COPS Office Provides Wellness Provider Vetting Guide

The guide is available online only and can be accessed here.


Product ID: COPS-W0963
Publication Date: 08/09/2021
Author(s): Fraternal Order of Police Division of Wellness Services

Staying Healthy in the Fray: The Impact of Crowd Management on Officers in the Context of Civil Unrest

The last few years have presented unprecedented challenges, both to our communities and to public safety officers and first responders—especially law enforcement. Current events, including COVID 19, political rhetoric and chaos, societal conflict and division, and attacks on the policing institution, individual officers, and officers’ families, have created a challenging environment where stress and trauma increased exponentially.

High stress police operations such as crowd management during periods of civil unrest is mentally and physically demanding. Crowd management often challenges officers to push their bodies beyond normal limits, leading to poor performance, fatigue, insomnia, and injury.

In the summer of 2020, many officers repeatedly worked shifts that, at times, exceeded 12 hours, for 10 to 12 days straight, leaving little time for appropriate nutrition, rest, exercise, recovery, or sleep. Large numbers of arrests, long periods on bicycles, standing or moving in formations, or responding to threats are physically and mentally demanding.

In light of the current environment, the National Police Foundation (NPF) has developed STAYING HEALTHY IN THE FRAY, a brief guide for law enforcement agencies on ways to recognize and protect the physical and mental wellbeing of officers during responses to intense and protracted protests and demonstrations.

Both physical and mental stressors are taking a toll on the women and men who have dedicated their lives to protecting our communities. This guidebook offers educational information and practical considerations for sworn officers of all ranks, particularly frontline officers and mid-level supervisors, as well as their families, to better protect officers’ mental and physical wellbeing during times of heightened stress.

Furthermore, this guidebook can be used as a resource by police leaders in promoting healthy organizational cultures that recognize  and  prioritize officer  safety  and wellness  as an  integral  part of  policing  protests—which ultimately can help foster better outcomes for all involved.

The content in this guidebook has been curated and derived from a review of research from professional medical organizations and has been peer reviewed by licensed mental health clinicians and law enforcement practitioners.

Author:
National Police Foundation

Training day: Documentary Provides Perspective on Police Mental Health Response

Law enforcement agencies can stream “Ernie and Joe: Crisis Cops” for free through May 2022 to better prepare cops to respond to people in crisis.

By Joel Shults for Police1.com

Ernie and Joe: Crisis Cops” is a 95-minute HBO documentary about two members of the San Antonio Police Department’s Mental Health Unit (MHU). The film explores the experiences of these two Texas police officers who use de-escalation techniques to resolve mental health calls. The film aims to spark dialogue about the culture of policing and better prepare cops to respond to people in crisis, according to the documentary’s filmmakers

Police agencies may register for unlimited free streaming access to the documentary. A 25-minute version is also available. Register here using code EJCC-POLICE1. Suggested questions for your shift, squad or department to discuss after viewing the documentary are listed at the end of this article.

Viewers will see actual encounters between Ernie Stevens and Joe Smarro with persons in distress. All the narrative of the video is done by the partners. Ernie is the most senior officer and a charter member of the unit. Joe is the younger. Although the unit has grown in numbers, it is clear from the in-car computer that the list of mental health-related requests rolls along in the list of pending calls. Their numbers are too high for the specialized unit to respond to all of them, validating the growing narrative of mental health issues growing beyond law enforcement’s capacity to handle them. The special unit is only able to handle far fewer than even 10% of the crisis calls that come in.

As the list of pending calls shows the label of mental health on the roster, the narration explains that “mental health” was not even a call category with dispatch until the formation of the MHU. Categories of disturbance, suicidal subject, family disputes, or other labels covered the event.

THE IMPORTANCE OF THE RIGHT APPROACH

Ernie and Joe are shown conducting training with both law enforcement and other professionals who encounter persons in mental health crisis. Using guest speakers who deal with mental health issues, the crisis cops help others understand the role of the MHU, as well as provide insight on working with persons in crisis toward a peaceful conclusion of a contact. MHU officers also do follow-up contacts to help ensure that their subjects’ referrals and available services are being accessed. Not all long-term hopes for those they intercede with are met, but the success stories are motivational.

Ernie and Joe acknowledge that there is skepticism among police officers for their philosophy of interacting with disturbed persons. They work in plain clothes in an unmarked car, although they are clear about identifying themselves as police officers. Officers watching the film will shudder as they see traditional officer safety tactics set aside. Although in one scenario where a weapon was reported to be possibly involved, they call for uniform back up, don their ballistic vests and expose their sidearms, their approach and demeanor to those they are hoping to help is intentionally not an attitude of aggression.

THE IMPORTANCE OF PERSONAL PURPOSE

The documentary provides some insight into the lives of Joe, an Iraq combat veteran with a PTSD diagnosis, and Ernie, the father of a teenager.

Both officers work overtime in uniformed assignments in addition to their full-time assignment to MHU. Joe is portrayed as going through a divorce, using painting to deal with the stresses of life and the job. Ernie seems more content as he enjoys his work, working to continue his education with an eye toward retirement and a new career as a teacher.

The importance of these personal insights is that it shows that developing skills for dealing with persons in distress does not require perfection in one’s own life.

THE IMPORTANCE OF POLICE TRAINING

The team notes that officers traditionally had 60 hours of firearms training in the academy with just an eight-hour block on crisis intervention. By the time of the filming of the documentary that training has been increased to 40 hours, much of which is taught by MHU members. They hope that the insights into mental health crises can be applied to reducing police suicides and increasing peer support within the agency.

THE IMPORTANCE OF TIME

They emphasize that time is an essential component of peaceful outcomes – “as long as it takes” – even while calls are stacked up. After all, other officers stay out of service for as long as it takes to work a crash or book a suspect. Knowing when to allow a subject some control and responsibility for their decisions rather than using persuasion rather than coercion, allowing appropriate and meaningful presence and physical contact, being honest about one’s own fear and concerns, and allowing the officer most comfortable with the situation to take the lead are all demonstrated in the movie.

THE IMPORTANCE OF DISCUSSION

Whether the short or long version is part of a training day, the documentary is a worthy springboard for discussion, reframing, critique and a new perspective on dealing with mental health crisis calls. As the national conversation on mental health and law enforcement’s role in responding to crises continues, no police agency can escape taking some action to report to their constituents how they are dealing with these issues. This viewing may be a great first step.

After watching “Ernie and Joe: Crisis Cops,” use the following questions to start a discussion about the documentary and police mental health response:

  • How do responders address officer safety tactics in the context of establishing trust in close contact with a subject?
  • It is not unusual for persons encountering the police to have extreme emotional responses. What are some signs of a person having a mental health crisis along with the stress of a police encounter?
  • How does the pressure of calls pending affect devoting time to effective intervention in a mental health crisis?
  • How can you use your personal experiences to help you relate to persons in crisis?
  • What might be your long-term process in dealing with a failed suicide intervention?
  • Many special assignments are on a rotational basis to balance experience with getting a break from the unique stresses of undercover work, working child abuse cases, or working in a mental health unit? What are the pros and cons of rotating assignments?
  • What strategies did you see the officers in the film using to keep their personal lives and mental health in balance?
  • What efforts can agencies engage in to help officers maintain resilience and recovery from trauma?
  • How confident are you that most of your colleagues are highly competent in dealing with mental health crises?
  • The environment of police-citizen encounters is very important. In what ways can an officer control the environment?
  • How important is being in plain clothes for mental health response units? What is the role of uniformed backup for these officers?

Click here to register your agency to stream “Ernie and Joe: Crisis Cops” for free unlimited streaming through May 2022 using code EJCC-POLICE1.

Also watch Joe Smarro’s TEDxSan Antonio’s talk “I See You” on officer mental wellness:

MENTAL HEALTH OUTREACH RESOURCES FROM POLICE1

DEA Finalizes Measures to Expand Medication-Assisted Treatment

Improved access will benefit rural and underserved areas with limited treatment options

The Drug Enforcement Administration today announced an important step to improve access to medications for opioid use disorder, especially in rural areas where those suffering with opioid use disorder may have limited treatment options.

Under the final rule published today, DEA registrants who are authorized to dispense methadone for opioid use disorder would be authorized to add a “mobile component” to their existing registration – eliminating the separate registration requirement for these mobile narcotic treatment programs (NTPs). This will streamline the registration process and make it easier for registrants to provide needed services in remote or underserved areas. The rule also outlines the reports and records that shall be maintained for NTPs that wish to expand the reach of their treatment programs by use of mobile components.

“In the United States, we have been facing an opioid epidemic for more than a decade,” said DEA Assistant Administrator for Diversion Control Tim McDermott. “We are losing tens of thousands of Americans per year to opioid-involved overdoses. The Administration, DOJ, DEA, HHS, among many others, are squarely focused on efforts to improve the use of medication-assisted treatment in order to reduce overdose deaths and help those with opioid-addictions recover. Today’s action sends a very important message that we support the use of medication-assisted treatment for opioid use disorder and are using all the tools at our disposal to make treatment options available to anyone in need of them, anywhere in the country.”

“Today’s action by the DEA will improve access to life-saving medication for opioid use disorder, especially for those in underserved communities who face barriers to treatment,” said Acting Director of National Drug Control Policy Regina LaBelle. “This new rule is a significant step forward that supports the Biden-Harris Administration’s drug policy priorities, including expanding access to evidence-based treatment and advancing racial equity in our approach to drug policy.”

According to the Centers for Disease Control, provisional data indicate that there were more than 67,500 reported overdose deaths attributed to opioids during the 12-month period ending in November 2020. This accounts for approximately three quarters of all drug overdose deaths in the United States.

The demand for evidence-based medication-assisted treatment for substance use disorders, including opioid use disorder, has increased over the years, especially for services provided by NTPs. In certain areas of the country – particularly rural, urban, and Tribal communities – this has resulted in long waiting lists and high services fees. In addition, the distance to the nearest NTP or the lack of consistent access to transportation in rural and underserved communities may prevent or substantially impede access to these critical services.

Methadone is one of three FDA-approved medications for opioid use disorder.  There are more than 1,900 narcotic treatment program locations across the country, including opioid treatment programs, withdrawal management services that utilize methadone, and compounders.

This final rule builds on existing experience and provides additional flexibility for NTPs in operating mobile components, subject to the regulatory restrictions put into place to prevent the diversion of controlled substances.

For more information, the final rule is available here.

COPS Releases Publication Suite Focused on Law Enforcement Officer Wellness

Law enforcement officers regularly experience stress and secondary trauma during their shifts and rely on their families and friends as a positive social support network to maintain holistic wellness. 

The purpose of this executive guide, titled “Family Matters: Executive Guide for Developing Family-Friendly Policies, Procedures, and Culture,” is to create a roadmap for law enforcement agencies to develop stronger family-friendly policies, procedures, and organizational cultures to work in collaboration with officer support networks. The publication and companion tools for families and agencies guide professional dialogue around holistic wellness innovations, best practices to support employees, and opportunities within agencies to strengthen relationships with law enforcement families.
 
The executive guide also includes information on employee benefits, family planning, trauma and loss, disciplinary considerations, and retirement planning.
 
Download the free 46-page guide by visiting https://cops.usdoj.gov/RIC/Publications/cops-w0948-pub.pdf
 
The COPS Office publishes materials for law enforcement and community stakeholders to use in collaboratively addressing crime and disorder challenges. These free publications provide you with best practice approaches and give you access to collective knowledge from the field. Below you can find our recent and featured publications, and you can also search the Resource Center or our Community Policing Topics pages for specific issues or call the COPS Office Response Center at 800-421-6770.

Law Officers: New Federal Gun Rule Ban Good for State

From the News Tribune

Two Mid-Missouri sheriffs agree a state bill banning police from enforcing federal gun rules is necessary to protect the constitutional rights of citizens.

Gov. Mike Parson this past weekend signed the Second Amendment Preservation Act, which would penalize local police departments if their officers enforce federal gun laws.

Under the bill, Missouri agencies that knowingly enforce any federal gun laws could be sued and fined $50,000 per violating officer.

“I was concerned with the first version of the bill because there were a lot of issues with it, and some of them were huge,” Cole County Sheriff John Wheeler told the News Tribune. “With any new bill, there are some unforeseen consequences that we could not support. It is still not a perfect bill, but in the end, the sheriffs were able to work with legislators and fix the language in a manner that we could support it.”

Wheeler and Callaway County Sheriff Clay Chism, along with Audrain County Sheriff Matt Oller, worked with members of the state Senate on a final version of the act that made it through the Legislature and on to the governor.

Most state and federal gun laws are the same, and federal law enforcement may enforce gun rules that are only in federal law.

“I think some people don’t realize U.S. marshals can still come in and take away weapons,” Wheeler said. “What this law says is we won’t help them. They can still come in and say they are going to do this, but my agency won’t do it.”

Republican lawmakers who worked to pass the bill have said they’re motivated by the possibility of new federal gun restrictions under Democratic President Joe Biden and the Democratic-led U.S. House.

But Democrats warned the measure unconstitutionally seeks to supersede federal laws and predicted it would be shot down by the courts.

House Minority Leader Crystal Quade in a statement described the law as “radical, dangerous and obviously unconstitutional.”

“The new law even allows criminals who violate federal gun law to sue our local law enforcement officers for a minimum $50,000 fine if they in any way assist with federal investigations,” Quade said. “It quite literally defunds the police and gives that taxpayer money to convicted criminals.”

“Contrary to some political and dishonest rhetoric that was disseminated, most Missouri sheriffs, including myself, wholeheartedly support the Second Amendment,” Callaway County Sheriff Clay Chism said. “It was paramount, though, to ensure SAPA was passed to protect law-abiding citizens and not give refuge to criminals who need prosecuted for their bad acts.”

The Republican-led Legislature passed a similar bill in 2013 declaring any federal policies that “infringe on the people’s right to keep and bear arms” shall be invalid in Missouri. It would have allowed state misdemeanor charges to be brought against federal authorities who attempted to enforce those laws or anyone who published the identity of a gun owner.

That bill was vetoed by then-Gov. Jay Nixon, a Democrat. The Legislature fell just shy of overriding Nixon’s veto.

News Tribune reporter Jeff Haldiman and the Associated Press contributed to this article.

Thriving in Law Enforcement

By Dr. John Azar-Dickens for Force Science News

Enter the police profession and risk higher divorce rates, alcoholism, suicide, PTSD, and early death. At least that’s what they told us at the academy.

I’m not convinced this is actually the case, but it is easy to believe when we watch fellow officers gain weight, lose health, drink more, sleep less, increase cynicism, and decrease job interest. We are taught that officers will be challenged just to survive the emotional toll of a law enforcement career—and that’s just the way it is. Except that it’s not.

In this article, I propose we move beyond the expectation that simply surviving is the best we can do. To that end, I offer habits that can dramatically increase the likelihood of surviving and thriving in law enforcement.

The Challenge

There is no doubt that law enforcement is challenging. In addition to the personal danger, officers can see more pain, suffering, and conscience-shocking depravity in one day than most people see in a lifetime. On top of that, it is hard to imagine another profession that falls under such enormous scrutiny from civic leaders, courts, and community groups. Controversial media and anti-police activist groups ensure officers are followed by cameras 24-7. Every word, movement, and decision may be recorded and available for strategic editing to support false and misleading narratives. Low pay, understaffing, politicized command staff, and erratic schedules can create work conditions that leave little time for mental and physical recovery.

Although admirable, the selfless service, duty first culture of policing, coupled with the strong independence of officers, can lead to an unwillingness to accept limitations, or admit when it’s time for help. In the short term, these qualities may allow officers to stay in the fight a bit longer, protect their communities for another day, or catch one more bad guy. But the benefits of selfless service can be short-lived, and the costs too great when officers fail to engage in necessary self-care.

The good news is that by committing to a habit of self-care, officers can not only survive their experiences, but they can also bring the best version of themselves to their community, their agency, and their family. In other words, they can thrive.

Habits of Health    

Exercise for thirty minutes, three times per week.

Physical movement can improve mood and a sense of well-being. While exercise may not always feel great while you are doing it, the psychological health benefits are well documented. You don’t have to train for a marathon or become a fitness model, simply find an activity that allows you to move your large muscle groups at a moderate pace. Aim to work out for a sustained 30-minute period, during which your exertion is greater than resting but not so great that you are gasping for air. A brisk walk is one of the best exercises we can do.

Discipline Your Eating.

Dieting is too often associated with short-term, extreme food and calorie restrictions. Instead of “dieting,” commit to studying how the foods you eat can impact your energy levels and body composition. Learn how your body type and energy needs influence your dietary requirements and then discipline yourself to stay within those limits more often than not.

You do not have to resort to hyper-restrictive, impossible eating regimens. “Yo-Yo dieting” is the weight swing that results from mindlessly overeating after engaging in restrictive, unrealistic diets. It is frustrating and often leads to weight gain that exceeds any weight lost from the diet. It’s not necessary to eat healthy all of the time. Instead, focus on being mindful of your eating and strike a balance between eating what you want and eating what you need. If you hit your favorite high-calorie wings spot for lunch, focus on reduced-calorie vegetables and lean meats in the evening.

Sleep for an average of 6-8 hours per night.

Sleep is critical for the proper functioning and restoration of physical and mental processes. Many of the problems experienced by law enforcement officers have been linked to sleep deprivation, including unhealthy weight management.

For many in law enforcement, getting 6-8 hours of sleep per night is exceedingly difficult, if not impossible. Even so, the goal is to average those numbers over a week. If you have to be awake for an extended period, find ways to add those missing hours back into your sleep on the other days or nights. Study the science of “sleep hygiene” and set the conditions that allow you to fall asleep faster and stay asleep longer.

Engage in activities outside of law enforcement.

Police are frequently immersed in the darkest side of the human experience. It is easy to lose perspective, and that can take a toll. You must step out and enjoy the positive side of life. If you do not have hobbies outside of law enforcement, find some and focus on actively engaging yourself in these interests. Coaching kids sports may be just what you need.      

Monitor your emotions and talk with the experts.

Sadness, anxiety, and depression are normal, even for police. One test for deciding when to check in with mental health professionals is whether you feel these discomforting emotions (sadness, anxiety, anger, fear, etc.) during more days of the month than not. If these feelings are persistent, think of them as you would the “check engine” light on your vehicle. Don’t wait until emotional distress becomes a formal disorder. Be proactive. If you were having shortness of breath or chest pain, you would not wait to have a heart attack before seeking help.

If possible, identify a counselor or psychologist who specializes in work with law enforcement. Be sensitive to the limits of your primary care provider and carefully consider any recommendations that you use medication. Too often, medicine is a band-aid and can prevent you from identifying and implementing the healthy lifestyle habits that lead to long-term resiliency and improved performance. Medicine certainly has its place, but it should not be your only response.  

Schedule an annual consult with a police psychologist or counselor.

Be proactive. Just as you would get your teeth cleaned to avoid cavities, get in the habit of a routine “mental health cleaning.” Take time at least once a year to pause and assess your habits with a mental health professional. Ensure you are continuing to experience policing (and life) in the most productive manner possible.

Periodic health assessments can identify symptoms and risks of cumulative trauma. In addition to the effects of a single incident of trauma, an officer’s psychological well-being can be impacted by the cumulative effect of repeated exposure to traumatic events. Annual consults can help ensure you are effectively managing these insidious issues.

Monitor significant conflict with your family and talk with family counseling experts.

Law enforcement work can take a toll on families. Left unnoticed, the stressors can grow until they negatively impact and degrade relationships. Law enforcement work is hard on police families. Your partner and children know the dangers you face, they know how the media portrays you on a daily basis, and they are concerned about your well-being. Ignoring the problem, hoping it simply goes away, or accepting the harm as a necessary part of the profession is no longer expected or necessary.

If family conflict threatens to get physical or you are experiencing conflict more days out of the month than not, take advantage of family counseling experts. The key is to identify the stressors and conditions that lead to conflict early. It does no good to save your community and lose your family.

Thrive

It is no longer acceptable to view the loss of families, mental health, and physical well-being as costs of serving in law enforcement. Technology and mental health strategies have advanced well beyond helping officers to simply survive their profession. Committing to simple, healthy habits, including making routine appointments with mental health professionals, ensures you’re bringing the best version of yourself to your family and community. Your commitment to serving others should include a commitment to care for yourself. It’s no longer enough to simply survive; it’s time to thrive.

________________________________

About Author
Dr. John Azar-Dickens is a Licensed Clinical Psychologist specializing in Forensic Psychology and a Certified Force Science Analyst. In addition to instructing nationally for the Force Science Institute, Dr. Azar-Dickens provides professional debriefing support and psychological assistance to officers involved in force incidents. A widely published author and active expert witness, Dr. Azar-Dickens continues to serve as a sworn patrol officer with the City of Rome, GA Police Department.

Alzheimer’s Association Provides Free Training for First Responders

A poll conducted from May 20 to June 2 by Police1.com asked:

Have you received training to recognize the signs of and appropriately respond to a person with dementia?

Of the 515 who participated, 51% responded “Yes” and 49% responded “No.”

The Alzheimer’s Association hopes to change that by providing free online training. 

As a first responder, it’s critical to understand how to best approach situations involving someone with Alzheimer’s disease. Approaching Alzheimer’s: First Responder Training program is a free, online training that features high-quality content in an interactive format, developed by the Alzheimer’s Association with input from first responders. It can be accessed:

  • Anytime of day, or night, accommodating for shift work and new hires
  • By anyone with access to a computer and the internet, making it easy to take from home or work

To promote the training within your department or agency, use this downloadable flyer to distribute or post in your breakroom.

The training also includes a downloadable tip sheet, Quick Tips for First Responders. This handy page can be folded to fit in a visor or emergency kit, and includes helpful phone numbers and strategies to help a person with dementia and their family.

Other resources for families in your community:

  • Safety information: Taking measures to ensure safety at all times can help prevent injuries, and it can help people with dementia feel relaxed and less overwhelmed. The Alzheimer’s Association safety section provides valuable information on safety in the home, driving and other safety issues.
  • MedicAlert® with 24/7 Wandering Support: A nationwide emergency response service for individuals living with Alzheimer’s disease or another dementia who wander or have a medical emergency.
  • Alzheimer’s Navigator®: Alzheimer’s Association’s Alzheimer’s Navigator is an innovative online tool designed specifically for families, to create a personalized action plan and linking them to information, support and local resources.

  • For more information on the MedicAlert Law Enforcement Agency Portal (LEAP), click here. The LEAP program provides FREE enrollment into the MedicAlert + Safe Return program for people living with dementia who are registered through a law enforcement agency’s online portal.

More information on the free first responder course

The course has an interactive map that allows you to explore topics relevant to your role. Once you have completed all topics, you can print a certificate celebrating that you are Ready to Respond! Training topics include:

  • Briefing (Dementia Overview)
  • Wandering
  • Driving
  • Abuse and Neglect
  • Shoplifting
  • Disaster Response

Sign up here.

For a video explaining the program, watch this YouTube video.

Unsplash photo by Huy Phan

How Simulation Training Helps Officers Hone Crisis Response Skills

Simulation training from VirTra can help officers learn how to effectively communicate with someone experiencing a mental health crisis to delay or avoid use of force. (VirTra)

 

By Margarita Birnbaum for Police1 BrandFocus

The Los Angeles and San Antonio police departments are among agencies that have partnered with mental health professionals to handle emergency calls that involve people in emotional distress. In doing that, police departments hope to reduce use-of-force incidents.

Nicole M. Florisi, a former police sergeant and current instructor at the Force Science Institute, says departments must offer their officers targeted training to help reduce use-of-force incidents involving people in emotional distress.

Specifically, the veteran SWAT officer and counselor says departments need to educate officers about behaviors associated with mental illnesses, such as depression, anxiety and schizophrenia. That training should include effective communication skills so officers can learn to successfully interact with people in emotional distress.

To get the most informative and realistic experience, Florisi recommends simulation-based training programs, such as those offered by VirTra, because the information and skills officers learn through simulation training involves mental and physical elements, as well as decision-making, and therefore sticks much more than what they learn through classroom lectures and passively watching videos.

“How we train most of the time isn’t really how the brain learns,” said Florisi, a part-time officer with the Jerome Police Department in Arizona. “We need to be in reality-based, scenario-based integrative training that hits all the components to create both psychological arousal and physiological arousal.”

She believes that simulation-based training may help prevent excessive force incidents raging from unnecessary arrests to fatal shootings.

Properly communicating with someone in emotional distress, Florisi says, “can be the difference between life and death. It can also be the difference in keeping your career or not.”

COMMUNICATION APPROACH IS CRITICAL

Certainly, most encounters between police officers and people who have a mental illness do not end in use of force, in part because many of those encounters have nothing to do with a person’s mental illness. Data, however, show that officers spend more time dealing with mental disturbance calls than they do on calls involving traffic accidents, burglaries and assaults.

The more information and context officers have about the circumstances that triggered an incident, says Florisi – such as a divorce, change in medication, loss of a loved one or drug use – the more likely that they will be able to keep everyone safe.

“Helping officers identify what type of communication is best in those situations is what’s really critical in dealing with anybody, not just someone who has a mental illness,” said Florisi, who wrote VirTra’s mental illness simulation curriculum.

Officers who go through VirTra’s mental illness training program learn basic information about depression, anxiety, schizophrenia and other disorders, including the physiological processes and harmful behaviors associated with them. They also learn the best tone, words and phrases to use to effectively communicate with someone experiencing a mental health crisis due to illness or substance abuse.

Two common mistakes officers make when dealing with a person in crisis, says Florisi, are:

  • Thinking that they can make the person obey them.
  • Thinking t​​hat they can reason with the person.


VirTra’s simulation training drives home that officers need to learn to respond to the individual’s behavior, rather than the emotional trigger.

“What we’re trying to do is reduce the emotion that’s driving the behavior,” Florisi said.

AWARENESS OF TRIGGERS, BLIND SPOTS IN TRAINING

Perhaps one of the most important things officers learn in the simulation training is managing their own emotions that may affect their job performance.

Many officers live with depression, anxiety and other mental illnesses and aren’t aware of how deeply they are affected by them or how their illnesses affect their job performance, Florisi says. In addition, many don’t understand how the body’s physiological responses to stress may affect their decision-making process.

“There’s a misconception, from the public but also among police officers, that you’re immune to human psychology and human factors, “Florisi said. “The brain doesn’t work like that.”

It’s important for officers to be watchful of the verbal and nonverbal triggers that may cause them to become aggressive, she says, which can lead to inappropriate use of force and potentially dire consequences.

One of the benefits of simulation training with reality-based scenarios is that officers can identify areas where they need improvement when responding to emotionally charged, high-stakes calls. As instructors shift the way the scenarios unfold to challenge officers during the simulation sessions, they can learn how to identify when they are responding poorly to a situation and use breathing and other techniques to calm down.

“We are tasked with the sanctity of life, and that requires some professional neutrality,” Florisi said. “To achieve our police objective, officers have to be able to successfully navigate their working environment — and part of that is learning to regulate emotion and communicate effectively.”

Visit VirTra for more information on mental illness and de-escalation training.

Health and Wellness for the Thin Blue Line

Understanding Macronutrients

By Lindsay Chetelat, RD, CDN​ for Working Dog Magazine​

In a profession founded upon dedicating long hours to protect and serve others, it can be difficult for members of the law enforcement community to make themselv​​es a priority. It is all too often that the health and wellness of police officers fall to the wayside as they spend day in and day out working tirelessly to defend their communities against evil.

Optimal nutrition and physical fitness are unique in the law enforcement world. Their lives depend on being fit, yet there are many obstacles to achieve the level of fitness necessary for the job. This three-part nutrition and fitness series will be geared towards providing the information to overcome these obstacles and build the foundation for lifelong health and wellness. The first installment in this issue will detail the ins and outs of macronutrients, while the second and third installments will encompass hydration and fueling for exercise, respectively.

Macronutrients – What you need to know: 

Macronutrients are the components in the diet that provide energy, or calories.
There are three macronutrients: carbohydrate, protein, and fat. Carbohydrate and protein provide four calories/gram and fat provides 9 calories/gram.
Each of these macronutrients confer a unique benefit to the proper functioning of the human body.
There are foods and beverages in each of these macronutrient categories that you should limit or avoid.

Carbohydrates

Carbohydrates are chains of simple sugar building blocks that the body prefers to burn for energy. Examples of “short” chain carbohydrates include lactose, which is found in milk, and sucrose, which is table sugar.  “Long” chain carbohydrates can be found in starches, such as bread, pasta, and rice.  Regardless of the chain length, all carbohydrates are broken down into the basic sugar building blocks to be used as fuel for your brain and muscles.

Fiber is an indigestible form of carbohydrate that is found in plant based foods. It has beneficial implications in heart and gastrointestinal health. Fiber helps you feel fuller longer, and therefore proves to be an essential tool in weight loss.

Carbohydrate is stored in the body as glycogen in the liver and muscle. As needed, the body breaks down glycogen and releases a simple sugar building block called glucose. Glycogen stored in the muscles is readily available for use during exercise, while glycogen in the liver is used to maintain normal glucose levels in the blood and provide fuel for the brain.

Based on Nancy Clark’s Sports Nutrition Guidebook, the average 150-lb male has 1800 calories of carbohydrate stored in the body.  Of these 1800 calories, 1400 calories are stored in the muscle to be used during exercise, 320 calories are stored in the liver to be released into the bloodstream, and 80 calories exist in the plasma and bodily fluids (1).  This same man also has 60,000-100,000 calories of stored fat. Technically, this amount of calories would be sufficient to run hundreds of miles, but muscles need carbohydrate to function properly and fat cannot be used as the sole fuel source (1). 

The American College of Sports Medicine cites carbohydrate needs for physically active adults as 3-5g/kg of body weight per day for low intensity or skill-based activities, 5-7g/kg for moderate exercise (~1 hour/day), 6-10g/kg for endurance exercise (1-3 hours/day), and 8-12g/kg for extreme exercise (>4-5 hours/day) (2). 

If you do not eat enough carbohydrate, this will translate to inadequate glycogen stores and, therefore, suboptimal mental and physical health.  Making sure the patrol car and the police canine are well fueled are essential job functions that ensure efficient and effective job performance. Maintaining a consistent intake of nutrient dense carbohydrates to promote adequate glycogen storage is of equal importance to the law enforcement officer.

Choosing the right carbohydrate sources also yields the benefit of receiving a wide variety of vitamins and minerals.  Vitamins and minerals, or micronutrients, play a multitude of roles including promoting optimal brain health and energy metabolism, and even reducing cancer risk in some cases.

The best sources of carbohydrate include whole grains, beans and legumes, starchy and non-starchy vegetables, and fruits. Dairy products are unique in that they are a good source of both carbohydrate and protein (see the protein section for more information). Carbohydrates dense in added sugar should be limited or avoided. These foods include sweets and desserts, soda, fruit juice cocktail, and fruit canned in syrup.

Protein

Protein is a building block for repair, growth, proper immune function, and many other vital bodily functions. The simple unit of protein is an amino acid.  Amino acids unite in different combinations to form protein chains of varying lengths. Our bodies can produce some amino acids, but we must obtain other amino acids from the food we eat (these are called essential amino acids).

Adequate protein intake is crucial for muscle growth and repair after enduring strenuous exercise. Equally as important is the role of protein in supporting basic bodily functions such as the immune system – your body’s defense mechanism against germs.  Protein rich foods also contain beneficial vitamins and minerals.  The body prefers to use protein for the functions described above.  If you do not consume adequate carbohydrate, your body will break down protein to produce glucose for energy, therefore distracting protein from its primary functions. Stay tuned for the third installment in this series on nutrient timing for recovery!

The average, inactive adult requires 0.8 g/kg of body weight per day, while active adults require 1.2-2.0 g/kg (2). The ultimate goal is to incorporate a variety of nutrient dense, lean protein sources throughout the day.  Excessive protein intake on a gram per kilogram of body weight basis or consumption of more than 20-25 grams of protein at one time does not equate to more gains (1). There is no storage capacity for protein in the body. The excess protein will be burned for energy or converted to triglycerides, a form of fat. Excessive protein intake also puts a person at risk for dehydration as the body seeks to eliminate urea, a waste product of protein breakdown.

Protein supplements have surged in popularity in the health and fitness world, but there is no evidence to indicate that providing these protein supplements in an already nutrient sufficient diet provides any benefit (1). Protein supplements can be used to achieve adequate protein intake in a person unable to meet their protein needs solely through food. 

Lean proteins are the best food sources to choose. While animal sources of protein are denser in protein and contain a complete amino acid profile, it is possible to meet protein needs through plant-based foods. These plant-based proteins must be consumed in larger quantities to match their animal-based counterparts.

People who completely avoid animal products (i.e. vegans) must compensate for the incomplete amino acid profile in plant-based proteins. Combining grains with beans or legumes and legumes with seeds will help ensure that a vegan obtains a complete amino acid profile (1). Adding soy products to all meals will also improve protein intake in this population (1).

High fat and highly processed proteins should be limited or avoided. These foods include meats with significant marbling, fried fish, fried chicken, highly processed cheeses (i.e. American cheese, Colby jack cheese), and highly processed deli meats (i.e. salami, bologna).

Fat

Fat is an energy packed nutrient that insulates the body and cushions our organs. Fat is important for the body to work properly in that it forms a protective layer around cell membranes and even serves as a carrier for vitamins A, D, E, and K. Choosing healthy fats (unsaturated fatty acids, including omega-3 fatty acids) has been shown to promote heart health. In contrast, high intakes of saturated fat and trans fat contribute to an increased risk of cardiovascular disease. Recent studies have even shown that saturated fat contributes to high cholesterol. For the most part, saturated fats are solid at room temperature and unsaturated fats are liquid at room temperature.

Fat sources to limit or avoid include deep fried foods, butter, hydrogenated shortenings, lard, coconut oil, palm oil, partially hydrogenated vegetable oil, full fat dairy and cheese products, and fatty red meats.

Fat intake at 20-35% of total caloric intake is regarded as healthy. Saturated fat should be limited to less than 7% of total calories and trans fats should be avoided at all costs. Food sources of fat should be primarily mono- and polyunsaturated fats.

The Registered Dietitian’s Macronutrients Tips for Success

A nutrient dense whole grain/starch should be consumed at every meal. For those involved in strength training and endurance exercise, half of your plate should be a nutrient dense whole grain or starch on tough workout or competition days.

Aim to include one green, red, yellow/orange, blue/purple, and white fruit and/or vegetable daily. Have fruits twice per day and vegetables at least three times per day.
Choose a lean protein at all meals and snacks. Protein intake should be evenly distributed throughout the day.
Include at least one healthy fat source at every meal.
Fresh and frozen fruits and vegetables have the same nutritional quality. If opting for canned vegetables, choose low-sodium and run water through them before cooking.  When selecting canned fruits, choose fruit canned in water, not syrup.

For someone who does not typically eat fruits, two cups per day of 100% fruit juice is an acceptable method to obtain adequate fruit intake.

Compare food and beverage products using the nutrition facts labels.

References
(1) Clark, N. Nancy Clark’s Sports Nutrition Guidebook Fifth Edition. Champagne, IL: Human Kinetics; 2013.

(2) Nutrition and Athletic Performance. Medicine & Science in Sports & Exercise. 2016;48(3):543-568.http://journals.lww.com/acsm-msse/Fulltext/2016/03000/Nutrition_and_Athletic_Performance.25.aspx.   Accessed November 15, 2016.

About the Author

Lindsay Chetelat, RD, CDN is an NYC-based registered dietitian who focuses on empowering individuals to take charge of their bodies through utilization of evidence based nutrition guidelines and theory based physical training techniques. Her approach is rooted in helping others gain an appreciation for their bodies and creating a mindset that transformation is about the progress one is willing to make in their journey, not quick fixes.