Policing May Be Hazardous To
Your Health
William Milchak, LCSW,CADC
Addictions Consultant-Psychiatry
Penn State College of Medicine
Disclaimers
All vocations have their inherent stressors!!!!!
We can agree that policing-law enforcement can be a
high stress occupation
Policing has it’s mental health and health
casualties….but not all fall prey!
Ex. Vietnam and OEF/OIF Veterans
My Evolving Interest
A Vet’s Experience with Vets
Camp Hill Prison Riots
Live with a Criminologist
We are Living in Dangerous Times
We have appx. 900,000 in law enforcement and we
largely ignore these issues
Ex. Is hyper-vigilance fatigue
4 Major Areas of Concern
Rates of PTSD
High rates of Suicide
Alcohol Abuse
Unhealthy and Die Young
Occupational Stress
“Police work is the most stressful occupation in America even
surpassing the formidable stress of air traffic controllers”
(Hans Selye…father of stress studies)
3 Most Stressful Occupations
1.
2.
3.
Mining
Police Officer
Prison Guard
U.S. Centers for Disease Control…CDC
Physiological Response to Stress
Cortisol
Dysregulation>compromises the immune system and
some organs
Stress and PTSD
“Exposure to actual or threatened death, serious
injury, or sexual violence”
Question…..are police exposed to more of these
scenarios in 2014 than they were 25 years ago?
Ex. “The Green Zone”
“Rent Free Inside my Head”
Tom W.
Intrusive Thoughts
Avoidance and Numbing
Increased Arousal
How Does this Play Out??
Detached and Isolated
Emotionally Shutdown
Poor Sleep and
Irritability….short fuse
Hyper-alert
Internal and External Stressors
 Lots of overtime and double shifts
 Little felt supervisory support
 Limited upward mobility…stuck
 Paperwork
 Internal Investigations
 Often very limited backup
 For many….daily exposure to violence
Consequences of Stress and Fatigue
An Analysis of Stress and Fatigue’s Impact on Police
Impaired Judgment
Impaired Eye-Hand Coordination
Inappropriate Reactions to Situations
(Basinka and Wiciak, 2012)
Health Consequences
Studies consistently reveal higher rates of some
health issues
Work has been done across Western nations and
remains consistent
John Volanti lead the charge
Volanti’s Pivotal Health Study
(100 New York State Troopers)
INREASE IN METABOLIC SYNDROME TO INCLUDE:
Abdominal Obesity
Hypertension
High Triglycerides
Low HDL
High Risk for Cardiovascular Disease
Higher Risk for Type II Diabetes
2012 Follow-Up of Same 100 Troopers
40% classified obese
Those working 30 years have significantly higher rates
of some cancers’
4-6 Xs the sleep problems
Other Health Perspectives
(New Jersey Police)
Heart disease
Cirrhosis of the liver
Digestive diseases (increases with age and service)
(New York Police)
Heart Disease
Digestive cancers and esophageal cancers
SUICIDE
(Rome, Italy)
Colon cancer
Heart disease
Bladder and kidney cancers
Police and Alcohol Abuse: Myth or Reality
20-25% alcohol abuse
Drink LESS…BINGE MORE
Drink as their non-policing peers (RELIEF)
Police drinking sub-culture
Less reluctant to seek help
Police Down Under
(New Zealand)
Prior 2005, most station houses had bars
Booze cheaper for police
Feel “vulnerable” drinking in the community
(Australia)
Less frequent, but larger quantities
30% score as “harmful drinking” on the AUDIT
Who among police is at most risk????
A New Zealand Police Bar







No License
Any officer can serve
No betting or gambling
Intoxicated cannot enter
No further sale to someone intoxicated
Orderly conduct maintained
NO CONSUMPTION OF ALCOHOL 2 HOURS PRIOR TO YOUR
SHIFT
 ALCOHOL FOR CONSUMPTION OUTSIDE THE BAR CAN BE SOLD
TO OFFICERS, NON-SWORN STAFF, AND RETIRED STAFF IN
REASONABALE QUANTITIES
 Bars set their own hours of operation subject to district commander’s say
Police Perspectives on Drinking
 Stress relief
 Peer Pressure
 We are misunderstood
 Male bonding
 Risk factors…age, years of service, and marital status
 SUICIDE
Suicide Among Police
National Suicide Rate
10.6 :100,000
“Estimated” Suicide Rate Among Police
17 :100,000
(Volanti, 2005)
2006-in 8 months, 8 California Highway Patrolmen Committed Suicide
(USA Today, 2007)
Regional Differences
(10.6 : 100,000 general adult population)
2008….4 Metro Areas
Detroit
Los Angeles
Chicago
New York
28:100,000
20:100,00
18:100,000
15: 100,000
Questions????
1. How many police officers die annually in the actual
line of duty?
2. How many die “at their own hand”
(International Association of Chiefs of Police)
*Police have 3Xs the rate of suicide as their municipal employee
peers!
** Vietnam Vets and suicide
Familiar Risk Factors
 Legal troubles
 Relationship problems
 Stress
 Critical Incident/s
 Illness
 $$$$$$$
 Alcohol
PTSD as a Risk Factor
1. PTSD secondary to witnessing homicide of
another officer
2. PTSD subsequent to witnessing death,
devastation, and abuse of children (911 Calls)
3. PTSD+Alcohol Abuse=10Xs the risk
Impact of a Suicide Upon the Unit
Fragments a department
Lack of protocol
Individual religious/moral values come into play
Mental health of employees impacted
What to do with the relationships with the deceased’s
family?
Where and how the suicide was committed
BLAME THE OFFICER..BLAME THEMSELF
Articles and Headlines
 Impact of Stress on Police Officer’s Physical and Mental Health
 Social and Stress-Related Influences of Police Officers and Alcohol Consumption
 Police Officer’s Stress Creates Significant Health Risks Compared to General Population
 Police Stress is Unhealthy
 Mental, Physical, and Behavioral Outcomes Associated with Perceived Work Stress in
Police Officers
 Changing the Police Sub-Culture
 Police Suicide, an Alarming Problem
 Suicide Rates: a Jolt to the Police Culture
 Domestic Violence and Divorce Higher for Police Families
Summary
Policing ranks among the most stressful occupations
Chronic stress and trauma exacts a heavy toll
Culture resistant to help-seeking
Unique stressors of women…little known
Our dangerous world and increased vigilance
Addressing the Concerns
Start with the Police Academy
Help them with the basics…plan meals and eat healthy.
How about vacation and down time? See your PCP!
Learn from the RESILIENCE studies
Police Peer Support Groups…COPING STRATEGIES
ex. “Battlemind”
AA meetings for law enforcement
Marworth’s Law Enforcement Program
Training Leaders to Recognize Operational Stress
Close
Law enforcement is morphing into new areas
Law enforcement is growing in its ranks
Felt ambivalence
Stereotypes linger
More safety nets are needed
I “thank a cop”