Eight Myths About Law Enforcement Officers and Mental Health Treatment

​​Most clinicians who work with law enforcement officers will tell you that the experience can be a little different. Sometimes, it seems to incorporate elements of a spy thriller. First, the call from the unknown number. Then, the interrogation from the unidentified caller, asking about your experience with cops, your ability to keep secrets and if you are in any way affiliated with the department. James Bond must be on the other end of the phone.

Let’s start by exploring the impacts that a career in law enforcement can have on officers. Law enforcement officers are a special population (like military and paramilitary personnel and other first responders) who experience coexisting medical and behavioral health issues with links to job-related stressors. According to a landmark study published by researcher John Violanti with the University at Buffalo in 2012, various factors contribute to the very serious physical and mental health concerns experienced by many law enforcement officers. These factors include:

  • Shift work
  • Long hours
  • Unpredictable schedules
  • Exposure to critical incidents
  • Being the frequent focus of public attention and criticism
  • Various physical demands
  • High rates of on-the-job injuries


The major concerns identified in Violanti’s study are high blood pressure, insomnia, heart disease, diabetes, posttraumatic stress disorder, obesity, depression, anxiety, cancer, substance abuse, relational distress and suicide. This special population often presents with higher rates of depression, substance abuse and suicide than does the general public.

In the October 2010 Issue of the FBI Law Enforcement Bulletin, Daniel Mattos, a law enforcement veteran for more than 30 years, described the psychological impact of police work: “By the very nature of what we do as police officers, we are unavoidably exposed to a host of toxic elements that can be likened to grains of emotional sand that ever so gradually are placed on our psychological backs. As time goes on, the sand increases in volume. Without the proper tools to remove it, the weight can become unbearable. In fact, in some cases, the sand becomes so heavy that it can collapse officers. The result of the sand’s weight takes a heavy toll on us; substance abuse, anxiety, depression, failed marriages, and other emotional and physical ailments that rise well above societal averages plague our profession.”

In an international meta-analytic study completed in 2012, researchers Claudia Morales-Manrique and Juan Valderrama-Zurian identified strong links between the high-demand/low-control nature of police work and the high stress levels that negatively impact the physical and mental health of police officers. In high-demand/low-control careers, individuals are required to be at constant peak performance levels, stemming from the unpredictability and wide range of scenarios that can be presented to them.

Research suggests that officer rates of completed suicides are three times higher than in the general population. In January 2014, Perry Mason, a retired Canadian constable (police officer), publicly described in an interview with The Hamilton Spectator his suicidal thoughts and a very near suicide attempt during his career. During 34 years of service, Mason also recounted that seven of his fellow officers had died from suicide. Mason admitted that he sought help, but also kept it highly secret because of his fears of possible repercussions to his career. He never disclosed his suicidal thoughts until after he retired.

Dilemmas and challenges complicating treatment

The high rates of physical and mental health conditions among law enforcement officers reflect the need for medical and behavioral support and treatment. However, treatment resistance is often a significant barrier.

In 2002, the American Psychological Association recognized the need to take a closer look at law enforcement as a special population and to define guidelines for forensic psychology. Ensuring public safety requires that officers are mentally, emotionally and physically stable and deemed “fit for duty” to perform effectively.

Law enforcement personnel often struggle to manage the challenges associated with competing demands. Very intense and difficult circumstances must be addressed while simultaneously mitigating the impact those demands have on personal health and well-being. Seeking and adhering to needed medical and behavioral treatments can present specific dilemmas and challenges.

Law enforcement officers are legally and ethically mandated to maintain good physical and mental health. However, the stressors these individuals face, ranging from inconsistent shift work to frequent and unpredictable threats to life, result in both physical and emotional challenges for the majority of officers during an average career. Law enforcement employers are legally obligated to verify and monitor officers to ensure physical, mental and emotional stability, as well as job performance capability. As a result, any signs of behavior that are in question, either on or off duty, are subject to scrutiny by the officer’s department or chain of command.

Every single law enforcement officer undergoes fit-for-duty evaluations that entail a combination of psychological testing and interviewing. In the book Practical Police Psychology: Stress Management and Crisis Intervention for Law Enforcement (2006), Laurence Miller writes that failure of the evaluation may result in job loss or suspension. An unintended consequence is that the majority of officers are hesitant to seek help with mental, emotional, relational or even physical issues because it could result in their inability to work.

According to retired police officer and psychologist Joel Fay in the April 2012 issue of the POA Journal, officers presenting with medical or mental health concerns often struggle taking medications as prescribed to address symptoms. Officers are restricted from having certain types of medications in their systems. For the safety of the public and the officers, police departments have policies against the use of certain classifications of medications such as strong painkillers and benzodiazepines. An officer-involved accident or shooting is often subject to a review of the incident that includes blood tests to determine the possible presence of chemicals or medications that may have played a role in the incident. Officers recognize that doctors may be unaware of these restrictions. Unable to fully understand the classifications of medications, officers may consequently resist taking prescribed medications.

So, what can we do as clinicians to help reduce the stigma and minimize the fear that going to counseling has for many law enforcement officers? The first step is to help officers understand their rights to privacy. I asked the legal experts at Bruno, Colin & Lowe P.C., with more than 60 years’ combined experience in protecting the rights of law enforcement officers in Colorado, and Mariya Dvoskina, a police and public safety psychologist with Nicoletti-Flater Associates, experts in the evaluation and critical incident response for law enforcement officers, to give me “just the facts.”

Collectively, we identified eight myths that keep many law enforcement officers from seeking support through counseling. Because each state may have some independent legislation in this regard, it is important for clinicians to verify the legal standards in the individual states in which they practice.

The myths

Myth #1

Departments/agencies have the right to obtain information about officers that seek help from licensed mental health professionals.

False! Licensed mental health professionals are legally and ethically bound to protect client privacy. If an officer reaches out to a therapist on his or her own — in other words, if the officer wasn’t ordered to see a therapist by a court or the officer’s department — then the employer doesn’t even have the right to know that the officer is attending therapy. Nothing that is said in counseling can be released to anyone without the officer’s written consent. The U.S. Supreme court has ruled that the confidential relationship between a psychotherapist and an officer is privileged. To learn more, see http://www.apa.org/about/offices/ogc/amicus/jaffee.aspx

The only times confidentiality can be broken are for the reasons below, which apply to every client/patient.

  • A suspected incident of child abuse or neglect must be reported.
  • A threat of imminent physical harm by a patient must be reported to law enforcement and to the person(s) threatened.
  • A mental health evaluation must be initiated for a patient who is imminently dangerous to self or to others, or who is gravely disabled, as a result of a mental disorder.
  • A suspected threat to national security must be reported to federal officials.
  • Suspected abuse of a senior adult (70 years of age or older), including institutional neglect, physical injury, financial exploitation or unreasonable restraint, must be reported.


 Myth #2

Rights to privacy change if you use your insurance or employee assistance program (EAP).

False! Treatment by a licensed mental health professional that is paid for by your insurance company or your EAP is protected by HIPAA (the Health Insurance Portability and Accountability Act), and the same rules apply.

Sometimes patients choose not to use insurance benefits so that their outpatient treatment remains separate from their medical record.

 

Myth #3

There is no reason to see a licensed professional because the rules are exactly the same with a peer support team.

False! Limits to confidentiality vary by department and the standards may be different than those that licensed professionals have. The peer support member must disclose these limitations in the first meeting. In addition to the exceptions to confidentiality listed in Myth #1, most peer support teams are also expected to report crimes and sometimes policy violations. Outside of those limitations, conversations between a peer support member and an officer are confidential.

Myth #4

The department or agency automatically has a right to know if an officer receives a mental health diagnosis or takes medication.

False! HIPAA protects both diagnosis and medication or other treatment methods because they are part of the clinical record and therefore confidential. If an officer would like the department to know this information, he or she must sign a release of information. Otherwise, the professional treatment provider cannot disclose anything related to the client/patient to the department or anyone else.

 
Myth #5

If an officer seeks help from a hospital or a rehabilitation facility voluntarily, the department automatically has the right to this information.

False! The department can only access information that an officer has granted it permission to have, as is the case with any other medical condition.

Myth #6

If an officer is placed on an M-1 hold, he or she automatically loses their right to carry and possess a firearm.

False! When there is a court-approved certification for an involuntary mental health hold, restrictions to weapons are limited while the certification is active. If the provider that requested the certification acknowledges that the client/patient is no longer a danger to themselves or anyone else, then the restriction can and should be released as well.

Myth #7

If an officer seeks the support of a licensed mental health professional, that automatically means that the officer is not fit for duty.

False! Seeking counseling voluntarily would NEVER automatically mean that an officer is unfit for duty.

Myth #8

Counseling is the same as a fit-for-duty evaluation.

False! The most important question to ask is “Who is the client?” If the officer is seeking support on his or her own, all of the rights stated above belong to the officer. If the department is the client, as is the case in a pre-employment evaluation or a fitness-for-duty evaluation, then the information most often belongs to the department.

By Jessika Redman | Counseling Today

About the Author

Jessika Redman is a licensed professional counselor, a national certified counselor and the founder of Well Relate LLC (http://www.wellrelate.com) in Castle Rock, Colorado. Contact her at jessika@wellrelate.com.

CopLine: A Law Enforcement Officer’s Lifeline

The perception that ‘​all of America hates cops​’​ ​is taking an emotional toll on law enforcement officers and their families. Photo by Gabe Pierce.

 

“CopLine, what’s going on?” Those are the first words a caller hears when those 10 numbers are dialed, (800) 267-5463 — 10 numbers that will connect you directly to a vetted, trained, retired officer who is there to listen to what a caller wants to address.

CopLine receives between 200 and 300 calls a month, and the numbers continue to increase. When I am asked about the call volume, it is always followed by a sigh or “That’s really unfortunate.” Maybe it’s me, but I have never looked at it that way. I don’t look at checking in with a friend or family member as “unfortunate,” only as a sign that someone cares and isn’t alone. The unfortunate part is those who do not call — those who were struggling with some external issue or internal strife and thought, “I don’t want to burden anyone; there are people who need to call more than I do.” Let me set the record straight: Hell, no, there is no one more important than you are.

That’s the crux of the problem as I see it, all too often. As a therapist, I rarely worry about an officer who is in my practice; I worry about those who aren’t, those who I didn’t reach. That’s why I have chosen to do some Facebook Live talks to help stop the stigma of talking to a mental health professional and to try to reach so many more than I can in my private practice. It isn’t a job or a career, it is a calling and a way of life. I can’t help but hear in my head the words from the opening of A Tale of Two Cities: “It was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolishness, it was the epoch of belief, it was the epoch of incredulity, it was the season of Light, it was the season of Darkness…” That is policing in 2020. No one can go it alone on a social level or personal level, not Lucie Manette, Charles Darnay or even Sydney Carton himself.

I have been asked countless times if CopLine saw an uptick in calls like other hotlines did when COVID-19 became a world “feardemic.” Please don’t misinterpret that as me downplaying the pandemic that has killed more than 800,000 people; I am referring to the fear in the world the pandemic has caused that has immobilized most people. CopLine had not experienced a significant uptick during this time, and callers addressed many stressors, with COVID-19 being only one of them. I pondered why that could be, and it wasn’t until our last training that it occurred to me.

There was a “spirited” conversation about doing our CopLine training remotely. Everything had gone the way of Zoom, and now the pressure was on. The reality is in the training and stringent vetting process of the retirees who answer the lines themselves, the many men and women who have finished their careers and still want to give back to their own and the “uniform” families that support them. Of our nine completed trainings, only three trainings successfully vetted all of the trainees who had taken the class. They all have the heart to answer the phone, but the skill set is far more challenging to acquire. Our success is in knowing that each volunteer has the proper skills to answer the calls and meet each caller where they are, without judgment or the need to problem-solve. This can only be done through grueling role-plays, hours of teaching and daily evaluations by the training cadre. In my true snarky fashion, I have told people there are two things you can’t do on Zoom: You can’t conceive a child and you can’t do CopLine training.

We have seen an uptick not only in calls, but in the emotional toll the societal shift is taking on law enforcement officers and their families.

Each retiree has spent a lifetime fighting invisible enemies and rising to national and international crises. We have seen this throughout history, but what no officer was prepared for was to become “the enemy.” COVID-19 was not the issue; it was the social shift of what at times feels like “all of America hates cops” that has weighed heavily on officers and their families. We have seen an uptick not only in calls, but in the emotional toll the societal shift is taking on law enforcement officers and their families. There are times when I use the word “heartbreaking” to describe what is relayed to me from listeners (who always have clinical support for themselves while they are on the lines). What has been so rewarding is that so many of the listeners have been through riots throughout our recent history (from the 1960s forward), and they really can “sit in the hole” side by side with the caller and understand what they are talking about on a very real and intimate level.

That is the foundation of CopLine, a very simple concept that was not made any more difficult through politics or BS. It’s a great idea, yes, but there is no way to execute it without the help of many. I have always had the easy lift and still do, as the listeners have always chosen the heavy lift and still do. We have ensured that confidentiality is maintained by not taking any government money through grants or loans. That has allowed us to eliminate the fear of cellphones being pinged or calls being traced and anyone coming to the caller’s house to “check up on them” if they talk about thoughts of suicide. Officers and their families need a safe place to talk about these thoughts and feelings, as well as all their other thoughts and feelings, without the fear of losing everything. We are not a suicide or crisis line. We do deal with those calls, but we are here to deal with all stressors in an officer’s life or their families. We believe that if an officer calls when they have “low-hanging fruit,” they will call when they have “high-hanging fruit,” and we have seen just that. More than 90% of our calls are not crisis or suicidal calls — they are about “normal” stressors from a stressful job, and our callers will find a partner on the other end of the line who has the skills and background to help.

It is simple: We are a confidential hotline for officers and their families to call to deal with any and all issues they are having on or off the job, without fear of any repercussions for being human. They will talk to only a vetted, trained retired officer, and from the second they dial (800) COP-LINE, they are never alone.

​​Without the unwavering support of organizations like the Los Angeles Sheriffs’ Relief Association, which generously took out an ad in APB and helped sponsor our 10th CopLine training, we wouldn’t be able to touch as many lives as we have. It truly takes a village, and we couldn’t be more honored to have leaders like the Sheriffs’ Relief Association to help build ours.

​By Stephanie Samuels | American Police Beat 
​Stephanie Samuels, M.A., MSW, LCSW, is a psychotherapist who works exclusively with police officers in New Jersey, New York, Pennsylvania and Oklahoma. She has lectured all over the country on PTSD and vicarious trauma, including undiagnosed PTSD and the fallout from departmental silence after officers are involved in critical incidents. She is the founder and president of CopLine, the first confidential international law enforcement hotline answered by retired officers.

Inmates, DOC settle Hepatitis C Treatment Suit

Missouri inmates have reached a settlement with the Missouri Department of Corrections and the department’s medical provider that will ensure that those incarcerated in state prisons will receive treatment for Hepatitis C.

Attorneys from The MacArthur Justice Center, the ACLU of Missouri and the Wilkinson Walsh law firm of Washington, D.C. announced the settlement on Aug. 21.

According to a news release from the ACLU, Hepatitis C, also known as HCV, is widespread in Missouri prisons. If untreated, it can lead to life-threatening conditions including cirrhosis and liver cancer. Drugs that can treat HCV are expensive, however, and routinely denied to incarcerated individuals in Missouri, according to the attorneys for the inmates.

As part of the settlement, the Missouri Department of Corrections and Corizon Health have agreed to spend approximately $50 million to treat incarcerated people in Missouri with chronic HCV and to monitor individuals at high risk for serious health conditions as a result of HCV infection.

In a statement, Amy Breihan, co-director of the MacArthur Justice Center’s Missouri office, said the settlement will “save countless lives.”

“It means Missouri will go from treating less than one percent of its infected prison population, to eventually treating every incarcerated person with chronic Hepatitis C,” she said. “The impact on the health of our incarcerated clients and the public overall will be immense.”

The case is Postawko et al. v. Missouri Department of Corrections, 2:16-cv-4219.

 
By: Jessica Shumaker | Missouri Lawyers Media molawyersmedia.com
 

How to Reduce Stress During Times of Crisis

​Who is taking care of the cops when they are enduring hatred, betrayal and intense scrutiny? (AP Photo/Gerald Herbert)​

 

With law enforcement blamed for society’s ills and the future of policing uncertain, officers face new traumas and total exhaustion.

An NYPD veteran said that the emotional toll on cops today is worse than after 9/11. Officers are taxed to the max, under constant media attack and experiencing hatred like never before.

After working 12-hour shifts with no days off, cops go home to teach school lessons to their kids, but only after they have decontaminated themselves and their equipment to protect loved ones from an enemy they cannot see. Spouses have been laid off and officers worry about making the mortgage. Cops have seen death from the pandemic firsthand and have lost colleagues, friends and family members to the virus.

Don’t forget the two-officer families who wrestle with long shifts, household chores and daycare issues. Don’t forget the line of duty deaths that cannot be memorialized properly.

On top of dealing with a pandemic and economic shutdown, add in the protests where bottles filled with concrete are thrown at cops, they are called pigs and murderers and are shoved and spit on. Businesses that supported officers have banned them from entering and denied the use of bathroom facilities. Officers’ wives, parents and children experience attacks of hatred from friends and strangers.

As all cops are unmercifully blamed for the actions and inactions of a few, officers struggle to explain to their young kids why people hate the police.

All cops are serving a sentence for a crime they didn’t commit.

COPS WORRY THAT BY DOING THEIR JOB THEY CAN LOSE THEIR JOB

Officers don’t worry about dying in the line of duty. If that happens, their families will be taken care of financially. Officers worry that despite performing their assigned duties by the book, they can still be sued, indicted, or fired. They fear not being able to put food on the table or a roof over their kids’ heads. Not to mention the humiliation and financial ruin of imprisonment. In this political climate, showing up for work can get you in trouble.

Officers worry about having to use force and being thrown under the bus by their agency and elected officials or fired before an investigation has commenced.

And then there is the talk of abolishing qualified immunity.

WHY DO WE NEED TO TAKE CARE OF THE COPS?

Policing during a pandemic is traumatic enough. With law enforcement blamed for society’s ills and the future of policing uncertain, officers face new traumas and total exhaustion. Throw out the term post-traumatic stress disorder because what cops are currently enduring is way beyond any stress known to mankind or a medical disorder.

Trauma takes a toll on the human physically and emotionally. The brain and memory encode traumatic events differently than normal events. Traumatic events get trapped within the body – the vagus nerve and individual organs. Physical symptoms of surviving trauma can mimic the pandemic virus: fatigue, stomach upset, muscle aches, shaking and chills, shortness of breath, headaches and congestion can be contributed to both. Officers may experience additional health issues like high blood pressure, ulcers, heart attacks and suicide ideations.

Unresolved trauma and stuffing or denying emotions can manifest as anger. Officers cannot afford, during this siege on law enforcement, to succumb to rage roaring out at the wrong moment while on duty.

WHO IS TAKING CARE OF THE COPS?

Who is taking care of the cops when they are enduring hatred, betrayal and intense scrutiny? When they are criticized and denounced for doing their jobs?

Under these dire circumstances, overcoming the stigmas officers face in asking for help and providing emotional support resources to officers will be a monumental task. But departments have a long history of failing to offer adequate emotional support to officers. Officers need more than wellness programs that do little to address their concerns. They want to know that their department’s administration will stand up for them if they use justified, reasonable and necessary force.

Officers are instructed to refrain from answering noncriminal calls and not to escalate situations (as if officers are the cause of such escalations). Officers face having their jobs reformed by people who have never policed and who have no idea what the job entails. That doesn’t constitute emotional support.

Agencies and the public need to wake up to the fact that unless emotional support is offered to officers, who continue to work under these stressful conditions, there will be mass retirements and resignations and recruitment will be impossible.

COPS HAVE TO TAKE CARE OF COPS

Reach out to a peer support team and talk about how you feel. Peer team members are trained to listen, validate and acknowledge your feelings, allowing you to fall apart and be honest with your feelings without fear of the impact on your career. Peer support team members, in most states, are covered by the same confidentiality protections as a doctor, lawyer, or clergy.

Talk to a peer team member and express your feelings in an environment of trust and support. Neutralize your emotions so they won’t come back to haunt you on duty or video. Don’t take what you are experiencing on the job home and take it out on those who love and support you.

If your agency does not have a peer team, seek out a team in your area or another city. A peer team will not turn you away.

TAKE CARE OF YOURSELF AND THE OFFICER NEXT TO YOU

You have to take care of yourself and your colleagues.

Eat properly. Rest when you can. Drink water to avoid dehydration during the summer heat. Don’t self-medicate with booze or junk food. Breathe deeply often to calm your mind and your emotions and reset your nervous system.

Talk to your spouse and family. Keep the lines of communication open and honest.

Care about those you work with. Be alert for signs they are burnt out or struggling. Provide support and assistance. Help other officers maintain composure and keep calm out on the streets.

Don’t take the hatred towards law enforcement personally. Officers are being used as political pawns in a vile election year.

MAJORITY OF AMERICANS SUPPORT AND RESPECT POLICE OFFICERS

A sergeant met two of his officers for dinner at an open restaurant. An older African American couple came to their table after putting on their masks. The man placed his hands on the shoulders of the two officers and said, “I paid for your meals.”

The sergeant said, “Appreciate your act of kindness, but you don’t need to do that.”

The gentleman said, “Yes, officers, I do.” He patted their shoulders, then he and his wife left.

What helps the most, officers say, is when citizens come up and express their support and encouragement.

As psychologist Erich Fromm said, “Love is the only sane, satisfactory answer to the problems of human existence.”

Time to support our officers who perform their jobs professionally and ethically every day under conditions never before seen or experienced in law enforcement.

​​By Barbara A. Schwartz | Police 1
 
About the author

Barbara A. Schwartz is certified as a first responder peer supporter by the International Critical Incident Stress Foundation (ICISF) and the Law Enforcement Alliance for Peer Support (LEAPS). She maintains specializations in grief, injured officer support, suicide prevention, and traumatic stress injuries.

As a Police Explorer scout and reserve officer, Schwartz served in patrol and investigations. Her articles and book reviews have appeared in American Police Beat, The Thin Blue Line, Command, The Tactical Edge, Crisis Negotiator Journal, Badge & Gun, The Harris County Star, The Blues, The Shield, The Police News, PoliceOne.com and Calibre Press Newsline.

She maintains memberships in the National Tactical Officers Association (NTOA) and the International Law Enforcement Educators and Trainers Association (ILEETA).

Schwartz has dedicated her life to supporting the brave officers of law enforcement.