Police Officer Stress and Mental Health Dr. Greg

Police Officer Stress and Mental Health Dr. Greg

Police Officer Stress and Mental Health Dr. Greg Anderson, Dean Applied Research Justice Institute of British Columbia [email protected] Disclosures: G.S. Anderson, Ph.D. Dean, Office of Applied Research & Graduate Studies Director for CIPSRT No relationships with commercial interests; no conflicts of interest to declare Research support Canadian Institutes of Health Research (CIHR) Canadian Institute for Public Safety Research and Treatment (CIPSRT) Government of Canada, Public Safety Canada (PSC) Solicitor General of British Columbia Justice Institute for British Columbia Occupational Stressors = Organizational + Operational Organizational stressors are associated with job context or setting. eg. staff shortages, lack of training on new equipment, lack of appropriate resources, inconsistent leadership styles, and a perceived lack of support between co-workers and leaders Operational stressors are directly tied to work content or duties. eg. Potetnially traumatic events, fatigue from shift work and overtime, jobrelated risk of injury (e.g., lower back pain), social life limitations, and the inescapability of work Anderson et al., 2002

Physical, Psycho-social, Cognitive, Environmental Stressor Hiring Personal Attributes Cognitiv e Appraisa l Training Coping Strategy Social Support Pre/Post Employment Training Stress Reactivity Sympathetic NS Catecholamines Glucocorticoids Hypothalamus + CRH

Pituitary Negative Feedback + ACTH Stress Reactivity STRESS REACTIVITY: Glucocorticoids are the main mediators of the stress response initiated via the HPA Axis Stressor Adrenal Cortex + Glucocorticoids: cortisol, corticosterone Stressor Repeated exposure with successful resolution may reduce the threat or challenge appraisal and improve performance ADAPTATION / HEALTH Stress Reactivity Evolution / Involution

Prolonged CORT leads to chronic stress through reduced GR density and resistance reducing negative feedback INJURY / DISEASE Police Stress: Evidence of Stressors and Their Source Operational Exposures to Potentially Traumatic Events Among Public Safety Personnel in Canada (Canadian Journal of Behavioural Science, in press) Exposure Total (%) 11+ times Municipal (%) RCMP (%) Life threatening natural disaster Fire or explosion Serious transportation accident Physical assault Severe human suffering Sudden violent death 64.4

86.0 93.2 90.6 79.1 93.8 4.8 39.6 71.3 48.7 51.9 50.5 61.2 85.8 94.7 95.3 79.1 95.2 70.2 88.4 95.9 95.4 79.7 95.7 Evidence of Physical Stress Above Resting Heart Rate Mean SD %age Heart

Rate Reserve Mean SD Standing 27 13 21 % 10 % Walking 32 15 25 % 10 % Climbing Stairs 34 15 27 % 13 %

Lifting 35 18 27 % 13 % Push / Pull 49 25 38 % 19 % Average Shift 23 13 18 % 10 % Anderson et al., 2002 Evidence of Psycho-social Stress Anticipation Above Resting

%age Heart Heart Rate Mean SD Rate Reserve Mean SD Code 1, assigned 20 11 15 % 7% Code 1, back-up 21 12 16 % 7% Code 2, assigned 25

11 18 % 8% Code 2, back-up 27 12 21 % 9% Code 3, assigned 28 17 21 % 13 % Code 3, back-up 41 10 32 %

7% Anderson et al., 2002 Evidence of Psycho-social Stress Threat Appraisal Above Resting Heart Rate Mean Max %age Heart Rate Reserve Mean Max Hand on Gun, No Suspect 29 52 15 % 29 % Hand on Gun, Suspect 40 52 31 %

43 % Snap Open, No Suspect 45 49 31 % 31 % Snap Open, Suspect 49 49 35 % 30 % Average Standing 27 21 % Anderson et al., 2002 Occupational Stressors = Organizational + Operational

Occupational Stressors Organizational Police Stress Questionnaire (20 items) Operational Police Stress Questionnaire (20 items) 7 point scale from no stress at all to a lot of stress Occupational Stressors = Organizational + Operational Municipal/ Total Provincial Policea Municipal/ RCMPb Total Mean (SD) Mean (SD) Mean (SD) Organizational Stressors Provincial Policea RCMPb Mean (SD) Mean (SD) Mean (SD) Operational Stressors The feeling that different rules apply to different people (favouritism) 4.15

(1.95) 4.17 (1.93) 4.22 Negative comments from the public (1.90) 3.45 (1.97) 3.83 (2.00) 3.80 (1.93) Lack of resources 4.29 (2.04) 4.05 (2.00) 4.95 Not enough time available to spend (1.91) with friends and family 3.54 (1.87) 3.44 (1.81) 3.83

(1.96) Bureaucratic red tape 4.44 (1.98) 4.35 (1.91) 4.83 Occupation-related health issues (e.g., (1.87) back pain) 3.62 (2.02) 3.55 (2.01) 3.94 (1.96) Inconsistent leadership style 4.44 (2.10) 4.29 (2.09) 4.56 Finding time to stay in good physical (2.05) condition 3.96 (1.85)

3.87 (1.85) 4.32 (1.78) Staff shortages 4.46 (2.08) 4.48 (1.96) 5.19 Fatigue (e.g., shift work, over-time) (1.60) 4.14 (1.99) 4.07 (1.97) 4.27 (1.99) Total Mean Score, mean (SD) 3.62 (1.33) 3.58 (1.30)

3.99 (1.31) Total Mean Score, mean (SD) 3.17 (1.28) 3.15 (1.29) 3.54 (1.36) Slightly greater risk from Operational stressors than Organizational stressors Evolution / Involution INJURY / DISEASE ADAPTATION / HEALTH Dr. Nick Carleton Stress Reactivity Mental health among Canadian public safety personnel: a brief overview of contemporary research Stressor

Mental health among Canadian public safety personnel: a brief overview of contemporary research R. Nicholas Carleton, PhD Disclosures R. Nicholas Carleton, Ph.D., R.D. Psych. Professor of Psychology Scientific Director for CIPSRT No relationships with commercial interests; no conflicts of interest to declare Research support Canadian Institutes of Health Research (CIHR) Canadian Institute for Public Safety Research and Treatment (CIPSRT) Government of Canada, Public Safety Canada (PSC) Saskatchewan Health Research Foundation (SHRF) University of Regina Prevalence Study September, 2016 Launch of the Pan-Canadian Pan-Public Safety Prevalence Survey Finalized with support from the developing national institute team Partially funded, Ministry of Public Safety and Emergency Preparedness

Develop a more robust baseline for Operational Stress Injuries e.g., PTSD, anxiety, depression Data were collected online using a survey available in English and French ~9,000 participants Quantitative and qualitative data Publications and detailed results available on our website www.cipsrt.ca Positive Screening Percentages for Recent Mental Disorders Based on Self-Report Measures Mental Disorder Symptoms Among Public Safety Personnel in Canada Gen ~ Total Sample Police RCMP Canadian Journal of Psychiatry ~1.1-3.5 23.2 19.5 30.0 PTSD ~7 26.4 19.6 31.7 Major Depressive Disorder ~3 18.6 14.6 23.3 Gen. Anxiety Disorder ~6.7 15.2 10.0 18.7 Social Anxiety Disorder

~1.6 8.9 5.9 12.0 Panic Disorder ~7-25 5.9 5.8 3.9 Alcohol Use Disorder 29.0 21.3 34.7 Any mood disorder2 30.3 23.7 37.3 Any anxiety disorder3 10.1 44.5 36.7 50.2 Any mental disorder4 Mental Disorder Count Mental Disorder Symptoms Among Public Safety Personnel in Canada Canadian Journal of Psychiatry Total Sample Police RCMP 0 mental disorders 1 mental disorders 2 mental disorders 3 or more mental disorders

58.2 15.1 8.7 18.0 65.9 13.8 8.0 12.3 52.7 14.8 8.1 24.4 Chronic Pain Symptoms Among Public Safety Personnel in Canada Canadian Journal of Pain All PSP categories screened positively at substantial rates for several different OSIs Demographic Comparisons women screened positively more than men persons with more years of service screened positively more married persons screened positively less than others university educated persons screened positively less than others no differences based on age, ethnicity, or urban/rural location

Chronic Pain Symptoms Among Public Safety Personnel in Canada Canadian Journal of Pain Any Chronic Pain Lower back Shoulder Neck Arm Leg Hand Foot Headaches Other Gen ~ Total Sample Police RCMP 18.9 22.3 6.1 5.4 2.2 7.2 2.8 3.4 6.2 - 40.2 24.0

17.6 16.8 11.1 14.3 10.9 12.6 15.2 7.1 35.9 22.1 14.7 15.4 10.6 12.7 9.8 11.8 14.4 5.7 43.4 26.5 19.6 17.8 12.5 15.7 12.0 14.9 16.0 8.8 Chronic Pain Symptoms Among Public Safety Personnel in Canada Canadian Journal of Pain Total Sample Police

RCMP Injury related to active duty 40.2 39.6 54.4 Injury related to work other than active duty Injury not related to work 9.6 10.2 7.3 16.2 18.9 8.5 Non-injury-related disease (e.g., osteoarthritis) 11.2 10.0 7.8

Prevalence of Past-Year and Lifetime Self-Reported Suicidal Behaviour Suicidal Ideation, Plans, and Attempts Among Public Safety Personnel in Canada Gen ~ Total Sample Police RCMP Canadian Psychology Past Year Suicidal Ideation Suicidal Planning Suicidal Attempt ~6 ~2 ~ <1 10.1 4.1 0.3 8.3 3.4 0.2 9.9 4.1 0.2 ~ 11 14 ~45 ~1-4 27.8

13.3 4.6 20.5 8.9 2.1 25.7 11.2 2.4 Lifetime Suicidal Ideation Suicidal Planning Suicidal Attempt Prevalence of exposure to mental health training among PSP categories (n=4,020) (under review) Training Type No Training Any Training Critical Incident Stress Management Critical Incident Stress Debrief Mental Health First Aid Peer Support R2MR Mun/Prov Police (%) RCMP (%) 25.4 74.6 37.5

34.3 18.6 27.1 51.9 42.0 58.0 31.5 29.7 14.2 18.6 33.8 Prevalence of exposure to mental health training among PSP categories (n=4,020) (under review) Type of Training Mental Health Knowledge Scale, Stigma Scale, OMSWA range (11-55) MAKS range (23-75) CISM CISD MH First Aid Peer Support R2MR Any Training No Training 61.44 61.14

61.87 61.54 61.83 61.38 60.38 1.3% Mental Health Resilience Scale, BRS range (6-30) 20.77 20.79 20.11 20.17 20.02 20.68 21.39 1.3% 22.31 22.36 22.35 22.38 22.04 22.02 20.90 3.7% Prevalence of exposure to mental health training among PSP categories (n=4,020) (under review) Type of Training CISM CISD MH First Aid

Peer Support R2MR Mental Health Knowledge Scale AOR (95% CI) Stigma Scale 0.47 (0.02, 0.91)* -0.40 (-0.86, 0.06) 0.68 (0.19, 1.16)** 0.41 (-0.05, 0.87) 0.96 (0.55, 1.36)*** 0.25 (-0.36, 0.87) 0.01 (-0.62, 0.65) -0.60 (-1.27, 0.07) -0.95 (-1.58, -0.32)** -1.31 (-1.87, -0.75)*** OMSWA AOR (95% CI) Mental Health Resilience Scale AOR (95% CI) 0.26 (-0.11, 0.63) 0.35 (-0.03, 0.73) 0.43 (0.03, 0.83)* 0.22 (-0.16, 0.60) 0.18 (-0.15, 0.52) Limitations and Future Directions

Similar limitations apply to all results Self-selection Generally demographically representative Over- or under-representation of symptoms Anonymous self-report; screening, not interviews Recent variable timeframe for mental health Broad categories Attrition Complicated direct comparisons with extant population data sets Thank you! Questions and Discussion R. Nicholas Carleton, Ph.D., R.D. Psych. Department of Psychology University of Regina [email protected] www.cipsrt-icrtsp.ca Steve Palmer Executive Director Collaborative Centre for Justice and Safety University of Regina +1-306-337-2570 [email protected] www.justiceandsafety.ca

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