THE BADGE OF LIFE

The “MENTAL HEALTH CHECK”

"Suicide Prevention" is an important part of our mental health efforts in law enforcement, but it's only one half of the forumla. It can never be enough that we only sit and wait until our officers are in crisis or are suicidal before we act. We must have programs that begin in our academies and that devote the time, every year, to preparing our officers for the emotional hazards of the job before they they reach the "trouble point!"

This is where the Emotional Self-Care (EST) training is vital in our police agencies. It is the "second part of the formula" needed to finally begin reducing suicides. In addition, however, it is also the key to creating a healthier, more balanced workforce that is better equipped to deal with the stresses of the job and the traumas before they happen. When they do occur, no longer will they be a mystery and no longer will we encounter the resistance and delay in getting treatment. Having already been exposed to therapy and resiliency development, officers will have already (directly or indirectly) worked on their resiliency and, most important of all, will have the resources/therapists to turn to and the help available.


	Read the poignant story behind this photograph at ForgottenPhoto

This must be a two-pronged approach to mental health in law enforcement that will not only reduce suicides but, long before, will enhance the emotional well-being of your personnel and drastically reduce many of the "hidden" problems arising because of the stresses and traumas of this difficult job.

The ANNUAL, VOLUNTARY MENTAL HEALTH CHECK takes the focus away from “just suicide" and begins targeting “mental health for all police officers.” It is preventive self care at its best for one of the world's highest stress occupations.

A therapy visit gives an opportunity to explore and discuss all the things that are ignored at the doughnut shop. This is the opportunity to

1. Examine the past year. Discuss events that may have been painful or even traumatic (but missed).

2. Look for vulnerabilities.

3. Consider learning opportunities from the year's experiences.

4. Talk about fears and insecurities.

5. Open the door to family issues and further therapy.

Much of the purpose behind the "annual mental health check" is to get an officer face-to-face with a live counselor and remove the stigma. For some or, later, many officers, this will lead to additional visits that establish a good trust relationship. For others, it may merely make it easier for them to pick up the "800-pound telephone" before the going becomes critical. Regardless, with the infusion of new officers attuned to the value of therapy and repeated encouragement of veterans (and leadership involvement), in time this will become a healthy part of the officer's regular care routine.

First, at academies, we believe we HAVE AN OBLIGATION to encourage our recruits to voluntarily and confidentially see a therapist or other mental health professional at least once a year with the same diligence they have their teeth cleaned, exercise, check the fire alarms in their homes or get a flu shot.

We realize, for example, we would be negligent if we failed to continually train officers in the use of their firearms.
We would be equally negligent if we did not maintain officer proficiency on the use of tasers.
We know we must train and update officers in a wide variety of subjects: EMT, hazardous materials, techniques of arrest, self defense.
Finally, we encourage officers to exercise a couple of hundred hours per year to maintain their physical health.

And what do we spend the LEAST time of all on? The mental health of our police personnel.

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RESILIENCE

Every cadet, every police officer has a certain amount of resiliency, or they wouldn't have made it as far as they have. Resilience is, simply put, the "ability to bounce back." Resilience is an individual thing and not a classroom exercise. There are no simple "formula's" that can be put on a chalkboard or powerpoint. Its development is reliant on the officer's personal history and strengths. The development of this characteristic, however, is the key to preparing officers for the challenges ahead--the stressors and the trauma.

The key to this kingdom is held by the therapist, who can work with the officer as incidents are experienced, reviewed and lessons learned. Instead of merely saying, "I made it," the past year's experiences are an opportunity to build and grow--and enhance one's resiliency. There is no better way of ensuring a solid defense against PTSD, or providing an officer the means of recognizing instantly when he is facing its potential. We have identified the following elements as crucial to the development of one's resilience:

Commitment to finding meaningful purpose in life
A belief in one’s ability to affect the outcome
A belief one can learn and grow as a result
Acceptance (particularly the acceptance of what one does not like)
Self-reliance
Spirituality (which need not be religious)

Focusing on resiliency and the ability to both learn and nurture gives a crucial element of hope in a world that officers find threatening and, often secretly, confusing. It also provides them an excellent opportunity to develop this wonderful skill in therapy.

As a tool for the law enforcement officer, it is as valuable as one’s ability to pump iron and one's prowess on the range.

WHO WILL GO (TO THE THERAPIST)?

That's up to you.

BRASS INVOLVEMENT: Are you (the chief and your staff) willing to be among the first, and go to several visits, and share your visits, uncomfortable as they may be, with your troops? If you're not willing to do this thing for your people, you will fail and mental unhealth and suicides will continue under the same old, tired programs.

OFFICERS: Don't try to predict who is receiving the message and who may take advantage of the annual therapy visits. From our experience, the one who looks most resistant may go. The one who looks the most responsive may also go. Or not. It may take time for it to settle. If they do go, one visit will undoubtedly turn into a couple of more. Some will do the "token visit" and give up (for now).

Officers should be encouraged (not coerced) to go even if they don't think anything is "wrong." That's the key to proactive mental health for an occupation that is under constant emotional fire.

Once again, the key is management. It's important that you focus yourself on the financial gains from this program, which is common sense and free!

If they don't go, year after year, what have you gained? First, you have impressed in them, over and over, that there is a place they can go to improve themselves, deal with issues great or small, and seek help. They know how to do it. They know what resilience is. They have access to the tools. They also have ears--in time, with the support of management and management participation, they will hear other officers speak of their experiences in therapy. By the very nature of the process, they will learn through talk of programs like AA and other 12 step/recovery programs.

It may take time. Remember, we are changing an old culture. Remember, we are also, at a rate of 50,000 per year, infusing law enforcement with new officers far more receptive to the importance of mental health and couseling to their success. We are convinced that, through these positive programs we can, in ten years, make significant inroads not only in police suicides, but in the health and well being of our entire police force.

Again, it's up to you, the managers.

These are the things that happen when a POSITIVE environment is encouraged and nurtured within a department. It is the direct opposite of gory power points and depressing stories of dead officers. Instead of focusing on what can be lost, the Badge of Life program focuses the officer on what can be gained by making his mental health as important as his physical health and his prowess on the range, his spouse as important as his sergeant.

CADETS

From our surveys of cadet classes, we find a generation that is open to the idea of annual therapy They have already been exposed to therapy--through school, a divorce, family problems, or the experience of a friend. Their minds are open.

We insist on, and the program will fail, without complete, absolute anonymity. Officers are encouraged to use their Employee Assistance Program but are also encouraged to seek an outside therapist if they feel more secure doing so.

Officers need to go even if they don't think anything is "wrong." That's the key to proactive mental health for an occupation that is under constant emotional fire.

Beginning at academies, we suggest that officers be encouraged to visit a therapist or other mental health professional at least once a year with the same diligence they have their teeth cleaned, exercise, check the fire alarms in their homes or get a flu shot.

VETERAN OFFICERS

We find that officers are more concerned about mental health and suicide than they are given credit for. Again, we say, for every police suicide, there are a thousand more officers out there still working, in pain from the pain and trauma of their experiences.

Unfortunately, many of them simply don't trust the administrators or youthful instructors who come to them with the apologies of "We're not here to sing Kumbay-yah" and the slides of the amygdala and hippocampus. Many come cynical and leave cynical, and for good reason. Sadly, the questions they really want answered aren't available. It's all about suicide and what to do "when you need help."

It takes careful selection to find the "right" person to talk to veteran officers. We have had instructors tell us they are uncomfortable talking to either cadets or veterans about their own experiences for fear of seeming "weak," so they limit themselves to critical incidents, such as shootings, traumatic incidents, child deaths, etc. Rare is the instructor who can talk at the gutter level a street cop wants to hear--the "dirty little secrets," the guilts, the rages, the betrayals, the bitterness at the brass.

In our classes to veteran officers, this is where we go--to the gutter. No one said police work was a garden party. We offer them what we have and make it clear it's a world of choices. We don't pamper them, nor do we expect to be pampered--we offer the honesty of our experience and invite it in return. Silence gives us more time to talk. We emphasize only one point--that we are offering choices between health and un-health, and the choice is theirs to make.

In looking at the faces, we know some take it. Some will not.

Some are tragically trapped in an ignorant culture that continues to dismiss suicides as "cowardly acts," angry acts, selfish acts, and "permanent solutions to a temporary problem" -- statements that reflect years of a defensive, frightened police culture.

Finally, for the retiree, there is no better preparation for the coming trauma of separation than having had an opportunity to explore the positives and negatives, plan, prepare for a new life's role, recognize expected changes in the "family," and free himself of the burdens of a career of anxiety and trauma.

CRITICAL VS CUMULATIVE PTSD

Critical Incidents are like Mack trucks--the big, catastrophic events that can cause posttraumatic stress disorder (PTSD) among police officers and can lead to suicide.

Departments with programs spot them right away: the shootouts, the loss of a partner, the death of a child. All systems are “Go.” Debriefings are held. Referrals to professionals are made when appropriate. Prompt action can greatly minimize, if not eliminate, the impacts of PTSD.

Cumulative PTSD,* however, is like one bumblebee sting after another. These are the incidents that aren’t “headliners,” that are missed by everyone, even the officer. They mulitply over the years. These bumblebee stings are the “dirty little secrets” of law enforcement: the shames, the mistakes, the repeated "routine" horrors, the betrayals, abuses and the dark fears only the officer knows and shares with no one, not even peer officers. We call them the "soul woundings" of law enforcement. After years, it may take only a minor incident (or none) to trigger a breakdown or suicide.

Make no mistake—cumulative PTSD is deadly. And for every police suicide, there are a thousand more officers still working and suffering from cumulative trauma. Departments suffer from them as well--through increased sick leave, citizens’ complaints, lawsuits and personnel actions.

Some of these are happening on departments with good suicide prevention programs. If everyone knows the standard list of "warning signs" to look for, why are they slipping under the radar? Why were they really missed? Was the officer that good at maintaining a facade? (now, think a moment--we train them to maintain facades!).

Are some merely putting on selective blinders to protect themselves and sending the widows away without support? We fear this is the case far too often.

INCENTIVES: One concern expressed has been the lack of incentive for officers to follow through on the idea of annual mental health checks. Like diets and physical exercise, some suggest, many will simply ignore the benefits no matter how well they are sold.

One proposal made by Marlin Weinberger (Star6 2009) was what are referred to as "Juice Cards." The proposal is that departments print and make available in break rooms and report rooms a stack of cards that an officer can quietly pick up and retain until he/she visits a therapist. At each visit (again, only if the officer wishes to) the officer can have the card signed and dated by the therapist. The card, when turned in to the officer's supervisor, would entitle the officer to, say, four hours off per visit, to be taken by the same criteria as CTO time. A limit could be placed on the number of redeemable cards per year--perhaps a limit of three or four. The expectation would be that, if the officer has gone this many times, a comfort level may well have been established with the therapist and further visits will be self-initiated.

Certainly, an officer can choose to maintain total confidentiality by never utilizing the cards.

While this may seem an expensive incentive, it is hardly costly when compared to the costs of sick leave, complaints, lawsuits, alcoholism, reckless behaviors and suicides.

It's merely one idea, one we appreciate.

"I see this program as a possible useful tool in the prevention of fully developed PTSD and possible maladaptive coping among police officers. In a sense, it is “inoculation” against future psychological problems. Given the stress and strain associated with police work, such an endeavor is well worth the time invested by departments."

John M. Violanti, PhD

Committing to the ritual of a yearly psych check “forces you to focus on what’s going on in your life, to take stock of yourself and how you’re doing. Without that obligation, when do we take time to evaluate our mental health and our relationships?”

Bill Lewinski, PhD

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