The prevalence and associated factors of depression in policing: a cross sectional study in Sri Lanka

The mediating effect of health behaviors on the association between job strain and mental health outcome: a national survey of police officers

Police officers often face emotionally challenging interpersonal situations and numerous studies have demonstrated that policing is a stressful occupation. A study revealed a significant positive correlation between emotional demands among police officers and emotional dissonance, as well as burnout. Health-promoting behaviors can contribute to better overall health outcomes and reduce the risk of developing health problems, but there is limited research evaluating the association of job strain and health behaviors with mental health outcomes in police officers. The objective of this study was to assess the job strain associated with mental health mediated by health behaviors in Taiwanese police officers. This was a cross-sectional quantitative study conducted in Oct 2016. A total of 41,871 police officers (response rate was 79.7%) participated questionnaire that consisted of demographic information, job characteristics, health behaviors, and mental component summary (MCS) scores of the Short-Form Health Survey. Independent t-tests and one-way analysis of variance (One-way ANOVA) were conducted to assess the differences in mean MCS scores across various demographics, health behavior, and job characteristics. Multivariate regression analyses were used to assess the relationship between job strain and health behaviors with mental health outcomes. MCS scores were associated with job characteristics and health behaviors among police officers except for gender. After adjusting for covariates, multivariate analysis indicated that police officers with high job demands and high job strain index exhibited poor MCS scores. Job strain was significantly associated with MCS mediated by health behaviors (consumption of fruits and vegetables, and physical activity) in Taiwanese police officers. Since regular physical activity and increased vegetable and fruit consumption might alleviate the effects of job strain on mental health status, it is recommended that institutional policies be established to promote health-enhancing behaviors among police officers.

Mental health and wellbeing of border security personnel: scoping review

BACKGROUND

Whilst the wellbeing of law enforcement personnel has been widely researched, border security personnel as a discrete group appear to be far less discussed, despite their roles frequently exposing them to potentially traumatic and challenging events such as contact with criminals or witnessing personal tragedies due to trafficking or smuggling.

AIMS

This scoping review aimed to explore existing literature to better understand the mental health of border security personnel and the factors affecting their wellbeing.

METHODS

Four electronic databases and grey literature were systematically searched for studies relevant to the review's aims. Following the extraction of relevant data from each study, thematic analysis was used to synthesize findings.

RESULTS

Thirteen studies included relevant data and were included in the review, identifying stressors including poor management; fatigue; negative public attitudes; inadequate staffing levels, resources, and training; poor opportunities for promotion; low pay; work overload; dangerous working environments; and work-related moral dilemmas.

CONCLUSIONS

The review found that there has been little academic attention paid to border security personnel as a specific branch of law enforcement. Many of the stressors identified in this review are those also reported by law enforcement generally, although negative attitudes from the public and exposure to moral dilemmas appear to be more relevant for border security staff. Directly addressing work-related stress (e.g. by fostering a supportive organizational culture, addressing mental health stigma, and encouraging help-seeking) may be useful in enhancing the resilience of border security personnel.

Physiological Predictors of Mental Disorders Among Police Officers in Indonesia

Police officers may be at a higher risk of suffering from mental disorders (MDs) compared with other occupations. This study aimed to examine the physiological predictors of MDs among police officers in Indonesia. The mental health status of each participant was examined using a standardized Minnesota Multiphasic Personality Inventory (MMPI) tool and underwent several laboratory examinations including hematology, urine, serology, and electrocardiogram tests. A logistic regression was performed to calculate the odds ratio. Of the 4590 participants, 2.14% were diagnosed with MDs. The study found 19 physiological variables are potential predictors of MDs. In multivariate analysis adjusted for body mass index, sex, and age, the concentration of ketones, protein, and specific gravity in urine and the amount of lymphocyte in the blood are among important predictors of MDs. This suggests that carefully examining the results of urinalysis and hematology tests can help us detect early cases of MDs among police officers.

Depression, suicidality and associated risk factors among police officers in urban Tanzania: a cross-sectional study

BACKGROUND

The WHO has classified depression as a disease of public concern. Police officers are a particular subpopulation group that is at an increased risk for mental health problems. This study examined the prevalence of depression, suicidality and associated risk factors among police officers in urban Tanzania.

AIMS

The aim of this study was to examine the prevalence of depression, suicidality and associated risk factors among police officers in Tanzania.

METHODS

A cross-sectional study was conducted between April 2019 and October 2020 among 550 participants in Dar es Salaam recruited using a multistage cluster sampling technique. The Patient Health Questionnaire-9 was used to screen for depression and suicidality. The Interpersonal Support Evaluation List-12 tool was used to measure perceived social support. Descriptive statistics were summarised using frequencies and percentages. Bivariate and multivariate analyses were used to establish associations between predictors of interest, depression and suicidality.

RESULTS

There were 497 participants in the study. Of these, 76.6% (376 of 491) were men, and the median (IQR) age was 37.0 (17) years. Around 19.8% (96 of 486) of the police officers screened positive for depression and 15.4% (75 of 413) for suicidality. A significant proportion was either moderately (29 of 96, 30.2%) or severely depressed (8 of 75, 10.7 %). Of those who experienced suicidal thoughts, 10.7% (8 of 75) reported having daily suicidal thoughts. Perceiving low social support was associated with an increased risk of reporting depression (adjusted OR (aOR): 28.04, 95% CI: 8.42 to 93.37, p<0.001) and suicidality (aOR: 10.85, 95% CI: 3.56 to 33.08, p<0.001) as compared with those with high perceived social support.

CONCLUSION

The magnitude of depression and suicidality among police officers in urban Tanzania is alarmingly high. The study findings indicate the need for routine screening for depression and suicidality among police officers and design appropriate mental health responsive services in this population.

Correlates of mental health in occupations at risk for traumatization: a cross-sectional study

BACKGROUND

Hospitals, police stations, and fire departments are highly demanding workplaces. Staff members are regularly exposed to various stressors including traumatic events. Correspondingly, several studies report high rates of mental health issues among these occupations. Nevertheless, despite these challenging circumstances, some staff members manage to sustain their mental health. The current study is the first to investigate three health-promoting factors simultaneously among three different, highly demanding occupations.

METHODS

The present cross-sectional survey investigated health-promoting factors (sense of coherence - SOC, trait-resilience, locus of control - LOC) and mental health outcomes (general psychopathological symptom burden, posttraumatic stress, burnout) in medical staff (n = 223), police officers (n = 257), and firefighters (n = 100).

RESULTS

Among all occupations, SOC, trait-resilience, and an internal LOC were negatively associated with general psychopathological symptoms, posttraumatic stress, and burnout symptoms. By contrast, all these outcome measures were positively correlated with an external LOC. Multiple regression models including all health-promoting factors explained 56% of the variance in general psychopathological symptoms and 27% in posttraumatic stress symptoms. Among all occupations, SOC was the strongest predictor of both general psychopathological symptom burden and posttraumatic stress symptoms. Multigroup path analyses revealed minor differences across occupations, mainly driven by a stronger influence of LOC in police officers.

CONCLUSION

Across all occupations, SOC was identified as the most important health-promoting factor. Future longitudinal studies should further examine the causal link between health-promoting factors and mental distress in different workplaces. Such studies will also allow for further development and evaluation of resilience promoting programs.

Global prevalence and risk factors for mental health problems in police personnel: a systematic review and meta-analysis

Police face an increased risk of developing mental health problems, yet reliable estimates of their psychological difficulties remain unknown. This systematic review and meta-analysis estimate the pooled prevalence and risk factors for mental health problems among police personnel worldwide. Three independent reviewers searched 16 databases and screened 11 506 articles published between January 1980 and October 2019. Eligible studies involved at least 100 active police professionals and used validated instruments to ascertain specific mental health problems. Estimates were pooled using random-effects meta-analyses. In total, 60 cross-sectional and seven longitudinal studies, involving 272 463 police personnel from 24 countries met criteria for inclusion. The overall pooled point prevalence was 14.6% for depression (95% CI 10.9% to 18.6%), 14.2% for post-traumatic stress disorder (PTSD; 95% CI 10.3% to 18.7%), 9.6% for a generalised anxiety disorder (95% CI 6.7% to 12.9%), 8.5% for suicidal ideation (95% CI 6.1% to 11.2%), 5.0% for alcohol dependence (95% CI 3.5% to 6.7%) and 25.7% for hazardous drinking (95% CI 19.6% to 32.4%). The strongest risk factor for depression and suicidal ideation was higher occupational stress, and the strongest risk factors for PTSD were higher occupational stress and avoidant coping strategies. Higher levels of peer-support were associated with significantly lower PTSD symptoms. Our findings suggest that the prevalence of mental health problems among police exceeds twice that previously reported in mixed samples of first responders, and is associated with poor social support, occupational stress and maladaptive coping strategies. Without effective intervention, psychological difficulties will remain a substantial health concern among police.

Salivary cortisol concentrations in police officers - a cross-sectional study in Beijing, China

Objective: We investigated the relationship between salivary cortisol level and the prevalence of depression 585 police officers working at the Police Departments of Beijing.

Method: Cross-sectional data were obtained from 585 Chinese police officers recruited from Beijing, China. Salivary cortisol was assayed using the chemiluminescence immunoassay. A multiple logistic regression analysis adjusted for potential confounders was used to assess independent associations between salivary cortisol level and depression.

Results: The median age of the included was 38 years (IQR, 29–45), 20.9% were female (n = 122). Finally, 15.6% (91/585; 95% CI: 12.6–18.5%) were considered to have depression. The median salivary cortisol level was significantly higher in police with depression than those police without depression [14.5(IQR, 11.9–15.9) nmol/l vs. 11.8(IQR, 9.4–14.2) nmol/l; P < 0.001]. The depression distribution across the salivary cortisol quartiles ranged between 5.4% (first quartile) and 26.9% (fourth quartile), P for trend <0.001. In multivariate models comparing the second (Q2), third and fourth quartiles against the first quartile of the salivary cortisol, cortisol in Q3 and Q4 were associated with depression, and increased prevalence of depression by 148% (OR: 2.48; 95% CI: 1.55–3.86) and 277% (3.77; 2.12–5.36). Based on ROC curves, the optimal cutoff value of salivary cortisol level to diagnose the depression was 13.8 nmol/l, which yielded the highest sensitivity and specificity [63.8% and 71.7%, respectively; area under the curve (AUC) = 0.695, 95% CI: 0.639–0.751; P < 0.0001].

Conclusions: The data showed that elevated levels of salivary cortisol were associated with increased prevalence of depression.

Burnout subtypes and associated factors among police officers in Sri Lanka: A cross-sectional study

Even though policing is associated with very high levels of occupational stress and burnout, no studies have been conducted to explore burnout subtypes among police officers globally. Hence, this cross-sectional study was conducted among 750 police officers working in a police division in Sri Lanka to determine the distribution and associations of burnout subtypes using the Burnout Clinical Subtype Questionnaire. The police officers had high scores for frenetic and worn-out subtypes in comparison to the underchallenged subtype. Multivariable analysis elicited a multitude of statistically significant associations with burnout subtypes (p < 0.05). Staff adequacy and fewer working hours were negatively associated with frenetic subtype. Younger police officers had a positive association, while, being married, satisfactory infrastructure facilities, frequent superior guidance, satisfactory higher official support, satisfactory allowances and the opportunity to serve public showed negative associations with underchallenged subtype. Being married, staff adequacy, frequent superior guidance, higher official support, satisfactory allowances, satisfactory social status and overall job satisfaction elicited significant negative associations with worn-out subtype. The findings are suggestive of high burnout subtype profile among the police officers in the study population and the associated factors of the three burnout subtypes are congruent with the characteristics of the burnout subtype profile.