Part 1 Literature Review / Part 2 Propose the Method for your original research

Mandatory Mental Health Counseling for Law Enforcement Officers Exposed to Trauma

John Bertang

Webster University

COUN 5850: Research and Program Evaluation (Section OB)

March 6, 2020

Abstract

There is limited research in the area of mandatory mental health counseling for law enforcement officers who experience trauma. The culture of the profession breeds autonomy and problem solving. Asking for help is considered a sign of weakness and may perpetuate the stigma surrounding mental health assistance. This quantitative research study will attempt to determine if mandatory counseling for law enforcement officers will have a positive impact on their mental well-being, and if the stigmatization of mental health counseling is reduced through the experience of participating in counseling. This research proposal intends to survey certified police officers at a police department in a small Southern coastal city of approximately 34,000 residents. At the beginning of the 18-month study the law enforcement officers who volunteer to participate will take a survey giving self-reported responses pertaining to mental health, stigmatization, and trauma that is experienced on-duty. According to department policy, all officers who experience traumatic situations will be required to meet with the department-hired mental health professional for two counseling sessions. Upon completion, officers who are participating in the research will be offered a follow-up survey to assess the impact of the counseling on their well-being and their current feelings about the perceived stigmatization of mental health counseling. This research will compare responses from the first survey to the information collected in the second survey for those officers who participate. There are several limitations to this study including that this author is an officer employed by the agency being studied. The researcher hopes the information gathered will be able to be generalized to other law enforcement agencies and emergency service employees who experience similar traumatic experiences.

Keywords: law enforcement, mental health counseling, mandatory, trauma, well-being

Introduction

The law enforcement community faces inherently dangerous situations daily. The profession is deeply rooted in confronting traumatic situations (Landers et al., 2019). Although exposure to trauma may be considered an accepted and acknowledged hazard of the job, it is readily apparent that the negative effects of stress and trauma are having detrimental effects on officers. It is normal to experience stress in everyday life. In fact, stress can be beneficial in certain situations (Keaton, 2017) which may allow officers to perform better, create a sense of urgency to complete a project or task, act as a source of motivation, or focus more intently on the issue at hand. When stress or traumatic situations create impairment in daily functioning it should become the catalyst to seek ways to reduce, minimize, or eliminate the damaging effects it can have on the officer and the devastating wake it can create in the aftermath.

The psychosocial working environment of officers exposes them to violence, repeated confrontation, death, human suffering, and other traumatic situations which, in turn, create a thriving opportunity for them to have elevated risks of psychological problems and developmental physical issues (Price, 2017). Chopko et al. (2015) found that the severity of traumatic situations, combined with the frequency of these adverse conditions, is believed to spawn mental health issues. Additionally, because of the nature of police work, officers never know what the next call will be or when a situation will turn out badly. Because of the lack of control over the environment and the nature of potentially traumatic calls for service, stress levels remain elevated above most other professions (Landers et al., 2019).

Statement of the Problem

While it is evident that officers face frequent danger compared to the experiences of the general population, it is imperative to look at various ways to address the negative mental health outcomes as a result of performing the duties of the profession. Officers pride themselves in helping others, which is in direct conflict to asking others for help (Tsai et al., 2018). This barrier, combined with the perceived stigma of receiving mental health treatment, further impedes the officer from receiving the assistance they desperately need.

Purpose of the Research

The purpose of this research is to identify issues, offer solutions, and implement programs to mitigate this workplace deficiency in law enforcement. The ultimate purpose is to provide officers with mental health counseling after a traumatic incident and to begin lifting the stigma of this counseling.

This research is important because trauma and stress experienced by police are generally similar regardless of the department or region. Officers are regular people—members of the community. Knowing the inherent dangers and the frequency with which they will encounter crisis situations, it is imperative to examine various ways to promote and protect the mental health of our nation’s frontline heroes. The President’s Task Force on 21st Century Policing (2015) noted that the physical and mental wellness of officers is critical to effectively serving the community. Trauma can breed aggression and impulsivity in officers as they perform their duties; it can also cause a delay in action or cause them to act inappropriately in a given circumstance (Price, 2017). Trust is the cornerstone of community policing; therefore officers must be mentally healthy or the ties and bridges that have been built in the community can rapidly erode.

Statistics overwhelmingly support the fact that mental health in law enforcement may be nearing a critical juncture. Officers commit suicide while at work at a rate of 3.5 times that of any other profession (Tiesman et al., 2015). While most officers’ greatest fear is to be shot and killed by a suspect, The President’s Task Force on 21st Century Policing (2015) found that officers are 2.4 times more likely to commit suicide than be killed by homicide. It appears that officers are not addressing the reality that mental health may play a more significant role in their career and life.

Social Significance of Study

The social significance of this research extends well beyond the scope of local law enforcement in this author’s region. Grassi et al. (2019) conducted a 22-year study of suicide rates of Italian police officers, which revealed a higher rate than the general population. The findings from law enforcement across the globe can even translate to similar findings in the United States military. Stanley et al. (2019) found that suicide rates in the various branches of the military are elevated. The stresses and traumatic issues that law enforcement and military communities face appear to have a common thread with negative outcomes.

Although the significance of mental disorders in law enforcement is amplified compared to the general population, there is a universal stigma associated with counseling and mental health. Officers believe they would be considered weak or would face job-related consequences (Thoen et al., 2019) if they were to ask for help. Officers take pride in being autonomous, courageous, and problem solvers; this contrasts with seeking professional mental health assistance and basically admitting that they can’t handle the challenges and feelings they are experiencing.

When officers have mental health issues as a result of traumatic experiences, they may experience a decline in future work performance (Landers et al., 2019). Post-traumatic stress disorder (PTSD) has a prevalence rate of 3.5% in American adults (American Psychiatric Association, 2013), yet it is believed to be as much as 4 times higher in law enforcement (Bell & Eski, 2015). PTSD can result from a single event or prolonged exposure to the negative aspects of the job (Boothroyd et al., 2019). It is clear to see that a profession charged with addressing some of the worst that humanity offers has a negative outlook concerning mental health.

Perhaps even more problematic, the spouses and partners of officers are often caught in the crossfire of this mental health conundrum. The intentional career path of an officer often has unintentional consequences for those with whom they live. Those who suffer from mental disorders can’t help but affect those who love them. This is no different than a family member living with someone who has a drug or alcohol addiction. The effects can be acute and result in a gradual degradation throughout the course of a relationship or lifetime. Chopko et al. (2015) noted that police work has a detrimental influence on officers’ spouses. They also found that secondary traumatic stress that spouses experience impacts negatively, presents in various forms of unhealthy coping methods, and eventually deteriorates the family relationship. While getting officers to realize they need mental health assistance is difficult, offering assistance to their spouses has proved to be an even greater obstacle. The ripple effects of mental health are far-reaching.

The problem of mental health in law enforcement is multi-faceted. There is a lack of studies examining mental heath in the law enforcement profession (Kyron et al., 2019). There is an above average number of worker compensation and other mental health claims (Gray & Collie, 2017). The side effects and lethality of officers with mental disorders as a result of traumatic events are devastating (Kyron et al., 2019). Because of the perceived stigma, however, the topic of counseling and other psychological services is easy to brush off and defer back to the officer’s reluctance to seek assistance. As law enforcement budgets dwindle and the general demands increase, the focus is usually on acquiring more officers and getting the equipment and tools to handle the job. The focus is not on spending money to train how to identify, reduce, and handle mental health issues.

Darley and Latane (1968) conducted research, the finding of which is widely known as the bystander effect. Accordingly, the law enforcement profession realizes there is a problem, yet little is done to ameliorate the problem. Addressing mental health appears to be everyone’s problem but no specific person’s or agency’s problem to fix. The prevailing mentality is to diffuse or overlook the problem.

Knowing the effects that PTSD and exposure to traumatic incidents have on officers, coupled with officers’ reluctance to seek help, make this research practical, imperative, and personal. One cannot help but ponder how the murders, sexual assaults, mangled bodies from collision, robberies, and child abuse cases affect the psyche, relationships, and other long-term biophysical factors of police officers.

This study will identify and allocate resources to address critical incidents and various situations where officers are required to obtain mental health counseling. Educating officers during pre-service and in-service training will allow them to become more knowledgeable about the topic. Addressing mental health issues on an individual and personal level may also help the program gain traction and allow buy-in to the urgency of mental well-being. By creating written policies, there will be a well-defined protocol that makes counseling mandatory, reiterates confidentiality, and provides the gateway to further resources if needed. As officers become more aware of the impact that their chosen career has had on them, they may consider the ripple effect that executing their job-related duties has on their spouses and family life. As education increases and it becomes painstakingly obvious that these efforts should have been implemented a long time ago, it is believed that this study will spawn more resources dedicated to the mental health and well-being of officers. By addressing deficiencies and capitalizing on personal and professional development, it is believed that the collective service provided to the community by the officers charged with this awesome responsibility will improve. The far-reaching effects of positive mental health (Chopko et al., 2015) may extend to the officer’s home, spouse, children, church, and beyond.

Research Question and Hypotheses

For the purpose of this study, the following research question will be addressed:

What is the impact of mandatory mental health counseling for law enforcement officers who have experienced a traumatic event?

This research study has two directional hypotheses:

1. Mandatory mental health counseling will reduce the stigma of mental health counseling in law enforcement officers who have experienced a traumatic event.

2. Mandatory mental health counseling will have a positive impact on the mental well-being of law enforcement officers who have experienced a traumatic event.

Definition of Key Terms:

1. Officer – A certified Class I Police Officer, with full arrest powers (Swindler, 2018). For purposes of this study, ‘officer’ will include anyone who is certified as a law enforcement officer in the state and who is employed by the local police department.

2. Traumatic event – A shocking or dangerous experience from which the effects can include disruptions to a person’s physical and emotional well-being (National Institute of Mental Health, n.d.). For purposes of this study, qualifying traumatic events will include being involved in a shooting, being severely injured during the performance of duties, severely harming another person while in the performance of police duties, witnessing severe child injury or death, prolonged exposure to mass casualty events, working extraordinary events for an extended period of time, such as the aftermath of a hurricane, or anything else that may be deemed traumatic by the Chief of Police.

3. Post-Traumatic Stress Disorder (PTSD) – The full description of PTSD is outlined in the Diagnostic and Statistical Manual of Mental Disorders (5th edition; DSM-5) of the American Psychiatric Association’s 2013 publication. For brevity and purposes of this research, PTSD will include “Exposure to actual or threatened death, serious injury, or sexual violence…, [singly or] repeated or extreme exposure…, with intrusive symptoms” (p. 271) as a result of an on-duty incident or encounter.

4. Mental Health Counseling – Officers who fit the criteria to receive mandatory services as a result of a traumatic event will receive at least two sessions of mental health counseling by the professional identified and recognized by the city government to administer the services. An initial session and follow-up session are required to assess and reevaluate the officer to determine if more treatment or other services may be required. It is recommended that at least one to two weeks pass before the follow-up session unless the officer or counselor deem otherwise.

5. Mental Well-Being – While this term may be subjective, an officer’s mental well-being may be assessed based on a number of things including how they perceive they are doing or coping, how the counselor perceives the officer is processing and handling the incident, and the degree to which both are reasonably sure that the officer is fit-for-duty in light of the job they are expected to perform. Ultimately, officers must be able to carry out their assigned job duties, not be a threat to self or anyone else, and maintain proficiency qualifications as it pertains to their profession—especially with their firearm and other tools of the trade.

Literature Review

There is little research to detail the effectiveness of proactive and preventative programs as it relates to law enforcement and mental well-being (Kuhns et al., 2015). The President’s Task Force on 21st Century Policing (2015) identifies mental health as a pillar of officer effectiveness and urges researchers to explore and evaluate better ways to address related programs. Policing is dangerous work. The International Association of Chiefs of Police notes that the on-the-job fatality rate is almost 5 times higher than that of the general population (2018). Psychological assistance is just one of the many programs and services that can be effective in addressing stress and traumatic incidents (Chopko et al., 2015). General media broadcasts often highlight officers handling stressful situations but rarely follow up with the aftermath and psychological damage that may occur. Examples include investigating child homicides or being involved in a shooting. Major traumatic events such as working at the World Trade Center on or around September 11th (Zvolensky et al., 2015) or policing the aftermaths of natural disasters (Galovski et al., 2016) has a major impact on the psychological well-being of officers. As the types and frequency of traumatic events increase, the likelihood of negative effects of mental issues of officers will increase. A common trend of corporations is to do more with less—policing is no different. There must be a breaking point and call to action to address, treat, and manage mental health.

Suicide and mental health issues continue to be of concern in the law enforcement community. While it seems obvious that stress and mental health can break down and do damage to a personal and professional life, there appears to be a hodge-podge approach for an evidence-based application of standardized methods to address officers who experience traumatic situations or are feeling the side effects of prolonged exposure to adverse and depressing conditions. Moreover, there does not appear to be an awareness of programs or a priority for implementation in the diverse law enforcement agencies across our nation. Research shows that the size does matter when it comes to the resources, programs, and training offered on the topic of mental health (Thoen at al., 2019).

A thorough literature review has reinforced the belief that little research or information exists about this sensitive yet critical topic. The few studies that have been done generally conclude that policing can have negative effects on mental health (Price, 2017), the stigma surrounding mental health and treatment remains a major barrier (White et al., 2016), and treatment can be beneficial (Christopher et al., 2016) if agencies and administrations take an active stance on mental wellness of its officers (White et al., 2016).

The following thematic approach to this literature review will examine the larger-scale problems that stress and trauma elicit. Traumatic events that stimulate or trigger mental health issues impact more than the officers directly involved. The ripple effect spreads to others who are close to the affected officer. The challenges that an officer must overcome are significant, but the breadth and depth of the problem is far greater.

This literature review will also cover the stigma associated with mental health treatment but will conclude with evidenced-based solutions as well as offering various approaches that an agency can take to be proactive and stay ahead of the mental health curve. While there does not appear to be a one-size-fits all solution, the collective research points in the direction that options and effective solutions are available.

Macro Issues of Stress and Trauma

According to Kerswell et al. (2019), law enforcement officers’ frequent exposure to PTEs (Potentially Traumatic Events) increases their chance of developing PTSD. Bell and Eski (2015) recognized that officers are 4 times more likely to suffer from PTSD compared to the general population. This appears to lend further credibility to the American Psychiatric Association’s (2013) claim that “Rates of PTSD are higher among veterans and others whose vocation increases the risk of traumatic exposure (e.g., police…)” (p. 276). It seems that officers are almost destined to suffer from PTSD if they remain in their profession long enough. The daily nature of an officer’s duties allows them to be in a prime position to have frequent exposure to incidents that can singly or ultimately have an adverse effect on their mental health and well-being.

A study that surveyed emergency service employees—including police—found that the vast majority reported that stressful and traumatic events ‘deeply affected’ them (Kyron et al, 2019). While symptoms and presentations of the residual effects of these incidents may vary, Bowe and Rosenheck (2015) found that short- and long-term effects from exposure to stress and trauma are likely and are associated with increased prevalence of substance use disorder. A mental health disorder that is comorbid with a substance use disorder may only complicate the challenges of seeking help, overcoming the disorders, and getting back to pre-illness normalcy.

Ancillary effects of mental health issues can ripple through an organization and have far-reaching implications. The prevalence of injury, both physically and mentally, from the law enforcement profession has yielded above-average worker compensation claims compared to other professions (Gray & Collie, 2017). A separate study by Price (2017) found that 46% of Worcester, MA officers were out on disability or retirement as a result of psychological issues due to stress and/or trauma. These staggering numbers can lead to staffing shortages, a decline in morale, and a financial strain on the systems that fund these programs. While it is difficult to tell if some officers are abusing the system, the statistics scream that more needs to be done to analyze and address the problems of stress and trauma to correct or lessen psychological issues and the complications surrounding the issues.

Soomro and Yanos (2018) conducted research and found a link between mental health and officers. Because of the work that officers do, stress and trauma was reported by 82% of respondents. More importantly, 12% of the respondents exceeded the clinical standards for having PTSD. The Federal Bureau of Investigations Uniform Crime Report revealed that there were over 900,000 law enforcement officers employed in the United States in 2018. If the Soomro and Yanos 2018 study was representative of the entire law enforcement population, it would translate into over 108,000 officers having clinical symptoms of PTSD. Officers carry weapons and are charged with making split-second decisions. Having PTSD and engaging in these daily scenarios is a recipe for disaster.

The Effects of Mental Health

The Diagnostic and Statistical Manual of Mental Disorders (5th edition; DSM-5), published by the American Psychiatric Association (2013), exhaustingly details the adverse effects that mental health disorders can wreak on a person. The physical, mental, and emotional toll that an individual can succumb to can be life altering or deadly. At the very least, stress and trauma can leave an officer with feelings of fatigue, a decreased libido, and increased alcohol usage; at its worst it can leave domestic violence, homicide, or suicide in its wake (Keaton, 2017). While there can be a wide variety of effects, it is clear that they are generally negative and detrimental to the overall health and well-being of the officer.

Officer Issues

Thoen et al. (2019) highlighted that officers feared asking for assistance with mental health related issues. Officers felt they would be stigmatized, viewed as weak by other officers, and may be required to succumb to various job-related consequences for reporting their problems. Having a gun and a badge is symbolic of the profession. It would not be uncommon for an agency to require an officer to surrender their weapon while seeking professional psychological help. If the officer may be a danger to self or others, either at work or at home, agencies normally operate out of an abundance of caution and seize the officer’s duty-issued weapon to reduce or limit liability. The officer will reacquire their weapon only when they are deemed ready, which may take weeks or months. This can add further psychological stress to an already overwhelmed officer.

Family Issues

A common motto of a police agency may be to serve and protect. While that may be the mission of each officer while on-duty, the home and off-duty lives of the officer may dramatically suffer because of the baggage that a mental disorder allows. Price (2017) writes about the diminished emotional and cognitive functioning that stress and trauma can cause. It has been demonstrated that there are many adverse effects to officers who choose the profession of law enforcement. However, the spouses and children are often the silent secondary victims (Landers et al., 2019). They often bear the brunt of the wounded officer as a result of experiencing a traumatic event.

After a traumatic incident, officers often call their spouses or family to let them know what happened or to tell them they are ‘okay’ at the very least (Landers et al., 2019). Following a traumatic incident, it is typical for a person to act differently, physically and mentally, because they may be attempting to process an abnormal event. Landers et al. (2019) conducted research to find the extent of vicarious or secondary trauma experienced by the spouses and family members of officers who experienced trauma. The results were staggering. When officers were exposed to trauma, it often deeply impacted their home and personal lives. Landers et al. (2019) noted that although there are not enough resources for officers who experience trauma, there are even less resources for the spouses and family members who are impacted. This may further cause a breakdown of the family unit and lead to separation or divorce.

The Stigma of Mental Health Counseling

Boulos and Zamorski (2015) found that the stigma attached to receiving professional help often causes additional problems and intensifies symptoms due to delayed treatment and intervention. Officers may fear job-related repercussions because of seeking mental health treatment (White et al., 2016). Furthermore, White et al. (2016) postulated that officers have a warrior mentality; they consider it a weakness to ask for help and often may ignore their problems or attempt to cope on their own. Research also shows that officers stigmatize their own mental health problems, partly due to the fact that they often negatively perceive and stereotype civilians who have mental problems (Karaffa & Koch, 2016). This may perpetuate officers’ maladaptive thinking that they can cope with their problems or that the issues will resolve themselves (Heffren & Hausdorf, 2016). This can result in negative coping. The law enforcement profession has already been identified as a career with a high risk of alcohol use disorder (Price, 2017) among other adverse coping behaviors.

Interestingly, Harvey et al. (2016) found that the more years of service an officer had on duty the greater the exposure to stress and traumatic events. Because officers are generally loyal, they may feel more pressure to avoid help the longer they remain on the job. This inverse relationship between years of service and decreasing desire or likelihood to ask for assistance can be highly detrimental to an officer’s psyche. The President’s Task Force on 21st Century Policing (2015) was clear when stating that the police culture is highly prohibitive of seeking and obtaining mental health assistance. The necessity of seeking help for a high-probability illness in a culture that shuns weakness allows the negative stereotypes and stigmas of mental health to thrive. The cycle must be broken. Interventions are necessary to create an environment of openness, acceptance, and sharing.

Positive Outlooks for Mental Health

Ramchand et al. (2018) discovered that there were a limited number of preventative programs to assist with issues such as suicide prevention in the law enforcement field. Additionally, they noted the lack of urgency and funding priority to address these issues. A survey of the literature did, in fact, show glimmers of hope in identifying evidence-based therapy and some insistences of continued research in officer-wellness and coping with traumatic events.

When large-scale adverse events occur, such as natural disasters or significant events, research shows that law enforcement agencies must identify officers who may be suffering from mental health issues as a result of being exposed to the traumatic events (Howlett & Stein, 2016; Qi et al., 2016). The evidence revealed that a significant percentage of officers are likely to have adverse mental health effects and will require intervention to help with coping and processing. Thoen et al. (2019) surveyed police agencies and found that there is a direct correlation between the size of the agency and the amount of support that is offered for mental health. The article identified some of the various ways that support could manifest—Employee Assistance Programs (EAPs), peer support groups, wellness training, critical incident stress management, crisis intervention teams, training programs, suicide prevention programs, chaplaincy, physical fitness programs, internal and external psychological services, crisis help lines, reading materials, and online resources. Obviously, the more resources and programs that are available, the greater the likelihood they will be utilized, because they may appeal to the specific needs of what the officer is experiencing. A significant factor in receiving mental health assistance is the perception that officers feel supported (Price, 2017) based on the types and qualities of the programs. Effective programs may produce effective results.

Effective Solutions

While there are varying forms of treatments to assist officers who have been exposed to traumatic situations, several appear to stand out. Trauma-focused cognitive behavioral therapy (TF-CBT) has proven to be effective in addressing people who have PTSD symptoms (Cusack et al., 2016). CBT is one of the most commonly used and accepted forms of therapy. By narrowing the therapy to address the special and unique characteristics of trauma, officers can overcome their maladaptive thinking and begin the healing process.

Boothroyd et al. (2019) evaluated a program called Operation Restore in which first responders who experienced traumatic situations were selected to participate in a multi-day program. This intervention allowed officers to share their feelings, identify with others in similar situations, and allowed them to better process their experiences. It also allowed them to better understand what they went through and see that there are positive ways to address and cope with their problems. The program boasts that 92% of the participants reported they experienced positive growth as a result of their participation in the activities associated with the program.

Finally, Christopher et al. (2016) conducted a study and found that mindfulness-based resiliency training (MBRT) proved to have positive results by allowing officers to better cope with the high pressures, demands, and mental challenges of policing. By investing in the officers and taking preventative measures, officers were given tools to more effectively deal with issues they will surely face as they progress in their careers. Improvements in resiliency, stress reduction, and family functioning were just some of the many benefits of MBRT.

Positive Agency Stance

While the capacity and resources that an agency can offer to address mental health varies (Boothroyd et al., 2019), agencies can take a proactive stance and invest in their officers. Price (2017) discussed various ways that agencies can alter their work environment to limit stress and reduce the long-term mental disorders associated with the profession. Pinals and Price (2010) discussed how agencies can mandate that professional mental health services be provided when officers experience traumatic events. They further stated that by making it mandatory, the stigma and reluctance of asking for help would be reduced or eliminated.

Agencies should have a plan, written policies, and programs that address the needs of the mental well-being of the officers. Thoen et al. (2019) found that most agencies do not have these in place or they are lacking in the potential of available services. By offering timely and effective treatment, the benefits of mental health counseling are more likely to be realized (Boothroyd et al., 2019). Officers will perceive that the agency genuinely cares about them and the issues that they are facing. While there does not seem to be a one-size-fits-all approach, agencies can evaluate what is most feasible considering the challenges and issues they are likely to face. If the agency takes a proactive stance in promoting the well-being of its officers, it can start lifting the veil of secrecy and stigmatization of mental health counseling.

Conclusion

It is evident there is relatively little research in this area considering the propensity of adverse health conditions to which officers are exposed. Traumatic issues and stress have negative impacts on officers throughout our nation and beyond. It is clear that the effects can shatter the personal and professional lives of officers. It also has adverse impacts on family members as evidenced in the secondary trauma reported by officers’ spouses.

The flicker of hope is that there is a plethora of programs and proactive approaches that agencies can take to support officers and provide the infrastructure to avoid the problems associated with trauma and stress. Moreover, knowing that officers will be exposed to unforeseen events, the programs and support systems can be in place to lessen the blow and provide the mental health assistance that is desperately needed. Research has shown that this can be done in a way that reduces the stigma and can allow officers to thrive and rise out of the gloom of a tragic event. Chopko et al. (2015) found that it is possible for some officers who experience traumatic events to grow and flourish because of positive after-action experiences. They can sometimes be able to use their experiences to help others, be advocates, and be a resource for other officers who experience similar trauma.

The proposed research is especially important because it can help to fill the gap in existing studies by tracking the progress and effectiveness of mandatory counseling after a traumatic event. It is apparent that larger agencies have most of the resources and programs in place because of larger budgets and opportunities. This author is currently employed by a small to medium size police agency—under 250 sworn officers—and has a vested interest in laying the foundation for a future of better trained, equipped, and mentally healthy officers to serve the community. The focus of this research is based on this agency, which is somewhat representative of most small to medium-sized departments across the United States. The data and findings from this research can be used to aid other agencies in their goal of improving support for their officers and creating a heathier employee to better serve their community.

Method

It is unmistakable that traumatic experiences can lead to acute and chronic problems if left untreated. Law enforcement officers experience significant traumatic events at a greater frequency than the average person merely because of their occupational duties and hazards. It is necessary to recognize and treat these issues to prevent further harm to the officer, their family, and the community.

While it appears that limited research has been conducted in this area, it is important to pre-plan and implement practices to address the adverse issues that law enforcement experiences. It is readily apparent that there is a stigma associated with having a mental disorder and asking for help, especially from officers who pride themselves on being mentally and physically fit. Therefore, it is imperative that mandatory mental health counseling be initiated to remove or minimize the stigma to allow proper assessment, treatment, and healing to begin. It is also necessary to evaluate that process to determine the effectiveness and impact on the officers and the department.

Research Question and Hypotheses

What is the impact of mandatory mental health counseling for law enforcement officers who have experienced a traumatic event?

The research question was developed based on the critical need to address this serious problem. Additionally, this author has a vested interest in continuing to better the police agency he serves and continue building bridges in the community by providing the best quality officers to serve and protect. The research question is relatively broad yet establishes the foundation for other opportunities and avenues of exploration to help law enforcement officers.

There are two directional hypotheses for this research proposal:

1. Mandatory mental health counseling will reduce the stigma of mental health counseling in law enforcement officers who have experienced a traumatic event.

2. Mandatory mental health counseling will have a positive impact on the mental well-being of law enforcement officers who have experienced a traumatic event

Participants

This research study will be conducted in the Police Department of a small Southern coastal city with a population of approximately 33,000 residents. The participants for this study will be members of the Police Department’s 229 certified Class I officers as recognized by the state’s Criminal Justice Academy. The agency’s size is small enough that all officers who consent to participate can be included to help validate the data. There are various opportunities to include the participants in this research with minimal disruption to their workflow. Allowing all members the opportunity to voluntarily participate will let each officer have direct input into an area that impacts them, their family, their department, and their future.

Including all officers who wish to volunteer will allow the greatest amount of data for future statistical analysis. Officers will be advised that the results of this research will be made available to them at the conclusion of the study. While no direct compensation will be offered for participation in this research, officers who choose to participate will do so while on duty and will be compensated at their normal hourly rate of pay. Declining to participate, for whatever reason, will have no impact on their pay or performance record. Officers may decline to participate for a good reason, bad reason, or no reason at all. They will not be asked why, nor will the topic resurface, with the exception of providing the number of eligible participants who choose to participate or not in the final report and summary of the research. For those who opt to participate in the research, informed consent must be acknowledged and signed prior to completion of the surveys in order for their data to be included in this research process.

Procedures

This author will incorporate information about the research into a 2-hour block of instruction during the mandatory in-service training that each officer is required to attend in the fall of the year. The first 90-minute block will include a face-to-face conversation with the group about mental health, the purpose of this research, and a review of the agency’s policy and support concerning mental health. A power-point presentation will be provided to help gain a better understanding about the national trends and what existing research shows about mental health and trauma as it relates to law enforcement officers. Special emphasis will be placed on ensuring confidentiality, anonymity, and the option to discuss the information further in person or via phone. Details will be outlined to demonstrate how the information will be gathered, stored, and processed. The purpose is to quell an already skeptical population about the stigma and potential embarrassment surrounding therapy. The participants will also receive general education and instruction pertaining to mental health, trauma, and the purpose of the research.

Even though all officers are required to attend the 2-hour block of instruction, they will be informed again that participation in the actual research is voluntary. After the in-service training, officers will be given the opportunity to opt out of the research.

When the information and training session has concluded, a demographic questionnaire and survey will be administered to the officers who choose to participate in the research. The demographic questionnaire will include the officer’s age bracket, gender, race, marital status, years-of-service, rank, and educational level. Obtaining demographic information will be particularly helpful in identifying strengths, future areas and opportunities for growth, and will assist with identifying trends. The participants will then complete the survey of approximately 25 Likert scale questions. The researcher will give careful attention when developing the questions to ensure they are relevant to the research question and hypotheses. The paper-and-pencil method will be used to eliminate potential questions and concerns about any perceived confidentiality risks from responding electronically on an agency’s computer.

Participants will be advised that this survey is the first step in the research project. The research will conclude at the end of 18 months. During the period of time between the first survey and the conclusion of the research at the end of 18 months, each officer who experiences a traumatic situation, as defined in the research, will be required to receive mandatory mental health counseling for a minimum of 2 sessions, per departmental policy, with the agency’s recently hired and designated mental health counselor. This author and the department’s mental health counselor will collaborate prior to the onset of the initial training to ensure a mutual understanding of purpose and intent. To be clear, the mandatory counseling required by the department will apply to all officers who experience a traumatic situation, whether or not they are participating in the research. These officers, however, will not complete the demographic questionnaire or surveys.

Upon termination of counseling, officers who are participants in the research will have the opportunity to continue in the study by participating in a second survey similar to the first one they took at the beginning of the research. Obviously, there will be some participants who do not experience a traumatic situation within the 18-month period, so they will not be able to complete the study. The follow-up survey will focus on the officer’s perception of mental health counseling after the traumatic experience, their experiences, helpfulness of therapy, and other related questions to assist in addressing the research question.

Instrumentation Both of the surveys and the demographic questionnaire will be paper-and-pencil. Officers who choose to participate in the research will complete the demographic questionnaire and first survey at the end of the block of in-service instruction. They will then place their questionnaire and survey into a secure folder with those of the other participants. Anonymity will be maintained by having a unique identifying number for each officer, which will be associated with that officer’s demographic questionnaire and two surveys. The anonymous information from the second surveys that officers provide will be pooled with the demographic information questionnaire and initial surveys. The intent is to use the data from the two surveys and demographic questionnaire to address the research question and hypotheses and to look for any correlations, and trends to better assist and guide the officers and the agency in the future.

The demographic survey will include questions related to age bracket, gender, race, marital status, years of service, rank, and educational level. This questionnaire will also inquire if the officer has ever participated in counseling services, experienced traumatic situations off-duty, and/or experienced traumatic situations on-duty. Aside from the demographic questionnaire, all survey items will be answered based on a 5-point Likert scale. Consideration will be given to make the surveys as reliable and valid as possible. Because the survey questions are brief and accessible, the likelihood of participation and completion is thought to be high.

Some examples of the questions to be developed for the two surveys are as follows:

Survey #1: Sample Questions (Taken by participants at the beginning of the study)

1 = Strongly Agree 2 = Agree 3 = Neutral 4 = Disagree 5 = Strongly Disagree

1. I believe counseling may be beneficial.

2. I believe there is a negative stigma associated with counseling.

3. I believe I should be required to attend mandatory counseling after experiencing a traumatic event.

4. I have recommended counseling services to others.

Survey #2: Sample Questions (Taken by participants after conclusion of mandatory counseling)

1 = Strongly Agree 2 = Agree 3 = Neutral 4 = Disagree 5 = Strongly Disagree

1. I believe there is a negative stigma associated with counseling.

2. I believe talking to a counselor has helped me process this traumatic experience better than if I had not participated in counseling.

3. I believe I have learned coping skills to help me deal with this traumatic experience.

4. I would recommend counseling to others.

The data from the two surveys will allow the researcher to determine if each hypothesis can be supported or not supported. Does mandatory counseling for law enforcement officers who have experienced a traumatic event reduce the stigma of mental health counseling? Does it improve the overall mental well-being of officers? In addition, the data from the demographic questionnaire is highly important because potential statistically significant correlations between the outcome of the first and second surveys may be used to highlight which populations or subgroups may respond favorably to the counseling and which do not. It may also reveal clues as to what practices to continue and what to adjust, such as increasing or decreasing the number of mandatory sessions. The demographic information may also expose groups that are underrepresented and may require a different approach to allow them to respond favorably and receive meaningful assistance after a traumatic experience.

In summary, all officers will be provided the opportunity to take part in a demographic questionnaire and an initial survey assessing their feelings and beliefs about mental health counseling. When and if they experience a traumatic situation, departmental policy dictates they receive mental health counseling. Upon conclusion of the counseling, they will be offered a second survey, which will focus on their experience, how mandatory mental health counseling has impacted them, and their feelings about the stigma of mental health counseling.

Variables

The independent variable is the mandatory counseling after the officer experiences a traumatic event. The dependent variable for the first hypothesis is the set of responses on the survey that relate to the perceived stigma of mental health counseling. The dependent variable for the second hypothesis is the set of responses on the survey that relate to the mental well-being of the officer. Care will be taken to identify extraneous variables that may confound the research outcomes. Examples include demand characteristics and participant variables. These are difficult to control; however, careful instruction during the initial block of training will aim at reducing those effects. Similarly, being deliberate and empathetic during the introduction of the second survey may quell the emergence of unintended variables.

Data Analysis

Considering that the demographic questionnaire uses nominal scales, and the two surveys use ordinal scales (Likert-based), descriptive statistics will be utilized to analyze and compare the information that is received. This will help to further the research and support or not support each hypothesis while attempting to answer the research question. Data will be summarized in table-format for summary and interpretation purposes. Percentages and frequencies of each response will be provided in bar graphs for ease of comprehension and to provide a visual statement of the data and responses. A thorough data analysis will be conducted using an appropriate non-parametric statistical test. A non-parametric rather than a parametric test will be used for the survey responses since ordinal data is not continuous and the distance between consecutive ratings cannot be presumed to be equal. For this reason a normal distribution cannot be assumed, and it is not possible to calculate a mean or standard deviation. The results will hopefully allow the researcher to attempt generalizability of the research to officers in other agencies of various sizes and geographic locations. It will also allow the possibility of transferability of the findings to other settings such as dispatchers, corrections officers, and Class II/III officers.

Limitations

There are several limitations of this study. It may be perceived that experimenter bias exists because this author is a law enforcement officer, employed by the agency being studied, and an avid proponent of mental health counseling as evidenced by his enrollment in the mental health counseling program at Webster University. Officers under this author’s direct supervision and command may feel compelled to participate or be reluctant to truthfully answer in fear of stigmatization, confidentiality-breaches, or perceived retaliation.

Experimental validity may be threatened due to interference from outside threats. The author/researcher may resign, retire, or vacate the research; the counselor hired by the agency may resign or not promote the research; there may be multi-cultural considerations between the counselor and the participants; the theory and techniques utilized by the counselor may be unpopular or ineffective; a bad experience by one of the officers who is mandated to receive counseling may be vocalized and taint other officer’s experiences and participation; officers may be influenced by prior mental health treatment or a preexisting condition of a mental disorder; or a significant major event—hurricane, disaster, or mass shooting—may occur which overwhelms the system and pushes the research to the wayside. The advantages of in-house research may help identify the strengths and limitations that mandatory mental health counseling has on this agency and the officers who are being studied. The results may directly impact the way future practices are handled concerning trauma, mental health, and officer well-being. Conversely, in-house research may limit the generalization to agencies that are significantly smaller or larger than this Police Department. The geographic location, setting, and resources of this agency may also provide unique characteristics and identifiers, which may detract from the similarity of other agencies and their challenges.

Finally, there may be unintended consequences of this research. While counseling is intended to help and heal, officers may cross the threshold of revealing thoughts of suicidal ideation or other issues that require mandatory reporting. Mandatory counseling may also identify issues that deem the officer is not fit-for-duty. This may result in a suspension or termination. When this occurs, it is very difficult to overcome this new stigma and obtain other opportunities in the field of law enforcement.

While this research is limited to certified Class I law enforcement officers, future research should be expanded to include Class II and III officers, dispatchers, correctional officers, firefighters, and others who work in the emergency services field. Research should also be done with various size agencies in rural and urban settings.

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Appendix

Certificate of Completion for Human Subjects Training