PTSD in police officers is ‘a clinical and public sector crisis’

According to a recent survey, one in five police officers in the UK are suffering from post-traumatic stress disorder (PTSD) – far more than previously estimated.

According to a recent survey, one in five police officers in the UK are suffering from post-traumatic stress disorder (PTSD) – far more than anyone ever thought.Tana888 | Shutterstock

PTSD is a medical condition is brought on by acute trauma and results in symptoms of extreme distress, such as flashbacks, acute anxiety, and sleep disruptions.

The stereotyped police officer is invincible, capable of handling almost anything. However, the truth is that policing is accompanied by tremendous occupational stress, which can accumulate to produce PTSD or its chronic sequel, called complex PTSD (CPTSD).

One serious finding is that PTSD/ CPTSD among police personnel is mostly unrecognized and therefore not treated.

Worse still, over 50% of the police officers surveyed reported that they were called out to the next incident before they were able to mentally process the impact of the earlier traumatic event. About two-thirds thought that trauma and PTSD were badly dealt with in the force.

PTSD is five times higher in police officers

Individuals with PTSD or CPTSD often wake up from sleep, reliving the trauma, or have near-panic attacks. Other characteristic symptoms include work difficulties, suspicion, and irrational anger towards people unrelated to the trauma, especially at home.

In CPTSD, the accumulation of repeated unresolved trauma impacts causes emotional detachment or disconnection from normal feelings.

The study considered responses from almost 17,000 police officers in the UK. The authors found a history of traumatic events in 95% of officers, almost always as part of their work. Among police personnel as a whole, the corresponding figure is 67%.  

One in five reported symptoms consistent with PTSD (8%) or CPTSD (12%) in the four weeks before the survey was taken.

Such symptoms include night terrors, nervous breakdowns, suicidal ideas, and accumulated stress from ‘routine’ police work such as viewing multiple scenes of murder, giving detailed official testimony at formal murder inquiries, or just prolonged viewing of stressful evidence like terrorism-related material.

This points to an incidence of 20%, which is five times higher than in the UK general population. However, only 5% of this subgroup know it, and shockingly, only 1-2% have been clinically diagnosed.

CPTSD is strongly linked with other medical conditions, including:

  • Threefold risk of cardiovascular disease (11%)
  • Twofold risk of digestive tract issues (53%)
  • Twofold risk of immune disorders (11%)

‘A clinical and public sector crisis’

Even in the 80% of police officers without clinical PTSD, classic symptoms such as re-experiencing of trauma, avoidance, and a sense of threat, were recognized in 27%, 28%, and 43% of the sample, respectively.

Symptoms like tiredness, anxiety, and daily or weekly sleep disturbances affected 50% of non-PTSD police staff. Yet, even with known mental or even psychological problems (depression, anxiety or stress), the vast majority of them preferred to continue working as usual rather than take time off to deal with them.

Around three-quarters of police officers with self-reported mental issues did seek help - typically through medication, cognitive behavioral therapy, or counseling. Even so, the average sick leave taken over the last 12 months was about 20 days, most commonly for work-related illness. The reason for the longest period of absence (almost 50 days on average) was ‘psychological injury as a result of a traumatic incident’.

These findings indicate a battered sense of wellbeing, which was confirmed by the WHO subjective wellbeing indices. These showed a low score - below 48 on a scale of 0-100 - for 60% of police staff, and an incredible 93% of those with CPTSD. This low score is equaled only by the bottom 20% of individuals in other employment sectors.

Jess Miller called the situation a “clinical and public sector crisis”.

The expectation that police officers would handle such extreme stress without flinching – the classic “stiff upper lip strategy” – is simply not realistic in modern policing conditions, say the researchers.

‘Real challenges’

Gill Scott-Moore, who heads the charity Police Care UK, points out the obvious conclusion: “The service has real challenges around recognizing and responding to the signs and symptoms of trauma exposure and is heavily reliant upon generic NHS provision that isn't equipped for the specialist treatment needed.”

We've got a tactic for everything in the police [but] we haven't for when you are dealing with traumatic incidents or trauma in yourself and we maybe need that.”

PC Lee Jackson

This underlines the importance of the new police wellbeing service set up in April 2019, aimed at equipping police in England and Wales to improve their occupational health. This £7.5m initiative is supervised by the College of Policing and Lancashire Chief Constable Andy Rhodes, who is the national leader on this issue.  

Rhodes is not surprised by the results. He comments: “It provides evidence to support investment in prevention as well as acute services,” especially as mental issues like PTSD are slowly becoming recognized as medical conditions rather than matters of shame.

Proper interventions are urgently required to deal with trauma impact and monitoring. Otherwise, policing and public safety costs will only escalate as police officers find themselves unable to handle mounting trauma.

If officers are breaking, then how can we expect them to adequately serve and protect the public?"

Che Donald, The Police Federation for England and Wales)

The study, funded by Police Care UK, was carried out by the Department of Sociology, University of Cambridge.

Sources:

Policing: The Job & The Life (2019). University of Cambridge. cam.ac.uk.

BBC. (2019). PTSD 'at crisis levels' among police officers. bbc.com/news/uk-48201088.  

Dr. Liji Thomas

Written by

Dr. Liji Thomas

Dr. Liji Thomas is an OB-GYN, who graduated from the Government Medical College, University of Calicut, Kerala, in 2001. Liji practiced as a full-time consultant in obstetrics/gynecology in a private hospital for a few years following her graduation. She has counseled hundreds of patients facing issues from pregnancy-related problems and infertility, and has been in charge of over 2,000 deliveries, striving always to achieve a normal delivery rather than operative.

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