Graphic courtesy of John Violanti
Police and Stress
There are approximately 861,000 police officers in the United States (http://www.bls.gov/oco/ocos160.htm). By the nature of their jobs, many police officers face tremendous stress on a daily basis. Research has shown that police officers are at increased risk for cardiovascular events and may face an increased risk for suicide. Yet, police officers are in general an understudied occupational group. The National Institute for Occupational Safety and Health (NIOSH), together with colleagues at the University at Buffalo (UB), is studying the effects of policing and stress on adverse metabolic and early stage (subclinical) cardiovascular outcomes with the ultimate goal of preventing these and other stress-related disorders.
Researchers are using a physiologic measure of stress, salivary cortisol (often called the "stress hormone"), to assess whether stress is associated with adverse metabolic outcomes (e.g., glucose intolerance and metabolic syndrome—a clustering of metabolic abnormalities including elevated waist circumference, triglycerides, blood pressure, fasting glucose, and reduced HDL cholesterol) and subclinical cardiovascular outcomes (e.g., decreased brachial artery response, increased carotid artery wall thickness, decreased heart rate variability) that are detectable before they manifest as disease such as diabetes and myocardial infarction.
To date, over 400 police officers have participated in the Buffalo Cardio-Metabolic Occupational Police Stress (BCOPS) study. The clinical examination includes a series of questionnaires, which measure demographic, lifestyle, and psychological factors (e.g., depression, post-traumatic stress), DEXA measurements to record bone density and body composition, ultrasounds of the brachial and carotid arteries, 18 salivary cortisol samples throughout the day and in response to a series of challenges, and blood samples. Upon completion of the clinical exam, officers are given an actigraph, a small electronic device that resembles a wrist watch, to wear over the next 15 days that measures the quantity and quality of sleep throughout their typical police shift cycle.
In addition to this effort, NIOSH and the National Institute of Justice within the U.S. Department of Justice have extended the BCOPS Study by measuring police officer fatigue and the impact of fatigue on officer health and performance. A unique feature of this study is the utilization of both objective sleep quality measures (obtained by the actigraph) and daily work history records which date back to 1960. These measures will allow researchers to assess the effects of shift work and extended work hours on officer stress and fatigue, and examine the effects of work-related stress and fatigue on cardiovascular and metabolic disease risk.
While there are many unique features of this study, the partnership that exists between the UB Principal Investigator Dr. John Violanti and the Buffalo Police Department Administration and Union has greatly contributed to its success. Recognizing the tremendous value the study findings could have on police officer safety and health, these groups have worked closely together to increase visibility of the studies and encourage the officers to participate. Additionally, as a retired New York state trooper, Dr. Violanti brings unique insight and maintains a sense of credibility among the officers.
Another feature of our research has been the success of two previous cross-sectional pilot studies involving a smaller number of Buffalo police officers. Findings include the following:
- Female officers had higher mean Impact of Events (a measure of post-traumatic stress symptoms) and CES-D (a measure of depressive symptoms) scores than male officers.
- Officers with higher post-traumatic stress disorder (PTSD) symptoms had a nearly two-fold reduction in brachial artery flow-mediated dilation, indicating greater impairment of endothelial function (physiologic dysfunction of the normal biochemical processes carried out by the cells which line the inner surface of blood vessels) than officers with fewer PTSD symptoms.
- Officers with moderate or severe PTSD symptoms had higher mean awakening cortisol values compared with those who had less severe PTSD symptoms.
- Officers with severe PTSD had a three-fold higher prevalence of metabolic syndrome than those reporting the fewest PTSD symptoms. This association was attenuated slightly by covariate adjustment for age and education.
- Additional findings include associations of negative life events with depressive symptoms (Hartley et al.), night shift work with short sleep duration and snoring (Charles et al.), and a series of statistical applications for optimizing the measurement and analysis of study exposures or outcomes (Andrew et al., Fekedulegn et al., Slaven et al.).
Currently, we are continuing to examine police officers as part of our study of the entire Buffalo Police Department. We look forward to sharing our results with you in the future. The complete results of this research may be applicable not only to police officers but to other first responders who also consistently place their safety and health on the line. Additionally, the information gained from this research may increase understanding of how stress in all workplaces might lead to adverse health outcomes.
We are interested in hearing from police officers, police administration, police unions, law enforcement planners, other emergency responders, and investigators focused in this area of research. Your input will be valuable in the design of future studies in this area.
- What are the key stressors involved with police work?
- How should NIOSH share our future results with law enforcement agencies throughout the country (e.g. workshops, print media, Web sites)?
- What types of interventions would be feasible in the future to 1) decrease work-related stress and 2) improve cardiovascular health among police officers?
Thank you for your assistance,
Tara A. Hartley, M.P.A., M.P.H., Cecil M. Burchfiel, Ph.D., M.P.H. and John M. Violanti, Ph.D.
Ms. Hartley is an Epidemiologist in the Biostatistics and Epidemiology Branch, and Dr. Burchfiel is the Project Officer and the Chief of the Biostatistics and Epidemiology Branch. They are located at the NIOSH Health Effects Laboratory Division, Morgantown, WV. Dr. Violanti is the Principal Investigator and is an Associate Research Professor in the Department of Social and Preventive Medicine, School of Public Health and Health Professions at the State University of New York at Buffalo, Buffalo, NY.
See the Comment Policy
Comments
I think this study/research is long overdue. Being married to a Police Officer and coming from a family of them, I feel qualified as a first-hand observer to comment... However, I have not seen nor heard the statistics on suicide among Police Officers in my area, but the stress levels are and have been exceedingly high. My husband, for example, has over 30 years on the "Force" - he has had 3 Heart Caths in the past 5 years; a 30% blockage was discovered... he has been diagnosed with sleep apnea, depression, hypertension, acid reflux in abundance, and does not know how to relax.
He almost died from a major arterial bleed and has now been diagnosed with Macroglobulinanemia. Being in the medical profession, I'm sure you are aware that this disease is a very rare bone marrow cancer that is not cureable, but is treatable. How's that to add to my husband's stress? He also has neuropathy in his feet and hands - more so in his feet. He is now on desk duty. Thank God for that! Because of his chosen profession, my husband deals with everything the best he can. He's quite aware and does attempt to "debrief" before coming home. Even so, quarreling in our home is a given on a daily basis. Although he's never thought of or attempted to become physically abusive to me or anyone else, he does fly off the handle and punch a wall, door, whatever else standing in his path.
He needs an outlet for his stress - as I'm sure, the other Officers do...
I would strongly recommend mandorizing self-help courses that would involve something like meditation or yoga. I've seen and heard about wonderful outcomes from stressful subjects who have and are participating in the like. These men and women are our lifelines in today's society of gangs, murderers, drug addicts, rapist, molestors, theives, etc... They protect us with their lives - no wonder they're so stressed! And to top it off, they are severely underpaid. I can't help but think of why we are paying sports figures, actors, muscians, et al, astronomical figures just to play something they enjoy? I don't see any of them putting their lives on the line for someone they don't know... Nonetheless, it's about time for aiding and assisting our men and women in blue... God Bless you all for your caring, compassion, and professionalism in providing these studies/research for the betterment of our lifelines.
Posted 6/30/08 at 2:29 pm
I am a retired California Highway Patrol officer and am currently being treated by a LMFC for anxiety and PTSD. Most of the medical problems listed above seem to apply to me. I suffer from sleep apnea/snoring, hypertension, excessive weight with weight loss being very difficult, even with exercise and diet. I was borderline diabetic at one point, but am OK now.
I will show this page to my counselor as he may find it interesting and may contact you.
Posted 6/30/08 at 9:36 pm
1. We believe the greatest stressors on a police officer are of the "cumulative" kind. In looking at 48 police suicides in the United States thus far during 2008, we see that the majority have eluded the "suicide prevention radar." Traditional belief (and current prevention programs) holds that those in greatest danger of suicide are those who are involved in catastrophic trauma, such as shootings, multiple-death accidents, loss of a child, etc. We are noting the contrary, based on this year's experience that suicides are generally unexpected and/or no precipitating event is identified ("It was an absolute surprise"). In only one case this year was the officer identified as a suicide risk prior to the event. Of the 48 suicides, 10 were under a variety of investigations from major to minor, several had histories of suicides within relationships, family or otherwise, or no direct precipitating event was given.
2. We are highly supportive of NIOSH sharing this important data in published form, as well as making it available on the internet through any means available. We would like to see the information disseminated throughout the law enforcement community through any other means deemed practicable.
3. We are firmly convinced that one of the greatest interventions is a concept we are trying to promote of "inoculation," through which we begin at the police academy level and, through workshops and lecture, embed a willingness among new officers to voluntarily visit a mental health specialist/therapist a minimum of once per year for a "mental health checkup," much as they do for their teeth or their physical health. By continued encouragement, we believe this preventive strategy will prove instrumental in making the officer "self-aware" and open to healthy emotional coping strategies, as well as healthy lifestyles (cardiovascular). While the permanent, long-term results are expected by beginning at the academy level, this same training can be given to incumbent officers as well.
We commend you on this exciting, far-reaching study.
Badge of Life, Psychological Survival for Police Officers
Posted 6/30/08 at 10:08 pm
According to me topic is related to stress of the police on the public and the public will be scared of the police every time. This will happen when the public will get scared of police and they will occupy the place in the publics hearts like fear.
Posted 7/1/08 at 11:13 pm
I commend your work. I think looking at the cummulative outcome of work stress on an Officer's body is a great idea. This could help Officer's realize just how much stress they are placing their body under and maybe do a better job taking care of themselves over their career. I am a Police Officer and so is my husband. He is on high blood pressure medication. In the last two months we have had two suicides on our department. One of our Lieutenants who took perfect care of his body as far as eating and working out, just had bypass surgery because he had an 80% blockage in his heart.
I think if Officer's realized that eating right and exercise alone is not enough to sustain a healthy lifestye, but realized that they must also care for their psychological well-being we would become much healthier as a culture.
Posted 7/2/08 at 10:26 am
I am completing doctoral studies on police stress. My dissertation focuses on the impact organizational stressors have on police performance. Although there is a wealth of literature on the "nature" of policing as a source of stress, there is an equally impressive body of research on how the organization itself creates stress, consequently lowering performance. You would be surprised to know that many, many police officers find the organization creates more stress than the job itself. In fact, during one study (Amaranto, E., Steinberg, J., Castellano, C. and Mitchell, R. (2003). Police stress interventions. Brief Treatment and Crisis Interventions, Vol.3, No. 1:47-53. Specifically, see page 52 for the list of stressors officers identify) that was examining the nature of the job as a source of stress, participants actually named "job context" not "job content" stressors as the source of the stress. This suggests that while researchers believe that the job itself should be the focus of continued study (And rightfully sothe job is demanding), the officers believe it is the organization that creates most of their stress. This implies the need to improve the organization through various reforms: Management styles, design and policy, among the many.
I am a retired police captain from Newark, NJ. I retired in 2005 after 20 years to pursue my doctoral degree. I would be happy to share my research and findings with the CDC/NIOSH when they are complete...in just a few months. I would also be willing to share my methodology and discuss some of the literature with NIOSH now.
Posted 7/2/08 at 11:15 am
What are the key stressors involved in police work?
Answer: Management
Posted 7/8/08 at 7:20 am
Here is some information about Police Stresses
So after you take a Look at this website Please come back and apologias for what you comment!
Posted 7/9/08 at 1:59 pm
As an Occupational Nurse at a prison,I would be very interested if the findings of the study can be generalized to correctional officers. Certainly they have many of the same stressors and as a result negative health outcomes.
Posted 7/11/08 at 11:19 am
In 1977, I as an officer in the Minneapolis Police Department assisted Dr. Peter Maynard and Nancy Maynard of the University of Rhode Island. Not being able to make inroads into any police department because of its closed society at the time, I was approached by Ms. Maynard after class at the U. of Minnesota. I was subsequently able to convince the administration at that time that a study was needed, pointing out to the chief the issues and problems that officers in the department were having. There were several articles published from this study, on not only police officer stress but also the stress the job placed on police families. Here is one of the sites http://www.jstor.org/pss/584464
The biggest stressors were the administration. The study brought about big changes in the department once the study was published. Rotating shifts were a big issue and the cause of much of the police stress within the family and the officer, working conditions, and the body not being able to adapt. Before one of the articles in 1979 were published, I was shot in a domestic dispute between two sisters. I was working the 11pm to 7 am shift, and just returned from day shift. My family suffered extreme stress over the incident, and subsequent disability. I became an expert on police stress.
Unfortunately, for me I suffered severe femoral nerve and back injury, which subsequently led to divorce. I went through 18 operations, I became the department's community educator, community relations, and public relations officer, and retired after I had 20 years, I have been retired 17 years this month. I went on to get my masters degree, and become a teacher. I have entered law school and want to practice international law.
Changes brought about because of the study, no more rotating shifts, an officer from the department was trained and became the substance abuse officer, Officer and family assistance officer. This office was away from any of the departments offices, and referrals were given to health professionals. The program ran on confidentially. The program was also accessible to officers families. Officers were no longer able to drink and carry weapons, nor did they have to carry one off duty, which was requirement before. The health issues from police job stress remain with most officers until they draw they draw their last breath. Much of the officers stress is brought about by not being able to effectively communicate with others, namely their significant other, more likely than not trying to shield them from some of the gruesome events encountered.
Posted 8/4/08 at 2:53 am
Through NIOSH science blog we can get the information about the BPD police of new york committing suicide due to the mental tensions on their daily work.
Posted 8/20/08 at 9:53 am
We in Nigeria are keenly interested in the outcome of your research. Kindly keep us posted on your findings. Best of regards.
Posted 8/23/08 at 11:58 am
I have been a police officer in South Australia for over 14 years now. Since the later part of 2007 & early 2008 I was suffering bad depression, anxiety and poor quality sleep (nightmares/terrors) Luckily for me, my local doctor was ex-military and quickly picked up on my symptons suggesting I may be suffering from PTSS. I have been seeing an excellent psychologist for the past six months now (not attached to the police force) who has provided me with fantastic help. The hardest thing was to acknowledge their was a problem and to ask for help. I could see myself heading down the path of many fellow officers and losing my family if I didn't get help when I did. When writing a list of all the terrible things I have seen and clearly remember, it was the numerous fatal car crashes that I have seen that seem to be a major contributing factor of my PTSS.
I have been searching the net for any related web sites and I'm glad I have found this one. I am not taking any medication to assist with my treatment and have found merely having an hour to myself (after work) to exercise/walk away from anyone else & taking herbal supplements (st. johns wort & valerian) have helped to calm me down & get a good nights sleep.
I am very keen to see the results of your study as more should be done. I never thought anything like this would happen to me and out of the blue it did. To all members out there not feeling quite right, please go and see your local doctor and have a chat. It was the best thing I have ever done. I have been able to continue working on patrols throughout this difficult period, by getting the right help.
Posted 9/7/08 at 8:37 am
Great information! Normalizing emotional response and feelings is so important. I'd like to see more articles like this.
Posted 9/18/08 at 2:18 am
I have been a police officer for 36 years; been involved in numerous investigations into murders; fatal traffic accidents, suicides, domestic violence, violent crime etc; I commend your excellent study; A doctor friend recommended I view it today; I see a number of problems which prevent police officers, especially male officers from seeking help for stress related issues; (1) The MACHO image (2) lack of support from management especially senior management, (3) lack of structured support services and trained personnel. Don't hesitate to contact me if I can further assist. Keep up good work.
Posted 9/30/08 at 5:35 pm
I am currently working on my Doctorate of Nursing Practice in the area of Forensics, and I've discovered that Law Enforcement Officers are the forgotten "victims" of post traumatic stress. I've been married to one for the past three years and have learned more about how the management system often has a negative impression about officers seeking any kind of assistance for anixety or depression. I agree with the possibility of incorporating stress reduction methods in the academy to help combat this problem along with yearly emotional checkups. I believe this would greatly decrease the amount of alcoholism and other harmful behaviour patterns often seen in this population.
Posted 10/16/08 at 5:37 pm
I am very glad to read of the study being conducted. To go a long with that study, how about looking into how the stress hormones play a role in cancers as well?
I don't believe upper police management nor their political masters really want this or any similar studies results published. The main reason is they would have to accept some level of responsibility or "liability". If as others have said and is well documented, that "Internal Stressors" are the main source of stress related health issues to include officer suicide, then they would have to acknowledge that and assume their rightfully responsibility. That would cost them money in medical disabilities, and they don't want that. It is kind of like the pink elephant in the room. We all know it is there, but we are afraid to talk about it.
To tie this up, something that I have put some thought into recently, that would "take the liability" away from management, and "remove" the stigma from the officer for needing a break from ALL POLICE RELATED WORK to include OFF DUTY POLICE JOBS, would be at all five year marks, every officer is required to take a paid two to three month sabbatical, that doesn't count against their leave balances. (This would be for the ranks of sergeant and below.) They are not allowed to work any "police" related outside employment. This in theory should provide them the time away from the stressors to cleanse their body of the toxins. I would suggest that prior to their leave time, they receive the tests similar to this study or others, and then the same tests a week or two prior to their return. I believe the results would be astounding!
Some would argue the cost is too high! I argue the cost is already too high!! For my agency, it costs in the area of $70,000 to $90,000.00 to recruit and train one officer to the point they are off of probation. An extremely rough return on investment would be, we need 8 to 10 years of work out of them for ROI. That doesn't count any additional specialized training we invest in them, during that period. What is the cost for a career of substandard police "service" to the public? What is the cost to society when those who swore an oath to uphold the law, become corrupt and tarnish the community, agency, profession and their families? What is the cost in human life when officers feel they have no where else to turn and they kill themselves at a rate some have said between 2 and 3 or as high as 7 to 8 times that are killed in the line of duty? I know others will argue the stats don't show that. How about the officers whose deaths are classified as "accidental", because if it were suicide, their family wouldn't receive any insurance money? I believe the cost for the "time out" is cheap!!! Those who serve and their families are better served and equally important the public is better served.
Posted 10/21/08 at 11:25 am
I am an Ohio Police Officer and was given the article to read. This is great! I have created a Suicide Awareness program called Dying In Blue which is presented as an advanced training course at the Ohio Peace Officers Training Academy. The idea was to begin to address early in the officers career that the day to day stressors we live with can reak havock in an officers life and their families. This includes suicide. Throughout Ohio, as I spend time with CIT units, officers and other interested parties, we found that in most all cases agency adminstrators fail to recognize or are not willing to discuss potential suicidal officers, let alone officers who are continually burned out by way of the common stressors (finance, relationships and chemical abuse).
We must educate every public safety officer that the risk of suicide is high and it WILL happen if we do not seek professional counseling. We must educate command staff that overworked officers, micromanaged officers, and highly disciplined officers are headed for trouble if intervention is not done.
Let's continue to break the ice and speak openly of stress, burn out and suicide.
Posted 10/29/08 at 7:59 pm