In the News

An Integrated Approach to Officer Wellbeing

Published by: the FBI National Academy Associate Magazine

As a psychiatrist, I view police officers as an underserved population.  Because of their regular exposure to stressors and trauma which is out of the scope of normalcy to the general public, police officers are extremely vulnerable to Post Traumatic Stress Disorder, addiction, depression, and suicide. While they are the first to offer help when needed, because of deeply ingrained cultural resistance they are among the last to seek help for themselves.  They deserve a well-integrated system to deliver the care they need.

Many officers seek out ways to deal with the stress of the job on their own and fall into unhealthy coping styles such as misusing alcohol or other substances.  These officers may be negatively affected by reduced productivity at work, increased mental health concerns, and dysfunctional family and/or social environments. In the worst of circumstances, some resort to taking their own lives.

The numbers from numerous reports speak for themselves:

  • 37.6% of American police officers endorsed one or more problem drinking behaviors.
  • Conservative studies estimate over 216,000 officers either suffering from PTSD or some other form of emotional stress that is significant enough to alter and disrupt their lives.
  •  A quarter of female police officers and nearly as many male officers assigned to shift work had thought about taking their own lives.  Reports of depressive symptoms among these officers were higher than in the general population — 12.5 percent among women and 6.2 percent among men, compared to 5.2 percent in the population at large.
  • One hundred to 150 police suicides occur each year—more than from gunfire and traffic accidents combinedIt is generally a combination of the diseases listed above, and make no mistake – PTSD, depression and addiction are brain diseases – that lead to tragic outcomes.  The Surgeon General of the United States, Dr. Vivek Murthy, recently issued a groundbreaking report calling for a cultural shift in the way we view these diseases, stating that for far too long, too many in our country have viewed conditions like addiction and PTSD as moral failings. Dr. Murthy urges us to adopt a view that such maladies are chronic illnesses “that we must approach with the same skill and compassion with which we approach heart disease, diabetes and cancer.”These conditions require a diligent, comprehensive treatment approach (which I refer to as Integrative Medicine) and I am proud and excited to work with a team dedicated to the wellness of the officers who have committed their lives to keeping others safe.

My goals are perfectly aligned with the statement made by former President of the FBI National Academy Barry Thomas; “The FBI National Academy Associates’ Executive Board is committed to the emotional, physical and spiritual wellbeing of the public safety workforce. As leaders in the law enforcement profession, we recognize that our people are our greatest asset and we are responsible for creating a climate that helps keep them healthy and resilient. Our Officer Safety and Wellness Team is dedicated to promoting awareness surrounding the difficulties of the profession, inspiring conversations that minimize the stigma that the suffering law enforcement officer may feel and to providing solutions for agencies, individuals or family members that find themselves dealing with a personal crises. Our mission is to improve the quality of life for all that dedicate themselves to protecting and serving others.”

In pursuit of these goals, I advocate an integrated approach to officers’ healthcare, which may be described by the following five tenets:

  1. The relationship between the practitioner and patient is paramount. In this relationship, the practitioner and patient work as partners in tandem to foster the patient’s health. As a team, the patient and provider continue to address acute illness but make prevention of disease the relationship’s primary goal.
  2. Integrative Medicine addresses the whole person. We examine and treat the person as a whole rather than a bundle of pathologies.
  3. Treatment is informed by evidence. In every discipline, physicians seek a balance between the art and science of medicine. Modalities supported by hard data are preferred to those accepted anecdotally. We rely on the diligent physician’s ability to supplement evidence-based treatment with treatments that are backed by the experiences of patients and practitioners but comprehensive, quality care also demands the rigor of peer-reviewed science whenever available.
  4. The treatment team is open to all relevant disciplines and approaches: No single practitioner can be an expert in every field. It is incumbent upon the provider to cast a broad net and accept help from all disciplines capable of healing the patient. For example, a complex, patient may benefit from the expertise of a primary care physician, addictionologist, psychiatrist, psychotherapist, acupuncturist, dietitian, naturopathic physician, physical therapist and other practitioners, depending on the patient’s condition. Moreover, communication between the providers is necessary to provide a continuum of care.
  5. All aspects of the patient’s experience—physical, emotional and spiritual—are considered.  Failure to consider every dimension of the patient’s experience, including any cultural influences, limits our understanding of the ways in which a patient will respond to a given intervention. The culture of Police officers must be understood by the physician and other members of the healthcare team in order help them effectively.

The complexity of depression, addiction, PTSD and the like requires a comprehensive, multifaceted treatment model to facilitate optimal healing. Integrative Medicine does not exclude treatment paradigms; rather, as the name implies, it includes all viable modalities. The complex, chronic diseases of addiction and mood disorders often frustrate healthcare providers in search of a cure. Cure implies a single event—success or failure, usually in terms of one criterion or treatment modality—and our medical culture is all too often invested in success at all costs. Healing, on the other hand, takes the onus off outcomes and places it upon relationships. Healing, then, can be conceived of as a continued effort to improve wellbeing in the midst of changing conditions and circumstances. The integrative model reminds us that when we are unable to cure we are still able to heal, and if we are able to heal we can maintain hope. It is in this spirit that I intend to pursue a productive, healing relationship with the FBINAA and its members.