Mindful or Suicidal: Recommendations for Improved Mental Health among Police Officers

Despite multiple national initiatives, the suicide rate among police officers remains constant and higher than line of duty deaths. Recent research identifies mindfulness techniques as an effective way to improve mental health, including the risk factors of depression and suicide. While a significant portion of resources and funding are allocated to ensure the safety and physical fitness of officers, including firearms training and physical fitness programs, there is a limited number of holistic programs that ensure officers’ mental health wellness. Based on current research and pioneer initiatives, this document explores the following question: What role can mindfulness practices play in reducing the risk of suicide among police officers? The document concludes with recommendations for law enforcement agencies, including implementation of evidence-based mindfulness practices and cultivation a pro-wellness work etiquette.

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Introduction

Based on data between 1999 and 2015, the Center for Disease Control and Prevention (CDC) places suicide as the second leading cause of death among all races and sexes for ages 25-34, and fourth for ages 35-44 (CDC, 2019). Given that the mean age of police officers is about 40 years, this group is at a higher risk of suicide (DataUsa, 2019). Additionally, the inability to deal with high levels of stress and trauma associated with the job makes police officers especially vulnerable to depression and feelings of hopelessness, directly linked to the risk of suicide (BLUE H.E.L.P., 2019; IACP, 2018; Mindful Justice, 2018). Despite the lack of a central database for suicide reporting, experts argue that law enforcement officers have a 54% greater chance of dying from suicide than members of the general population. This results in an average of 160 officers taking their lives every year (Vargas, 2019; The Crime Report, 2019), placing suicide higher than line of duty deaths (Heyman, Dill, & Douglas, 2018; see Appendix A).

Despite the high risk of suicide, an organizational culture of masculinity and toughness often prevents officers from seeking the mental health care they need. The problem is further compounded by the lack of mandatory reporting of officer suicide (IACP, 2013; Yeoman, 2017). Consequently, agencies are unable to fully access the scope of the problem and identify individuals whose mental wellness needs improvement (Vargas, 2019). A growing number of agencies, both domestic and international, recognize the importance of mental wellness (IACP, 2018) and adopt evidence-based mindfulness techniques as an effective way to improve mental health, including the risk factors of depression and suicide (Bergman, Christopher, & Bowen, 2016; Trombka et al., 2018; Yeoman, 2017). This document explores current suicide prevention programs as well as evidence-based mindfulness practices that could prove effective in suicide prevention.

Leading Causes of Suicide

Suicide is not caused by a single event but an accumulation of unresolved stress and trauma (The Crime Report, 2019). Research also suggests that police officers have a much lower life expectancy as compared to the general population (Violanti et al., 2013). Officers are exposed to a multitude of psychological risks associated with organizational stressors, including high job demands, decision-making latitude, organizational culture, and interpersonal relations. These risks are likely to result in prolonged stress, obesity, posttraumatic stress disorder (PTSD), cardiac arrest, or suicide (Bonner, 2000; Goh et al., 2015; Patterson, 2002; Violanti et al., 2017). For example, 9-19% of all police officers suffer from PTSD, which could have been caused by witnessing homicides and having contact with dead bodies, accident and assault victims, and abused children (Violanti et al., 2013). Additionally, female officers were more likely to show metabolic syndromes associated with stress from organizational pressure and lack of support (Hartley et al., 2011).

Other studies show consistent and troubling results. For example, police officers witness an average of 188 critical incidents through their careers (Chopko, Palmieri, and Adams, 2015). These traumatic events could include killing someone by accident, witnessing death, being held hostage, being seriously beaten, or having loved ones threatened (see Appendix B for a full list of critical incidents). Accumulated trauma leads to PTSD and depression, with rates five times higher for police officers as compared to the general population, contributing to poor physical health, impaired decision-making, and ultimately suicide (Chopko et al., 2015; Violanti et al., 2017; Heyman et al., 2018).

Officer Wellness and Suicide Prevention

Officer suicide does not only put strain on already tight agency budgets (Violanti et al., 2013), but also limits the number of officers protecting the community (IACP, 2018). Given the high controversy of the topic, increased media coverage has been given to the mental and emotional toll of the job, as well as the need to protect those who safeguard their communities (The Crime Report, 2019). As a result, a multitude of legislations and reports recommend focusing on policies and programs that promote physical and psychological wellness of law enforcement officers (IACP, 2018).

The Law Enforcement Mental Health and Wellness Act of 2017 is designed to make mental health services more accessible to law enforcement officers (US Congress, 2018). More specifically, the Department of Justice, Department of Defense, and the Department of Veterans Affairs are tasked with developing resources that would address the mental health needs of the officers. The legislation would grant funding for developing peer mentoring pilot programs and training for mental health providers, specific to law enforcement mental health needs and supporting law enforcement officers by studying the effectiveness of crisis hotlines and annual mental health checks (US Congress, 2018).

In addition to the new legislation, the COPS Office (Kuhns et al., 2015) and the IACP (2018) provide recommendations for mental and physical wellness program implementation based on several model examples:

  1. San Antonio, TX: Performance Recovery Optimization (PRO©). This program is based on the the military program that sought to reduce and prevent psychological trauma by teaching soldiers and veterans stress management techniques that would make them more resilient to the rigors of combat. PRO© includes an eight-hour training session for cadets and a five-hour in-service training for officers, as well as an elective three-day professional development course. Although research shows that only daily practice yields long-term results (Jha et al., 2016), the program is not incorporated into the daily officer routine. Additionally, the program is mainly based on physical responses as opposed to emotional causes of stress.
  2. San Antonio, TX: Peer Support Team. The program provides an early intervention to keep stress from escalating into distress. Peer mentors specialize in topics like grief, children’s issues, acute stress disorder, and substance abuse. Although the program focuses on detecting early signs of stress, it does not teach the officers how to cope with negative emotions during high-stress critical incidents.
  3. Camden County, NJ: Wellness Coach. The program is designed to promote health and wellness by having a certified wellness coach visit police departments monthly to advise officers on topics such as exercise, fitness, and conditioning; tobacco cessation; weight loss; stress management; nutrition; high blood pressure and heart disease; diabetes; and more. Although the program emphasizes overall wellness, it does not require officers to engage in daily exercises.
  4. Reno, NV: Resiliency and wellness program. The program is designed to screen officers for early indications of heart disease and diabetes. Although the program is designed to detect physical manifestations of stress, it does not offer long-term preventive methods.

Based on the consensus of diverse organizations, there is a need for programs that improve overall mental and physical heath of officers (IACP, 2018; Kuhns et al., 2015; US Congress, 2018). However, the overwhelming number of wellness and suicide prevention programs are reactive in nature. Some programs focus on physical fitness or addressing pre-existing health conditions, while no program recommends proactive measures, including daily mindfulness practices to target the underlying causes of suicide, including stress, anxiety, and depression.

Mindfulness in Practice

The participatory medicine movement emphasizes being proactive for one’s health (identifying and countering initial symptoms), as opposed to reactive (trying to address a health problem after it occurs; usually involves hospitalization and medication). Mindfulness is based on the idea of proactive medicine and can be defined as paying attention to the present moment on purpose and without judgement. More specifically, meditation and breathing exercises heighten awareness and generate a deep state of relaxation (Kabat-Zinn, 2013; Air Force New, 2017). According to Dr. Kabat-Zinn, a leader in mindfulness practices and the creator of the Stress Reduction Clinic and the Center for Mindfulness in Medicine, Health Care, and Society at the University of Massachusetts Medical School, “by focusing on the breath, the idea is to cultivate attention on the body and mind as it is moment to moment, and so help with pain, both physical and emotional” (Booth, 2017). Research outlines a multitude of benefits of mindfulness practices, including the ability to deal with stress, chronic pain, and make decisions based on logic as opposed to emotions.

What Does the Research Say?

Mindfulness training involves teaching people skills to focus their attention on the present moment, without emotional reactivity. As pointed out by Dr. Amishi Jha, another leader in mindfulness research and a co-director of the University of Miami Mindfulness Initiative, strengthening our cognitive capacity makes us more likely to remain calm and focused in moments of high emotional intensity or stress. As a result, we are less likely to be affected by anger, fear, or worry (Tannen, 2018). Research shows that mindfulness can reduce organizational stress, but also improve problem solving skills and emotional resilience among high-functioning groups, including elite military forces and police officers (Bergman, Christopher, & Bowen, 2016; Jha et al., 2017; Pe et al., 2013; Schmeichel et al., 2010; Zanesco et al., 2018).

Special Operations Forces (SOF) who participated in a month-long mindfulness course reported improved attention and working memory, which are necessary to reduce emotional reactivity and increase problem solving skills. The mindfulness program consisted of 8-hour weekly in-class trainings and 15 minutes of daily guided meditation (Zanesco et al., 2018). The findings are consistent with previous studies on military cohorts that point to increased cognitive resilience during stressful and emotionally degrading situations. Researchers argue that mindfulness training helps troops deal with the distress and emotional disturbance of deployment. More specifically, mindfulness training can help enhance one’s ability to deal with negative feelings and regulate one’s emotions, especially among high-functioning groups like police officers (Pe et al., 2013; Schmeichel et al., 2010).

Servicemembers who practiced mindfulness reported relatively constant levels of negative emotions, while those with no such training reported increased negative emotions during the pre-deployment period (Jha et al., 2017). Additionally, US Marine reservists who went through an 8-week mindfulness and decision-making training, including a total of 24 hours of class time, a 2-hour meeting, and a day-long silence workshop, were less likely to experience deceased attention, which left untreated could result in diminished performance and resilience to deal with stress. Lastly, in addition to elite military service members, police officers could benefit from mindfulness training to improve their cognitive skills (Jha et al., 2017).

In addition to building emotional resilience, mindfulness has been directly linked to depression prevention. Studies have shown that developing mindfulness skills and self-compassion creates reduced reactivity and depressive thinking among participants (Kuyken et al., 2010; 2015). Additionally, studies on mindfulness among law enforcement officers suggest that the techniques reduce organizational as well as operational stress and anger (Bergman, Christopher, & Bowen, 2016). In addition, other studies found that mindfulness had a positive impact on overall resilience, perceived stress, burnout, emotional intelligence, difficulties with emotion regulation, mental health, physical health, anger, fatigue, and sleep disturbance (Christopher et al., 2014). However, nearly all mindfulness studies suffer from a small sample size (Stetka, 2017). Nevertheless, the growing interest in the technique provides an opportunity for a large-scale randomized and rigorous test of its effectiveness among those organizations and agencies who are voluntary pioneers in mindfulness training.

Mindfulness Pioneers

The New Zealand Air Force (2017) and the US military were among the first proponents of the benefits of mindfulness. According to Woodbourne Base Psychologist Flight Lieutenant Carsten Grimm, evidence-based mindfulness training enhances officers’ attention and adaptability by helping them to stay calm and regulate their emotions. In other words, mindfulness gives officers resilience tools to better deal with the amount of workload and the emotional demands of the job. Consequently, mindfulness training has been incorporated into recruit courses and officer training, and has received a positive response. More specifically, the techniques helped officers understand how they were feeling and reacting, but perhaps most importantly how to apply these skills during work and at home (Air Force News, 2017).

Similarly, research conducted by Dr. Jha and her colleagues (2015, 2017) has been the basis for the mindfulness techniques used by the US military and police force. The US Army emphasizes the need for strengthened cognitive and physical capabilities of their soldiers (Myers, 2015). More specifically, mindfulness is a promising technique to help soldiers deal with the psychological toll of deployment, including stress and anxiety of high-performance in high-stress situations. In general, providing soldiers with physical training is not enough to teach them how to deal with stress. The research founded by the U.S. Army Medical Research and Materiel Command, and conducted by Dr. Jha and her colleagues, shows that mindfulness meditation exercises help train and protect a serviceman’s mind against high-stress combat situations and improve overall cognitive resilience and performance (Jha et al., 2015). Similar research on active-duty Marines showed improvements in mood, memory, and attention (Jha et al., 2017). In the end, the Army and the Marines recognize the need to protect a soldier’s mind in the same way physical training prepares and protects their body. As a result, like physical exercise, daily mindfulness training can result in powerful benefits. (Myers, 2015). Given the effectives among high-performing military personness, mindfulness practices are starting to make their way into policing.

Local police departments (PD) have recognized the research behind mindfulness and have implemented mindfulness-based programs as a part of officer training (Kim, 2017). More specifically, Tempe PD in Arizona, Hillsboro PD in Oregon, Bend PD in Oregon, El Cerrito PD in California, Dallas PD in Texas, and Madison PD in Wisconsin all see the need for a holistic and proactive approach to officer well-being (Kim, 2017; Kozlowska, 2017; Spoon, 2016; Suttie, 2016). More specifically, mindfulness practices have the potential of reducing depression, PTSD, alcohol abuse, and promoting awareness and compassion for the high-stress job of the officer (Kim, 2017).

For example, Madison PD, with cooperation of the University of Wisconsin-Madison and funding from the National Institute of Justice (NIJ), is measuring the effectiveness of implementing one guided session per week for two hours, focusing on a variety of practices including meditation, mindful movement (walking, yoga), and group discussions about practices and teachings. Officers also are given additional exercises for outside of the sessions. Although the research is ongoing, the initial results were marked as promising (Spoon, 2017).

Another example is Bend PD in Oregon, which believes in prioritizing officer wellness. Given that officers are exposed to a multitude of negative events on a daily basis, the agency has implemented a wellness screening test and mindfulness training. Mindfulness training is one of several wellness incentives at the Bend PD, ranging from 10-minute mindfulness sessions to yoga classes, peer mentoring, and a psychologist on staff. Every program is data-driven and addresses an area the officers finds most problematic, including sleeplessness, lack of energy, focus, and likelihood of certain injuries. Specifically, mindfulness training helps officers prepare for potentially violent situations by maintaining a clear-mind. The department is actively engaged in promoting the benefits of mindfulness and providing training to other in and out of state PDs (Peacher, 2018).

The need to address officer well-being and reduce stress associated with the high demands of the job can be expressed by adopting a holistic approach to mental and physical health. More specifically, mindfulness-based practices could help officers effectively deal with stress, anxiety, and excessive reactivity associated with their job.

Recommendations

Current legislation and reports emphasize peer mentoring and annual mental health checkups, but do not propose national and evidence-based program development (IACP, 2018; US Congress, 2018). Given the effectiveness of holistic practices, this document proposes the implementation of mindfulness practices to help officers with stress and trauma management.

The U.S. Department of Justice should do the following:

Law enforcement agencies should do the following: