Associations between police lethal force errors, measures of diurnal and reactive cortisol, and mental health

The International Performance, Resilience and Efficiency Program Protocol for the Application of HRV Biofeedback in Applied Law Enforcement Settings

Law enforcement officers are routinely exposed to high-threat encounters that elicit physiological stress responses that impact health, performance, and safety. Therefore, self-regulation using evidence-based approaches is a priority in police research and practice. This paper describes a five-module heart rate variability biofeedback (HRVB) protocol that is part of a larger resilience program (the International Performance Resilience and Efficiency Program - iPREP) established in 2014. Supported by 10 years of user-informed research and development, our methods are tailored to address occupational stressors and the practical realities of training and resource availability in operational settings. Building on existing clinical methods that comprise five to six weekly sessions and up to 40-min of daily practice, our iPREP HRVB protocol is typically delivered in a condensed format across 2-3 days and is seamlessly integrated with reality-based training scenarios commonly employed in policing. By combining best practices in clinical HRVB with police-specific pedagogical frameworks, officers receive accelerated and job-relevant training to adaptively modulate autonomic responses to acute and chronic stress. Efficacy of the iPREP HRVB protocol is supported by several research studies of various methodological designs (i.e., randomized control trial, longitudinal cohort) that demonstrate immediate and sustained improvements in police performance and physiological health outcomes. We conclude with a critical appraisal of the available empirical evidence contrasting common and emerging breathing techniques proposed for use in operational policing contexts. The critical appraisal guide is intended to serve as a resource for law enforcement agencies, governing bodies, and operators when choosing appropriate and effective self-regulation training approaches.

Physiological Responses to Organizational Stressors Among Police Managers

Police officers demonstrate increased risk of physical and mental health conditions due to repeated and prolonged exposure to stressful occupational conditions. Occupational stress is broken into two types: operational stress, related to the content of field duties (e.g., physical demands); and organizational stress, related to cultural and structural contexts (e.g., interpersonal relationships). Applied police research focuses on physiological activation in operational tasks as a mechanism explaining health risk and non-optimal performance outcomes. However, recent survey-based studies indicate numerous organizational stressors associated with self-reported mental health symptoms. The question of whether organizational stressors elicit significant physiological activity remains unknown. The current proof-of-concept field study tests the hypothesis that police managers will display significant physiological reactivity before, during, and after engaging in reality-based scenarios representative of stressful police management tasks developed from evidence-based pedagogical approaches. A sample of 25 training police managers (7 female, M = 16 +/- 5.3 years of experience) completed 5 reality-based scenarios, including resolving a heated conflict between colleagues, delivering negative feedback to a subordinate, and critical incident command. Significant increases in heart rate relative to rest were observed during all tasks, and in anticipation of several tasks. Greater increases in reactive heart rate were associated with longer recovery times. Sex differences and relationships between objective biological and subjective psychological measures of stress are discussed. The current findings demonstrate significant physiological responses to organizational stressors similar to levels observed during operational tasks, despite the absence of physical or aerobic exertion. Implications for police health and training are discussed.

Caring for a "Blue" Population: Addressing Priorities of the Officer Safety and Wellness Group in Nurse Practitioner Practice

Increased public concern over policing and the psychological impact of trauma-associated events by first responders have highlighted a critical need to improve the availability of mental health and wellness resources for law enforcement officers. The national Officer Safety and Wellness Group prioritized mental health, alcohol use, fatigue, and body weight/poor nutrition as targets for safety and wellness initiatives. Departmental culture will need to change from silence and fear-driven hesitancy to a culture of openness and support. Increased education, openness, and support for mental health will likely reduce stigma and improve access to care. Psychiatric-mental health nurse practitioners and other advanced practice nurses who wish to work with law enforcement officers should be aware of the specific health risks and standards of care that are summarized in this article. [Journal of Psychosocial Nursing and Mental Health Services, 61(10), 13-18.].