Protecting Against Stress & Trauma: Research Lessons for Law Enforcement – Next Steps
At this Research for the Real World seminar, NIJ brought together law enforcement practitioners and leading researchers in the field of stress to discuss the current research evidence and practical benefits of targeted stress-management interventions and how they can promote officer mental wellness. In addition, this gathering provided an exploration into what additional research is needed to best support officer health and wellness, potentially highlighting priority areas for future research.
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HOWARD SPIVAK: Okay. That’s an interesting lead into a question I wanted to ask, which is, what can NIJ do to help advance this if understanding how to influence leadership is part of what needs to happen? How do we bring some science to that? I’m not just asking you, Wendy. I’m asking actually all of you at this point. How do we bring some science to that and what can NIJ do and what can research community do to help this.
CHRISTOPHER SCALLON: So you can try to find out what’s going on, and you’re right, doc, you don’t know who’s struggling and what’s going on. But in helping police officers or helping first responders come to the understanding—a very significant understanding—if you just want to treat the first responder, imagine taking your hand and dipping it in boiling oil, you take it out and you just treat the palm. Your hand is still messed up, right? The big piece that I think has been missing has been the spouse or the partner. If you’re not incorporating that into the program, which addresses how we respond to stress and anxiety and PTSD, you’re only treating the palm. You’re not treating the whole hand. I teach a class. It’s about three seconds long. It’s called “How to Destroy a Marriage,” and basically don’t talk. Because I talk to a lot of police officers around the country, I said, “Do you tell your spouse, significant other or partner about what you see day to day?” And the overwhelming response is “No.” And I’m, like, “Well, why?” The response is, “Because I don’t want to give that to them.” So I flip it around and I say, “Well, let’s say your spouse or your significant other comes home and he or she’s been pistol-whipped and robbed, what are you going to do?” “Well, I’m going to ask what happened.” “Well what if your spouse told you, ‘I don’t want to give you the trauma that I experienced?’” And they’re like, “Well, no, I would find out.” Well, see? We’re a little bit hypocritical that way and if you really want to know what’s going on with somebody, talk to their family.
I don’t know from a clinical standpoint but I’ll tell you from my experience, we go to get help, not to psychology or a psychiatrist. We don’t get mental health. We wait until it affects us physically and then we reach out normally to our general practitioners or we go there because that’s how I reached out. I had gotten to the point where I hadn’t slept in over two weeks and I had lost like 50 pounds in a month and a half. And I was like “I need to go to the doctor,” not like “Something’s wrong up here.” I was, like, “No, I need to go to the doctor because I can’t sleep.” Right? So I go to the doctor and I said, “Well, can you help me?” And he’s like, “Well, when did this happen?” I was, like, “Since the shooting.” He’s, like “What? Okay. Let me refer you to my friend that works at the psychiatric facility.” But the thing is, if you want to help, what NIJ can do, start focusing research—because it’s going to work. I’ll tell you, I can see the future—incorporating agencies to address both home and the individual that’s working within the agency.
I created a few years ago a spousal group. Coming back from Virginia Beach, I headed the debriefing response to the mass shooting that we had there. There was a spouse who turned on “Good Morning America” and heard her husband on the radio because “Good Morning America” will start taking all sorts of stuff, and that was her first exposure to her husband’s shooting. So what are we doing? Address home, make it just as much a priority as it is the job, and I’ll finish with this. When I first started this job, when I started working, I did 100 percent—110 percent of me was about this job. You couldn’t catch me without talking about something, doing with the job or that I’m doing that I’ve done, that I experienced and stuff like that. I don’t think we should lose that enthusiasm, but I tell folks, “You should have that much enthusiasm for home as you do at work and that’ll create a little bit better atmosphere.” When we start opening up that dialogue between the family members, it kind of bleeds over into work and it becomes okay.
HOWARD SPIVAK: Okay. So we’ve heard about an agenda of better understanding the family as part of the response. We’ve heard a fair amount about linking the physiology with the experience and with the treatment. What other things can we be doing in research? I’d like to hear from each of you on this. Dan?
DAN GRUPE: One really challenging issue if you’re studying stress is trying to distinguish between exposure to stressful events and one’s response to these events. I think there’s a role for technology and data that police agencies are already utilizing, to be able to start to answer some of these basic questions about the incidence of different types of events, officer’s exposure to different types of stressors, and then the subjective impact of those stressors. So agencies are collecting a ton of data on calls for service. We have access as researchers to every advanced and more discreet tools for monitoring physiology, activity in the field so I think if agencies are willing to partner with academics and if academics are interested and open to getting out into the real world and partnering with these agencies, I think there are some really cool opportunities both to do some groundbreaking research on these basic questions about stress, exposure to events, and their impact.
And also to start to get at some of these questions that we don’t really have answers for as far as what are rates of exposure and what are rates of prevalence of these disorders. So I think leveraging technology, leveraging the incredible amounts of data that are being collected, and then continuing to forge these kinds of partnerships with academia and subject experts.
HOWARD SPIVAK: Thanks. John, you’ve also talked about epidemiology a bit and getting a better sense of the incidence of suicide, as well the incidence of post-traumatic stress disorder. Can you speak more to some of that and what other things we need to be better monitoring, and counting, and understanding?
JOHN VIOLANTI: One of our most recent interests is shift work. What we want to look at here is how does one adapt to shift work as opposed to those who do not adapt to shift work? We want to look at the differences. There’s a statistical procedure called latent class analysis. In this procedure, what we do is we can find out by looking at people whether they’ve adapted or have not adapted by looking at physiological factors, various blood tests, and so forth. Then maybe do some focus groups on officers to find out how they do it to get some real-life experiences from that.
We want to look at the DNA in people who can’t adapt to shift work and see what the problem is there. The whole goal of that is simply to find those people who do adapt well. What’s the big secret? Why do you adapt better to shift work than Joe Smith? There are various variables we can look at. Some people call them morning people. They do better than night people, or night people do better than morning people, and so forth and so on. But we’re looking at a cluster of variables to try to figure that out. If we get a good answer, we find out how people adapt well to shift work, we can put that out there.
Another thing which kind of bothered us too was -there’s a tremendous number of studies out there, on everything in shift work. We want to do an expert panel sort of review, a best evidence review of all of the work that’s out there, thousands and thousands of articles to kind of isolate what the best possible studies are, and to take those studies and apply them to adapting to shift work. Those are two new ideas we’ve just come up with recently and our colleagues are working on that.
As far as suicide goes, I don’t know what we can do with that until we know further how many there are. But I think prevention, education, telling people about the signs of suicide, educating middle management people about suicide, very important. Who do you go to first? You go to your sergeant? Peer support people, I think Chris has a good idea with that. I’d rather go to another officer to talk than I would to the psychiatrist who lives next door to the commissioner. We don’t want to do that. I mean police officers don’t particularly trust outside people. They’d rather go to another officer first. That officer can have a network to professional mental health people who he or she knows they can trust and send the officer there if they need it. So getting rid of the stigma is very important, it’s rampant. Nobody wants to come forward and say, “I’m sick. I have a mental health problem.” So we need to deal with that stigma. That’s the thing that’s blocking most of the help, and that’s the reason people are stuffing it and going into the ultimate act of suicide. Chris was right, you bring people in who have succeeded in dealing with the problem. Those are examples to officers that this is the way to do it, this is how I can get help. The organization needs to understand that mental health is, for lack of a better term, a disease. I mean, if I break my arm, is that the same as having depression? If you look at the disease model of mental health, then it is. So that needs to be better understood. Hopefully we can move in that direction.
HOWARD SPIVAK: Wendy, you’ve been a LEADS scholar. You’re now doing a residency at NIJ, what would you like to see begin to advance in better understanding this issue, and integrating more science into practice here?
WENDY STIVER: I think in this particular topic, we could build an entire research agenda around it because it’s foundational. All of the other things that we’re researching and looking at in finding ways to improve policing may not necessarily have much of an effect or an impact if we lose our people, if we don’t take care of the people doing the job. I think that that is huge and bringing in more practitioners together with researchers to better understand this.
I’ve spent the last two weeks here in the building reading journal articles about some of these things and I feel like I’m swimming against the ocean. I’ve gone a little bit crazy with this. So it’s going to take a lot more than just a couple of us working on this together. I think that expanding on the knowledge and building bridges using programs like LEADS to make--like I said, we’ve got to make this stuff more tactical and practical. We’ve got to find ways to bridge the research to real life so that cops understand that there are tools that we can use coming out of the research. I go back home and I was given just a few minutes at a staff meeting to talk about this. And then I looked around the room and there were just blank stares, right? Even with the amount of work that I’m doing on it and the amount we’re talking about it in my agency, there’s a divide that we’re going to have to figure out to bridge. And LEADS has been a phenomenal experience in doing that. It is a delightful experience to be able to get together with some of the smartest cops in the country and have these conversations, and then work together to figure out how we can push things back to our agencies. So it keeps growing and it keeps getting better, and we definitely need more of it.
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