Article

Police suicide: A national comparison with fire-fighter and military personnel

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Abstract

Purpose – The objectives of this paper are to examine national police suicide rates, to compare police suicides with fire-fighters and military personnel, and to examine suicide in women and minority officers. Design/methodology/approach – The National Occupational Mortality Surveillance (NOMS) (1984-1998) was used as a data source. Descriptive statistics and proportionate mortality ratios (PMRs) were calculated. Findings – Overall, the police suicide rate was four times that of fire-fighters. Minority officers had 4.5 times and policewomen 12 times the number of suicides than did fire-fighters. Police suicides outnumbered homicides by 2.36 times. Police had significantly higher than expected PMRs for suicide. Research limitations/implications – NOMS data are presently available up to 1998, and data in the study are descriptive only. Although suggestive of risk, statistically significantly elevated PMRs cannot be interpreted directly as indicating a causal relationship between police work and suicide. Confounders are not recorded in NOMS and may lend considerable weight to suicide. Practical implications – The paper reflects the need to look deeper into police suicides and their root causes. Police organizations are advised to initiate suicide awareness training and psychological assistance to officers. Originality/value – The paper is among the first nationally to compare suicide among similar hazardous occupations, suggesting the need for prevention.

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... A check of the NPSF's website reveals no statistics cited and the BOL publicly criticized the NPSF for refusing to share their data source or collection method (O'Hara, n.d.), which makes the NPSF's data suspect. Although variations in estimates exist, researchers estimate that law enforcement officers are up to 3 times more likely to die by suicide than by other people they encounter while on the job (Chopko, Palmieri, & Facemire, 2014;Janik & Kravitz, 1994;Miller, 2005;Mohandie & Hatcher, 1999;Stuart, 2008;Violanti, 2010a;Violanti, et al., 2009). Violanti, Robinson, and Shen (2013), found that detectives/investigators had a suicide rate 82% higher than street officers did. ...
... Among demographic groups, suicide is highest among White and Native American males (CDC, 2017;Shiels et al., 2017) who are middle-aged (CDC, 2017). This is why it is especially troubling, that in one study, female officers had a 400% and Black male officers, had a 200%, higher likelihood of suicide when compared with their peers in the fire service and military (Violanti, 2010a). Because the researchers of this study compared police, fire, and military, the healthy worker effect is more mitigated than in comparisons with the general population. ...
... This is unfortunate given there is a lack of accounting for diversity in suicide research (Cha et al., 2018). What researchers have discovered in regard to minority responder suicide is that the rates among these responder populations are higher than those of the majority (Van Haute & Violanti, 2015;Violanti, 2010aViolanti, , 2010b. ...
Thesis
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The primary purpose of this quantitative study is to understand suicide among emergency responders. The secondary purpose is to examine how educators can use information about suicide among emergency responders to develop and adapt curriculum to mitigate psychological trauma experienced by those in emergency medical services (EMS), the fire service, and law enforcement. I use social cognitive theory to investigate responder suicide and as a framework to understand the role of education. Official death records were cross-referenced with data possessed by responder credentialing agencies. I analyzed the records to determine the suicide rates of responders compared to the general population and a matched set of responders who did not die of suicide. I also analyzed educational factors hypothesized to confer protection against psychological trauma and suicide, including EMS credential level, academic education level, attainment of firefighter or law enforcement training, and various combinations of credential, education, and fire or police training. The findings suggest that emergency responders have a higher suicide rate compared to the general population. Responders who die by suicide generally have higher levels of education. Being a responder without an EMS credential confers the most protection while the interactive effects of credential and education have significant (p < .05) association with suicide. The impact of psychological trauma is the same regardless of the responder field of practice.
... Indeed, literature indicates that nearly four times as many officers die yearly from suicide compared to felonious assault (Gilmartin, 2002). Furthermore, police suicide rates may be as high as twice the national average of suicides among the general population, and significantly higher than comparable occupations (Heiman, 1977;Violanti, 2010). ...
... The literature has been clear that suicide remains as a significant problem facing individual officers as well as police agencies (Clark and White, 2003;Hackett, 2003). Despite ruminations suggesting otherwise, suicide is a problem that affects members of law enforcement differentially when compared to other populations (Barron, 2010;Gershon, 2000;Heiman, 1977;Violanti, 2010;Violanti et al., 1996;Violanti et al., 2009). ...
... Scholars have studied stress as an occupational hazard (Anshel, 2000;Beehr, Johnson, and Nieva, 1995;Gächter, Savage, and Torgler, 2011;Hackett, 2003;Janik and Kravitz, 1994;Johnson and Colbert, 2007;Loo, 2003;Morash, Haar, and Kwak, 2006;Niederhoffer, 1967;Stevens, 2005;Toch, 2002) and have taken a more general approach to the subject. Yet most research recognizes that sources are more specific, positing police stress as either a result of environmental, street level, traumatic experiences (Aaron, 2000;Brough, 2004;Kates, 1999;Liberman et al., 2002;Pasillas, Follette, and Perumean-Chaney, 2006;Violanti, 1997Violanti, :2010Waters and Ussery, 2007;Zhao et al., 2002) or organizational, routine pressures caused by the bureaucratic structure of the police agency (Beehr et al., 1995;Brooks and Piquero, 1998;Brough, 2004;Gershon et al., 2009;Hart et al., 1995;Shane, 2010;Zhao et al. 2002). The current analysis aims to provide more insight to a question asked by a scholar more than thirty years ago: "What precisely are the main sources of stress in police work?" (Spielberger et al., 1981, p. 9) ...
Book
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The purpose of this dissertation is to test general strain theory as an explanation for the effects of violent crime exposure on police officers from large urban areas. Data were collected through the Police Work Experience Survey (PWES) on officers from three of the largest metropolitan areas in Texas: Dallas, Austin, and El Paso. Additionally, the findings were examined through the lens of the police subcultural perspective. Ideas for future research are also presented.
... Self-stigma and public stigma have both been inversely associated with help-seeking (Corrigan, 2004;Conner et al., 2010). Having a mental disorder is often associated with being perceived as incapable, incompetent, weak, and a failure (Violanti, 2010;Caputo and Rouner, 2011). Pressure to maintain a strong persona is often greater among PSP organizations (Corsianos, 2011), which may lead PSP to avoid accessing professional services for fear of retribution by peers or administration (Blum, 2000;Karaffa and Koch, 2015;White et al., 2016;Wheeler et al., 2018). ...
... Pressure to maintain a strong persona is often greater among PSP organizations (Corsianos, 2011), which may lead PSP to avoid accessing professional services for fear of retribution by peers or administration (Blum, 2000;Karaffa and Koch, 2015;White et al., 2016;Wheeler et al., 2018). PSP who are mistrustful of peers with mental disorders (e.g., perceiving peers as unstable or a risk to personal safety on calls) will not feel comfortable disclosing mental health struggles, further reducing social support and treatment-seeking behavior (Violanti, 2010;Wilmoth, 2014). Mental health stigma may also influence mental health symptom reporting, hindering realistic prevalence estimates, limiting overall resource availability (Henderson et al., 2016), and creating a cycle that further impedes treatment-seeking behavior. ...
Article
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Introduction: Public safety personnel (PSP; e.g., communications officials [e.g., 911 call center operators/dispatchers], correctional service employees, firefighters, paramedics, police officers) experience an elevated risk for mental disorders due to inherent work-related stress. Several programs have been designed to increase mental health knowledge, intending to reduce stigma, and increase mental health service help-seeking (e.g., resilience training); however, extant programs have not demonstrated sustained improvements for PSP mental health. The current study assessed levels of mental health knowledge, stigma, and service use intentions in a sample of Canadian PSP and compared trends to published estimates of mental health symptoms across PSP categories to inform future programming. Methods: PSP completed questionnaires assessing mental health knowledge, stigma against coworkers with mental illness, and professional service use intentions. Correlations among variables and one-way analyses of variance were conducted to assess differences among categories. PSP were categorized into six categories for comparison: communication officials, correctional workers, firefighters, municipal/provincial police, paramedics, and Royal Canadian Mounted Police (RCMP). Results: There were significant differences between categories for each variable. Correctional workers reported the most mental health knowledge, least stigma, and highest intentions to use mental health services, and the highest positive screens for mental disorders. Conversely, firefighters reported the lowest mental health knowledge, highest stigma, and lowest willingness to seek professional help, and the lowest prevalence of positive screens for mental disorders. Discussion: The results contrast previously hypothesized associations among mental health variables where education, stigma reduction, and help-seeking have been expected to improve mental health. The discrepant results offer potentially critical information for organizational policies to better support PSP. Individuals reporting mental health symptoms may be a more appropriate target audience for intervention strategies, given the possible, crucial role personal experience plays in increasing mental health knowledge, and ultimately, encouraging help-seeking.
... In the West, there has been some research looking at suicide rates among racial minority groups in policing. African American women in US police agencies have been found to have higher suicide rates than the general population (Violanti, 2010). Hispanic police officers also had a higher suicide rate than the male Hispanic population in the United States (Violanti, 2010). ...
... African American women in US police agencies have been found to have higher suicide rates than the general population (Violanti, 2010). Hispanic police officers also had a higher suicide rate than the male Hispanic population in the United States (Violanti, 2010). However, due to the relatively small numbers of minority officers in these studies, it is hard to make strong conclusions about the role of ethnicity and suicide in policing. ...
Chapter
National security priorities, result-oriented pressures, and cost sensitivity are common features of contemporary policing. While the global shift to evidence-based policing (EBP) increased police reliance on behavioral science research on interrogation and interviews, skepticism about the effectiveness of “soft” science is pervasive and “hard” sciences have been privileged. Psychologists have consequently been challenged to fulfill their roles in compliance with the four key principles that underpin psychologists' codes of ethics, namely, respect for rights and dignity, competent caring, integrity, and social responsibility. This chapter reviews the alignment of these principles with the relational skills implicit in the four tenets of the leading theory in international police practice, procedural justice (PJ). An analysis of research constructs applied in contemporary interviewing research demonstrated the integral connection between these relational skills and effective interviewing of high-value detainees. These links are present both in a “ticking bomb” scenario as well as less exigent contexts. By mapping the links between ethical principles, PJ tenets, relational research constructs and outcomes, this chapter offers a potential framework for behavioral scientists in policing contexts to develop their ethical literacy and better articulate and evaluate potential ethical issues in their practice. Adherence to PJ tenets can reduce psychologists' role conflicts and facilitate the ethical practice of psychology and EBP.
... No evidence of such an effect was, however, observed in our data. Moreover, the choice of reference occupation is still being debated across countries and authors [13,15,16], the selection of one specific occupation with no relevant assumption for our national context, would complicate interpretation and comparison of our results. The quality of occupational information in the SNC is not perfect, as it precluded us from classifying occupation in 34% of males and 53% of females, corresponding to 22% and 46% of suicides deaths, respectively. ...
... Our results are consistent with the results of other studies and confirm the detrimental effect of low socioeconomic positions, including unemployment, with respect to suicide mortality [19][20][21][22][23]. Employment in elementary occupations, such as manufacturing labourers or personal care and related workers (at lowest and second lowest skill level), associated with excess of suicide in both sexes, is another consistent finding [5,13,24]. In agreement with prior reports [12,16,[24][25][26][27][28], agriculture, hunting and forestry as well as defence in men and health and social activities sectors in women were identified as economic activities at risk of suicide. Our findings are also consistent with evidence that easy access to lethal means of suicide in healthcare and military personnel increases the mortality from suicide [24,29,30]. ...
Article
Full-text available
Purpose To identify occupations and socio-economic groups with detrimental or protective effect on suicide mortality. Methods For every occupation and economic activity/industry, we computed directly age-standardized mortality rates (DSRs) using the age structure of the European population (2010) and standardized mortality ratios (SMRs) for suicide using national cause-specific mortality rates. We further stratified analyses by socio-economic variables, job-skill level, and by three calendar periods (1990–1998/1999–2006/2007–2014). Results The study sample comprised 5,834,618 participants (94,918,456 person-years). The highest DSRs were observed among unemployed/job-seeking group, in agricultural, fishery and related male workers, and in health and social activities female workers. The lowest DSRs were observed in real estate and renting, research and development, IT and other business activities in men and in agriculture, hunting and forestry industry in women. A consistent reduction in DSRs across three calendar periods was observed in men. In female corporate managers, DSRs increased over the 2007–2014 period compared with 1999–2006. Compared to general working-age population, unemployed/job-seeking people, manufacturing labourers, personal care and related workers, and motor vehicle drivers of both sexes were identified at risk of suicide. Moreover, an excess of suicide was observed among male material recording and transport clerks; nursing and midwife-associated professionals; and agricultural workers as well as among female writers and performing artists. Conclusions The findings suggest the detrimental effect of low socioeconomic positions, including unemployment, with respect to suicide mortality and a relationship between suicide and poor psychosocial working conditions in elementary occupations. Sex-specific results need further investigation.
... In a medium-sized northeast US police department, the prevalence of depression was higher among female than male personnel (12.5 vs. 6.2%) (Violanti et al., 2010). It appears to be a consistent finding that psychosocial symptoms are predictive of suicidal ideation in female officers (Violanti et al., 2008). ...
... In one study intrusive memories associated with post-traumatic stress disorder explained 46% of the variance in suicidal ideation among female officers (Pienaar et al., 2007). The often high, yet disparate female officer suicide rates combined with findings on suicidal ideation in this population warrant further investigation into suicide ideation, attempts and completion rates (Violanti et al., 2010). In the present study, 66 deaths were recorded for African-American males in the all law enforcement category, making them almost two times more likely to commit suicide (PMR = 188, 95% CI = 146-240) than African Americans in all occupation categories. ...
Article
Purpose The purpose of this paper is to update the assessment of national data on law enforcement worker suicide based on the National Occupational Mortality Surveillance database (NOMS, Centers for Disease Control and Prevention). Design/methodology/approach Death certificate data for 4,441,814 decedents, age 18–90 who died in one of the 26 reporting states were the source of NOMS data. Utilizing proportionate mortality ratios (PMRs), the ratio of suicides in law enforcement occupations in those who are 18–90 years old with a designated usual occupation was calculated. Findings Findings indicate a significantly higher proportion of deaths from suicide for law enforcement officers (PMR = 154, 95% CI = 147–162), compared to all the US decedents in the study population who were employed during their lifetime. Law enforcement personnel are 54% more likely to die of suicide than all decedents with a usual occupation. PMRs were highest for African-Americans, Hispanic males and for females. PMRs were similar for detectives, corrections officers and all law enforcement jobs, when not stratified by race, ethnicity and sex. Research limitations/implications Bias may arise because a PMR can be affected by disproportionate increased or decreased mortality from causes of death other than suicide. Practical implications A better understanding of the scope of law enforcement suicide can inform policy focused on the planning and initiation of prevention programs. Originality/value The use of a national database to study law enforcement worker suicide adds to other information available on law enforcement worker suicide in specific geographic areas. The discussion on prevention in this paper presents ideas for policy.
... For instance, emergency services personnel (i.e., police, ambulance, firefighters) work within high-paced and high-risk environments, whereby poor judgment may put lives of personnel and the public at risk (Andersen, Papazoglou, Nyman, Koskelainen, & Gustafsberg, 2015). Emergency services cultures emphasize the need for personnel to be resilient amid stressful circumstances, and issues with mental health may be seen as a personal weakness and a risk to others (Violanti, 2010). A recent study surveyed 483 firefighters with suicidal thoughts and behaviors, with 41% reported issues with reputation as a barrier to seeking professional care, while 30% indicated embarrassment as a concern (Hom, Stanley, Ringer, & Joiner, 2016). ...
... A mistrust of individuals with mental health issues may be present within workplaces, as they may be perceived as unstable and a threat to the lives of those around them. The stigma that exists within masculine-dominated emergency services workplaces, which promote displays of strength and resilience, may act to inhibit help-seeking and potentially increase risk of suicide (Violanti, 2010). Indeed, the current study found that participants who preferred not to answer suicide-related questions were more likely to report various barriers to seeking help. ...
Article
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Suicide is a leading cause of morbidity, yet a significant challenge to receiving adequate support is an unwillingness to disclose mental health issues. The current study explores reasons for nondisclosure among emergency personnel, a population at risk of developing mental health problems. Twenty-nine police, ambulance, and fire and rescue agencies from around Australia participated in a mental health and wellbeing survey (N 14,536, male 60.5%, 52.0% over 45 years of age, heterosexual 92.5%). Rates of mental health issues and perceptions of stigma were compared between participants who answered suicide-related questions and those who preferred not to say. Participants who preferred not to answer suicide-related questions (n 1,098) reported higher rates of psychological distress (symptoms of depression and anxiety), and lower wellbeing and social support, than those who reported suicidal thoughts (n 1,966) or no suicidal thoughts (n 11,472). Perceptions of mental health stigma within the workplace, and regarding one’s own mental health, also tended to be higher among nonresponders. Imputing their responses based on this survey information resulted in notably higher rates of estimated suicidal thoughts, plans, and attempts. Allowing for nondisclosure in self-report measures of suicide may provide more accurate prevalence estimates and facilitate identification of individuals most at risk of suicide. Addressing stigma in the workplace and also regarding one’s own mental health issues may act to improve disclosure of suicidal thoughts and adaptive help-seeking behaviors.
... al., 2013;Hammad et. al., 2013;Patterson, 2009;Russell, 2014;Violanti, 2010 & Valle, 1979;Balckmore, 1978;Biggam et. al., 1997;Nel, 1994;Dowling et. ...
Article
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Tekanan merupakan satu keadaan yang tidak dapat dielakkan dalam pekerjaan terutamanya dalam organisasi kepolisan. Bukti impirikal menyatakan bahawa kerjaya kepolisan adalah pekerjaan yang paling tertekan berbanding dengan pekerjaan yang lain kerana kerjaya ini melibatkan tugasan yang mempunyai impak tekanan terhadap mental dalam kalangan pegawai polis. Artikel ini membincangkan tentang kajian-kajian lepas yang berkaitan dengan isu tekanan kerja, punca dan kesan daripada tekanan kerja dan hubungkait antara tekanan kerja dengan Kecerdasan Emosi dalam organisasi kepolisan. Kajian impirikal telah membuktikan bahawa terdapat hubungan yang signifikan antara Kecerdasan Emosi dengan tekanan kerja di mana Kecerdasan Emosi merupakan komponen yang penting dalam mengurangkan tahap tekanan kerja dalam kalangan pegawai polis. Oleh itu, pengetahuan terhadap tahap tekanan kerja dalam kalangan pekerja dalam sesebuah organisasi adalah amat penting bagi memastikan langkah-langkah yang berkesan dapat diambil untuk mengurangkan tekanan kerja dan kesannya dalam organisasi tersebut dengan menggunakan elemen-elemen Kecerdasan Emosi.
... Between 7 and 15 percent of the police population likely meets diagnostic criteria for PTSD (Harvey-Lintz and Tidwell, 1997;Robinson et al., 1997;Maia et al., 2007), and an even greater 34 percent experiences significant PTSS that do not reach the diagnostic threshold (Carlier et al., 1997). PTSS in police officers following exposure to traumatic events have been linked to the development of significant health problems, and rates of suicidal ideation among police officers are four times greater than that of firefighters (Vena et al., 1986;Violanti, 2004Violanti, , 2010. This suggests that some police officers are particularly harmed by the effects of their occupational trauma exposure. ...
Article
Full-text available
Purpose Women comprise a significant and growing proportion of the law enforcement population. Despite this, their potentially unique reactions to job-related posttraumatic stress symptoms (PTSS) and depression have been underrepresented in the relevant literature, particularly within the context of exposure to community violence. Also understudied is the role of empathy in the development of post-trauma reactions, which has been a risk factor for the development of posttraumatic distress in previous studies. With the recent endorsement of empathy training by the President’s Task Force on 21st Century Policing, it is important to examine ways in which empathy may contribute to differences in PTSS and depression for male and female officers. The paper aims to discuss this issue. Design/methodology/approach Male and female police officers ( n =189) exposed to violence during the 2014 Ferguson protests completed a battery of measures designed to assess demographic information, prior trauma history, and mental health outcomes. Findings Moderation analyses showed that empathy moderated the relationships between exposure and PTSS and exposure and depression in female officers, such that exposure was associated with higher posttraumatic stress and depressive symptoms only for female officers with high levels of empathy. These relationships were not found for men. Originality/value This study is the first to examine sex differences and the role of empathy in the mental health effects of law enforcement secondary to violence during community protests against policing.
... Our search of the state death records revealed that over 50 fire departments in Minnesota have lost a firefighter by suicide since 1994. Police officers are three times more likely to die by suicide than to be killed by a person encountered on a scene (Chopko, Palmieri, & Facemire, 2014;Janik & Kravitz, 1994;Miller, 2005;Mohandie & Hatcher, 1999;Stuart, 2008;Violanti, 2010;Violanti, et al., 2009). ...
Article
Full-text available
The paradox in response hinging on suicidality or not.
... In addition, in another empirical study with police officers (n = 934), Violanti (2004) found that the combined impact of PTSD and increased alcohol use appeared to increase the odds of suicide ideation approximately 10 times. In addition, Violanti's (2010) findings in this area of research revealed that police suicides outnumbered police homicides by 2.36 times. Analogous findings in research with firefighters revealed the association between PTSD and suicide risk (Henderson, Van Hasselt, LeDuc, & Couwels, 2016). ...
Article
Full-text available
First responders are often exposed to multiple potentially traumatic incidents over the course of their career. However, scientific research showed that first responders are more resilient compared with the general population. In addition, experience of life-threatening situations and acute stress may lead first responders to the development of posttraumatic stress disorder (PTSD) or posttraumatic stress symptoms. Current clinical research and practice has developed evidence-based treatments shown to be effective in helping first responders ameliorate their PTSD symptoms and perform their duties effectively. Literature showed that cognitive–behavioral therapy (CBT) entails multiple evidence-based techniques that lead those suffering from PTSD toward symptom improvement and trauma recovery. The current article aims to (a) provide readers with rigorous information about stress and trauma experienced by first responders, (b) present PTSD symptomatology as well as risk and protective PTSD factors prevalent among first responders, (c) provide information about the psychophysiology of PTSD, and (d) explore the efficacy of CBT treatment for first responders diagnosed with PTSD. The author highlights the necessity for psychophysiological measurement of CBT treatment efficacy for first responders diagnosed with PTSD; also, potential gaps in the current scientific literature regarding this issue are highlighted. Recommendations for future research and clinical practice are discussed so that health professionals and researchers continue to serve those who serve our communities.
... Depression and posttraumatic stress disorder (PTSD) symptomatology (i.e., 'posttraumatic stress') frequently co-occur with one another [21,22] and with alcohol use disorders [23][24][25][26]. Among first responders, generally, both depression and posttraumatic stress are significantly associated with suicidal ideation [8,[27][28][29], and depressive symptoms are associated with suicide attempts/completed suicides [30][31][32]. Indeed, the stress of the firefighting profession places many firefighters at increased risk for mental health issues such as depression and posttraumatic stress, which are both significant risk factors for suicidality [33][34][35]. ...
... (Violanti, 2010). Increased stigma towards mental health conditions has been associated with lower intentions to seek mental health services, both in the general population (Clement et al., 2015) and PSP . ...
Article
Full-text available
Public safety personnel (PSP) are frequently exposed to potentially psychologically traumatic events (PPTE). Frequent exposure to PPTE is associated with a high prevalence of mental health symptom reporting among PSP, and stigma is associated with lower rates of intended mental health service use for PSP. A valid and expedient measure of stigma could provide mental health professionals with an instrument that could potentially improve mental health outcomes. The Opening Minds Scale - Workplace Attitudes (OMS-WA) is a commonly used self-report measure of stigma that has yet to be psychometrically validated. The current study was designed to assess the factor structure and factorial validity of a short version of the OMS-WA in PSP. An exploratory factor analysis (EFA) was conducted on an 11-item version of the OMS-WA in a sample of Canadian PSP (n = 2081), followed by confirmatory factor analysis (CFA) with a second sample of Canadian PSP (n = 2088). The EFA results suggested a nine-item, two-factor model for the OMS-WA. The identified factors were Attitudes Predicting Avoidance and Beliefs About Danger/Unpredictability. Nine of the 11 items produced salient loadings on the two factors. Internal consistency was good for the nine-item total scale, excellent for the first factor, and acceptable for the second factor. CFA supported a nine-item two-factor model of a short version of the OMS-WA. The current results provide evidence of factor validity for a nine-item questionnaire for quick screening of stigmatizing attitudes towards co-workers with mental health conditions in PSP.
... Understanding that PTSD confers risk for suicidality, psychosocial moderators, such as occupations in which rates of PTSD may be elevated, are also important to examine. Indeed, research has highlighted the link between PTSD and suicide among military service members (see Pompili et al., 2013 for review) and civilian police officers (Violanti, 2004(Violanti, , 2010Violanti et al., 2006). Following the call for research to identify occupational groups that may experience disproportionately high rates of suicide (Milner et al., 2013), a recent study demonstrated that protective service occupation workers were at elevated risk for workplace suicides (McIntosh et al., 2016;Tiesman et al., 2015). ...
Article
Research into the causes and prevention of suicide has been deemed a national priority, with a recent focus on sectors of the workforce, such as firefighters, who experience occupational hazards that may confer risk for suicide. Elevated levels of posttraumatic stress symptoms (PTSS), which show robust relationships with both suicidal ideation (SI) and suicide attempts, are common among firefighters. However, no study to date has investigated the relationship between PTSS and suicidality among firefighters. The current study therefore aimed to identify the degree to which PTSS were related were related to a history of SI and prior attempts in a national sample of firefighters (N = 893). Results revealed that greater PTSS were associated with greater risk of reporting lifetime SI and prior attempts, after controlling for other known risk factors for suicidality. Exploratory models investigating the unique contributions of individual PTSS clusters to suicidality found that numbing and re-experiencing PTSS were significantly related to SI, but only re-experiencing was related to prior attempts. The theoretical and clinical implications of these relationships, particularly among firefighters, are discussed.
... They are frequently considered a high-risk group for suicide when compared with the general population (Milner, Spittal, Pirkis, & LaMontagne, 2013) or other first responders, such as firefighters or correctional institution officers Tiesman, Hendricks, Bell, & Amandus, 2010;Violanti, 2010). Nevertheless, a review of 20 original studies from North America, Europe, and Australia, published by Hem, Berg, and Ekeberg in 2001, did not find an elevated suicide rate among police officers. ...
Article
Background: Police officers, as first responders to difficult situations with ready access to firearms, are frequently considered to be at increased suicide risk. Aims: We aimed to calculate the suicide rate for male officers of the Portuguese National Police (PSP) and compare it with the Portuguese general population. Method: Retrospective review of the PSP male officers' suicides between 2005 and 2014 and comparison with the suicide rate for the general Portuguese population, adjusted for sex and age. Results: A total of 39 suicides were identified, with 34 using a firearm - mostly the service one (30 cases). The average truncated (20-59 years) suicide rate for male officers was 20.6 per 100,000 person-years (95% CI =14.2-27.1). Over the same period, the rate for the general Portuguese population was 13.9 per 100,000 person-years (95% CI = 13.5-14.3). The standardized rate ratio was 1.5 (95% CI = 0.9-2.4). Limitations: Despite the 10-year period of observation, this is a small sample and there are issues with missing data, such as lack of information for retired or dismissed police officers. Denominators were converted to estimates of person-years observations and we should be mindful of the limitations in the validity of the reported rates. Conclusion: Portuguese male police officers mostly die by suicide using service firearms. The suicide rates among them were not statistically different from those of the sex- and age-adjusted general population. However, given that police officers are healthy workers, we would expect lower rates - thus, similar rates could suggest an increased risk in the study sample.
... One of the most well reported negative coping mechanisms for LE is alcohol, Violanti (2010) suggests that repeated exposure to critical incidents indicative of police work leads to PTSD, an increased alcohol consumption, which increases the risk of suicidal ideation and completing the act. In other words, the lack of recognition when considering the mental strain police work inflicts is manifested in negative coping mechanisms, a drop in organizational productivity and effectiveness, and suicide. ...
Technical Report
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There is a lack of mental health initiatives which effectively address the presence of and long-term implications of critical incident trauma, and complicating matters even further is the deficit in critical incident management. Mental health first aid is integral in lowering the probability of long-term dysfunction and the onset of mental health disadvantages that can (and do) ruin LE careers and negatively impact public service. Using a multitude of resources, this issue will be examined and the proposed solution, a victim advocacy model of response, is viable both financially and on a full-time basis. The following proposal will incorporate a response mechanism to manage crisis trauma as it influences LE and the public.
... bls.gov/ooh/protective-service/police-and-detectives.htm), including firefighters and military personnel (Violanti, 2010). In addition to high operational stress, organizational stressors also contribute significantly to the demands of the job, including internal politics, litigation, lack of lateral or vertical specialty opportunities (e.g., "stuck in patrol"), criminal justice system outcomes (e.g., responded to a critical incident sexual assault, and suspect is released), irregular shifts, and regular policy changes (Gelderen et al. 2007;Juniper et al. 2010;Shane 2010;Tuckey et al. 2012). ...
Article
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As first responders who are frequently exposed to job-related trauma, police officers are at an elevated risk of adverse mental and physical health outcomes. Evidence-based approaches to stress reduction are sorely needed to address the complex variety of problems that police officers face. In this pilot study we examined the feasibility and preliminary effectiveness of a mindfulness-based intervention designed to address police officer stress. A total of 43 police officers completed an 8-week Mindfulness-Based Resilience Training (MBRT) program, which was designed to improve mindfulness, resilience, stress, health outcomes, and emotional functioning. Using multilevel models we found significant improvement in self-reported mindfulness, resilience, police and perceived stress, burnout, emotional intelligence, difficulties with emotion regulation, mental health, physical health, anger, fatigue, and sleep disturbance. Although there were no significant pre-to-post-MBRT changes in cortisol awakening response (CAR), while controlling for pre-MBRT increase area under the curve (AUCI), change in mental health was a significant predictor of post-AUCI. Implications of these findings and areas for future research are discussed.
... These data provide some evidence that three to four times as many officers succumb to suicide than are killed by felonious assault. Others have found officer suicide rates to be as high as twice the national average of suicides among the general population, and significantly higher than comparable occupations (Violanti, 2010). These data strongly suggested that police officers are at a greater risk of death by their own hands than of another. ...
Article
Purpose A wide body of research has demonstrated that police officers are profoundly affected by their exposure to violence and the traumatic events viewed commonly as part of their job duties. Faced with stress, officers learn to adapt by incorporating coping techniques. Methods The current study utilizes Agnew's general strain theory to explain occurrences of the most dangerous maladaptive coping technique: suicide ideation. Male and female police officers from three large cities in Texas were surveyed (n = 1,410). Results The present study utilizes logistic regression techniques, finding that strain has a positive and direct effect on male officers suicide ideation risk, but not for female police. Moreover, depression has a mediating effect on strain and suicide ideation for both genders. Conclusions Some critical differences in suicide ideation outcomes between male and female police officers are reported. Policy implications concerning retention and recruiting are also discussed.
... Acute fatigue and loss of pleasure experienced at work may lead to disengagement. This may also be the reason for a high risk of depression and even for suicide attempts in police officers (Rajaratnam et al., 2011;Violanti, 2010). Similarly, vital exhaustion, a psychological construct closely related to burnout, is associated with depression and it is a risk factor for cardiovascular disease (McGowan et al., 2004;Melamed et al., 2006). ...
Article
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Purpose - The policing profession is associated with psychosocial hazard. Fatigue and burnout often affect police officers, and may impair the functioning of the organization and public safety. The relationship between fatigue and burnout may be modified by job-related emotions. While negative emotions have been extensively studied, the role of positive emotions at work is relatively less known. Additionally, there is insufficient knowledge about the role of the intensity of emotions. The aim of the study was to examine the role of job-related emotions in the relationship between fatigue and burnout in police officers. Design/methodology/approach - One hundred and sixty-nine police officers (26 women) completed a test battery that assessed acute fatigue, burnout (Oldenburg Burnout Inventory: exhaustion and disengagement), and emotions (Job-related Affective Well-being Scale). Findings - Acute fatigue was associated more strongly with exhaustion than with disengagement. Low-arousal negative emotions partially mediated the relationship between fatigue and exhaustion. High-arousal positive and negative emotions were partial mediators between fatigue and disengagement experienced by police officers. Research limitations/implications - Our results show that high-arousal emotions were associated with changes in work motivation, while low-arousal negative emotions reduced energetic ability to work. Originality/value - This paper enhances understanding of burnout among police officers and the mediating role of emotions. The patterns of the relationships between fatigue, burnout and emotions are discussed in the context of the conservation of resources theory and the tripartite model of anxiety and depression.
... In contrast, among 615 police officers and 271 firefighters fatalities in New Jersey between 1974 and 1980, rates of suicide for both occupations appeared lower than those of the general population of white males (Feuer & Rosenman, 1986). A separate study utilizing NOMS data from 1984-1998 found that police officers die by suicide at a rate approximately four times that of firefighters (Violanti, 2010a). Moreover, police officer deaths have a higher risk of misclassification than firefighters (Violanti, 2010b). ...
Article
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First responders-police officers, firefighters, emergency medical technicians (EMTs), and paramedics-experience significant job-related stressors and exposures that may confer increased risk for mental health morbidities (e.g., posttraumatic stress disorder [PTSD], suicidal thoughts and behaviors) and hastened mortality (e.g., death by suicide). Inherent in these occupations, however, are also factors (e.g., camaraderie, pre-enlistment screening) that may inoculate against the development or maintenance of psychiatric conditions. Several reviews of the literature have documented the prevalence and potency of PTSD among first responders; the value of these extant reviews is considerable. Nonetheless, the literature has not been systematically described with regard to suicidality. In this systematic review, we present 63 quantitative studies examining suicidal thoughts, behaviors, and/or fatalities among first responders; identify population-specific risk and protective factors; and pinpoint strengths and weaknesses of the existing literature. Findings reveal elevated risk for suicide among first responders; however, studies utilizing more rigorous methodologies (e.g., longitudinal designs, probability sampling strategies) are sorely needed. First responders have an armamentarium of resources to take care of others; it is the duty of researchers, clinicians, and the public to aid in taking care of their health as well, in part by reducing suicide risk.
... The results of research examining police suicide are also mixed. The suicide rate of officers has been reported as up to three times higher than the general public and it has been noted that police suicides are sometimes disguised making the true numbers even greater (Charbonneau 2000;Janik and Kravitz 1994;Miller 2005; Mohandie and Hatcher 1999;Pienaar et al. 2007;Schmidtke, et al. 1999;Violanti 2010;Violanti et al. 1998). Yet others have reported the rate at a similar level, or lower, compared with the general population (Berg et al. 2003;Cantor et al. 1999;Hem et al. 2001;Marzuk et al. 2002). ...
Article
Police officers have often been reported to experience high rates of suicide compared to the general population. Suicidal ideation (SI) is considered a strong predictor of suicidal acts. However, few studies have examined SI in U.S. law enforcement officers. This study investigated the prevalence of SI and the association between SI and amount of subjective work-related traumatic stress, personal relationship stress, work-related but non-traumatic stress, age, depression, posttraumatic stress disorder symptoms, alcohol use, and posttraumatic growth among law enforcement officers (N = 193) from a Midwestern state. Multiple regression analysis demonstrated that greater depression symptoms significantly predicted greater SI among officers.
... Perception of public negativity, apathy, and lack of support has also been documented as a source of stress for officers (Allison et al. 2019;Liberman et al. 2002). Sources of occupational stress have been given specific focus in examinations of the troubling rate of suicide and suicidal ideation among police officers (Berg et al. 2006;Chae and Boyle 2013;Gershon et al. 2009;Violanti 2004Violanti , 2010Violanti et al. 2017). As current literature continues to document the correlations between profession-based stressors and negative mental health outcomes in police officers, it stands to reason these factors may also impact officers' evaluation of the relationship they have with the public they serve. ...
Article
Current scholarship suggests attention should be focused on differences in specific job-related conditions to understand help-seeking behavior among police officers. This project examines how officers’ feelings of department satisfaction and on-the-job emotions may be associated with trust in members of the community they police. Specifically, officers were asked to report trust levels both in a general sense and in the context of a potential officer-involved shooting (OIS) incident. Print and electronic surveys were completed by 169 police officers across 9 agencies located in 5 New Jersey counties between September 2019 and March 2020. Survey questions covered frequency of on-the-job emotions, satisfaction with department administration, and knowledge of local culture. Bivariate comparisons show officers’ levels of both general and post-OIS community trust significantly differ based on reported frequency of emotion, assessment of job satisfaction and department administration, and wider cultural context. Furthermore, multivariate analyses indicate significant factors associated with trust levels include frequency of both positive (fulfillment) and negative (frustration) emotions, satisfaction with training, and attitudes towards the importance of understanding local culture. Findings suggest the complexity of police–community relationships should be more fully explored in relation to supporting aspects of job-related mental wellness in police officers.
... Dissatisfaction in job and the nature of the job may put them at risk for the expansion of mental health tribulations. Previous research findings indicate that the suicide rate of police officers is higher and the underlying problem is not suicides, however-it's mental health (Violanti, 2010). ...
Article
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The purpose of the present study was to examine the relationship between job satisfaction and mental health of Bangladeshi police officers. Additional objectives were to investigate the variation in job satisfaction and mental health by their gender, age, educational qualification, and job-duration. 115 participants were taken purposively from 12 police stations of Dhaka city. Results indicated that job satisfaction and mental health were not significantly differed by respondents' gender. Job satisfaction was only significantly differed by their duration of job. Variation in mental health was significant for respondents' age, educational qualification, and job-duration. Job satisfaction and mental health was negatively correlated (r=-.26, p<.01). Moreover, job satisfaction had significant positive correlation with all aspects of it and overall attitude toward job (r= .31, p<.01), and negative correlation with willingness to quit job (r=-.25, p<.01). Furthermore, among the five aspects of job satisfaction, the job itself (r=-.26, p<.01) and promotion opportunity (r=-.24, p<.05) had negative correlation with mental health. Respondents, satisfied with promotion, showed positive attitude toward the job (r= .33, p<.01) and low perceived job stress (r=-.24, p<.01). The findings of this present study can be enormously helpful to the police administrative to take required actions for the betterment of the officers.
... While some studies (Chan, 2006;Ciarrochi et al., 2002;Gendron, 2007;Mikolajczak et al., 2007;Moon and Hur, 2011;Pishghadam and Sahebjam, 2012;Weng et al., 2011) examined the relationship between psychological well-being at work (PWBW) and ESE, the police environment remains an area unexplored by current researchers. Although previous research has focused on the stress (Violanti, 2010;Bélanger, 2017), the impact of the use of force (St-Denis, 2012) or the management of traumatic events (Leclercq, 2008) of police officers profession, they have provided few clues as to the orientation of future studies wishing to explain PHW. Considering the specificity of their profession, the preponderance of their function in society and the importance of their good PHW, this study focuses on the understanding of this phenomenon among the police population. ...
Article
Purpose The evaluation of emotional management in police environments has impacts on their health and on their interventions (Monier, 2014; Van Hoorebeke, 2003). There are significant costs related to occupational diseases in the police force: absenteeism, turnover, deterioration of the work climate (Al Ali et al., 2012). Considering that policing involves a high level of emotional control and management (Monier, 2014; Al Ali et al., 2012; Dar, 2011) and that no study has yet examined the relationship between police officers’ emotional competencies and their psychological health at work (PHW), the purpose of this paper is to explore the relationship and influence of emotional self-efficacy (ESE) on PHW in policing. Design/methodology/approach PHW results from psychological distress at work (PDW) (irritability, anxiety, disengagement) and psychological well-being at work (PWBW) (social harmony, serenity and commitment at work) (Gilbert et al., 2011). ESE is defined as the individual’s belief in his or her own emotional skills and effectiveness in producing desired results (Bandura, 1997), conceptualized through seven emotional skills: the use of emotions; the perception of one’s own emotions and that of others; the understanding of one’s emotions and that of others; and the management of one’s emotions and that of others (Deschênes et al., 2016). A correlational estimate was used with a sample of 990 employed police officers, 26 percent of whom were under 34 years of age and 74 percent over 35. The ESE scales (a=0.97) of Deschênes et al. (2018) and Gilbert et al. (2011) on PWBW (a=0.91) and PDW (a=0.94) are used to measure the concepts under study. Findings The results of the regression analyses confirm links between police officers’ emotional skills and PHW. The results show that self-efficacy in managing emotions, self-efficacy in managing emotions that others feel, self-efficacy in using emotions and self-efficacy in understanding emotions partially explain PWBW (R²=0.30, p<0.001). On the other hand, self-efficacy in perceiving the emotions that others feel, self-efficacy in using emotions and self-efficacy in managing emotions partially explain PDW (R²=0.30, p<0.001). Originality/value This study provided an understanding of the correlation between police officers’ feelings of ESE and their PHW, particularly with PWBW. Beyond the innovation and theoretical contribution of such a study on the police environment, the results reveal the scope of the consideration of emotional skills in this profession.
... While some studies (Chan, 2006;Ciarrochi et al., 2002;Gendron, 2007;Mikolajczak et al., 2007;Moon and Hur, 2011;Pishghadam and Sahebjam, 2012;Weng et al., 2011) examined the relationship between psychological well-being at work (PWBW) and ESE, the police environment remains an area unexplored by current researchers. Although previous research has focused on the stress (Violanti, 2010;Bélanger, 2017), the impact of the use of force (St-Denis, 2012) or the management of traumatic events (Leclercq, 2008) of police officers profession, they have provided few clues as to the orientation of future studies wishing to explain PHW. Considering the specificity of their profession, the preponderance of their function in society and the importance of their good PHW, this study focuses on the understanding of this phenomenon among the police population. ...
Article
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If you would like to write for this, or any other Emerald publication, then please use our Emerald for Authors service information about how to choose which publication to write for and submission guidelines are available for all. Please visit www.emeraldinsight.com/authors for more information. About Emerald www.emeraldinsight.com Emerald is a global publisher linking research and practice to the benefit of society. The company manages a portfolio of more than 290 journals and over 2,350 books and book series volumes, as well as providing an extensive range of online products and additional customer resources and services. Emerald is both COUNTER 4 and TRANSFER compliant. The organization is a partner of the Committee on Publication Ethics (COPE) and also works with Portico and the LOCKSS initiative for digital archive preservation. Abstract Purpose-The evaluation of emotional management in police environments has impacts on their health and on their interventions (Monier, 2014; Van Hoorebeke, 2003). There are significant costs related to occupational diseases in the police force: absenteeism, turnover, deterioration of the work climate (Al Ali et al., 2012). Considering that policing involves a high level of emotional control and management (Monier, 2014; Al Ali et al., 2012; Dar, 2011) and that no study has yet examined the relationship between police officers' emotional competencies and their psychological health at work (PHW), the purpose of this paper is to explore the relationship and influence of emotional self-efficacy (ESE) on PHW in policing. Design/methodology/approach-PHW results from psychological distress at work (PDW) (irritability, anxiety, disengagement) and psychological well-being at work (PWBW) (social harmony, serenity and commitment at work) (Gilbert et al., 2011). ESE is defined as the individual's belief in his or her own emotional skills and effectiveness in producing desired results (Bandura, 1997), conceptualized through seven emotional skills: the use of emotions; the perception of one's own emotions and that of others; the understanding of one's emotions and that of others; and the management of one's emotions and that of others (Deschênes et al., 2016). A correlational estimate was used with a sample of 990 employed police officers, 26 percent of whom were under 34 years of age and 74 percent over 35. The ESE scales (a ¼ 0.97) of Deschênes et al. (2018) and Gilbert et al. (2011) on PWBW (a ¼ 0.91) and PDW (a ¼ 0.94) are used to measure the concepts under study. Findings-The results of the regression analyses confirm links between police officers' emotional skills and PHW. The results show that self-efficacy in managing emotions, self-efficacy in managing emotions that others feel, self-efficacy in using emotions and self-efficacy in understanding emotions partially explain PWBW (R 2 ¼ 0.30, po0.001). On the other hand, self-efficacy in perceiving the emotions that others feel, self-efficacy in using emotions and self-efficacy in managing emotions partially explain PDW (R 2 ¼ 0.30, po0.001). Originality/value-This study provided an understanding of the correlation between police officers' feelings of ESE and their PHW, particularly with PWBW. Beyond the innovation and theoretical contribution of such a study on the police environment, the results reveal the scope of the consideration of emotional skills in this profession.
... 3 In 2017, it is estimated that 140 police officers committed suicide (Heyman et al., 2018: 20), compared to 46 feloniously killed. Generally, police suicide is almost 2.5 times the police homicide rate, with even higher rates amongst minority and female officers (Violanti, 2010). Alcohol abuse and domestic problems are also common in police officers, often linked to suicides (Violanti et al., 2019: 155). ...
Article
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This article reviews neuroscience and cognitive psychology literature to understand how trauma and emotion impact policing and why some strategies are counterproductive by threatening police legitimacy. This review further illuminates the pernicious effect of stress in the policing environment, in both officer and citizen. Therefore, the article makes the point that the current focus on tactical training and the ‘warrior ethos’ diminishes community policing values, destroys trust, undermines respect and discourages cooperation while fostering resentment and hostility thus making everyday policing more hazardous. It argues that community policing strategies offer the only path for successful consensus policing in a democracy.
... Police as a group have significantly more exposure to traumatic events, such as being assaulted, viewing assault, or viewing a dead body, than those in the general population (Haugen et al., 2012;Federal Bureau of Investigation, 2017;Morgan and Kena, 2018), which appears associated with psychological distress and worry (Leino et al., 2011). They also appear to be more likely to experience post-traumatic stress disorder than the general population (Kessler and Chiu, 2005;Maia et al., 2007;Klimley et al., 2018) and may be at greater risk for death by homicide and suicide compared to the general population (Violanti, 2010). How might either having such experiences or even simply learning about them affect one's emotional state and subsequently one's decision making? ...
Article
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In this paper, we review basic findings from experimental studies in judgment and decision making that could contribute to designing policies and trainings to enhance police decision making. Traditional judgment and decision-making research has focused on simple choices between hypothetical gambles, which has been criticized for its lack of generalizability to real world contexts. Over the past 15 years, researchers have focused on understanding the dynamic processes in decision making. This recent focus has allowed for the possibility of more generalizable applications of basic decision science to social issues. We review recent work in three dynamic decision-making topics: dynamic accumulation of evidence in the decision to shoot or not shoot, how previous decisions influence current choices, and how the cognitive and neurological processing of fear influences decisions and decision errors. We conclude this review with a summary of how basic experimental research can apply in policing and training.
... Certain consequences of psychological distress also appear to be more prevalent among police officers. For example, when comparing suicide rates of police officers to firefighters, Violanti (2010) found that the police suicide rate was four times higher. ...
Article
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Given their potential to reach a large audience, online recruitment videos are likely a useful way for police services to recruit applicants. To increase the likelihood of people applying, these videos should focus on issues potential employees consider when making career decisions. A literature review revealed six job factors that people consider when contemplating a potential career. A coding framework focusing on these factors (and their respective sub-categories) was developed and applied to all available recruitment videos created by Canadian policing organizations (N = 37). The coding dictionary could be applied reliably and it revealed that only 23% of the job factors that emerged from the literature review are addressed in the videos and when they are, they are not particularly salient. Ways of using this study to develop more effective, data-driven, police recruitment videos are discussed.
... Up to one-third of first responders are at risk of developing PTSD, and many others may experience symptoms of depression, chronic fatigue, and marital problems or other personal consequences (Marmar et al., 2006;Bourbannais et al., 2007;Rees and Smith, 2008;Gershon et al., 2009;Wang et al. 2010;Ménard and Arter, 2013;Oliphant, 2016). Consequently, rates of alcohol dependence, substance use, and risk of suicide and suicidal ideation can be higher among public safety personnel generally (Oliphant, 2016;Stanley et al., 2016;Carleton et al., 2018b) and police officers specifically, compared to the general public (Loo, 2003;Violanti et al., 2007;Violanti, 2010;Mishara and Martin, 2012;Ménard and Arter, 2013;Chopko et al., 2014). ...
Article
Operational and organizational stressors are characteristic components of police work. Police culture has historically resisted acknowledging the need to accept interventions in response to the operational stress injuries resulting from the frequent exposure to workplace trauma. Similarly, few police leaders have effectively managed to change the police culture to one accepting and receptive to members seeking and accessing help for operational stress injuries. In this review, the authors discuss various sources of operational and organizational stress in policing, identify a number of promising wellness practices and strategies, and argue for the need for strong leadership among police executives to lead their organizations through the changes necessary to produce a police organization that is healthy and resilient.
... Such an investigation requests availability of individual and occupational risk factors of suicide for a large sample of workers, which is rarely possible. Most studies conducted in occupations at high suicidal risk, such as agricultural or military workers [18,19], used medico-administrative data, such as occupation and mortality registries, with no or few individually assessed variables enabling etiological research. ...
Article
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Background: Suicide is a major and complex public health problem. In Switzerland, suicide accounts for about 1000 deaths yearly and is the fourth leading cause of mortality. The first nationwide Swiss study of suicides identified eight male and four female occupations with statistically significant excess of suicide compared to the general Swiss population. Working time, self-employer status, low socio-economic status and low skill level required for occupation were associated with increase in suicide risk. Presently, we aim to compare the distribution of suicide risk across occupations with the prevalence of somatic and psychiatric morbidity in Swiss working-aged adults. We hypothesized that some diseases would cluster in particular occupations, indicating potential work-relatedness of suicides found in these occupations. Methods: We used the Swiss National Cohort (SNC) and included 10575 males and 2756 females deceased by suicide between 1990 and 2014. We estimated the prevalence of 16 categories of concomitant diseases in each occupation, using national mortality records, and assessed the homogeneity of diseases distribution across occupations. For diseases, which prevalence varied significantly across occupations, we analyzed the correlation with the distribution of suicide risk, estimated as the standardized mortality ratio (SMR) of suicide. Results: Mental and behavioral disorders were the most commonly reported concomitant diseases in our population. In men, the prevalence of these disorders and more specifically, the prevalence of substance-related and addictive disorders, and of psychotic disorders varied significantly across occupations and was correlated with the SMR of suicide. The prevalence of malignant neoplasms and the prevalence of diseases of the musculoskeletal system and connective tissue also varied significantly across male occupations, while in women, such a variation was observed for neoplasms of uncertain or unknown behavior and diseases of the nervous system and sense organs, without being correlated with the SMR of suicide. Conclusion: Some of the identified morbidities can be occupation-related and could negatively affect the working capacity and the employability, which in turn could be related to the suicide. Disentangling concomitant diseases according to their work-relatedness and relationship with the suicide risk is important for identifying occupation-related suicides, understanding their characteristics, and developing appropriated interventions for their prevention.
Chapter
Suicide is a significant social problem and is a major concern for police and police organizations. This chapter reviews the evidence related to police suicide and suicidal ideation. It considers the prevalence of police suicide, demographics, and other associated factors in particular management and leadership, work patterns and occupational stress, as well as nonwork factors such as family problems, drug and alcohol use. Finally the chapter explores prevention strategies.
Article
Introduction We modeled suicidal rate among Swiss working‐age males, considering three groups of factors at socio‐demographic, occupational, and societal levels jointly. Our goal was twofold: to verify the effect of occupation after adjustment for non‐occupational factors and to identify protective and risk factors relevant for suicide prevention in working male adults. Methods The study population included all men aged [18–65] years at the 2000 population census and followed up within the Swiss National Cohort (SNC). The risk of suicide was modeled using Poisson regression. Results The cohort comprised 1,534,564 men and 4371 deaths by suicide. Suicide rate varied significantly according to age, civil status, nationality, highest education achieved, and socio‐professional category at socio‐demographic level; occupation, occupational activity branch, weekly working hours, and home‐to‐work commute time at occupational level; calendar period of death, region, religious affiliation, and volunteering activity at societal level. After adjustment for non‐occupational factors, agricultural and fishery laborers, military and civil security workers, and health and social workers were identified as high‐risk groups with respect to suicide. Conclusion This study evidenced a complex web of factors at socio‐demographic, occupational, and societal levels behind the suicide in Swiss male workers and identified the most at‐risk groups, deserving targeted prevention efforts.
Article
Policing is widely recognised as one of the most stressful occupations. Numerous studies have explored the ways in which stress impacts on the personal and professional lives of officers. Using this literature as context, the article explores the way in which representations of policing in film and TV have changed to reflect this issue, to the point where the predominant mode of representation is the dysfunctional officer broken by the job. Using bricolage as a research approach, three twenty-first-century examples are examined; Wallander from Sweden, The Wire from the US and Red Riding from the UK, raising questions about the dystopian pleasures of these media texts with a suggestion of further work to explore the relationship between representations and the reality of the stresses of policing.
Article
Purpose Police officers are exposed to a wide variety of stressors – frequently interacting with people at their worst moments and sometimes absorbing the trauma that victims experience themselves. Investigating sexual assaults reported by adults presents significant challenges given the often high levels of distress experienced by victims paired with the likelihood that no arrest will be made and the low conviction rates. Little research explores the impact this investigatory work has on the detectives who are assigned to these cases. Design/methodology/approach Using interviews conducted with 42 sexual assault detectives across six jurisdictions designed to understand sexual assault case attrition, the study enhances understanding of the effects of investigating crimes of sexual violence on detectives. Specifically, the aurhors explore their experiences within the context of burnout and secondary traumatic stress. Findings The current study clearly identifies the incidence of emotional symptoms among sexual assault investigators. During the course of interviews about their decision-making, detectives, unprompted by researchers, manifested symptoms of trauma resulting from their assigned caseloads. Research limitations/implications Open-ended interviews offer a promising approach to exploring foundational questions. Practical implications Exposure to victims who have suffered the trauma of sexual assault can have a subsequent impact on the job performance and personal life of those who respond to victims in immediate crisis and to those who provide long-term assistance. A plan for future research is detailed to better pinpoint how and when these symptoms arise and interventions that may address their effects. Originality/value While there is a large literature detailing vicarious trauma for social workers, nurses and doctors, the topic is generally understudied among police officers and specifically detectives despite their repeated contacts with adult victims of violent crimes. This research builds upon the knowledge of burnout experienced by child maltreatment detectives to enhance understanding of sexual assault detectives.
Article
Suicide is a widespread problem that is severely underreported within the fire service. There is a growing body of evidence that suggests firefighters are at increased risk of committing suicide compared with their civilian counterparts due to disturbingly higher rates of posttraumatic stress disorder and substance use disorders, which serve as markers for suicide completion. The main problem for mental health professionals in addressing suicide in this population is the substantial lack of empirical research on mental health of firefighters as well as the compounding cultural stigma that exists in addressing mental and behavioral health issues. Additionally, there remains a discrepancy in reported rates of suicide and a lack of information on attempted suicides—related to low reporting rates by family members, fellow firefighters, and departments, as well as no official national tracking database for suicide in firefighters—that further complicates research in this area. This article (a) discusses current research on suicide within the fire service, (b) explores issues and challenges for psychological assessment and intervention for practitioners working with this population, (c) describes specific approaches toward decreasing suicide in firefighters, and (d) suggests policy considerations for fire departments and mental health professionals.
Chapter
Suicide is a serious public health problem that impacts individuals, families, communities, and law enforcement personnel. More than 42,000 completed suicides were counted in the United States in 2014. Suicide has long been a concern within law enforcement. In this chapter, the authors explore the current status of Law Enforcement Officer (LEO) suicide research and dispel the myth that officer suicides are dramatically higher than in the general population. We then review general information on suicide prevention, and supplement this general information with law enforcement-specific risk factors, warning signs, variables, tips, and recommendations for intervention and postvention. Additionally, we suggest a range of available resources for further consideration.
Chapter
First responders maintain strong marriages in spite of the potential negative impact of multiple stressors including schedule conflicts, financial strain, and the threat of illness, disability, and death. Patterns of thought and behavior that are beneficial at work, such as vigilance, rapidly establishing control, and shutting off emotional responding cause problems at home, particularly when intensified by trauma. Excessive belief in a partner's heroism and the choice by some responders of dependent romantic partners cause other problems, as does the sometimes culturally sanctioned practice of coping through alcohol use or sexual encounters. Shifts in perspective that reframe common concerns more positively are offered. Departments are encouraged to increase efforts to support spouses and marriages, given the importance of close relationships to health.
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Law Enforcement (LE) officers are considered to be at elevated risk of suicide. This study explored variables associated with LE suicide and the extent they differentiated LE suicides from those within similar occupations considered at risk – Army and Firefighters. Using a public health database of violent deaths, the US National Violent Death Reporting System (NVDRS), the prevalence of and association between seven suicide variables (treatment for a mental health condition, Post Traumatic Stress disorder diagnosis, alcohol and substance abuse, job problems, intimate partner problems) and suicide within LE, Army and Firefighters was computed. Method of suicide and demographic characteristics were also identified. All of the suicide variables were associated with suicide in the three occupation groups. LE suicides were differentiated from Army and Firefighter suicides by being more strongly associated with job problems and suicide by females was more common. Implications for suicide prevention strategies within LE are discussed.
Article
Police officers encounter a variety of stressors, most of which are unique to the profession. These can exact a toll on an officer's mental health, and leave them at increased risk for experiencing psychological problems. However, due to stigma surrounding mental health, as well as traditional law enforcement culture, many officers find it difficult to report, or seek help for, difficulties due to fear of repercussions and/or distrust. Consequently, the potential value of incorporating trained peers as a “first line of defense” has received increased attention. This article describes the Peers as Law Enforcement Support (PALS) program developed in a collaboration between a local police agency and University psychology department. Results of a pilot study evaluating participants' perspectives on course content and quality of instruction are presented. Finally, the need for a broad spectrum approach to prevention and intervention of mental health issues in officers is underscored.
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Purpose: The purpose of this paper is to provide a review of law enforcement suicide research from 1997 to 2016. Design/methodology/approach: The PRISMA systematic review methodology was implemented. A SCOPUS search identified a total of 97 documents. After applying all exclusion criteria, the results included a list of 44 articles in the review. Findings: Overall, studies investigating law enforcement suicide rates show conflicting results, with some studies showing lower suicide rates among law enforcement, some showing higher rates, and some showing no difference to comparison populations. Recurring research themes were lack of an appropriate comparison group, and small statistical power, particularly for minority and female officers. Stressors related to suicide among police included lack of organizational support, traumatic events, shift work, stigma associated with asking for help, or problems associated with fitting in with the police culture. Problems associated with domestic relationships and alcohol use were commonly mentioned as precursors to suicide or as correlates of suicidal ideation and were hypothesized to arise from stressful working conditions. Research limitations/implications: Some limitations in law enforcement suicide research include the lack of theory, under-reporting of suicides, and guarded survey responses from police officers. Future directions in police suicide research include investigating etiological factors such as past adverse life and family experiences, social-ecological variation in suicide, or differences in suicide rates within the law enforcement occupation. Practical implications: Police work, given chronic and traumatic stress, lack of support, danger, and close public scrutiny is a fertile occupation for increased suicide risk. Awareness of the scope of the problem and associated risk factors can help to initiate prevention programs. Originality/value: This paper provides a long-term review of literature regarding police suicidality, with suggestions for research and prevention.
Chapter
Suicide is a serious public health problem that impacts individuals, families, communities, and law enforcement personnel. More than 42,000 completed suicides were counted in the United States in 2014. Suicide has long been a concern within law enforcement. In this chapter, the authors explore the current status of Law Enforcement Officer (LEO) suicide research and dispel the myth that officer suicides are dramatically higher than in the general population. We then review general information on suicide prevention, and supplement this general information with law enforcement-specific risk factors, warning signs, variables, tips, and recommendations for intervention and postvention. Additionally, we suggest a range of available resources for further consideration.
Chapter
This chapter will consider society’s ongoing fascination with violent crime, particularly sexual crimes against women and children. It will focus on the development of the true crime genre. The Moors Murders case has been the subject of a number of such treatments; this genre seeks to or makes the claim that it will provide the definitive story of a particular crime—usually a serial killer or rapist. The conventions of the genre raise a number of ethical, philosophical and moral issues. The narrative structure of true crime focuses on the perpetrator, whereas victims and their families are marginalised. They become minor characters appearing briefly before disappearing from the narrative having been subjected to degradation and violent assault.
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As first responders who are frequently exposed to job-related trauma, police officers are at an elevated risk of adverse mental and physical health outcomes. Evidence-based approaches to stress reduction are sorely needed to address the complex variety of problems that police officers face. In this pilot study we examined the feasibility and preliminary effectiveness of a mindfulness-based intervention designed to address police officer stress. A total of 43 police officers completed an 8-week Mindfulness-Based Resilience Training (MBRT) program, which was designed to improve mindfulness, resilience, stress, health outcomes, and emotional functioning. Using multilevel models we found significant improvement in self-reported mindfulness, resilience, police and perceived stress, burnout, emotional intelligence, difficulties with emotion regulation, mental health, physical health, anger, fatigue, and sleep disturbance. Although there were no significant pre-to-post-MBRT changes in cortisol awakening response (CAR), while controlling for pre-MBRT increase area under the curve (AUCI), change in mental health was a significant predictor of post-AUCI. Implications of these findings and areas for future research are discussed.
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In the past two decades, cultural diversity within police forces has increased. However, there is little research conducted on the impact of race on police officer attitudes toward police work. This study employed the multivariate technique of logistic regression to determine predictors of job satisfaction, burnout, and perception of unfair treatment. The findings indicate that African American police officers are more likely to feel criticized, more likely to believe they are perceived as militant, and less likely to feel negative or depressed about work.
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Five different health behaviors (cigarette use, alcohol use, binge eating, illicit drug use, and drunk driving) were studied prospectively in 5 different groups of subjects. Associations between attitudes toward these behaviors and the behaviors themselves were investigated over at least 2 waves of measurement. Findings revealed that attitudes predicted behavior nonspuriously in 2 instances: alcohol use and marijuana use. Attitudes did not predict drunk driving, binge eating, or smoking behaviors. Past behavior predicted attitude in the domains of binge eating and smoking, but not in the domains of alcohol use, drunk driving, or marijuana use. The results are discussed in terms of several alternative approaches that have implications for interventions that attempt to influence health behavior through attitude change. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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The authors assessed the suicide rates of New York City police officers during a recent period. The authors reviewed death certificates of active New York City police officers who died from 1977 through 1996 (N=668); age-, gender-, and race-specific suicide rates among New York City police officers and the city's residents were determined. The police suicide rate was 14.9 per 100,000 person-years, compared with a demographically adjusted suicide rate of New York City residents of 18.3 per 100,000 person-years. Suicide rates among male police officers were comparable to their reference population. Female police officers had a higher risk of suicide than female residents of New York, but the number of suicides of female police officers was small. The rate of suicide among New York City police officers is equal to, or even lower than, the suicide rate of the city's resident population.
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To describe the association between labour market status and death by suicide with focus on admission with a psychiatric disorder. Nested case-control study. Data from routine registers. Entire Danish population. 9011 people aged 25-60 years who committed suicide during 1982-1997 and 180 220 matched controls. In the general population, not being fully employed is associated with a twofold to threefold increased relative risk of death by suicide, compared with being fully employed. In contrast, fully employed people who have been first admitted to a psychiatric hospital within the past year are at increased suicide risk. Patients who are unemployed, social benefits recipients, disability pensioners, or otherwise marginalised on the labour market have a suicide risk of 0.60 (95% CI: 0.46 to 0.78), 0.41 (0.23 to 0.74), 0.70 (0.45 to 1.08), and 0.86 (0.53 to 1.41), respectively. Although a similar risk decrease is found in women, men, people younger than 30 years, people older than 45 years, and in people who become unemployed, the reversed effect attenuates with time since admission, and little association is seen when a marginal structural model is applied. Although the results show an increased suicide mortality associated with unemployment and labour market marginalisation in the general population, the results suggest little or an inverse association between unemployment and suicide in people with psychiatric illness. The associations seen suggest the need to consider healthy worker selection effects when studying the causal pathway from unemployment and psychiatric illness to suicide.
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The purpose of this study was to examine the epidemiology, phenomenology, and occupation-specific risk factors for suicide among regular-duty military personnel as a model for other professions at risk for workplace suicide. Suicide incidence and methods were determined in a retrospective military cohort comprising all deaths (N=732) of regular-duty military personnel in the Irish Defence Forces between 1970 and 2002. A retrospective, case-control study using pair-matched military comparison subjects was conducted to determine occupation-specific risk factors for suicide, particularly by firearm, among military personnel. Risk factors were subjected to chi-square analysis or independent t tests and entered into a binary logistic regression analysis model. The period-averaged suicide rate for the cohort was 15.3/100,000. Firearm suicides accounted for 53% of the cases. Suicides that took place on duty occurred predominantly when personnel were alone shortly after duty commencement in the morning. Bivariate and logistic regression analyses identified psychiatric illness and a past history of deliberate self-harm, morning duty (shortly after duty assumption and consequent access to firearms), and a recent medical downgrading as independent risk factors predicting firearm suicide among military personnel. Occupation influences suicide method. Access to and opportunity to use lethal means in the workplace are distinct but related occupation-specific suicide risk factors in the military and in other at-risk professions. In professions where access to lethal means is inevitable, moderating opportunity for suicide is crucially important. In regular-duty military personnel, a medical downgrading, combined with risk factors established in civilians such as younger age, male gender, psychiatric illness, and past self-harm, increases the risk of suicide. The findings may be used to guide military harm-reduction strategies and have applicability in strategies for other professions at risk for workplace suicide.
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In this paper, we integrate two vital but independent avenues of research on suicide. Quantitative studies in sociology, using official statistics to test hypotheses, focus on the effects of urbanization, religious affiliation and other reasons why individuals commit suicide. Observational studies examine legal, organizational and professional factors that lead to misclassifying suspicious deaths, but they fail to consider their effects on the causes of suicide. Surprisingly, no study has examined whether the social construction of rates biases attempts to test sociological theories of the cause of suicide. We attempt to bridge this gap by organizing criticisms of suicide rates theoretically, framing them in a measurement error model, and introducing a number of techniques to control for misreporting and "correct" official rates. Using several independently collected data sets for county groups (N=404) in the United States for 1970-71, we find that systematic misreporting exists. However, misreporting in the official statistics has little discernible impact on the effects of variables commonly used to test sociological theories of suicide. Our results suggest a number of theoretical refinements necessary for pursuing further quantitative and qualitative studies of suicide.
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Purpose A wide body of research has demonstrated that police officers are profoundly affected by their exposure to violence and the traumatic events viewed commonly as part of their job duties. Faced with stress, officers learn to adapt by incorporating coping techniques. Methods The current study utilizes Agnew's general strain theory to explain occurrences of the most dangerous maladaptive coping technique: suicide ideation. Male and female police officers from three large cities in Texas were surveyed (n = 1,410). Results The present study utilizes logistic regression techniques, finding that strain has a positive and direct effect on male officers suicide ideation risk, but not for female police. Moreover, depression has a mediating effect on strain and suicide ideation for both genders. Conclusions Some critical differences in suicide ideation outcomes between male and female police officers are reported. Policy implications concerning retention and recruiting are also discussed.
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Police officers have often been reported to experience high rates of suicide compared to the general population. Suicidal ideation (SI) is considered a strong predictor of suicidal acts. However, few studies have examined SI in U.S. law enforcement officers. This study investigated the prevalence of SI and the association between SI and amount of subjective work-related traumatic stress, personal relationship stress, work-related but non-traumatic stress, age, depression, posttraumatic stress disorder symptoms, alcohol use, and posttraumatic growth among law enforcement officers (N = 193) from a Midwestern state. Multiple regression analysis demonstrated that greater depression symptoms significantly predicted greater SI among officers.
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In this paper we identify a number of strategies that police officers use to cope with stress caused by problems in the workplace. We also compare coping strategies for gender and racial groups, and link differences to level of stress. Extensive observational data and a survey of 1,087 police officers in 24 departments were used to address the research questions. We found that African-Americans rely more strongly than Caucasians on bonds with other minorities, and that Caucasian officers more often use expression of feelings, trying to get others to like them, and camaraderie with coworkers. Women cope with stress by using escape and by keeping written records more often than men. The data also suggest that an officer's stress-level group depends on the coping strategies he or she uses. Implications for future research are discussed, as are programs to help police develop effective strategies for coping with workplace problems.
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Content/ Objectives: No recent national studies have been published on age at death and causes of death for U.S. physicians, and previous studies have had sampling limitations. Physician morbidity and mortality are of interest for several reasons, including the fact that physicians’ personal health habits may affect their patient counseling practices.Methods: Data in this report are from the National Occupational Mortality Surveillance database and are derived from deaths occurring in 28 states between 1984 and 1995. Occupation is coded according to the U.S. Bureau of the Census classification system, and cause of death is coded according to the ninth revision of the International Classification of Diseases.Results: Among both U.S. white and black men, physicians were, on average, older when they died, (73.0 years for white and 68.7 for black) than were lawyers (72.3 and 62.0), all examined professionals (70.9 and 65.3), and all men (70.3 and 63.6). The top ten causes of death for white male physicians were essentially the same as those of the general population, although they were more likely to die from cerebrovascular disease, accidents, and suicide, and less likely to die from chronic obstructive pulmonary disease, pneumonia/influenza, or liver disease than were other professional white men.Conclusions: These findings should help to erase the myth of the unhealthy doctor. At least for men, mortality outcomes suggest that physicians make healthy personal choices.
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This book focuses on the psychological impact of police civilian combat. During a police career, the men and women of our police agencies are exposed to distressing events that go far beyond the experience of the ordinary citizen. There is an increased need today to help police officers deal with these traumatic experiences. As police work becomes increasingly complex, this need will grow. Mental health and other professionals need to be made aware of the conditions and precipitants and trauma stress among the police. A goal of this books it to provide such information. Our perspective in this book is based on the idea that trauma stress does not necessarily occur within the vacuum of the individual. Instead, trauma is a product of the rather complex interaction of person, place, situation, support mechanisms, and interventions. To effectively communicate this to the reader, we included some new conceptual and methodological considerations, essays on special cases and groups in policing, and innovative ideas on recovery and treatment of trauma. Our hope is that this information will be used to prevent or minimize trauma stress in police officers and, if this is not possible, that it be used to help in establishing improved support and therapeutic measures for police officers. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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This article investigates the relationship between social stressors, comprising conflicts with co-workers and supervisors and social animosities at work, irritation and depressive symptoms. It is argued that only a few mediation hypotheses have been investigated in organizational stress research. In the present study it was hypothesized that irritation mediates the effect of social stressors on depressive symptoms. This hypothesis was tested using four waves of a six-wave longitudinal study based on a representative sample (N =313) of the residents of Dresden, Germany. The advantages of longitudinal designs were comprehensively used including the testing of different time lags, the testing of reversed causation, and modelling of unmeasured third variables that may have spuriously created the pattern of observed relationships. Structural equation modelling provided evidence for the proposed mediation mechanism and suggests that time lags of at least 2 years are required to demonstrate the effects.
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Many researchers have claimed that the study of suicide and the formation of public policy are not undermined by the misclassification of suicide as other causes of death. We evaluated this claim using a new technique and causes of death not previously considered. We examined computerized California death certificates, 1966-1990. Mortality peaks at symbolic ages are a characteristic feature of suicide. We sought such peaks in (1) causes of death commonly suspected of containing misclassified suicides (e.g., accidental barbiturate poisoning), (2) causes of death not hitherto suspected (e.g., pedestrian deaths), and (3) control groups. The first two categories displayed peaks at symbolic ages, but control groups did not. The size of the peak, indicative of misclassified suicides, varied markedly by race (p < .0001) and sex (p < .0001). Misclassification is evident for all time periods examined, large and small counties, and each race and sex. The maximum misclassification occurs for Blacks (14.92% of officially recorded suicides). We conclude that suicides are misallocated to at least five other causes of death (two of which have not been previously considered in the literature) and are most likely to be underreported for groups with low official suicide rates, that is, Blacks and females. Consequently, Blacks and females are not as protected from suicide as was previously supposed. It may be inadvisable to use official suicide data to test scientific hypotheses about suicide, unless the effects of underreporting are estimated and, if necessary, corrected for.
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The worldwide English language literature on suicide in nurses is reviewed in this article. There is evidence from several countries that female nurses are at increased risk of suicide. Very little information is available about the specific causes. Increased risk in nurses has been statistically associated with smoking and negatively related to extent of caffeine consumption. Unlike some other high-risk occupational groups, it is unclear to what extent access to means for suicide contributes to nurses'risk. The methodological issues and specific needs of research concerning suicide in nurses are discussed.
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Studies on suicide among police show inconsistent results, thereby contributing to considerable speculation regarding why police officers commit suicide. The present paper is the first nationwide study on suicidal ideation and attempts among police. 3, 272 Norwegian police completed Paykel's Suicidal Feelings in the General Population questionnaire. Lifetime prevalence of specific questionnaire items ranged from 24% for the feeling that life was not worth living, 6.4% for having seriously considered suicide, and 0.7% for attempted suicide. Independent predictors of serious suicidal ideation were marital status, subjective health complaints, reality weakness, anxiety, and depression. Serious suicidal ideation was mainly attributed to personal and family problems.
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Age-, sex-, race-, and employment-adjusted standardized mortality ratios (SMRs) were calculated for sailors committing suicide between 1990 and 1996 and compared with adjusted SMRs for civilians. Cluster analyses were conducted on annual rates from 1983 through 1995 to examine differences between comparison groups across time and location. Results showed fewer than expected suicides for Caucasian and African American males and a somewhat higher than expected suicide rate among other ethnic group males and among Caucasian women. The suicide rate showed an increase during the study period, with some evidence toward a clustering effect in time and space.
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This study presents findings from an updated retrospective cohort mortality study of male police officers from January 1, 1950 to December 31, 1990 (n = 2,593; 58,474 person-years; 98% follow-up). Significantly higher than expected mortality rates were found for all cause mortality (Standardized mortality ratio [SMR] = 110; 95% confidence interval [95% CI] = 1.04-1.17), all malignant neoplasms (SMR = 125; 95% CI = 1.10-1.41), cancer of the esophagus (SMR = 213; 95% CI = 1.01-3.91), cancer of the colon (SMR = 187; 95% CI = 1.29-2.59), cancer of the kidney (SMR = 2.08, 95% CI = 100-3.82), Hodgkin's disease (SMR = 313; 95% CI = 1.01-7.29), cirrhosis of the liver (SMR = 150; 95% CI = 1.00-2.16), and suicide (SMR = 153; 95% CI = 1.00-2.24). All accidents were significantly lower (SMR = 53; 95% CI = 0.34-0.79). Mortality by years of police service showed higher than expected rates for (1) all malignant neoplasms in the 1- to 9-years-of-service group; (2) all causes, bladder cancer, leukemia, and arteriosclerotic heart disease in the 10 to 19-year group; and (3) colon cancer and cirrhosis of the liver in the over 30 years of service group. Hypotheses for findings are discussed.
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The Standardized Mortality Ratio (SMR) is a commonly used epidemiologic tool for evaluating a test population with respect to a standard. Computation of the measure requires that the size and demographic composition of the test population-at-risk (PAR) be known. In the absence of this knowledge of the PAR, some have turned to evaluations based on proportional mortality rates, a method which is generally regarded as deficient because of the inability of relative measures to provide information about absolute rates.Often, the ratio of the cause-specific SMR to the underlying ‘force of mortality’ (i.e. the SMR for all causes) is of interest; this ratio is referred to herein as the relative SMR (RSMR). It is shown in this paper, both empirically and in a theoretical framework, that the RSMR is close in value to the (age) standardized proportional mortality ratio (SPMR), this closeness being expressible in the form of a ‘confidence interval’ involving the SPMR. Computation of the SPMR does not require knowledge of the PAR.
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The author presents and comments on recently acquired police suicide data from several cities in the United States and from the Metropolitan Police Department of London and on extensive archival police suicide files. He also explores some of the psychosocial factors that may affect the high incidence of suicide among people who actively specialize in police work.
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The age-standardized mortality ratio (SMR) is a relative index of mortality, expressing the mortality experience of the study population relative to that of a comparison ("standard") population. With the general population as the "standard", the SMR for an occupational population will underestimate the mortality experience of that latter population (since it comprises individuals necessarily healthy enough to be employable --and whose mortality risk is therefore initially lower than the general population average). However, this "healthy worker effect" does not equally to all groups within the study population. Therefore, if one attempts to adjust for this effect, the summary nature of the SMR must be recognized, and allowance must be made for variation in the healthy worker effect between different age groups, different races, different work-status groups, different causes of death, and different elapsed-time periods of observation.
Article
Suicide in the UK is the 2nd commonest cause of death among the under 45 year age group accounting for 10% of all Potential Years of Life Lost (PYLL). An epidemiological analysis has been carried out on selected factors based on 558 consecutive cases (1985-89) of self-inflicted death. The study reveals a dramatic increase in suicide among young men and especially security force personnel. There has also been a change in the methods used and the age/sex profile.
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The question of the validity and reliability of suicide statistics may be considered at three levels: (1) Are suicide deaths misidentified or differentially identified across jurisdictions or over time? (2) To what degree are suicide deaths misidentified? and (3) Is the degree to which suicides are misidentified sufficient to threaten the validity of research based on suicide statistics? There is general agreement that suicides are likely to be undercounted, both for structural reasons (the burden-of-proof issue, the requirement that the coroner or medical examiner suspect the possibility of suicide) and for sociocultural reasons. There is also substantial anecdotal and empirical evidence suggesting that the mode of death for some true suicides is in fact certified as other than suicide. Overall, it does not seem that very many true nonsuicides are incorrectly certified as suicides. There is not, however, much agreement as to the degree to which true suicides are undercounted. At least some of the inconsistencies in the findings of different investigators arise because the validity of suicide certification seems to vary from place to place. But the source of apparent conflicts in many of the findings is undoubtedly the lack of a "gold standard" against which the verdicts of any given death certification process can be measured. At best, we can estimate that the sensitivity with which coroners and medical examiners certify true suicides varies from approximately 55% to 99%. A central question in estimating the sensitivity of suicide certification is this: What proportion of true suicides are either equivocal or likely to go unsuspected by the coroner or medical examiner? Very little has been done to investigate this issue. Yet the sensitivity of suicide certification clearly varies for equivocal versus unequivocal suicides. As shown in Table 1.2, specificity is also at issue when it comes to certifying equivocal cases. The final question--whether the degree of undercounting of suicide deaths is so great that it threatens the validity of research based on official statistics--is at the crux of the general concern about suicide certification. There are examples of studies in which conclusions based on crude comparisons of reported suicide statistics appear to be invalid. For the most part, these are comparisons among nations with substantially differing death certification procedures. When official statistics are interpreted with a degree of caution and an understanding of the source and direction of biases likely to affect the published rates, however, it seems unlikely that major conclusions based on these statistics will be in error.(ABSTRACT TRUNCATED AT 400 WORDS)
Article
Very little is known about the long-term health risks associated with the high stress police officer occupation. We report here on a retrospective cohort of 2,376 ever-employed white male police officers employed between January 1950 and October 1979. Vital status was obtained for 96%, the officers accumulating a total of 39,462 person-years. Six-hundred sixty-one deaths were observed. Total mortality from all causes was comparable to that of the overall U.S. white male population (standardized mortality ratio [SMR] = 106). Significantly increased mortality was seen for all malignant neoplasms combined (SMR = 127), cancer of the esophagus (SMR = 286), and cancer of the colon (SMR = 180). Significantly lower than expected mortality was seen for infectious diseases (SMR = 26), respiratory diseases (SMR = 64), and accidents (SMR = 60). Internal cohort comparisons revealed that policeman exhibited significantly higher mortality from suicide compared to all other municipal employees (rate ratio = 2.9). Analysis of mortality by length of service as a police officer showed that those employed 10-19 years were at significantly increased risk of digestive cancers and cancers of the colon and lymphatic and hematopoietic tissues and decreased risk for all diseases of the circulatory system. Policeman employed more than 40 years had significantly elevated SMRs for all causes, all malignant neoplasms combined, digestive cancers, cancers of the bladder and lymphatic and hematopoietic tissues, and arteriosclerotic heart disease. Risk of mortality from arteriosclerotic heart disease tended to increase with increasing years employed. These findings are discussed in light of the police stress literature. The hypotheses generated in this study must be tested through study of the role of important confounders including reactions to stress on the job.
Article
A total of 3,868 urban policemen in Rome were investigated through a historical cohort study with emphasis on mortality from cardiovascular disease and cancer. Overall mortality from cardiovascular disease, respiratory conditions, digestive and genitourinary diseases, and accidents was lower than expected. An excess risk of ischemic heart disease was observed among subjects aged less than 50 years [14 deaths, standardized mortality ratio (SMR = 1.63), 95% CI = 0.89-2.73], corresponding to workers with a short duration of employment and a short latency since first employment. Overall cancer mortality was as expected and no excess was found for lung cancer (82 deaths, SMR = 1.05). Increased mortality was observed from colon cancer (16 deaths, SMR = 1.47), melanoma (four deaths, SMR = 2.34), bladder cancer (13 deaths, SMR = 1.27), renal cancer (seven deaths, SMR = 1.39), and non-Hodgkin's lymphoma (six deaths, SMR = 1.51), although none of the excesses were statistically significant. Two deaths from male breast cancer (SMR = 14.36) and three from cancer of endocrine glands were found (SMR = 3.44). Nested case-control studies were conducted to evaluate cancer mortality risk by job category. Bladder cancer was significantly increased among car drivers (OR = 4.17); for kidney cancer, an increased odds ratio (OR = 2.27) was found among motorcyclists; non-Hodgkin's lymphoma clustered among motorcyclists (OR = 5.14). In summary, excess risk for specific cancer sites (colon, male breast, and endocrine glands) might be linked to occupational exposures; professional drivers seem to be at higher risk of bladder cancer, kidney cancer, and non-Hodgkin's lymphoma.
Article
Suicide rates among industrial groups were examined systematically using death certificate data from 1984 through 1989 in Alabama. Poisson log-linear modelling was used to estimate the rate ratios (RR) of industries compared to a referent and to adjust for confounding. Marked differences in suicide rates were found among industrial groups. The rates ranged from 5.31 to 62.36 per 100,000 population per year. People employed in public administration had the lowest rate. In comparison with public administration, the construction industry had the highest risk (adjusted RR = 11.8, 95% confidence interval (CI): 9.6-14.6). Employees of the mining industry experienced a similarly high risk (adjusted RR = 11.5, 95% CI: 8.2-16.3). Persons employed in farming, agriculture services, forestry, and fisheries, manufacturing, and transportation, communications, and other public utilities industries had intermediate risks. Smaller elevations of suicide rates compared to public administration were observed in the wholesale trade, retail trade, finance, insurance, and real estate, and services industries. The differences of suicide rates may be related to sociodemographic differences, self-selection for occupation, ease of access to lethal agents, or job stress.
Article
Many researchers have claimed that the study of suicide and the formation of public policy are not undermined by the misclassification of suicide as other causes of death. We evaluated this claim using a new technique and causes of death not previously considered. We examined computerized California death certificates, 1966-1990. Mortality peaks at symbolic ages are a characteristic feature of suicide. We sought such peaks in (1) causes of death commonly suspected of containing misclassified suicides (e.g., accidental barbiturate poisoning), (2) causes of death not hitherto suspected (e.g., pedestrian deaths), and (3) control groups. The first two categories displayed peaks at symbolic ages, but control groups did not. The size of the peak, indicative of misclassified suicides, varied markedly by race (p < .0001) and sex (p < .0001). Misclassification is evident for all time periods examined, large and small counties, and each race and sex. The maximum misclassification occurs for Blacks (14.92% of officially recorded suicides). We conclude that suicides are misallocated to at least five other causes of death (two of which have not been previously considered in the literature) and are most likely to be underreported for groups with low official suicide rates, that is, Blacks and females. Consequently, Blacks and females are not as protected from suicide as was previously supposed. It may be inadvisable to use official suicide data to test scientific hypotheses about suicide, unless the effects of underreporting are estimated and, if necessary, corrected for.
Article
During the period 1980 to 1992, 95% of the 3178 military suicide victims were men and 92% enlisted; of the men, 71% were aged 20 to 34, 82% were white, and 61% used a firearm. Information extracted from the Report of Casualty of the Worldwide Casualty System maintained by the Department of Defense was used to describe the occupational risk among military men. Occupations related to the use of or access to firearms were associated with a significant risk of suicide when compared to other military occupations. Collectively, military security and law enforcement specialists had a significant occupational rate ratio (1.25; 95% confidence interval: 1.02, 1.53; P < 0.05). This corresponds to findings from national civilian labor force fatality data where police and detectives are also at an elevated risk of suicide. Because the scope and work of these military high-risk groups may differ from service to service, additional occupational information should be examined to facilitate a better understanding of the complex etiology of suicide and to develop appropriate prevention strategies.
Article
Inherent dangers in police work, such as the possibility of homicide victimization or accidents, often overshadow the psychological consequences of this occupation. The present study employed data from a Buffalo, NY retrospective mortality municipal worker cohort to evaluate the risk of suicide, homicide, and accidents among police officers, and compared that risk to other municipal workers. Within the police occupation, officers had an 8.23-fold risk of suicide over homicide and a 3.1-fold risk of suicide over accidents. Compared to municipal workers, police officers had an RR = 1.53 (95% CI = 0.633-3.72) for suicide over homicide, a significant RR = 3.1 (95% CI = 1.94-4.97) for suicide over accidents, and a significant RR = 2.65 (95% CI = 1.76-4.00) for suicide over homicide and accidents combined. Possible reasons for suicide among police officers are discussed.
Article
Police suicide research has yielded inconsistent results. An opportunity presented to survey Queensland police suicides in a historical context and add to the existing literature; the study describes changes in police suicide over time, the associated characteristics, and opportunities for intervention. Suicides were examined from the origins of police in Queensland in 1843 up to 1992. Suicide rates were higher earlier, around 60 per 100,000, declining to around 20 per 100,000 recently. The recent rate is lower than most other police studies but the same as the general community (employed). Most suicides were associated with psychological and physical ill health, alcohol abuse, and domestic problems, in keeping with general community surveys. However, occupational problems were more evident than is generally the case. The proximity in time of disciplinary events and suicides was striking. Future studies should explore the interactions between these factors.
Article
Urban firefighters are at risk for posttraumatic stress disorder (PTSD) due in part to their exposure to duty-related trauma. This study compared duty-related trauma exposures and the prevalences of posttraumatic stress in U.S. and Canadian firefighters. Both samples reported relatively numerous and frequent posttrauma symptoms, and the rates of self-reported PTSD prevalence did not differ significantly. However, analysis of departmental records for respondents' previous year on duty revealed significant differences in both frequencies and categories of traumatic incident exposures. Some of the vulnerability and moderating risk factors associated with PTSD caseness differed between the U.S. and Canadian samples. Potential explanations for the observed differences in risk factors for PTSD in these 2 firefighter samples are considered.
Article
The objective of this study was to investigate variations in the risk of suicide by industrial and occupational groups. Cox proportional hazards regression models were fitted to the data from the National Longitudinal Mortality Study (1979-1989). In estimating the effects of industry and occupation, controls were made for the potentially confounding effects of age, sex, marital status, education, income, and region of residence. It was found that persons employed in mining experienced the highest risk of suicide (RR=4.29, CI=1.59, 12.13) compared to workers in finance, insurance, and real estate. Elevated risks were also observed among business and repair services (RR=4.20, CI=1.72, 10.25), professional and related services (RR=2.92, CI=1.25,6.82), and wholesale and retail trade (RR=2.71, CI=1.17,6.25). When comparisons were made by occupational status, it was found that laborers experienced the highest risk of suicide (RR=2.12, CI=1.09,4. 12) when compared to farmers, farm managers, and farm workers. There are differentials in the risk of suicide among industrial groups, and the industry with the highest risk is mining. The disparities in suicide remained even after the effects of socioeconomic and other variables were controlled. Further research needs to determine if the high suicide risk observed in some industrial groups may be linked to possible depressive symptomatology in the workplace.
Article
CONTENT/OBJECTIVES: No recent national studies have been published on age at death and causes of death for U.S. physicians, and previous studies have had sampling limitations. Physician morbidity and mortality are of interest for several reasons, including the fact that physicians' personal health habits may affect their patient counseling practices. Data in this report are from the National Occupational Mortality Surveillance database and are derived from deaths occurring in 28 states between 1984 and 1995. Occupation is coded according to the U.S. Bureau of the Census classification system, and cause of death is coded according to the ninth revision of the International Classification of Diseases. Among both U.S. white and black men, physicians were, on average, older when they died, (73.0 years for white and 68.7 for black) than were lawyers (72.3 and 62.0), all examined professionals (70.9 and 65.3), and all men (70.3 and 63.6). The top ten causes of death for white male physicians were essentially the same as those of the general population, although they were more likely to die from cerebrovascular disease, accidents, and suicide, and less likely to die from chronic obstructive pulmonary disease, pneumonia/influenza, or liver disease than were other professional white men. These findings should help to erase the myth of the unhealthy doctor. At least for men, mortality outcomes suggest that physicians make healthy personal choices.
Article
Meta-analyses of police suicide rates and ratios to the comparison population were conducted using 101 samples from the literature. The large effect sizes (ES = .74) showed that suicide rates based on short time frames were significantly higher than for long time frames. There were regional differences such that rates in the Americas and Europe were higher than in the Caribbean and Asian regions. There were differences in rates between federal, regional, and municipal police forces. Issues researchers need to address include the use of long time frames; the reporting of more complete suicide statistics, including breakdowns by year, sex, and ethnic groups; and the rates for population comparison groups.
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