about preventing suicides and the danger of viewing depression as a weakness. "Don't deny the fact that you're human," she said. "Yes, you're cops. But you're human" (APBweb.com).


RESOURCES:

American Police Beat, "Confronting Police Suicides," APBweb.com, (accessed 1-22-2013).

Brown, Hal, "The Effects of Post Traumatic Stress Disorder (PTSD) on the Officer and the Family," AAETS.org, (accessed 1-23-2013).

Caruso, Kevin, "Police Suicide Prevention and Awareness," Suicide.org, (accessed 1-22-2013).

Clark, Ron, RN, MS, and Andy O'Hara, "2012 Police Suicides: The NSOPS Study," Policesuicidestudy.com, 1-4-2013.

Kulbarsh, Pamela, "Police Suicides Drop in 2012," Officer.com, 1-9-2013.

Peluso, Paul, "Officer Newscast: 2012 Police Suicides Study," Podcast, Officer.com/podcast, 1-16-2013.

Wasilewski, Mike and Althea Olson, "Depression in Law Enforcement," Lawofficer.com, 8-10-2010.

Whether it is a multiple-casualty accident, a deadly fire, or a tragic school shooting as occurred last week in Newtown, Connecticut, law enforcement, fire fighters, and EMS personnel rush to the scenes. They must do their jobs regardless of what they confront.

Father William Hamilton, ATF chaplain, shared concerns about the first responders to the Newtown school shooting. "This is something human nature just should never have to see...Some of these individuals were there for 12 hours and more in the scene with these...poor victims." Small towns do not allow for much anonymity. "They know these kids. They know these teachers" (LATimes.com).

This tragedy will leave a permanent imprint. Chaplain Terry Morgan urges police officers he works with to give themselves permission to react.  "It is ok at times like this to have [an] emotional side. Understand you may have to step away for a moment to shed a tear, and take a few deep breaths" (Officer.com).

When a state police officer witnessed a man shoot and kill a 3-month-old in Blossvale, NY, a team of peer counselors were brought together to help that officer and his department to cope with the tragedy. Utica Deputy Fire Chief Brendan Dunn is part of that area's Critical Incident Stress Management Team. The team helps responders to discuss what happened, the feelings it caused, and post traumatic stress reactions (WKTV.com).

Hopefully most individuals do not face traumatic incidents more than once in their lifetimes. According to Dunn, "For an emergency responder or the military, it may be a way of life." Training will help responders carry out their job functions, but it cannot make it easy to deal with trauma.

So what will help first responders confront their emotions and regain a sense of control? "Critical Incident Stress Debriefing (CISD) can be a valuable tool following a traumatic event" (AAETS.org).

A critical incident is described on the American Academy of Experts in Traumatic Stress website as one that changes a person's normal physical and/or psychological functioning. Some of the first cases of traumatic stress identified were caused by military combat. Short- or long-term crisis reactions can also be experienced by emergency responders and victims of traumatic crimes. Many agencies use CISD to manage grief and distress.

"Debriefing is a specific technique designed to assist others in dealing with the physical or psychological symptoms that are generally associated with trauma exposure. Debriefing allows those involved with the incident to process the event and reflect on its impact" (AAETS.org). "Defusing, another component of CISD, allows for the ventilation of emotions and thoughts associated with the crisis event" (AAETS.org).

The CISD Process

1. Assess the impact of the incident on individuals.
2. Identify issues of safety and security.
3. Vent emotions and validate reactions.
4. Predict, prepare, and plan for potential psychological and physical reactions.
5. Review the critical incident and its impact. Watch for maladaptive behaviors.
6. As closure, identify ongoing support services and build action plans.
7. Assist with re-entry into the community or workplace.

This is a process that should be started within 24-72 hours of a critical event. According the the International Critical Incident Stress Foundation, the Connecticut Critical Incident Stress Management Team responded to Newtown on the day of the school shootings. "On Friday, December 14th, 2012, the CT CISM Team received a call shortly before noon, requesting assistance in dealing with what was a developing large scale event. A gunman had shot numerous adults and children inside the Sandy Hook Elementary School, directly adjacent to a fire house" (ICISF.org).

"Experts say first responders are surprisingly resilient, with the vast majority recovering from the stress of a horrific scene within days or weeks. But some will continue to have symptoms, and those people will probably benefit from some form of counseling" (ABCNews.com).

Gary Franz, Deputy Chief of Graham Fire and Rescue, talked about the grief, anger, and frustration his personnel felt after responding to an arson scene in which Charlie Powell, 7, and Braden Powell, 5, had been murdered by their father in Puyallup, Washington.  "Our men and women are men and women," Franz said. "We don't have any super-human power against what everybody in this nation -- and particularly in this community -- are experiencing" (KOMONews.com).

"The department held what's called a critical incident stress debrief," Franz said. The people and first responders of Puyallup will never forget the Powell tragedy, but they have moved forward. Now Newtown has begun the long process of grieving and then moving beyond this crisis.


RESOURCES:

• Bailey, Pat, "After Witnessing Blossvale Tragedy, First Responders Deal with Grief," WKTV.com, 06-24-2010.
• Cohen, Lindsay, "1st Responders to Powell Explosion Struggling with Grief, Anger," KOMONews.com, 02-10-2012.
• Davis, Joseph A, Ph.D., "Providing Critical Incident Stress Debriefing (CISD) to Individuals and Communities in Situational Crisis," AAETS.org, 1998.
• Hamilton, Fr. William, "Chaplain Describes First Responders' Grief," LATimes.com, 12-17-2012.
• International Critical Incident Stress Foundation, "Updates - CT CISM Team Response to Newtown, CT School Shooting," ICISF.org, 12-14-2012.
• Moisse, Katie, "Connecticut School Shooting: First on Scene Face Haunting Memories," ABCNews.go.com, 12-15-2012.
• Morgan, Terry, "Coping with Tragedy: The Newtown School Massacre," Officer.com, 12-17-2012.