High Rates of Mental Health Disorders in Civilian Employees Working in Police Organizations.

Working in a police organization often involves being exposed to potentially traumatic events and stressful circumstances regardless of occupation or rank. Police mental health is a public health concern, but the mental health of civilian employees working in police organizations has been much less studied. The current study aims to compare the frequency of mental health conditions in both police officers and civilians. This was evaluated by measuring mean scores on several mental health screening tools including scales to determine symptom severity for posttraumatic stress disorder (PTSD) with the PTSD Checklist - PCL-5, depression with the Patient Health Questionnaire-9 (PHQ), general anxiety with the Generalized Anxiety Disorder 7-item scale (GAD-7), and alcohol use with the Alcohol Use Disorders Identification Test (AUDIT). The total potential population was 1,225 civilian employees and 3,714 police officers, of which 513 (10%) participated. Of these, 201 (16%) were civilians, and 312 (8%) were police officers (p<0.001). In the study population, 26% screened positive for any mental health disorder. Somewhat surprisingly, we found significantly more civilians (32.8%) than police officers (22.7%) met diagnostic criteria. We also found that civilian participants had higher mean scores in measures of PTSD, anxiety, and depression, although only for depression did this reach statistical significance. Civilians were 1.7 times more likely to screen positive for depression compared to police officers, a statistically significant difference. In contrast, police officers demonstrated statistically higher scores for alcohol use than civilians. One limitation of this study is that the data reflects responses from only a minority of the overall population and, therefore, may not accurately reflect the frequency of mental health issues in the total police organization including civilian employees. Nonetheless, the results strongly suggest that the mental health of all employees can be negatively impacted by working in a police environment, and this is important given the growing number of civilians employed within police organizations. These findings support initiatives aimed at destigmatizing mental health disorders, improving stress management, and increasing access to mental health care on an organization-wide basis, and not just limited to front-line police officers.

Police use of handcuffs in the homeless population leads to long-term negative attitudes within this group.

The police interact with homeless individuals frequently. However, there has been relatively little research on the attitudes of homeless individuals towards the police, and how police interactions may impact these. This is important since the attitudes of homeless individuals can impact how often they report crimes, and how well they support police when they are investigating crimes in this population. We interviewed 213 homeless individuals in a single city, representing approximately 10% of the total homeless population. They were interviewed at either homeless shelters, or events held specifically for the homeless population. Of these individuals, 75% were male, and 47% had interacted with a police officer within the past month. Self-reports suggested that 60% had a drug and/or alcohol issue and 78% had a mental illness. We found a highly statistically significant difference between the group that had been handcuffed and/or arrested compared to those that had not. This was across multiple domains and included how the individual regarded the police in terms of their empathy and communication skills, and how much they trusted the police. These changes were long-term, and if a homeless individual had been arrested or handcuffed (and verbal reporting suggested that being handcuffed was the by far the most important factor) then these negative attitudes lasted at least 2 years. The primary conclusion from this study is that when police handcuff a homeless individual, this can lead to long-term negative views about the police across several domains that appear to be long lasting, and were linked to feelings of not being respected by the police. It is therefore proposed that police officers should be made aware of the potential long-term negative consequences of this single action, and that police forces should consider providing specific training to minimize any unnecessary overuse of handcuffs.

How to Improve Interactions between Police and the Mentally Ill.

There have been repeated instances of police forces having violent, sometimes fatal, interactions with individuals with mental illness. Police forces are frequently first responders to those with mental illness. Despite this, training police in how to best interact with individuals who have a mental illness has been poorly studied. The present article reviews the literature examining mental illness training programs delivered to law-enforcement officers. Some of the key findings are the benefits of training utilizing realistic "hands-on" scenarios, which focus primarily on verbal and non-verbal communication, increasing empathy, and de-escalation strategies. Current issues in training police officers are firstly the tendency for organizations to provide training without proper outcome measures of effectiveness, secondly the focus of training is on changing attitudes although there is little evidence to demonstrate this relates to behavioral change, and thirdly the belief that a mental health training program given on a single occasion is sufficient to improve interactions over the longer-term. Future police training needs to address these issues.

A novel approach to training police officers to interact with individuals who may have a psychiatric disorder.

Police and law enforcement providers frequently come in contact with individuals who have psychiatric disorders. Repeated studies suggest that greater understanding of psychiatric conditions by police officers would be beneficial. However, few training approaches have been examined. We present a novel approach to training police officers to interact with those who may have a psychiatric disorder. This approach involved development of a program in which police officers interacted with actors highly trained to present one of six realistic psychiatric scenarios. Confidential feedback was given, both by experienced police officers and by the actors, to improve awareness of the officers' behavior. Qualitative feedback from both officers and actors was used to determine the acceptance of role-play training. A total of 663 police officers were trained, with feedback from 381. Results showed that this approach was well accepted by most police officers, and the use of carefully controlled role play in training for police is strongly recommended. Future analysis will determine whether training improves police behavior with respect to interaction with mentally ill individuals.

A Novel Training Program for Police Officers that Improves Interactions with Mentally Ill Individuals and is Cost-Effective.

Police and law enforcement providers frequently come into contact with individuals who have psychiatric disorders, sometimes with tragic results. Repeated studies suggest that greater understanding of psychiatric conditions by police officers would be beneficial. Here we present a novel approach to training police officers to improve their interactions with those who might have a mental illness. This approach involved developing a carefully scripted role-play training, which involved police officers (n = 663) interacting with highly trained actors during six realistic scenarios. The primary goal of the training was to improve empathy, communication skills, and the ability of officers to de-escalate potentially difficult situations. Uniquely, feedback was given to officers after each scenario by several individuals including experienced police officers, a mental health professional, and by the actors involved (with insights such as "this is how you made me feel"). Results showed that there were no changes in attitudes of the police toward the mentally ill comparing data at baseline and at 6 months after the training in those who completed both ratings (n = 170). In contrast, there were significant improvements in directly measured behaviors (n = 142) as well as in indirect measurements of behavior throughout the police force. Thus, compared to previous years, there was a significant increase in the recognition of mental health issues as a reason for a call (40%), improved efficiency in dealing with mental health issues, and a decrease in weapon or physical interactions with mentally ill individuals. The training cost was $120 per officer but led to significant cost savings (more than $80,000) in the following 6 months. In conclusion, this novel 1-day training course significantly changed behavior of police officers in meaningful ways and also led to cost savings. We propose that this training model could be adopted by other police agencies.