May 2021
Policing is a stressful profession, characterized by long shifts, challenging interactions with people in trouble or crisis, difficult work environments, and exposure to high-stress and occasionally life-threatening circumstances. The prospect of encountering situations that can become volatile, dangerous, and traumatic can take a toll on officer wellness, despite the rarity of such events. Programs focused on improving the mental and physical wellness of police officers aim to enhance participants’ mindfulness about when they experience stress, improve their ability to navigate difficult scenarios, and boost their resiliency to recover from traumatic events. These improvements, in turn, should improve officer performance.
Summary Assessment
- Evidence that mental health interventions can improve self-reported mental health outcomes in officers is persuasive, showing that officers who participate in supportive programs focused on resilience, self-regulation, adaptive coping skills, cognitive behavioral change, and relaxation have reduced levels of stress, negative emotions, and depression, and improved feelings of peacefulness, vitality, and health.
- Despite this growing body of evidence on the benefits of mental and physical health programs for police officer outcomes, no studies have rigorously examined their impact on police violence, misconduct, or other measures of public safety.
- Long shifts, sleep deprivation, and overtime hours can all contribute to stress and compromised wellness, increasing the risk of use of force, accidents, and injuries.
- Organizational stressors also play a crucial role in officer stress levels. A perceived lack of organizational justice, an unprofessional work environment, and poor agency leadership can create a climate that induces elevated officer stress levels.
- Officers who are exposed to traumatic events may be more likely to engage in physical violence at home, suggesting that a trauma-informed approach to police officer wellness could benefit officers, their families, and potentially community members. However, more research is needed.
Current Practice and Research
The characteristics of police work can have a harmful impact on officer mental health and wellbeing. Police officers often experience mental strain in their daily activities, in part because of hypervigilance to their surroundings and toward those with whom they interact. Repeated hypervigilance over an extended period of time can compromise officer wellness, leading to anxiety, lethargy, depression, and suicidal ideation. Organizational factors – how the police agency is structured, defines its role and mission, and manages its staff – can also greatly affect officer stress levels. For example, one study found that officers who lack influence over their work activities and perceive internal biases related to their racial, gender, or ethnic group are more likely to experience higher levels of stress. Compounding these factors are the traumatic events that officers experience in the course of their professional duties. A survey of police officers in an urban department found that 60% of male officers and 46% of female officers had experienced five or more traumatic events in the past year alone. These challenges can lead to severe mental health issues among officers. Psychiatric assessments of officers found that 41% were classified as at high risk of a mental health condition and 15% showed signs of post traumatic stress disorder (PTSD). Of particular concern are results of a survey showing that 12% of officers reported that it was “quite likely” or “very likely” that they would attempt suicide one day. Some agencies have adopted the use of psychological autopsies to better understand the specific cause, set of causes, or manner of causation of officer suicides to help prevent suicides and suicide attempts. Compromised mental health within police ranks not only affects the officers themselves, but also influences their interactions with community members and their behaviors with family members and friends. One study found that officers who had dependent drinking habits were eight times more likely to self-report engaging in violence at home than those without a drinking habit, and those with PTSD were four times more likely to do so than those without PTSD. Another study found that officers experiencing stress-related factors, such as exposure to violence and job burnout (defined as personal detachment and a hardening of emotions), were more likely to self-report violent behavior toward their spouses.
One study found that officers who had dependent drinking habits were eight times more likely to self-report engaging in violence at home than those without a drinking habit, and those with PTSD were four times more likely to do so than those without PTSD.
While evidence on the relationship between officer stress and domestic violence is strong, the links between mental health and police misconduct on the job are less well established. A correlational study employing findings from several prior studies suggests PTSD could account for up to 46% of cases of excessive force. This estimation likely overstates the causal contribution of mental health problems to police misconduct, but illustrates that mental health could be a meaningful contributor to police misconduct. In addition, it is estimated that as many as 24% of all officers who used physical violence at home also had PTSD. Again, this estimate represents fairly aggressive assumptions of the causal relationship between intervention and impact, making the results less definitive. Few studies have documented the prevalence of wellness programs for law enforcement personnel. One small but stratified random sample of municipal police departments and sheriffs’ offices nationwide found that 53% of agencies had an employee assistance program, while less than one-third (29%) had wellness (resiliency, responding to secondary trauma, mental health awareness) programs or trainings, and 11% reported no training at all.
Drivers and Impacts of Compromised Wellness
Several factors can influence the degree of stress experienced by officers, including the number of hours on the job (including overtime), the nature and length of shift work, and the role that sleep deprivation can play in compromising both mental and physical wellness. Overtime can be a tremendous source of strain on officers, regardless of whether the additional hours are taken voluntarily. Overtime hours can hinder a person's physical, cognitive, and emotional functioning and lead to physical and mental health issues such as obesity, depression, and burnout. An audit of the King County (WA) Sheriff’s Department found that working one additional hour of overtime increased an officer’s odds of a use-of-force incident by 2.7% in the following week, and increased the odds of an ethics violation by 3.1%. The study found that as the number of officer overtime hours increased, the risk of a use-of-force incident, worker’s compensation claim, and a car crash increased exponentially. This risk is magnified when the number of overtime hours for an agency is concentrated among a relatively small share of officers.
Several factors can influence the degree of stress experienced by officers, including the number of hours on the job (including overtime), the nature and length of shift work, and the role that sleep deprivation can play in compromising both mental and physical wellness.
In addition to overtime, many officers work extra jobs in order to supplement their government income, moonlighting that is permitted by most agencies. A survey of a 162 law enforcement agencies found that the vast majority (80%) permit such off-duty employment, regardless of agency size or location, and that 43% of sworn officers did off-duty work. There is no recent research, however, on the degree to which off-duty work contributes to or exacerbates sleep deprivation and stress.
While fatigue itself is a physiological marker of stress, sleep also plays a critical role in mitigating the impact of stress on health and job performance. One study found that a longer night of sleep increased police recruits’ ability to complete psychomotor vigilance tasks the following day, dropping from a 67% probability of making an error after three hours of sleep to a 50% probability after eight hours of sleep. A more recent study found that officers with poor sleep quality – independent of their length of sleep – were 1.3 times more likely to experience an on-duty injury. Research also indicates that sleep mediates the relationship between traumatic stress and health functioning. In a study involving 80 officers, the researcher found that those who slept less were significantly more likely to associate Black people with weapons, showing that inadequate sleep may heighten preexisting implicit biases. However, study participants were predominantly White and from a single agency, limiting the generalizability of these findings to other agencies and officers. The shift length can also affect sleep duration and quality, along with related measures of alertness and wellbeing. A study examining the impact of 13-hour shifts compared to 10-hour shifts on a host of performance measures found that the longer shifts resulted in significant reductions in the officers’ quality of sleep, concentration, cognitive processing, and quality of life, along with significant increases in fatigue, daytime dysfunction due to sleepiness, reaction time, anticipatory errors, and the number of received complaints. An earlier study found that officers on 10-hour shifts slept 30 minutes longer than those on eight-hour shifts, and also showed that officers on 12-hour shifts were sleepier on the job, with lower levels of alertness.
Research on Officer Wellness Programs
The most effective officer wellness programs focus on enhancing mindfulness, cognitive behavior changes, and resiliency. These types of interventions help officers become more aware of the causes of stress and engage in mindful practices to counter the effects of those factors. Such activities can include pausing to become aware of how the body is reacting to stress, using deep breathing and meditation techniques to achieve a state of calm, and taking mindful moments to acknowledge thoughts and feelings. Randomized controlled trial studies have demonstrated the benefits of resiliency and self-regulation training on reduced stress and depression and improvements in perceived wellness and the ability to cope with stressful situations. Another randomized controlled trial involving officer use of adaptive coping and relaxation techniques during critical incidents found that treated officers were four times more likely to have improved scores in a post-intervention health assessment survey.
A study examining the impact of 13-hour shifts compared to 10-hour shifts on a host of performance measures found that the longer shifts resulted in significant reductions in the officers’ quality of sleep, concentration, cognitive processing, and quality of life, along with significant increases in fatigue, daytime dysfunction due to sleepiness, reaction time, anticipatory errors, and the number of received complaints.
Individual counseling and therapy have not been rigorously evaluated among police but show promising benefits in the military and the general population. One study involving active duty military service members found that cognitive behavioral therapy (CBT) reduced suicide attempts by 60% compared to soldiers treated with non-CBT psychotherapy approaches. In addition, a study of trauma-focused CBT in the general population found that 73% to 77% of treated patients recovered from PTSD, compared to just 7% in the control group. A newer form of wellness program equips officers with biometric bracelets, which can measure a host of physiological-related metrics and inform the officers if they should pursue a more in-depth physical examination with their doctors. Physiological markers of stress emerge when stressful events trigger reactions in multiple systems of the body. This includes cardiovascular (elevated heart rate, changes in heart rate variability, and increased blood pressure), neuroendocrine (elevated levels of cortisol or adrenaline, and noradrenaline), and immune responses. Such biomarkers are critical to research, as they provide a more objective way to study stress and its impacts on cognitive and physical functioning than data reliant on self-reporting. Recognizing these benefits, researchers have begun using these devices to study real-time physiological stress in police officers and are beginning to produce valuable insight into the specific situations that are likely to induce stress, and ways to reduce it.
Randomized controlled trial studies have demonstrated the benefits of resiliency and self-regulation training on reduced stress and depression and improvements in perceived wellness and the ability to cope with stressful situations.
Finally, early intervention systems (EIS) can be a starting point to help agencies identify officers who may be on a trajectory of a major adverse event as a result of poor mental health. The Task Force on Policing’s policy assessment on EISs provides more details about the benefits, challenges, and impacts associated with such programs. A wide array of responses can be used with officers identified from an EIS, ranging from coaching or training to therapy sessions or drug and alcohol treatment. Most EIS models begin with a meeting between the high-risk officer and his or her supervisor to review prior incidents, discuss plans for handling similar situations in the future, and determine if additional services are needed. Such conversations are beneficial because they provide an opportunity for supervisors to learn details about their officers’ lives and mental wellbeing.
Creating a Culture of Officer Wellness
One key challenge confronting agencies seeking to launch wellness programs is convincing officers to participate in them. Departmental culture can greatly influence an officer’s willingness to join a wellness program, as the “tough persona” character of many police agencies often ties help-seeking to weakness, stigmatizing officers who seek assistance. Officers have reported feeling reluctant to ask for help because they feared they would be perceived as weak, stigmatized, ridiculed, ignored by their department, or forced to face job-related consequences for disclosing mental health problems. These sentiments can negatively affect the successful implementation of wellness programs. One program that can help agencies overcome this challenge is the Road to Mental Readiness program used in Canadian police departments. The program addresses stigma, barriers to care, mental health in the workplace, comprehension of stress responses, the mental health continuum model, and resilience skills (goal-setting, visualization, self-talk, and tactical breathing). Its goals are to increase officers’ understanding of their mental health, reduce stigma associated with mental health issues, reduce symptoms of poor mental health, enhance resilience, and help police executives and supervisors better recognize and provide support to officers in need of assistance. Evaluations of this type of program have found small short-term effects on reducing stigma and increasing resiliency. The reviews also emphasize the need for repeated interventions that take place across a department over time. Many law enforcement agencies have implemented peer support programs to help reduce both the fear and reality of stigma among help-seeking officers. Peer-to-peer models often rely on counselor helplines with current or retired officers who can speak from a position of experience, or full-time professional counselors knowledgeable about the stressors associated with police life. Such counselors are trained by mental health professionals to actively listen, counsel, and engage in crisis management with officers. One important objective of such support efforts is to assure participating officers that they will not be disciplined, taken off duty, or viewed as weak or unfit for duty by their superiors. While peer support programs appear promising, there is a lack of rigorous research examining the impact such programs may have on mental health and wellness outcomes.
Critical Policy Elements
- While research points to the value of agencies investing in officer wellness programs, particularly those addressing mental health issues, challenges remain in scaling up such interventions to align with and meet the needs of officers who would most benefit from them.
- Absent additional research on the effectiveness of officer wellness programs, law enforcement agencies should provide a diverse array of choices, including individual counseling, therapy sessions, resilience trainings, and cognitive behavioral therapy.
- Wellness programs should be designed to be preventive rather than punitive. Departments should aim to reduce stigma associated with such programs and create a culture of support for officers in need.
- In cases of suicide, law enforcement agencies should conduct a psychological autopsy to understand the personal and organizational factors that may have led an officer to take his life, and identify appropriate strategies to mitigate such issues among other staff.
- Law enforcement agencies should identify officers with mental health issues as early as possible in order to provide them with appropriate treatment and services; flagging officers in need of support can be facilitated through the use of early intervention systems.
• Agencies should also look at their own internal dynamics and make necessary adjustments to ensure that departmental culture, communications, and practices are not contributing to officer stress.
Expected Impacts
Preventing Misuse of Force
Research suggests a link between officers exposed to trauma or experiencing PTSD and higher rates of excessive force and domestic violence by such officers. Programs that address trauma experienced by officers may prevent use of force, but more research is needed to confirm this relationship.
Enhancing Transparency and Accountability
Officer wellness programs are generally intended to improve officers’ physical and mental health to promote their well-being and performance on the job. These programs are primarily designed as supportive rather than punitive interventions, so they are unlikely to enhance accountability for incidents of misconduct that may be related to an officer’s health. However, the public release of data showing the number and proportion of officers participating in wellness programs could enhance transparency.
Strengthening Community Trust
Longer shifts are associated with higher rates of formal complaints, suggesting that wellness programs that are combined with efforts to reduce shift hours could improve officer performance, reducing public complaints and strengthening community trust in the police.
Reducing Racial Disparities
There is no research indicating the degree to which officer wellness programs reduce racial disparities in policing practices or outcomes for members of the public. However, one study linked sleep deprivation to a greater tendency for officers to act on their implicit biases, suggesting that improving officer wellness associated with sufficient sleep could have a positive impact.
Ensuring Officer Safety
No research has established a direct relationship between officer wellness programs and specific metrics of officer safety, but one study found that officers with poor sleep quality had a greater likelihood of on-duty injury. This suggests that wellness programs that promote good sleep habits could promote officer safety.
Promoting Public Safety
Despite a growing body of evidence documenting the benefits of mental health programs for police officers, officer wellness programs have not been evaluated for their impacts on public safety outcomes.
