Macho attitudes in law enforcement can increase chronic and potentially fatal illnesses

Macho attitudes in law enforcement can increase chronic and potentially fatal illnesses
© Greg Nash

Law enforcement officers are consistently exposed to the worst of society, making the profession one of the most demanding and mentally taxing careers. They are expected to make life and death decisions while maintaining their mental, emotional and physical health and well-being. These high expectations along with ongoing exposure to chronic stress and both primary and secondary trauma create potentially severe and life-threatening health risks for our law enforcement professionals.

Unfortunately, the result can be undiagnosed or unsupported emotional problems and even mental illness. In 2017, there were 140 reported cases of police officer suicide compared to 46 cases of death while in the line of duty. In 2018, the suicide rate rose for the third year in a row, to above 160 deaths.

That figure is nearly three times the number of law enforcement officers killed in the line of duty, yet our various law enforcement agencies have yet to take this risks seriously enough to implement sufficient training and support services for their officers.

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Most commonly found health risks

Due to the high levels of chronic stress and trauma exposure that a career in law enforcement entails, emotional problems and mental illness are unfortunately all too common among law enforcement officers. Post-Traumatic Stress Disorder (PTSD) occurs five times more in law enforcement officers than civilians due to the amount of violence, death and tragedy encountered by these professionals.

Thirty-five percent of police officers have struggled with PTSD versus 6.8 percent of the general population. Law enforcement professionals are also likely to experience other stress- and trauma-related disorders like anxiety, depression and sleep disorders. Such chronic stress and trauma-related disorders can take a toll on physical health as well, causing obesity, respiratory problems, and chronic medical conditions like hypertension and heart disease.

Law enforcement officers may suffer from is substance abuse as well. This disorder typically develops as a way to handle high stress and trauma exposure and occurs in larger numbers of police officers than civilians. Unfortunately, trauma-related issues and their co-morbid disorders often go unseen among police officers.

Issues like depression occur in 12 percent of officers, compared to 6.8 percent in the general population. Law enforcement officers are 1.5 times more likely to commit suicide due to untreated mental illness. Yet police officers rarely seek medical attention or therapy for ongoing issues due to the stigma attached to seeking help or treatment and the risk of being labelled unfit for duty.

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Factors leading to health risks and suicidality

There are many factors that contribute to the severe physical and mental health risks faced by police officers. Some are just part of the job: the stresses of shift work, work-life balance and family issues, traumatic encounters with violence, death and tragedies of all kinds. Law enforcement agencies tend to operate with quasi-military top-down management structures, and officers complain of little control over their work lives and the demands placed on them. In a 2012 international study, researchers Claudia Morales-Manrique and Juan Valderrama-Zurian identified links between the high-demand and low-control nature of law enforcement and the high-stress levels that impact the physical and mental health of police officers.

Other risks have to do with law enforcement culture — macho attitudes that encourage officers to tough it out, to not seek help and to regard basic self-regulation and self-care skills as soft. As a result, police spend too much time in a state of hyper-vigilance and high stress with high levels of cortisol, adrenaline and noradrenaline in their blood stream, a significant risk factor for many chronic and potentially fatal illnesses. These macho attitudes can affect female officers as well.

Negative media attention and community attitude also increase the stress levels for police officers, who despite such criticism daily choose to put themselves on the line in order to protect the rest of us from harm.

We expect police officers to be mentally and physically fit and capable of making life and death decisions on the spot, and we expect them to get it right. The law enforcement persona is one of calm, self-sufficiency mental toughness with no allowance for vulnerability or even normal human feelings. Physical and mental toughness is an institutional value and a source of pride for most police officers. Physical and mental toughness are important, but need to be grounded in healthy self-regulations skills and self-care practices. Police officers are not robots.

This persona of invulnerability often prevents police officers from taking care of themselves in acutely traumatic situations. Officers may fail to recognize or acknowledge their own symptoms, or they fall into the "suck it up" culture reinforced by department environments and influential officers. Admitting the need for help or advice after handling a traumatic experience could be taken as a sign of weakness — or worse, an indication of not being fit for duty. Official policy holds up these values with regularly scheduled fit-for-duty tests designed to ensure physical and mental fitness. Management structures are often more concerned about liability issues than the ongoing and long-term health of their employees.

Many law enforcement agencies do not have official support systems in place for officers who might be struggling. Less than 5 percent of departments have suicide prevention programs, and officers can fear suspension or job loss if the department learns of mental health struggles.

Awareness as a first step

Unfortunately, law enforcement culture is not accommodating for those who are struggling with emotional issues or mental illness. Yet the pressures we put on police officers creates an environment that leads to significant chronic stress and trauma related health risks, including a higher risk of suicide. At the very least, these conditions lead to widespread burnout, cause mid and late career officers to be less than effective in their job and more prone to bad decisions. Burnout is often a precursor to depression and suicidality. Despite the widespread signs of officer depression — such as withdrawal from other officers, lack of motivation and taking unnecessary risks — mental illness among law enforcement continues to go untreated.

Officers who are of sound emotional and mental health have better relationships with the communities they protect, so awareness and support are in everyone's best interest.

Fleet Maull is the director of training and research for the Center for Mindfulness in Public Safety, a nonprofit organization providing mindfulness-based wellness & resiliency (MBWR) training for corrections and law enforcement professionals.