Mental Health in the UK Police Force: a Qualitative Investigation into the Stigma with Mental Illness

Posttraumatic Stress Symptoms and Predictors Among Spanish Police and Armed Forces During the COVID-19 Pandemic in Spain

OBJECTIVE

To assess the psychological impact of the COVID-19 crisis on the police and armed forces.

METHODS

Participants ( N = 242) completed an online survey that assessed posttraumatic stress symptoms (PTSS), burnout, emotional suppression, and labor and sociodemographic variables. Mean difference, correlation, and stepwise linear regression tests were performed.

RESULTS

One-third of participants showed severe PTSS, linked to patrolling duties, very frequent contact with other people, fear of contagion, perceived pandemic severity, living with at-risk people, taking a COVID-19 test, working more than normal, suffering an assault, having little vacation, and having to distance from loved ones. PTSS also correlated with the burnout dimensions and emotional suppression. Three-quarters had not received any support from their workplace.

CONCLUSIONS

Effective interventions to optimize these professionals' personal, social, and working conditions are needed.

Spirituality/Religion Among First Responders With and Without Posttraumatic Stress Disorder and Alcohol Misuse

Objective: To examine the co-occurrence of alcohol misuse and posttraumatic stress disorder (PTSD) and potential sources of coping (e.g., spirituality/religion) and clinically relevant variables among first responders (e.g., firefighters, law enforcement corrections officers, paramedics). Method: We assessed rates of independent and co-occurring alcohol misuse and PTSD among a national online sample of 320 first responders as well as the prevalence and salience of S/R, guilt, shame, moral injury, aspects of S/R, and treatment interest. Results: In our sample, 46.88% (n = 150) met criteria for comorbid alcohol misuse and probable PTSD and individuals with these comorbid conditions reported significantly greater negative religious coping, moral injury, and shame than all other diagnostic groups (i.e., independent alcohol misuse, independent PTSD, and neither). Correlations also revealed significant relationships between alcohol misuse and PTSD symptomatology with positive and negative religious coping, moral injury, shame, guilt, interest in treatment, and interest in spiritually integrated treatment. Conclusions: Findings highlight the high rates of independent and co-occurring alcohol misuse and PTSD among first responders as well as the salience of S/R in this population.

Occupational burnout and public stigma associated with employee mental well-being: A multi-industry, cross-sectional study during COVID-19

BACKGROUND

While mental illness (e.g., depression, anxiety) has been examined frequently in the workplace, the COVID-19 pandemic has only increased the attention towards mental illness. Mental well-being views mental health as a continuum from ill health to thriving. Few studies have examined factors associated with mental well-being in the workplace. Public stigma for mental illness, the general population's negative attitude towards mental illness, and occupational burnout are examined.

OBJECTIVE

The purpose of this study was to examine the relationship between burnout and public stigma on mental well-being in a sample of employees across industries in the United States.

METHODS

Employees surveyed from 16 companies from various industries were assessed. Room Here, a non-profit organization whose goal is to improve employee mental fitness, gathered data from these companies located in the western mountain region of the U.S. Data were collected during the pandemic. Across this portfolio of companies, 259 employees were included in the sample. Survey assesses respondents' mental well-being, stigma towards mental illness, and occupational burnout. Ordinary least squares (OLS) regression was used in this cross-sectional study on secondary data.

RESULTS

Results suggested occupational burnout was associated with a decrease in mental well-being, while public stigma was associated with an improvement in mental well-being.

CONCLUSION

This study sought to examine the relationship between mental well-being, burnout, and public stigma. Employee burnout and public stigma were related to mental well-being. Implications for burnout and stigma reduction programs are discussed as well as future research.

C. A, Singh Pradhan PM. Occupational stress and environmental impact among traffic police officers in Kathmandu Valley, Nepal: A qualitative study

Policing is considered an extremely stressful, physically demanding, and mentally challenging occupation. The growing population with an increasing number of vehicles and the harsh working environment has made the work of traffic police even more stressful. This qualitative study aims to examine work and environment-related stressful factors among traffic police officials of Kathmandu Valley, Nepal. This qualitative study used a thematic analysis approach. Face-to-face interviews were conducted with different cadres of 15 traffic police personnel working in Kathmandu Valley, Nepal for at least six months. The study adhered to the Consolidated Criteria for Reporting Qualitative Studies (COREQ) guideline. The findings of this study are structured around five major themes- workload, work-life balance, basic amenities, work environment and occupational health problems, and possible solutions and suggestions. Most of the participants (10 out of 15) reported having work stress due to the heavy workload and hazardous working conditions that had a significant impact on their job performance and mental well-being. This study highlights the challenges faced by traffic police officers in Kathmandu Valley, Nepal. The findings suggest that efforts should be made to improve the working environment of traffic police officers to reduce the physical as well as mental burden among them. The occupational health and safety (OHS) and mental well-being of traffic enforcers' is a critical public health issue, therefore, it should be on the agenda of policymakers, organizational leaders, and stakeholders.

Walk the line: a systemic perspective on stress experienced by emergency medical personnel by comparing military and civilian prehospital settings

Introduction

Emergency Medicine (EM) personnel in both military and civilian prehospital settings are often exposed to stressful and extreme events. Therefore, a cross-pollination between both contexts in terms of coping strategies may generate new information for purposes of training, prevention, and support programs. In the current study, we aimed at comparing both contexts to understand the type of stress events personnel experience; whether experience differs between civilian and military personnel; and how they cope with it.

Methods

We used a mixed method approach, combining the results of a quantitative questionnaire and a thematic analysis of 23 in-depth semi-structured interviews to gain additional qualitative information.

Results

Whereas the questionnaire pointed to a significant preference for task-oriented coping over avoidant and emotion-oriented coping, the interviews offered a more nuanced insight, showing a constant aim to position themselves on a continuum between emotional disconnection from the patient to preserve operationality on the one hand; and remaining enough empathic to preserve humanity on the other hand. We further identified an ambivalent awareness regarding emotions and stress, a vulnerable disbalance between an excessive passion for the job with the sacrifice of own's personal life (for a growing volatile and dangerous working environment) and a lack of recognition from both the patient and organizational environment. The combination of these factors may carry the risk for moral injury and compassion fatigue. Therefore, mutual trust between the organizational level and EM personnel as well as among team members is crucial.

Discussion

The results are discussed from a systemic SHELL perspective, indicating how the specific profile of EM personnel relates to the software, hardware, environmental and liveware components of their professional and private life. Trainings on stress- and risk awareness should be approached both on an individual and systemic level, knowing that there is clearly no "one-size-fits-all" manner.

An exploration of the personal experiences of digital forensics analysts who work with child sexual abuse material on a daily basis: "you cannot unsee the darker side of life"

Introduction

Digital forensics analysts are a specialist group of police officers who are involved in investigating cases of online child sexual exploitation and abuse (CSEA), and identifying and classifying child sexual abuse material (CSAM) according to levels of severity, respectively. The existing literature that has examined this phenomenon suggests that this group of police officers are at greater risk of psychological harm as a result of being exposed to CSAM, and that working with this type of material has the potential to significantly affect their mental health and wellbeing.

Methods

The study presented here used Interpretative Phenomenological Analysis (IPA) to explore digital forensics analysts' personal experiences of working in this role, and with CSAM, on a daily basis, as well as how they feel this has impacted on them, and how they manage this. Seven digital forensics analysts from a specialist unit in the UK took part in semi-structured, in-person interviews.

Results

Three themes were identified, namely: (i) Once you know you cannot unknow, (ii) Constant struggle to decompress, and (iii) The ups and downs of working as a digital forensics analyst. Participants talked about the difficulty of escaping the reality of the sheer prevalence of CSEA, and that working as a digital forensics analyst ultimately takes a toll on one's mental health and wellbeing.

Discussion

As a result of undertaking this work on a daily basis, participants reported experiencing symptoms comparable to compassion fatigue, secondary traumatic stress, and burnout, and reflected about the long-term or irreversible psychological effect that working in this role may have. Findings are discussed in relation to theoretical and practical implications, as well as directions for future research.

Primary Care Consultations Among UK Police Officers and Staff: Links With Adverse Mental Health and Job Strain

OBJECTIVE

The current study examined links between adverse mental health, job strain, and likelihood and frequency of primary care consultations among police employees.

METHODS

We conducted secondary data analysis on the Airwave Health Monitoring Study data ( n = 33,730). Measures included self-report data on mental health, job strain, job support, and primary care consultations in the past 12 months. Data were analyzed using a zero-inflated Poisson regression framework.

RESULTS

Findings showed that overall, help seeking was low based on mental health status and job strain. Adverse mental health was associated with more primary care consultations. Police employees with high, active, or passive job strain reported more primary care consultation compared with police employees with low strain.

CONCLUSIONS

Findings suggest that more work to reduce stigma of taking the initial step of help seeking would be beneficial.

A preliminary study investigating the neglected domain of mental health in Australian lifesavers and lifeguards

BACKGROUND

Surf lifesavers and lifeguards have provided essential education, preventative, and rescue services to the Australian community for over 110 years. In this first responder role, surf lifesavers and lifeguards are inadvertently exposed to high risk and trauma related experiences, which may negatively impact mental well-being. To date however, there has been limited research into the mental health of surf lifesavers and lifeguards, and no studies at all on the mental health of adolescent surf lifesavers. The preliminary study aimed to measure the exposure of potentially traumatic events (PTEs), post-traumatic stress symptoms (PTSS), self-efficacy, social support, and attitudes towards mental health problems in Surf Life Saving (SLS) members.

METHODS

An anonymous, online survey was developed (adolescent and adult versions) and created to measure the domain of mental health in surf lifesavers and lifeguards. Pearson's correlations investigated relationships between PTEs, PTSS, self-efficacy, social support, attitudes towards mental health problems, age, years as a SLS member, and years patrolling. Spearman's Rank was used for violations of normality.

RESULTS

A total of 57 surf lifesavers/lifeguards aged 13-59 years were included in the final analysis. There was a significant positive relationship between exposure to direct trauma and PTSS, which in turn, were associated with greater negative attitudes towards mental health problems towards the mental health of others, and lower levels of self-efficacy. Male and female adults with PTSS reported lower social support, whereas for adolescent males, a positive relationship between direct trauma and PTSS was observed.

CONCLUSION

This research is the first to explore the mental health of Australian surf lifesavers and lifeguards. The results highlight the potential risks to mental health and well-being associated with this first responder role. More research to protect the vulnerability of this population is warranted.

How we can protect the protectors: learning from police officers and staff involved in child sexual abuse and exploitation investigations

Background

Police officers and staff who work in child sexual abuse and exploitation (CSAE) investigations are routinely exposed to traumatic materials and situations. Despite support services, working in this space can have negative impacts on wellbeing. This paper explores the experiences and perceptions held by police officers and staff involved in CSAE investigations in the United Kingdom, regarding work-related wellbeing support and barriers to accessing such support.

Method

A sample of 661 serving police officers and staff working in CSAE investigations participated in a United Kingdom-wide 'Protecting the Protectors' survey. We analysed quantitative and qualitative responses relating to participants' experiences and perceptions regarding three main areas: (1) availability, usage and helpfulness of existing work-based well-being support; (2) barriers to accessing support; and (3) desired support services.

Findings

Five interconnected themes emerged from the qualitative data that represented participants' experiences and views of work-based wellbeing support and the barriers to accessing it. These were 'Lack of trust', 'Stigma', 'Organisational approaches to wellbeing', 'Support services', and 'Internalised barriers'. The findings suggest that whilst respondents were aware of work-based support, they indicated most frequently that they 'never or almost never' used them. Respondents also identified barriers to accessing support, which related to a perception of a critical or judgmental workplace culture and indicating a lack of trust in their organisations.

Conclusion

Stigma regarding mental ill health has a pervasive and harmful impact on emotional health and wellbeing of police officers and staff involved in CSAE investigations, which creates a sense of lack of emotional safety. Therefore, eliminating stigma and creating a workplace culture that explicitly values and prioritises the emotional health and wellbeing of the workforce would improve the wellbeing of officers and staff. Police organisations could further improve CSAE teams' wellbeing by developing a continuum of care which is available to workers from recruitment to the end of the role, training managers and supervisors to better support CSAE teams, improving workplace practices, and ensuring high quality, specialist support services are readily and consistently available across forces.

Competent Witnesses: How Penitentiary Workers Explain the Violence in Italian Prisons during the COVID-19 Pandemic

BACKGROUND

During the COVID-19 pandemic, in the Italian prison of Santa Maria Capua Vetere (SMCV), prison police repressed a riot with extreme violence, bringing the state of prisons and the conditions of prisoners back to the attention of the Italian public opinion.

OBJECTIVE

This exploratory study aimed to collect the experiences and the competent opinions of the social and health personnel of Italian prisons regarding the episode of violence that happened in SMCV; the general state of health of the Italian prison system was explored, too, together with the collection of proposals for interventions aimed at the eradication of violence in prison.

METHOD

The study employed a qualitative research design. Eighteen social-health workers from 12 Italian prisons were interviewed using in-depth interviews of ~60 min each that were conducted and recorded via Skype video calls. The interview transcripts were analyzed with qualitative reflexive thematic analysis (RTA) to identify the most relevant and recursive themes.

RESULTS

Four themes were identified: (1) reactions and thoughts about the events of SMCV; (2) structural problems of Italian prison police; (3) Italian prison system; and (4) reform proposals.

CONCLUSIONS

A new and deeper awareness of the suffering of the current Italian penitentiary system emerged, together with courageous reform proposals that can restore dignity and centrality to the re-education of the detainees, preventing further future violence.

A re-evaluation of Stuart's police officer stigma scale: Measuring mental health stigma in first responders

Stigma about mental illness is often identified as one of the most prominent obstacles to seeking mental health services. This seems to be particularly true among first responders. Unfortunately, the research regarding stigma in first responders is lacking. This may be due, in part, to the absence of appropriate measurement tools to allow such research. Police Officer Stigma Scale (POSS) has recently been developed to address this issue, but its psychometric properties have gone largely untested. Therefore, this study sought to identify the underlying factor structure and internal consistency of the POSS. This paper used a sample of 135 first responders. Using factor analysis with an orthogonal rotation on Stuart's 11-item POSS, the participant's results revealed two main components, accounting for a total of 72.79% of the overall variance. Factor one is "maltreatment of colleagues with a mental disorder," and is associated with six of the 11 items on the scale, such as "Most police officers believe that a colleague who has had a mental illness is not trustworthy." Factor two is "fear of disclosing a mental disorder." It includes items such as "Most police officers would not disclose to a supervisor/manager if they were experiencing a mental illness." Findings from this research are similar to the results of previous studies with components such as unwillingness to disclose a mental health condition, fear of how the public will treat an individual with a mental disorder, and anger toward those who decide to seek treatment or get diagnosed with a mental illness. These findings imply that Stuart's POSS is reliable but needs to include two components rather than one. With the two main components, further research can now be conducted to understand why and ultimately mitigate maltreatment or stigma against first responders with a mental health condition.

Unravelling the Complexities of Workplace Disclosure Among Persons with Non-Visible Disabilities and Illnesses: A Qualitative Meta-Ethnography

BACKGROUND

Deciding whether and how to disclose a disability at work for persons with non-visible disabilities and illnesses involve complex processes. Research has focused on antecedents and outcomes of disclosure. More research is needed to understand the lived experiences related to disclosure decision-making and actual navigation of disclosure and concealment at work.

PURPOSE

To understand the experiences of persons with non-visible disabilities and illnesses regarding workplace disclosure decision-making, navigating disclosure and/or concealment, and experiential differences across disability and illness types, ages, geographic locations, and genders.

METHODS

We conducted a qualitative meta-synthesis using Noblit and Hare's seven steps of meta-ethnography. Searches were conducted via six databases. Studies were analyzed to develop conceptual categories, third-order constructs (themes), and a line-of-argument with comparisons drawn from the disclosure decision making model, disclosure process model, and consideration of disability and illness types, genders, ages, and geographic locations.

RESULTS

Twenty-four studies were included involving 489 participants, aged 16 to 81, from nine countries, focusing on one non-visible disability or illness, or multiple. We developed four themes for the disclosure decision-making process (self- and other-focused, experiential, and environmental/workplace factors) and two themes for the disclosure/concealment event (disclosure/concealment logistics and timing) and noted emerging trends across ages, genders, disability and illness types, and geographic locations.

CONCLUSIONS

Knowledge obtained could be used among professionals who support persons with non-visible disabilities and illnesses to help them navigate disclosure at work, and to consider the role of age, genders, disability and illness types, and geographic locations on disclosure.

Mental health and help seeking among trauma-exposed emergency service staff: a qualitative evidence synthesis

OBJECTIVES

To identify factors and contexts that may contribute to mental health and recovery from psychological difficulties for emergency service workers (ESWs) exposed to occupational trauma, and barriers and facilitators to help-seeking behaviour among trauma-exposed ESWs.

BACKGROUND

ESWs are at greater risk of stressor-related psychopathology than the general population. Exposure to occupational stressors and trauma contribute to the observed rates of post-trauma psychopathology in this occupational group with implications for workforce sustainability. Types of organisational interventions offered to trauma-exposed ESWs are inconsistent across the UK, with uncertainty around how to engage staff.

DESIGN

Four databases (OVID MEDLINE, EMBASE, PsycINFO and SCOPUS) were systematically searched from 1 January 1980 to March 2020, with citation tracking and reference chaining. A modified Critical Appraisal Skills Programme tool and quality appraisal prompts were used to identify fatally flawed studies. Qualitative studies of trauma-exposure in front-line ESWs were included, and data were extracted using a customised extraction table. Included studies were analysed using thematic synthesis.

RESULTS

A qualitative evidence synthesis was conducted with 24 qualitative studies meeting inclusion criteria, as defined by the PerSPEcTiF framework. Fourteen descriptive themes emerged from this review, categorised into two overarching constructs: (1) factors contributing to mental health (such as the need for downtime, peer support and reassurance) and (2) factors influencing help-seeking behaviour (such as stigma, the content/form/mandatory nature of interventions, and mental health literacy issues including emotional awareness and education).

CONCLUSION

ESWs reported disconnect between the organisations' cultural positioning on trauma-related mental health, the reality of undertaking the role and the perceived applicability and usefulness of trauma interventions. Following traumatic exposure, ESWs identify benefitting from recovery time and informal support from trusted colleagues. A culture which encourages help seeking and open dialogue around mental health may reduce stigma and improve recovery from mental ill health associated with trauma exposure.

Policing in a Pandemic: a Commentary on Officer Well-being During COVID-19

The role of police officers during the coronavirus (COVID-19) pandemic is challenging, faced with the difficult task of keeping communities safe and preventing the spread of COVID-19 while putting their physical and mental health at risk. Emerging evidence points to the stress experiences of officers during the COVID-19 pandemic. With cases now surpassing 174 million and close to four million deaths worldwide, as well as stringent lockdown measures, police officers are faced with unprecedented challenges resulting from the pandemic. This commentary suggests police departments strengthen resources by putting in place appropriate emergency planning for future public health incidents, in addition to preparing for temporary or permanent loss of human resources. It is important to implement robust training plans post-pandemic to allow officers to offer better care for communities when faced with future public health emergencies. Finally, police officers should be provided with the resources and support to cope with the stresses associated with COVID-19.

An Evaluation of a Suicide Prevention E-Learning Program for Police Officers (COPS): Improvement in Knowledge and Competence

Background: Police officers are at high risk for mental and physical health problems and suicidal ideation. The specific risk factors are numerous and concern stressful missions and administrative aspects of the police profession. So far, the police get only little training on specific missions as well as on coping with stress and suicidal ideation in the police profession. In this study we test the efficacy of the online training COPS (Coping with Suicide) for police officers. Methods: A total of 142 police officers from Germany and Switzerland participated in the study; complete data (baseline and post) are available from 102 participants. The training consisted of three modules covering the topics of delivering death notifications, dealing with individuals with suicidal ideation and dealing with one's own distress and suicidal ideation in the police profession. The primary outcomes are perceived knowledge and self-rated competence regarding the contents of the program, actual knowledge as well as symptoms of depression and anxiety (PHQ-9), and attitudes toward suicide (ATTS). The data are collected at baseline and after completing the training. Results: We found a significant increase in knowledge as well as in perceived competence after completing the training. Mental health and attitudes toward suicide did not change significantly. Years on the job had no moderating effect on the effectiveness of the training. Discussion: The results suggest that a short e-learning program significantly improves knowledge and self-rated competence in delivering death notifications, in suicide prevention and stress management. It can be easily integrated into the daily routine of police-officers, and participants could participate at their own pace and from any location. One limitation of this study is the lack of a control-group. Further advantages and limitations of this study are discussed. Clinical Trial Registration: https://www.drks.de/drks_web/, identifier: DRKS00023882.

Psychological Impact of COVID-19 Duties During Lockdown on Police Personnel and Their Perception About the Behavior of the People: an Exploratory Study from India

To evaluate the psychosocial issues among the police personnel during the COVID-19 pandemic. In a web-based cross-sectional survey, 623 police personnel were evaluated on Patient Health Questionnaire-4 (PHQ-4) and Perceived stress scale (PSS), and a self-designed questionnaire. 10.6% of the police personnel had significant anxiety and 18% have significant depressive symptoms with overall psychological morbidity of 22.2%. Higher age was significantly associated with higher depressive symptoms, total PHQ-4 score, and higher perceived stress. The present survey suggests that a substantial proportion of the police personnel on COVID-19 duty during the lockdown period have significant anxiety, depressive symptoms, and perceive significant stress. There is an urgent need to evaluate the mental health issues and provide psychological support to the police personnel who are considered as faceless warriors of the COVID-19.

Supplementary Information

The online version contains supplementary material available at 10.1007/s11469-020-00408-8.