The thin blue line: Stress and trauma in police work

By Laurie Scarborough

Police work is considered one of the most stressful professions (Gulle, Tredoux, & Foster, 1998; Mostert & Rothman, 2006; Renck, Weisæth, & Skarbö, 2002; Storm & Rothman, 2003). Police are frequently exposed to danger, threat and violence, which can lead to trauma (Burke & Mikkelsen, 2006; Regehr, Johanis, Dimitropoulos, Bartram, & Hope, 2003; Stephens & Long, 2000; Violanti et al., 2006).

This is particularly the case in South Africa, where violence and crime rates are especially high (Mostert & Rothman, 2006; Storm & Rothman, 2003). Violent crime rates for 2015 in South Africa were 748 per 100 000 people (this included murder, attempted murder, sexual offenses, grievous bodily harm, and aggravated robbery; South African Police Service, 2015). This is just over double the United States of America, at 372.6 per 100 000 (murder, attempted murder, rape, robbery, and aggravated assault; Federal Bureau of Investigation, 2015). Members of the South African Police Service (SAPS) have significantly higher stress levels than American police (Gulle et al., 1998), and this is possibly explained by a more violent society, and more frequent exposure to violence and trauma incidents. However, the same research showed that while trauma-related stress scores were not significantly different between American police and SAPS, there was a difference in organisational stressors, with scores for organisational-related stress being higher for SAPS members (Gulle et al., 1998). This indicates that it is, perhaps, not the traumatic aspects of the work that are the primary sources of stress for SAPS. The nature of police work and the structure of police force leads to serious organisational stress (Foster, Tredoux, & Nichols, 2005; Storm & Rothman, 2003).

Police work may have similar stress outcomes to other professions, however because of the importance of police work to greater society, there is value in doing research into the causes and effects of stress in police workers, in order to address these problems and create a more effective police force. Police experiencing high levels of stress and psychological difficulties could risk the safety of themselves, colleagues, or civilians (Foster et al., 2005), and thus this area merits attention. The source of police stress and its implications will be considered in the following discussion.

Sources of stress in police work

Much of police stress research has focused on traumatic aspects of police work. This research has found that exposure to violent and dangerous situations, as well as witnessing abuse and the effects of abuse, can cause trauma and stress (Arnetz, Nevedal, Lumley, Backman, & Lublin, 2009). Repeated exposure, as well as the severity of the traumatic incident, were related to higher levels of traumatic responses, such as stress or Post-Traumatic Stress Disorder (PTSD; Arnetz et al., 2009; Regehr et al., 2003; Renck et al., 2002; Stephens, Long, & Miller, 1997; Weiss et al., 2010). Frequent exposure to traumatic incidents, many of which serious, is an inherent part of the job; exposure to these incidents is much higher than the average citizen, which is reflected in the inflated PTSD prevalence amongst police workers (Stephens, Long, & Flett, 1999).

Despite this obvious source of stress in police work, it is in fact the organisational stressors of the profession that are the primary cause of stress in police workers, and contribute the most to stress levels (Burke & Mikkelsen, 2006; Gershon, Barocas, Canoton, Li, & Vlahov, 2009; Foster et al., 2005; Gulle et al., 1998; Regehr et al., 2003; Renck et al., 2002). Not only this, but the stress caused by organisational factors exacerbates and prolongs stress reactions to trauma (Paton, Smith, & Violanti, 2000; Regehr et al., 2003).

Police work involves high amounts of administrative tasks and bureaucracy (Alexander, 1999; Foster et al., 2005; Storm & Rothman, 2003), for which police receive little preparation, and this is a large source of stress to police (Gulle et al., 1998; Foster et al., 2005; Regehr et al., 2003). This is made worse by low literacy rates in SAPS officers (Foster et al., 2005), making their administrative tasks harder and decreasing productivity. Higher ranked police lack the necessary skills (especially investigative skills) to effectively perform their tasks, and management is ill trained and ineffective (Foster et al., 2005), thus creating a failing team.

Because of this, the public are losing faith in SAPS, and officers constantly have to battle negative press and negative public opinion (Burke & Mikkelsen, 2006; Foster et al., 2005; Regehr et al., 2003). Almost 60% of South Africans have no respect for SAPS at all (Foster et al., 2005). Although the Constitution of the Republic of South Africa (1996, Act 108, Section 205(3)) states that the police should prevent crime, in the reality the police perform mostly a patrol and investigative function (Leggett, 2003). The public however, expect the police to be preventing crime (Foster et al., 2005), which adds to conceptions of police incompetency when faced with high crime rates.

A further stress is that police failures can result in legal ramifications and public and internal inquiries, that are well publicised and often salacious and misinformed (Regehr et al., 2003). This can be demotivating, especially when exacerbated by lack of support from an inadequate justice system that is often too lenient with convicted criminals (Burke & Mikkelsen, 2006), and a failing prison system that does not rehabilitate criminals (Gulle et al., 1998). This can make the work seem irrelevant, and can lead to disillusionment of career expectations not being met (Burke & Mikkelsen, 2006), resulting in burnout and stress reactions (Pines & Keinan, 2005).

Poor management, which is often authoritarian and militaristic in nature, lack of support from management and others within the force, as well as poor communication between ranks, is a large source of organisational stress to police workers (Alexander, 1999; Burke & Mikkelsen, 2006; Foster et al., 2005; Gershon et al., 2009; Regehr et al., 2003; Storm & Rothman, 2003). Shift work, over time, and insufficient members of the force make the work schedules difficult to manage (Alexander, 1999; Foster et al., 2005; Gershon et al., 2009; Storm & Rothman, 2003), and it leaves little time to recover from the stress that is associated with the work. A lack of resources (including insufficient numbers of police workers, lack of support services, underfunding leading to poor equipment and inadequate salaries), is also a source of stress (Foster et al., 2005; Gulle et al., 1998).

Gershon et al. (2009) compared trauma-related stress and organisational stress and found that organisational problems lead to the highest number of police experiencing high stress (organisational unfairness – 59.7%, discrimination – 57.9%, lack of cooperation – 54%, and internal investigation – 51.7%). These are overall higher than the trauma incidents, of which the highest percentage of officers experiencing high levels of stress was 54.3%, after witnessing a scene with blood, followed by 32.4%, after shooting someone. Gulle et al. (1998), did a similar study using a factor analysis and found that of the top five factors contributing to SAPS stress, four were organisational in nature (lack of support and resources – including lack of support from the judicial system, social responsibilities – including negative public and media opinion, career advancement, and perceived job performance). Traumatic stress was the fifth factor. Furthermore, the same study found that all ten of the most frequent monthly stressors in SAPS were organisational (excessive administrative demands, court leniency with criminals, inadequate number of police officers, incomeptent colleagues, inadequate judicial system, negative public opinion and attitudes, lack of appropriate resources, poor salary, and inadequacy of the prison system). Further sources of stress were discrimination, largely based on race and gender (Foster et al., 2005; Gershon et al., 2009; Gulle et al., 1998).

Gershon et al. (2009) suggest that perhaps the reason that organisational stressors affect police more than traumatic stress is because when officers join the force, they expect and are therefore more prepared for the traumatic aspects of the work, yet they neither expect nor are trained to deal with the organisational issues with the force, resulting in these aspects causing more stress (Gershon et al., 2009). Interventions targeting this will be discussed later.

For now, we turn to an investigation of the outcomes of the police stress, which contributes to poorer job performance (Mostert & Rothman, 2006).

Effects of stress on police

The effects of stress on police include increased prevalence of PTSD, substance abuse, depression, suicide, and anxiety, burnout, poorer job performance, absenteeism, illness, early retirement, heightened aggression, and emotional dysregulation (Arnetz et al., 2009; Burke & Mikkelsen, 2006; Davidson & Moss, 2008; Follette, Polusny, & Milbeck, 1994; Foster et al., 2005; Gershon et al., 2009; Hodgins, Creamer, & Bell, 2001; Mostert & Rothman, 2006; Pines & Keinan, 2005; Regehr et al., 2003; Renck et al., 2002; Stephens et al., 1999; Storm & Rothman, 2003; Violanti et al., 2006; Weiss et al., 2010). A list of negative outcomes this long has serious implications for SAPS and the justice system, because when job performance is affected by mental and physical health problems, the police could become ineffective and negligent, resulting in possible injury or death of fellow officers or citizens (Arnetz et al., 2009; Foster et al., 2005). This could lead to further loss of public support and trust in the police (Gershon et al., 2009).

Because of this, interventions should be targeted at police workers, aiming not only to address trauma and the effects of stress, but also the source of the stress. Thus, there are two broad interventions that are needed: the first addressing the effects of police stress and trauma, and the second concentrating on reducing organisational problems that are causing stress and exacerbating trauma.

Mandatory debriefing for police after a traumatic incident has been successfully introduced in Scandinavian countries, with a particular focus on group therapy (Renck et al., 2002). A support group with people who have experienced similar things can increase understanding and feelings of support (Regehr et al., 2003). Social support from peers, family and supervisors, that allows for disclosure about emotional responses to trauma reduces rates of suicidal ideation and mental and physical illness prevalence, and increases coping (Burke & Mikkelsen, 2006; Davidson & Moss, 2008; Stephens & Long, 2000; Stephens et al., 1997). However, there is a ‘cop culture’ that tends to reject emotional sharing and sees any emotional disclosure, negative response to trauma, or help-seeking behaviour as weakness (Arnetz et al., 2009; Davidson & Moss, 2008; Foster et al., 2005; Paton et al., 2000; Stephens et al., 1997; Stephens & Long, 2000), making it unlikely that police workers would voluntarily seek mental healthcare (Stephens et al., 1997). This could prevent healing after trauma (Paton et al., 2000). Introducing mandatory debriefing or counselling could thus reduce stigma around seeking help (Foster et al., 2005), increase emotional support and disclosure, and improve mental and physical outcomes after trauma, thus improving potential for job performance. Despite higher prevalence of mental illness in police populations, the state medical aid does not offer sufficient cover for mental healthcare, and there is currently only one mental health professional per 15 000 police workers (Foster et al., 2005). Police mental healthcare is clearly not a priority to the government and campaigns could be launched to address this issue.

Training police for trauma work could also prevent symptoms by better equipping police to cope with frequent exposure to trauma (Foster et al., 2005; Paton et al., 2000). Relaxation techniques and mental rehearsal of common traumatic incidents in police work was found to improve health outcomes, which can improve job efficacy (Arnetz et al., 2009).

A second set of interventions should address the organisational issues with the police force structure. While little can be done about police exposure to trauma because it is an inherent part of the job and a function of society, a distinction between the traumatic and organisational causes of stress is important, because the organisational factors can be more easily addressed (Gulle et al., 1998). Human resource professionals could be employed to do assessments with recruits and make appropriate placements of officers into positions based on ability and suitability (Foster et al., 2005). This would serve the double function of creating a better performing police force, as well as improve general attitudes towards work which could reduce absenteeism and early retirement. Structural issues with the force should also be addressed by the provision of necessary resources, including campaigning for recruitment of police officers and provision of sufficient funding, and training managers and supervisors to more effectively communicate with and support officers below them in rank (Paton et al., 2000). Because organisational problems are the primary source of stress in police workers, more rigorous training is needed to prepare police for the organisational tasks and stressors associated with police work (Foster et al., 2005; Paton et al., 2000).

Psychologists have many skills that could be used to help with the problems within SAPS. Training of personnel and facilitating of support groups, as well as offering counselling and career assessments could all help to address the current problems with the force. Because South African crime rates are so high, leading to possible inflated prevalence of trauma, stress and mental illness, and many of our police force are illiterate (Foster et al., 2005), making their high amounts of administrative tasks difficult, stress in police is worse in South Africa than other countries. Thus, more research could be done with South African samples, informing needed interventions designed for the South African context.

References

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