Protecting Against Stress and Trauma - NIJ Research for the Real World Seminar

Transcripts for:

• Defining the Problem
• Research & Practice
• Next Steps
• Questions and Answers

Part 1: Defining the Problem

DAVID MUHLHAUSEN: Good morning and welcome to the National Institute of Justice. I’m very pleased to see so many people here today to learn about the important research and educational work we conduct at the National Institute of Justice. The researchers you will hear from today are pioneers in the field of the Evidence-Based Policing Movement. They are leading scholars and LEADS scholars. For those of you not familiar with the LEADS Scholarship Program, LEADS stands for Law Enforcement Advancing Data and Science.

One of our LEADS scholars here today, Sgt. Obed Magny is from the Sacramento Police Department where they just lost an officer. In fact, Obed flew here to DC from California directly from the fallen officer’s funeral. All of us here at NIJ and OJP are saddened to hear about the loss of Officer Tara O’Sullivan from the Sacramento Police Department. She was 26 years old and had been on the force for only six months. Our hearts go out to Sgt. Magny and to all his colleagues at the Sacramento Police Department and Officer O’Sullivan’s friends, family, and loved ones.

NIJ has long recognized that police and corrections work are among the most stressful and dangerous of professions. The safety, health, and wellness concerns that draw us together today are not new. And this work is not becoming any less stressful, not any time soon. Over 20 years ago, NIJ started funding research into fatigue and its impact on officer health, safety, and performance. In 2005, we funded research examining the connection between shift work, exhaustion, sleep disorders, and officer health and wellness. Although we have invested significant resources into many factors affecting the health of police officers and corrections officers, there remains a need for further research into factors affecting officer safety, health, and wellness. In 2016, NIJ began a concentrated effort to address these issues. We integrated science and evidence-based tools into our safety, health, and wellness strategic plan. This strategic plan focuses on stress, PTSD, and suicide in law enforcement, as well as the broader criminal justice community. Sadly, NIJ’s initiatives come at urgent time when suicides and PTSD are a rising concern. NIJ will focus our efforts and never let up until these tragedies are a thing of the past.

Some of the sources of stress in law enforcement are known or have been known to generations of officers. These include consistent exposure to people in distress and pain, the responsibility of protecting the lives of citizens, threats to officer life, and an officer having to control emotions at all times even when provoked, and the unpredictable pace of the daily job. Situations can arise quickly in an officer’s line of work. To be blunt, these and related issues have not always been given the focus they deserve. Importantly, the corrections community is sometimes neglected. This is even though the stresses and dangers of working in prison conditions are as great, if not greater, than those faced by police officers working in the general population. NIJ’s strategic plan includes studies of the unique safety concerns present, indeed omnipresent in correctional settings. We fund this research now and will continue to do so. Our research delves into agency policies and their effects on officer stress. For example, overtime work has long been rewarded, even required during short staffing. There is reverse incentive to earn more money and show loyalty and commitment by working overtime. But there is often a price in health, safety, and wellness.

As DOJ’s research and evaluation agency, NIJ has a commitment to evidence-based practices. We demand rigorous evaluations to determine what works and what doesn’t work. One way we determine the most effective practices is by supporting our LEADS scholars in the field. Today, we have among us several practitioners who are LEADS scholars. They are developing science-based interventions that can be applied in many settings including with their own agencies. Many of them are working on health and wellness-related projects. LEADS scholars please rise, stand up.  I asked you to rise because I want to recognize all the hard work you put in both in the execution of your official duties and for the additional research you take on your own time, so thank you very much.

NIJ began this Research for the Real World series back in 2009. We want to feature research that is changing our thinking about criminal justice policies and practices. We seek to hear from both practitioners doing research and researchers striving to impact practice. Panels like the one today are critically important because they allow us to discuss our work and share it with people it directly affects. Our panelists today include researchers who are subject matter experts in the field of stress and trauma, as well as two practitioners with experience in treating officer stress and trauma. NIJ works shoulder to shoulder with these practitioners. I look forward to hearing our speakers discuss the work they do and how it will support officers in their varied work environments every day. It is now my pleasure to welcome Principal Deputy Assistant Attorney General of the Office of Justice Programs, Katie Sullivan who will kick off our discussion.

DAVID MUHLHAUSEN: Before joining the Department of Justice, Katie was a Colorado State Trial Court judge for 11 years. She has heard over 45,000 cases during her years on the bench including domestic violence cases, sexual assaults, cases involving drugs and alcohol. Before I give Katie the floor, I want to say that NIJ is very excited to have Katie here. She’s a dynamic leader and she just exudes enthusiasm, and NIJ, I believe, is operating, I would say, in fifth gear. Now that Katie’s here, we have to find our fifth gear because we’re just going to have to push even harder and do more. So Katie, you have the floor.

KATHARINE T. SULLIVAN: Thank you, Dave.

KATHARINE T. SULLIVAN: Thank you. Hey, this is so great. Thank you so much. It’s a real privilege. I want to tell all of you I started last Monday in leading the Office of Justice Programs, longtime friend of Dave Muhlhausen’s and know how deep his commitment is to the work that’s being done here at the National Institute of Justice. So when he asked me to come and just deliver a couple of quick welcoming remarks, the answer is “absolutely yes.” particularly for this series. The Research for the Real World is something I think is vital. I understand this program has been going on for many, many years and I know that David and Howard work very hard to make sure that this series in particular is relevant, and helpful, and have figured out ways to make it more dynamic and useful to all of you. So I really appreciate so much the work that Dave and Howard are doing and this is going to be a great panel. Thank you to the panelists. You guys have gone out of your way to come and be here today. We so appreciate your expertise and so thank you very much. I know this is going to be a great discussion.

I do want to talk just briefly about trauma and policing. So I was never a police officer, I was a prosecutor and then presided over a rural trial court for 11 years in Colorado. When you’re a rural court judge, you have to do everything, right? So you’re listening to a motions hearing for a DUI stop and then you got to take a break because someone comes in with a temporary protection order or an eviction. You really wear so many hats as a rural court judge and you really get to see a very, very big picture. I have always so deeply appreciated law enforcement and the job that you all do. And I always looked at being a prosecutor as partnering with law enforcement—that the way a prosecutor’s office works very effectively is to create partnerships and collaboration, and really good strong communication.

When I was kind of a brand new district attorney, the domestic violence laws—so this would’ve been in 2000—in the state of Colorado changed and we went to the mandatory arrest. Some of you are too young to know that it wasn’t always a mandatory arrest situation, but in 2000 in reaction to the Violence Against Women Act, many states adopted this law instructing police officers that if there was probable cause, they must arrest in a domestic violence situation. Our officers were having a difficult time. It really marked a very big change in the way that they approached these cases. They weren’t completely sure how to handle it. All of them did not have a great attitude about it.

So I started as a district attorney in this rural part of Colorado and so I said that every domestic violence case, I would go ahead and go out with them, just to call me and pick me up, and I would go to the scene with them while we were figuring all of this out. So very shortly after that about 11:00 at night, I got a phone call, got in the car, the guys took me out and it’s pitch black in the middle of nowhere on a ranch in Colorado. A woman is hysterical. She’s with the victim’s advocate and she keeps talking about how he has a gun, he has a gun, he has a gun. She says he ran that way into the pitch black. The officers start trying to look for him. And didn’t find him that day but he did turn himself in the next morning. She was put in a safe shelter. This was 19 years ago and I remember every single detail of that event. Every detail. That was one time that I went out with these officers. Forevermore that experience has reminded me that you guys do that every day, multiple times a day. You’re going into those situations that when you roll up on something, you have absolutely no idea what might happen.

I have to tell you first of all thank you. Thank you for what you do. Thank you for protecting us. Thank you for protecting your communities. But I also want to say that just from that one event, I think about how you have to create skills in order to be able to get up out of bed every morning to go roll up on the next call. There are certain things that you do internally and emotionally and all these brilliant people are going to talk about it in order to keep doing your jobs especially in this culture. Right now, we just have a lot of tension around law enforcement and communities. That doesn’t help in any way, shape, or form. So I think this idea of trauma and secondary trauma is a vital discussion and I’m so appreciative that Dave has brought this and used this as a topic for this panel.

I also want to talk about the suicide rates among law enforcement which Dave mentioned. Suicide is the worst outcome of the mental health challenges faced by law enforcement. But police also have higher than average rates of depression and PTSD. Just very quick anecdote, I ran a drug court and a DUI court. Our teams would all come to Colorado, to Denver, and we’d have a big conference. In one year, they focused on secondary trauma. We took the test. I was like, “Oh my God. I have a docket that is so busy, I love to work. I got to go sit here and listen to this stuff about secondary trauma. This has nothing to do with me. I sit up on the bench.” All this stuff. Now I start taking the little tests. Turns out I’m sort of in the high yellow zone moving into a red zone. I mean, it was stunning to me. I really had a prism change and I know that it isn’t always in the criminal justice world. We don’t always talk about the emotional health of the people in the criminal justice world. But I think we’re starting to and I know that NIJ is committed to this and this panel is committed to it.

So with an open mind, I think that you guys are going to learn a lot and hopefully a lot about yourselves in ways that you can help not only yourselves but the other people that you work with, so thank you very much. Thank you to everyone on Webex. This is a very popular series. I’m absolutely thrilled to be here and so appreciate all of you. Thank you.

HOWARD SPIVAK: Good morning, everybody. I’m Howard Spivak. I’m the Principal Deputy Director of NIJ and we’ll be moderating the panel. This session is going to be different from many of the other Research in the Real World sessions in that we’re not going to have four talking heads standing up here giving presentations but we’re going to have a facilitated discussion about this issue of stress and trauma and how we deal with it, which I think will allow for some exchange and some interesting conversation. We will eventually open things up for questions and comments from the audience as well.

As David mentioned, NIJ over the last three or four years has increased its efforts in the area of safety and wellness for people working in the criminal justice system. But actually one of the surprises for me when I first came to NIJ was the fact that NIJ had in fact funded some of the early research on sleep deprivation and its impact on functioning at work. That was particularly relevant to me because I’m trained as a physician. I spent two years during my training working 36 hours on, 12 hours off with all of 28 days off for vacation during those two years. So not only was I being asked to make life and death decisions with 30 or more hours of being awake, but I literally fall asleep driving home and pass my house. It was incredibly dangerous and in fact, some of the research that NIJ has funded contributed to the change in the medical training system that has stopped that from happening. I wish it had happened before I started training but at least it’s happening now.

So on that note, I think I’d like to get started and I’d like to introduce the panelists. To my far right is Chris Scallon who is a retired sergeant from the Norfolk Police Department and is currently director of Public Safety Support for Chateau Recovery. He has 24 years of experience mentoring law enforcement officers who experienced critical incidents. To my right is John Violanti who’s a researcher professor at the University of Buffalo and is an expert in the field of police stress, health, and suicide. To my immediate left is Wendy Stiver who’s a major in the Dayton Ohio Police Department, is also a LEADS Scholar. Did you stand when David asked? You didn’t? Okay. And is also currently a practitioner in residence at NIJ, so she’s spending a lot of time here doing work. And among other things, she’s done work in addressing the issue of officer stress and trauma through my mindfulness training. Then to my far left is Dan Grupe who is an assistant researcher at the University of Wisconsin in Madison and his background is in studying resiliency to stress and trauma. I’d just like to get things started and I think a nice way to do this is to start with Wendy and have her talk a bit about some of her own personal experiences as well as what she’s seen with some of her colleagues on the job with respect to stress and exposure to trauma and implications of that. So Wendy.

WENDY STIVER: Thank you, Howard. I just celebrated I guess my 20th anniversary. I don’t know if celebrated is the right word because the only thing I really remember about the academy is every single senior police officer that talked to us said “Enjoy it because it’s going to go really fast.” It feels like it did and at the time, the idea of my career just zipping away before my eyes was sad. So I’m glad I made it to 20 years but I’m a little wistful that the fun part of it might be behind me.

But I started in ‘99 in Dayton, Ohio. I spent five years in the military before that. I started in ‘99 in Dayton, Ohio and in 2000, one of my friends was shot. She was shot in the collarbone. The bullet skipped across her spine and left her paralyzed from the neck down. She survived another two years and succumbed to her injuries. At the same time she was in the ICU, my dad was in the ICU having a triple bypass. So I actually was bouncing back and forth between visiting my friend, Mary, and visiting my dad. Less than a year later, I was involved in a critical incident and was very fortunate to survive that. My partner and I responded to a burglary alarm and it appeared like a couple of guys wrapping up at a construction site on a Friday night. When we asked them for their identification, one of them ran to his truck, got in his truck, and it looked like he was about to drive away. My partner ran up to the driver side and was pulling on the door handle which the door was locked, so he couldn’t get in. So I thought “Oh, no. You’re not getting away that easy.” So I went to run around to the passenger side of the truck and before I could clear the back end of the truck, the driver threw it in reverse and dragged me probably about 40 feet through this construction site. My partner shot and killed him. So that’s the only reason I’m really here today to talk about it.

That actually wasn’t the scariest thing that happened to us that week because a couple days before we got sent to a domestic violence call and we approached this house and we’re listening at the side of the house and we hear what sounds like somebody racking a shotgun. So we look at each other and we’re like “Oh, crap, we got to go.” So he goes to the back and I go to the front. I knocked on the front door and this guy comes to the front door. And the next thing I know, there’s a--the barrel of the gun that big in my face. It looked that big at the time. About the same time I realized I had a gun in my face, this guy realized he was pointing a BB gun at a cop. Fortunately, that little bit of delay and that little bit of recognition allowed him to drop it and me not to shoot him because I had that tunnel vision we hear about. What I didn’t see was the pregnant woman and the small child standing behind him. The reason that that actually was the scariest thing that happened to us is because all of our colleagues showed up and chastised us for not shooting this guy. So often, it’s not necessarily the critical incident that causes the most stress in what we do. It’s the way we get treated and the way we interact with our colleagues and sometimes the way our organizations respond to these things.

To quote one of my favorite LEADS scholars, Jason Potts, it was a time in my career where I just run around with my hair on fire, trying to get into as much excitement as I could. All of these things just kind of built up. The organizational response wasn’t that great. Then I moved into a phase in my career where I just started working all the time and I went the entire year of 2007, I didn’t sleep more than three hours consecutively. I just lived on three-hour naps. As we talked about that sleep deprivation just made things worse and worse and worse and I ended up in the hospital. So I’ve always had kind of an interest in how we can do this better and how we can maybe leverage some of the research and some of these ideas that are out there into taking care of our folks a little bit better so we don’t lose them halfway through their careers. Because at this time, I actually had realized that I had had about enough and I was looking at going to culinary school. Some of you have eaten food that I’ve prepared and you can vouch for the fact that that probably wasn’t a great idea. I haven’t really been very good at a lot of the other things I’ve tried. I also tried recently craft brewing at home and my neighbors will vouch for that probably it wasn’t a good career move either. So, I’m here and I’ve got this wonderful opportunity to really spend some time digging into some of the research and looking at ways that we can improve not only the way we respond to these issues but the way we prepare for them. Because I think Dan and John are going to tell us that the way that we prepare ourselves to survive and navigate these careers is probably going to have a much bigger effect on how we respond to them afterwards.

HOWARD SPIVAK: Thank you. Actually, following up on that, John, let’s bring some science to this. Now, we know that these kind of experiences have considerable effects on both neurological and biological function which both affects the immediate responses but also has long-term consequences. So, can you speak to some of the physiological issues that connect with all of these experiences and what the potential impact of that is?

JOHN VIOLANTI: Sure, doctor. Thank you. I was a police officer as well. I was a New York State trooper for about 23 years. Many of the things that you talk about, we’ve all been there with a gun in the face and the horrible things we see. I think most of our research in the past 14 years has involved the effect of post-traumatic stress disorder or stress on the physiological and disease aspect of police officers. We’re finding some amazing things. We’re looking at this over time and we’re seeing that, for example, people who have high rates of post-traumatic stress disorder are three times more likely to have the metabolic syndrome, which is a sort of a list of components that lead to heart disease. So we’re finding them at higher risk for cardiovascular health disease simply because of the trauma they experience in this work.

Additionally, sleep deprivation is an important thing we’ve looked at. Many officers are surviving on three hours sleep. They’re working 10- to 12-hour shifts. Some are doubling back because of the shortage of personnel out there. They go to court after work. They go home. They work their second job. They take care of their family. And the next night, they go back to work again. Some officers have admitted falling asleep at the wheel. Other officers cannot handle that deprivation aspect. We see sleep deprivation leading to increased risk for cardiovascular disease, diabetes.

We see the diet of people who work shift work is absolutely terrible. There’s no place to eat for one thing. And in general, it’s food that is not good for health. There is a lot of different aspects of post-traumatic stress disorder. I’m quite interested in that aspect. I think one of our most recent studies had to do with the effect of PTSD on the ability of police officers to make decisions on the street which is scary. We found, for example, in our brain imaging studies that post-traumatic people who have had high levels of post-traumatic stress symptomatology had more difficulty in making decisions which we measured in the lab by the way. But still, the parts of the brain that are required to make good decisions are essentially blocked off by post-traumatic stress disorder. So it’s a scary thing. We need to find interventions to help people deal with that.

It’s my view that we should be proactive about this, that at the academy level, people should start to be made aware of the trauma they’re going to experience for the next 20 years. A lot of young people coming in the police work today have never seen the horrible things that police officers see. They’ve never seen a dead body. They’ve never seen abused kids, horrible traffic accidents, terrible assaults, bodies in the bathtub, all severed. This is quite a shock. This is reality shock. And after the first year on the job, we see developing aspects of chronic stress and post-traumatic stress disorder. So, I say proactively start at the beginning. Inoculate them, get them ready for what they’re about to experience. Otherwise, we have to go into a reactive mode which is not the best mode to go into.

Disease is prevalent in police officers. Heart attacks, cardiovascular disease are one of the most common types of death. We just looked at a study on that and found that 48 percent of the officers who had job-related illness died on the job of a heart attack. This is very scary. We’ve also seen that the rate of heart disease is increasing. We looked at the heart attacks over 21 years in a sample and found that there’s a significant increase in cardiovascular deaths in police officers over a period of 21 years. Much of this is related to stress. You know, lifestyle certainly has a lot to do with it. But stress has a lot to do with affecting our cardiovascular system. I think it’s essential that we address wellness to bring that back into policing. It’s starting to come out. I applaud the young leaders of today who have good ideas about mental health and want to help.

I think it’s important to understand that leadership is very important here. Many officers that I talked to say that with the support of the organization, with the support of leadership, I always do much better. We need to integrate that. We need to integrate leadership. And that officer that goes out on the street where the rubber hits the road is very important. If the top person on the top of the organization cares, everybody else cares. I saw this recently in New York City at the NYPD. We had a seminar on police suicide. Three hundred people from all over the world were there. And Commissioner O’Neill started this, supported this, said in his speech that, “Hey, I care. I care about you people, you know. I care.” You don’t think that made a big impact. It did.

Moving over to suicide which I’ve been studying suicide for 20 years now and I still have not found an answer. But I can tell you in my opinion, police suicide is part of police work. It’s part of the job. And you might say, “Well, maybe it’s relationship problems, maybe it’s finance problems, maybe it’s things on the outside of the job.” But think about how much the job affects those outside things, quite a bit, quite a bit. It’s part of the equation. I believe that. Some people don’t. I do.

When we look at suicide rates, we see that we are as an occupation at an increased risk for suicide. We’re not the only occupation. Physicians certainly of late have been subject to burn out and suicide as well. But we are one of the leading occupations in suicide. We could stop this. We could stop this with the support of the organization. I think it’s essential that leadership be trained in suicide, at middle management, and at the top to deal with this very serious problem we have. We’ve seen clusters lately and this is very disturbing, Chicago, New York City. We need to take action on this.

HOWARD SPIVAK: Thank you. Chris, we also know this isn’t a one size fits all and that people have different reactions and different responses to sometimes the same experiences. So how do we better understand that? How do we understand who’s most at risk? How do we understand the variations and how to deal with that and create strategies that accommodate those variations?

CHRISTOPHER SCALLON: Thank you. It’s really an honor to be here. Not unlike the Major, I’m here as a result of being what this was all about. I was diagnosed with post-traumatic stress disorder, acute depression with suicidal ideations. I attempted suicide three times as a police officer. So I get it. This job can be overwhelming. I’m in agreement with the doc, that it kind of bleeds over into everything. So, the big thing is—and especially in running peer support units is that we look for the big things, right? Early on in my career, I was working in narcotics and I had a guy talk to me. He’s like, “You’re missing a lot of stuff when you’re doing your searches.” And I said, “Well, because I’m searching for a gun.” He goes, “No. Search for a razorblade.” So when we start focusing our searches and start identifying these little things, we’re going to find more stuff, as opposed to just addressing the big things.

Again, it’s interesting that we have the stuff about how this job is stressful. This job is very stressful and it puts us in some very bad places. But we’re not born in a vacuum. We bring with us our culture, our upbringing and it’s interesting to me because 20 years, 24 years goes like that. I see these folks coming in and there’s no life experience there, for the most part. But then I also see at the same time veterans coming in. So, if you have a combat veteran coming in or you have somebody that’s still living with mom going through the academy, those are two very specific individuals. So how do we address that? I think we address it by creating a context or an atmosphere in which it is, A, okay to ask for help. It’s okay to say that you’re struggling with something and not have it being met with, like, the Major was talking about, “Why didn’t you shoot the guy?” “You weren’t here, so, you know.” Everybody has their own opinions.

But it needs to be top down. If the people on top and executive-level management aren’t supporting this, now let’s be honest, really supporting it, not checking a box because I have to do this because it’s police suicide, click, yeah. We got somebody you can talk to. That bothers me a lot, and we’re seeing that. So, if we get the upper echelon on board. A while ago, I was speaking with a chief of an agency and he said, “Chris, change comes from the bottom up.” And I was like that’s a coup. That’s like we’re revolting against you. Why don’t you drive the ship and tell us which way to go? Recently, there was a police chief in Northern Virginia that came out and spoke about how he was struggling with post-traumatic stress disorder. What it did for that agency, it made it okay. And that’s ultimately what we need. We need to make it okay because the trauma, the stress, the anxiety, PTSD, it exists on a spectrum. There’s high functioning and low functioning. Unfortunately, I got to the very low functioning phase but I could’ve gotten tagged at any single time along my journey, but I didn’t.  Anybody ever been to a call where you get back and you’re done, you’re like, “You know, guys, I was very emotionally charged?” No, No. We make jokes and stuff like that. We need to start switching it around and start making it okay. You can have all the best people in the world working in these agencies, it cannot happen unless the head of that agency recognizes it as an importance. The problem is a lot of people don’t want to recognize it for a simple fact. And this kills me every time. —

I was speaking at a Midwest agency and I was talking about trauma and I tell my story of suicide or attempted suicide, and PTSD, and shootings and all this stuff. A couple folks came up to me afterwards and they’re like, “I’m listening to me on the stage.” I’m like, “Yeah, I get it.” Because it’s funny. I equate it to this old music video from Blind Melon with this little girl walking around in a bee costume and she’s like this outcast. And then she comes across all these other people dressed as bees. Well that’s what it’s like when you talk about trauma openly. I’m no more embarrassed of my diagnosis that I would be if I broke my leg.  So when people see that, they’re drawn to it. So fortunately two of the individuals I spoke to left the agency and got help. They needed it. I got a phone call from somebody that was working with that agency that said, “You know, hey, this is what happened.” I’m like, “That’s great. They got help.” Unfortunately, the head of that agency was upset that now they are two people shy of a full complement. If manpower is the issue, then we’re not doing anything. It’s the people that matter. The most important thing that an agency and the most powerful thing that an agency can have is healthy individuals within it that aren’t afraid to talk.

HOWARD SPIVAK: Thank you. Dan, you’ve done a lot of work around resiliency, how do you develop resiliency? How do you teach it? How do you reinforce it? How do you prepare people in ways that allow them to moderate some of these effects or deal with some of these experiences?

DAN GRUPE: Yeah, that’s a big question. There are—just to pick up on some of what Wendy and Chris said—some definite risk factors that we know, people who are not resilient exhibit. So one thing is the experiences, the lifetime experiences that you’ve had. Early life adversity, exposure to adverse childhood events is a huge risk factor. We talked about exposure to trauma and something that both Wendy and Chris kind of mentioned. The exposure to traumatic events is something that to some extent is expected when people go into policing, and there’s multiple studies that have shown that the impact of traumatic events is actually less predictive of the development of PTSD than people’s perception of the day in, day out stress associated with the work, and especially the organizational stress.

So, when we’re thinking about resilience and developing resilience, part of it is about building skills within the individual. We can talk about ways that we’ve been looking at doing that in Madison. But part of it is really about the organization and having an organization that supports resilience. I think not just paying lip service to this in saying we want our officers to be healthy and well. We’re not providing them with tools and resources to do that, but actually modeling it from the top. One other thing, and Chris spoke to this as well, that determines who’s resilient and who’s not in the face of trauma and adversity, is the way in which you relate to that traumatic event, the way in which you identify with it, the way in which you’re able to kind of integrate that event into your life, or the way that you distance yourself from it. There are studies showing that people who experience traumatic events but have what’s called a dissociative response, kind of like an out-of-body nonintegrated experience with that event, those people are at higher risk of developing PTSD. So I think individuals who are resilient are able to acknowledge the fact that they’ve experienced some of the worst human suffering that people can bear witness to and give themselves permission to express emotion, to not avoid the experience of emotion. I don’t know if we want to talk now, or if it’s in the next part of the panel about ways in which we’re trying to actually cultivate resilience and train some of these things, but we do believe in the work that we’re doing that this is not just something that you’re born with or not, it’s not the case. But if you experience some of these adverse events, you’re on a trajectory and there’s no way to get off of it. We think that this is something that we can train. We think that there are skills that we can help people build.

Part 2: Research & Practice

HOWARD SPIVAK: That’s a nice lead-in, actually, to the next section, which is really better understanding the interface between research and practice. I think one of the things we struggle with at NIJ is how to facilitate that and how to get research into the practice setting. So I’d actually like to ask our two practitioners to start with. Where does science enter this? Is there an effort to understand science and bring it into practice? And if so, how is it happening at least currently? Wendy, why don’t you start?

WENDY STIVER: We’ve got the LEADS Program, obviously, which is a fantastic way of building on those researcher-practitioner partnerships. But I think this is a good time to also talk about, particularly in this subject, we’ve got research that tells us that there’s some techniques out there that may work, that may help us. But we’ve got cultural resistance to it. So building a bridge between research and resiliency, and things like mindfulness, and getting cops to do that.

If Gary Cordner’s in the room, I’d like to point out that yoga is one of those things that he loves to talk about. He’s a huge fan. But there’s this resistance to some of these things, and I think that’s kind of where having a good practitioner-researcher partnership can help to build a bridge, and make things like mindfulness be accepted as both tactical and practical. Because some of the research is telling us that these resiliency practices can actually help us perform better in the field. They can reduce errors in the kind of decision-making that happens in a use-of-force incident.

If we can get cops to understand and leadership to understand, that the things that make us healthier—mentally healthier in this job—can help us perform better, then it might be more acceptable to the entire field and it may benefit a large number police of officers both in terms of mental health and in surviving critical encounters. That’s a really difficult line to draw. So it’s going to take a lot of us who understand both the research and the practice of policing to make that real and tangible and practical for acceptance.

HOWARD SPIVAK:  Chris, part of the work you do now is trying to bring some of this work into police departments. What’s your experience been like in doing this?

CHRISTOPHER SCALLON: So here’s the deal. We’re not a complex animal as many would like to believe as a cop or fireman, or public safety. The best bridge that I see in most agencies is normally somebody who’s really gotten lost, and then has sought out professional help. And through research and through just therapy or whether it be in an in-patient setting, out--whatever it is, they come back. And they come back better. You start acquiring the champions of mental health in your agencies, that’s what bridges the gap. Foster those individuals, give them the opportunity.

When I was asked to create--well, I wasn’t asked to create, I said I got tired of being sick and tired. And I was like, “You know, I don’t ever want anybody to go to those dark places that I went to.” I know most agencies in the country are fully-manned. There’s no shortage of anybody like that. Imagine asking to create another unit within an agency that is already short-staffed. So I was given 10 minutes, and to the credit of the folks that I was dealing with, the assistant chiefs and the chiefs, they said, “You got 10 minutes.” I said, “Okay.” I did my research. Now we have a bomb squad in Norfolk and there’s a lot of money that goes into it annually for the budget. And I said, “Listen, in the past 20-plus years, how many live bombs have we had?” ”Well, we blew up some guy’s book bag who left it at the mall and we found a fake pipe bomb in the last 20 years,” So a little giggles all around. I said, “Do you know how many officers killed themselves in the last 20 years— from my agency? Well, it used be 12, now it’s 13.” We lost another one about a year or so ago. Well, they kind of were like, “We can’t not do it. So we kind of create the momentum.

The problem that we have with agencies is sustaining it. So the science is there. We trust who we trust. We trust the doctors that are working within this field, the science is there. Convincing us is not the issue. It’s creating an atmosphere to where we’re allowed to enter and kind of bring it in. The problem is with agencies is that when I was creating this peer support unit, someone said it. One of the clinical directors I was working with said, “Chris, you’re basically building a plane while you’re flying it.” And I was like, “You know what? You’re right.” Because I’m trying to get the parameters to get this thing going. But at the same time, I have an officer coming in. And it runs the spectrum of the officer that’s venting for two seconds, or the officer that’s in crisis who wants to kill themselves and their family.

The research, which I’ve worked with a ton of folks —through IACP, through DOJ, and all that stuff. The research is there. The biggest push right now, for the resiliency and all that stuff—the resiliency works, we know this—is shifting that culture, making it okay. I feel redundant saying it, but it’s making it okay to do yoga because I got joked when we brought yoga into the police department. They’re like, “What are we going to have? Spin class?” That’s just cops like to complain. You give us $100, we complain it’s not in twenties. But it’s one of these things that we just need to shift it. It’s really promising that we’re having the newer officers that are coming in are—I think in my opinion in what I’ve seen—are more open to getting help. Or more open to talking about things, which is a really nice change. But then you have the salty veterans out there who will tell you, “Well, that stuff, you know, just suck it up.” Well, you know, you’re horrible. Your life is a mess, sucking it up hasn’t worked for you. So I’m going to try to something different. I’m going to try maybe not sucking it up and talking.

HOWARD SPIVAK: So let’s just carry on with that a little bit. What’s different about people coming into the profession now that there is a change in attitude going on? Why do you think that’s the case?

CHRISTOPHER SCALLON: I think it’s a different upbringing. I sat on the board for several years for new hires. I would ask a couple questions, but the one question I would always ask is, “Have you ever been in a fight?” Now listen, I grew up in Brooklyn and South America. And my nose didn’t get like this because… I’ve been in a couple scrapes in my time growing up by the military or otherwise. And resoundingly, no. I had one guy say, “Well, I got into a pushing match with my brother.” I don’t think their life experiences are the same that we experienced  growing up in in the ‘70s or ‘60s or ‘80s for that matter. So I think that we have a significant culture shift. Now it’s okay to be a little bit more emotional about it. When I first got on, they would test you to see how you would do. And if you showed any sign of weakness, you are isolated. You aren’t allowed to go to a unit, so you put on your best “I’m a grown-up” and you went to work. I think that’s changed, generationally-speaking.

HOWARD SPIVAK: Thank you. I want to turn to the researchers now. NIJ’s an applied research agency. So it’s important for us to be funding research in the field. We also know that research in the field isn’t easy and research in police departments has its challenges. Can you speak to that both in general, but also specifically around the issue of stress and trauma, and doing research. So Dan, why don’t you start?

DAN GRUPE: Yeah, so we’ve been working for about the past four years with the Madison, Wisconsin Police Department. It was really important to us when we started to do this work. We’re coming as outsiders. We’re from the university. We hadn’t worked in law enforcement before, just to come and be fully transparent about our motivations, about what we are hoping to get out of this, about the scientific knowledge we are hoping to gain, but also about the impact that we wanted to have for officers and for society more broadly. So we came in very openly, we spent a lot of time with that agency. We had a protracted period of time before we had funding to start doing this research. For scientists getting out of the office, getting out from your computer, getting in the field, going on a ride-along, going to in-services, going to have coffee with cops, it helps to build trust. The work that we’re doing is delivering mindfulness training and there is just kind of a cultural divide or some potential tension there. Those kinds of experiences allowed us as researchers, and also the teachers who are doing the work, to start to understand the culture, and the language, and to try different things out and see what works, and what doesn’t work.

HOWARD SPIVAK: I’d like you to speak a little bit about the research you’re doing now and what’s involved in it, and what your testing.

DAN GRUPE: Sure. I do think one of the big challenges generally is kind of this gatekeeper problem where you have a police agency that, for good reasons, may not want to engage with an outside organization if there is a lack of trust and if we’re collecting sensitive data. We’re asking officers, “Are you stressed? Are you depressed? Do you have relationship problems? Are you thinking about suicide?” These kinds of questions. So there is a lot of hesitancy on the part of officers and on the part of the agencies, and really a need for researchers to demonstrate that they’ve done their homework, that they really care about this issue, and that they are to be trusted.

So we have an agency that’s been super cooperative, Madison PD I think has been on the forefront of a lot of more progressive initiatives in policing over the past 30 or 40 years. And that really helps us get past what can be a real hurdle to getting into this work. When I look around at the, a lot of the researchers who do research in law enforcement—Dr. Violanti is an example—it’s a lot of people who have been inside of the agency. So for me, I don’t think I look like a cop. There might not be a lot of trust for the guy in tweed. So you really have to do that work to demonstrate, to build that trust. The work that we’re doing in Madison, I’ll just talk about quickly. We’ve been looking at a mindfulness-based training program to help officers work with stress and help combat some of these negative health outcomes that Dr. Violanti talked about.

HOWARD SPIVAK: Can you actually explain what mindfulness is?

DAN GRUPE: Yes. Absolutely. Because it gets bandied about a lot and I think everybody probably has heard the word and maybe has some different sense of what it means. Really at its core, the definition of mindfulness that Jon Kabat-Zinn who really popularized this and brought it to the West and kind of secularized some of these practices, mindfulness is paying attention on purpose, in the present moment, and without judgment. So it’s not thinking about the past. It’s not worrying about the future. If you have experienced difficultly, if you’ve experienced trauma, it’s not being ashamed of that. It’s not thinking, “I’m not supposed to feel this way. This is not the way that police officers are supposed to behave.” It’s looking at those feelings, or responses, or emotions, or whatever they are without judgment.

So that’s mindfulness kind of as a trait and this is something that we believe we can train. So, we have an eight-week training program, and I should take a step back and say there’s work that’s going on in Oregon for about the past seven or eight years. Mike Christopher is a researcher out there. Rich Goerling is a lieutenant in the Hillsboro, Oregon Police Department. They really pioneered a lot of this work. We’re following up on it now and kind of taking our own approach to it. So we have an eight-week training program where we are giving officers different very practical, grounded, embodied skills and practices that they can use to try to cultivate better present moment awareness, grounding yourself in the present. Breathing exercises, movement practices, things like yoga, related to tai chi.

We’ve been doing this work for the past two or three years. We’ve demonstrated our initial pilot study. A lot of the issues that we’ve already talked about. Officers report they’re sleeping better. Officers report they’re less anxious, they’re less stressed, less feelings of burnout. We recently showed that symptoms of post-traumatic stress go down after eight weeks of this training in police officers. In particular, one of the symptoms of PTSD that’s most prevalent and kind of relevant for law enforcement populations is hypervigilance or the sense of kind of always being on edge, always being on guard and it’s this tendency that’s really adaptive. If you’re going on the kinds of calls that we’ve talked about where threat is real and you need to be prepared for it, but it’s not an adaptive trait, you go home and you’re hanging out with your wife and kids. Through this kind of training in mindful awareness of the present moment, we think that we can maybe allow people to recognize whether the way that you’re responding in a particular situation, the way that you’re holding your body, the way that you’re breathing, kind of the thoughts that you’re having, are those adaptive given the current threat situation, and it seems like that’s something that we may be able to shift with this kind of training.

We’re currently doing work funded by the NIJ. We’re in the middle of a two-year randomized controlled trial where we’re following up on some of these early improvements that we’ve seen and now we’re starting to look at some more objective biological and physiological outcomes. So Dr. Violanti’s done a lot of work on post-traumatic stress, cortisol responses in police officers. One of the things that we’re looking at is the potential impact of this training in mindfulness on cortisol reactivity, and we’re looking at inflammatory markers, which are a risk factor for cardiovascular disease. We’re looking at sleep objectively using wearable devices where we can track the actual amount of sleep time, really trying to dig into some of those more biological, physiological outcomes to show this is all part of the same situation. It’s not like your mind and your body are two totally different things. So through this kind of training, we think we can affect some of these biological, physiological outcomes that are more proximal indicators of long-term disease in police officers.

HOWARD SPIVAK: John, can you speak to some of your experience trying to do research and I think particularly around post-traumatic stress disorder which, as common as it is, carries such a huge stigma that it’s an uncomfortable diagnosis for people to have. So, what’s been your experience in doing this work?

JOHN VIOLANTI: Well, I totally agree on the stigma. Again, we’re talking about the police culture here and how one should never appear to be weak. One should never ask for help because we don’t need the help. And developing PTSD, I think, is a shock to most police officers because they don’t expect to feel emotion and when they do, they don’t know what to do with it so they stuff it. And when they stuff it, it starts affecting physiologically as well. We did find some interesting things with PTSD which I mentioned before on the effect on health. Also we found that resiliency moderated PTSD in relationship with depression. So, making your people more resilient to PTSD, I think, is important. A lot of the sociological research tells us that it’s not that the resiliency—it’s not only in fact a personality factor, but it’s also social factor. What I mean by that is the organization essentially is a psychological safety net, if you will, to have that group of cohesive individuals who trust each other, that can help alleviate a lot of the problems with PTSD.

Post-traumatic stress disorder, again, I think Dan talked about cortisol, which is known as the stress hormone. Every time you’re under stress, cortisol is secreted through the, what we call the HPA Axis, which is sort of a system in your body. There’s a normal pattern in cortisol. It kind of it looks like a bell-shaped curve. When you wake up in the morning, it peaks during midday then it goes back down. But when you’re under stress, it sort of knocks the heck out of that pattern. What happens after a while if you have PTSD, what happens to cortisol is it loses the normal pattern and it becomes dysregulated. Now we’ve seen officers out there with, instead of a bell-shaped curve, they have a flat liner curve in cortisol. They have cortisol that goes down instead of staying up. It’s this regulation of cortisol, the stress hormone, which can open the body up for disease and that’s what happens. So, that’s why when we look at PTSD and we look at cardiovascular disease and inflammatory markers from blood samples and so forth, we see an increased risk for cardiovascular disease. We look at things like artery health. We can measure this by the way with ultrasound. We look at the carotid artery, which are your arteries in your neck, which when they get plugged up, you can have a stroke. All of these various artery factors are affected by post-traumatic stress disorder and chronic stress, and it all comes back to cortisol and it all comes back to dysregulation of all systems in the body.

I think mindfulness is a great find and I love the idea of mindfulness. I think it’s finally going to help police officers to get out of that mode of being hypervigilant all the time, to always thinking about the horrible things they’ve seen, which is hard to do. It’s really hard to do, to get them in the present moment, to get their minds out of what’s going to happen tomorrow and to give them a chance to finally relax in their own time. That’s a good intervention and education’s a good intervention. The thing that worries me about PTSD is that we do not know how many officers have PTSD. We do not know. We cannot go out there and diagnose 950,000 police officers in this country to find out if they have PTSD. The small studies that are accumulated tell us about 15 percent, but who knows? I think this is something we have to figure out.

Secondly, we don’t know how many officers out there commit suicide or die by suicide. We guess. We estimate. We think this. We think that, but we don’t know. That’s another very disturbing factor for me. How are we going to find this out? We need a central reporting system, some kind of reporting system like the FBI has, to log suicides. What’s the scope of the problem? I don’t know, nobody knows. It’s scary. Post-traumatic stress and suicide are related. We know that from the big studies in the military. Now studies of like five million veterans found veterans that had PTSD had like almost a 3.1 fold risk of suicide. These are all statistics and they’re statistics. So I guess then my view is, well, we need to look further into this to get a nationwide view of what’s going on here. We just don’t know.

HOWARD SPIVAK: Thank you. So Wendy, there’s clearly a growing understanding of the interplay between environment and experience and our bodies and our biology and our neurological function. How well do you think cops understand or know this and how can we better enhance that understanding?

WENDY STIVER: So I think it’s a good time to talk about leadership. We’ve been talking a lot in policing about trauma-informed policing, and having a better awareness of the trauma that our victims and our witnesses are dealing with when we deal with them. I think it’s time to start talking about trauma-informed leadership, and recognizing that it’s the role of leadership to understand some of these things and push them out to our agencies because it’s not just about caring for the organizational spirit. It’s about caring for our communities because how we treat our police officers is going to be reflected in how they treat our communities and so it’s good for business. If we can do a better job of managing these things through leadership and push those things out to our cops, our cops will do a better job of taking care of the people in the communities. Coming from the military, I was raised in the military. I spent five years in the Army and I had the privilege to work for some pretty cool generals. The one thing that I was taught during that experience was that if you take care of the people, they will take care of the mission.

So it’s important not just for our folks but to make sure that they’re doing a good job at their jobs. That they’re able to go out there and perform better in the field, to survive when critical incidents happen and deliver better services to citizens because if we’re more presently aware of what’s going on around us, we have better situational awareness. We can do a better job of what we do, because a lot of what we do is about remembering things. We listen to stories, we write them down, and we testify about them in court, right? So, a lot of this job really depends on sharpening those skill sets and applying them to the real world.

Part 3: Next Steps

HOWARD SPIVAK: Okay. That’s an interesting lead into a question I wanted to ask, which is, what can NIJ do to help advance this if understanding how to influence leadership is part of what needs to happen? How do we bring some science to that? I’m not just asking you, Wendy. I’m asking actually all of you at this point. How do we bring some science to that and what can NIJ do and what can research community do to help this.

CHRISTOPHER SCALLON: So you can try to find out what’s going on, and you’re right, doc, you don’t know who’s struggling and what’s going on. But in helping police officers or helping first responders come to the understanding—a very significant understanding—if you just want to treat the first responder, imagine taking your hand and dipping it in boiling oil, you take it out and you just treat the palm. Your hand is still messed up, right? The big piece that I think has been missing has been the spouse or the partner. If you’re not incorporating that into the program, which addresses how we respond to stress and anxiety and PTSD, you’re only treating the palm. You’re not treating the whole hand. I teach a class. It’s about three seconds long. It’s called “How to Destroy a Marriage,” and basically don’t talk. Because I talk to a lot of police officers around the country, I said, “Do you tell your spouse, significant other or partner about what you see day to day?” And the overwhelming response is “No.” And I’m, like, “Well, why?” The response is, “Because I don’t want to give that to them.” So I flip it around and I say, “Well, let’s say your spouse or your significant other comes home and he or she’s been pistol-whipped and robbed, what are you going to do?” “Well, I’m going to ask what happened.” “Well what if your spouse told you, ‘I don’t want to give you the trauma that I experienced?’” And they’re like, “Well, no, I would find out.” Well, see? We’re a little bit hypocritical that way and if you really want to know what’s going on with somebody, talk to their family.

I don’t know from a clinical standpoint but I’ll tell you from my experience, we go to get help, not to psychology or a psychiatrist. We don’t get mental health. We wait until it affects us physically and then we reach out normally to our general practitioners or we go there because that’s how I reached out. I had gotten to the point where I hadn’t slept in over two weeks and I had lost like 50 pounds in a month and a half. And I was like “I need to go to the doctor,” not like “Something’s wrong up here.” I was, like, “No, I need to go to the doctor because I can’t sleep.” Right? So I go to the doctor and I said, “Well, can you help me?” And he’s like, “Well, when did this happen?” I was, like, “Since the shooting.” He’s, like “What? Okay. Let me refer you to my friend that works at the psychiatric facility.” But the thing is, if you want to help, what NIJ can do, start focusing research—because it’s going to work. I’ll tell you, I can see the future—incorporating agencies to address both home and the individual that’s working within the agency.

I created a few years ago a spousal group. Coming back from Virginia Beach, I headed the debriefing response to the mass shooting that we had there. There was a spouse who turned on “Good Morning America” and heard her husband on the radio because “Good Morning America” will start taking all sorts of stuff, and that was her first exposure to her husband’s shooting. So what are we doing? Address home, make it just as much a priority as it is the job, and I’ll finish with this. When I first started this job, when I started working, I did 100 percent—110 percent of me was about this job. You couldn’t catch me without talking about something, doing with the job or that I’m doing that I’ve done, that I experienced and stuff like that. I don’t think we should lose that enthusiasm, but I tell folks, “You should have that much enthusiasm for home as you do at work and that’ll create a little bit better atmosphere.” When we start opening up that dialogue between the family members, it kind of bleeds over into work and it becomes okay.

HOWARD SPIVAK: Okay. So we’ve heard about an agenda of better understanding the family as part of the response. We’ve heard a fair amount about linking the physiology with the experience and with the treatment. What other things can we be doing in research? I’d like to hear from each of you on this. Dan?

DAN GRUPE: One really challenging issue if you’re studying stress is trying to distinguish between exposure to stressful events and one’s response to these events. I think there’s a role for technology and data that police agencies are already utilizing, to be able to start to answer some of these basic questions about the incidence of different types of events, officer’s exposure to different types of stressors, and then the subjective impact of those stressors. So agencies are collecting a ton of data on calls for service. We have access as researchers to every advanced and more discreet tools for monitoring physiology, activity in the field so I think if agencies are willing to partner with academics and if academics are interested and open to getting out into the real world and partnering with these agencies, I think there are some really cool opportunities both to do some groundbreaking research on these basic questions about stress, exposure to events, and their impact.

And also to start to get at some of these questions that we don’t really have answers for as far as what are rates of exposure and what are rates of prevalence of these disorders. So I think leveraging technology, leveraging the incredible amounts of data that are being collected, and then continuing to forge these kinds of partnerships with academia and subject experts.

HOWARD SPIVAK: Thanks. John, you’ve also talked about epidemiology a bit and getting a better sense of the incidence of suicide, as well the incidence of post-traumatic stress disorder. Can you speak more to some of that and what other things we need to be better monitoring, and counting, and understanding?

JOHN VIOLANTI: One of our most recent interests is shift work. What we want to look at here is how does one adapt to shift work as opposed to those who do not adapt to shift work? We want to look at the differences. There’s a statistical procedure called latent class analysis. In this procedure, what we do is we can find out by looking at people whether they’ve adapted or have not adapted by looking at physiological factors, various blood tests, and so forth. Then maybe do some focus groups on officers to find out how they do it to get some real-life experiences from that.

We want to look at the DNA in people who can’t adapt to shift work and see what the problem is there. The whole goal of that is simply to find those people who do adapt well. What’s the big secret? Why do you adapt better to shift work than Joe Smith? There are various variables we can look at. Some people call them morning people. They do better than night people, or night people do better than morning people, and so forth and so on. But we’re looking at a cluster of variables to try to figure that out. If we get a good answer, we find out how people adapt well to shift work, we can put that out there.

Another thing which kind of bothered us too was -there’s a tremendous number of studies out there, on everything in shift work. We want to do an expert panel sort of review, a best evidence review of all of the work that’s out there, thousands and thousands of articles to kind of isolate what the best possible studies are, and to take those studies and apply them to adapting to shift work. Those are two new ideas we’ve just come up with recently and our colleagues are working on that.

As far as suicide goes, I don’t know what we can do with that until we know further how many there are. But I think prevention, education, telling people about the signs of suicide, educating middle management people about suicide, very important. Who do you go to first? You go to your sergeant? Peer support people, I think Chris has a good idea with that. I’d rather go to another officer to talk than I would to the psychiatrist who lives next door to the commissioner. We don’t want to do that. I mean police officers don’t particularly trust outside people. They’d rather go to another officer first. That officer can have a network to professional mental health people who he or she knows they can trust and send the officer there if they need it. So getting rid of the stigma is very important, it’s rampant. Nobody wants to come forward and say, “I’m sick. I have a mental health problem.” So we need to deal with that stigma. That’s the thing that’s blocking most of the help, and that’s the reason people are stuffing it and going into the ultimate act of suicide. Chris was right, you bring people in who have succeeded in dealing with the problem. Those are examples to officers that this is the way to do it, this is how I can get help. The organization needs to understand that mental health is, for lack of a better term, a disease. I mean, if I break my arm, is that the same as having depression? If you look at the disease model of mental health, then it is. So that needs to be better understood. Hopefully we can move in that direction.

HOWARD SPIVAK: Wendy, you’ve been a LEADS scholar. You’re now doing a residency at NIJ, what would you like to see begin to advance in better understanding this issue, and integrating more science into practice here?

WENDY STIVER: I think in this particular topic, we could build an entire research agenda around it because it’s foundational. All of the other things that we’re researching and looking at in finding ways to improve policing may not necessarily have much of an effect or an impact if we lose our people, if we don’t take care of the people doing the job. I think that that is huge and bringing in more practitioners together with researchers to better understand this.

I’ve spent the last two weeks here in the building reading journal articles about some of these things and I feel like I’m swimming against the ocean. I’ve gone a little bit crazy with this. So it’s going to take a lot more than just a couple of us working on this together. I think that expanding on the knowledge and building bridges using programs like LEADS to make--like I said, we’ve got to make this stuff more tactical and practical. We’ve got to find ways to bridge the research to real life so that cops understand that there are tools that we can use coming out of the research. I go back home and I was given just a few minutes at a staff meeting to talk about this. And then I looked around the room and there were just blank stares, right? Even with the amount of work that I’m doing on it and the amount we’re talking about it in my agency, there’s a divide that we’re going to have to figure out to bridge. And LEADS has been a phenomenal experience in doing that. It is a delightful experience to be able to get together with some of the smartest cops in the country and have these conversations, and then work together to figure out how we can push things back to our agencies. So it keeps growing and it keeps getting better, and we definitely need more of it.

Questions and Answers

RACHEL ANDERSON:  Rachel Anderson. I am a AAAS fellow at the National Institutes of Health and former fellow here at NIJ. I've really appreciated listening to your discussion this morning. One thing that I didn't hear anyone mention was substance abuse. I'm sure most people here have the same sense that coping with stress and trauma is often cited as a factor that drives alcohol and other substance use. And in particular, chronic alcohol use disregulates brain stress systems and exacerbates symptoms of stress-related disorders like PTSD. So I'm hoping that some of you might have some comments on the need or experiences that you've had with preventive efforts or treatment interventions for substance abuse, for individuals in this high stress profession.

CHRISTOPHER SCALLON: That's my day to day. So here's the deal with substance abuse. It's a symptom. And often agencies focus on the symptom. I know you probably never heard of it but there's been a cop once or twice get a DUI. We immediately treat that as a, oh my God, he messed up or she messed up, blah, blah, blah. We're not asking the right questions. We should be asking, wait a minute, why at 10 o’clock in the morning did this officer crash his car and is drunk? Why? Not what's wrong with him but what's happened to get us to this point? The big thing with substance abuse is that there's such a stigma associated with it and in getting treatment but that's not even the worst of it. We don't have the facilities or we don't have the knowledge of where to go when we need to get help. There's a great example of an officer that came to me. Well, we went to his house at about 3:00 in the morning because crisis never happens at noon. It's always like 3:00 in the morning. We sent him to a facility. A nationally recognized facility. Our insurance covered all but $500 a day. And so 20- 21-, 28- 45- or 90-day stay, an officer is looking to come out-of-pocket anywhere between $10,000 to $50,000.

Now here's the other side of it. We need to have facilities that are first-responder savvy. Now imagine sitting in a group because when you go in to inpatient work, you'll be doing group work and you'll be doing individual counseling. So imagine sitting next to somebody and they're like, "All right what's going on with you?" "Well, I grew up being abused by my mother. I wound up stabbing my stepfather in the face. I started drinking to cover it up and next thing you know, by the way, I'm getting ready to serve 18 years if I don't complete this program and my roommate woke me up and I thought it was my mom, so I stabbed him." "Okay. Well, thank you. What's your name?" "Hi, I'm Chris. I'm a cop." Yeah, that's going to be the best most awkward setting. In order to get healthy, in order to become sober to get through the recovery process, you have to be honest and no cop is going to be honest sitting next to somebody who they find themselves more adversarial.

HOWARD SPIVAK: Other comments?

JOHN VIOLANTI: That's funny that, in terms of research, stress and alcohol abuse are co-morbid. They occur a lot quick. In one of our research projects, we looked at that and what the effect was on suicide ideation and if you had high levels of stress and you had high alcohol use, you had a tenfold risk of suicide ideation. So all of those things are kind of a nasty triad that people involved in alcohol are at higher risk for suicide as well.

HOWARD SPIVAK: So from what I'm hearing, it sounds like we need to deal with the substance abuse in a bigger context and not just focus on the substance abuse itself?

CHRISTOPHER SCALLON: Yeah, the substance abuse is a result of some underlying trauma or cumulative trauma or whatever it is. If all we're working on is to get to somebody to stop drinking, we're missing the boat completely. We need to fix it and the best way I'd describe it to folks is it's that we have a cup that starts empty and then we put trauma in it. And it starts getting filled up a little bit, maybe a big splash. And eventually it starts overflowing. Well, the overflowing is the suicidal ideations. The overflowing is the DUI. You're trying to self-medicate through whatever whether it be pharmaceuticals which I've experienced. So if you just pour it out, yeah, sure, your cup is not overflowing but how long is it going to take for that cup to get filled up again? So what that involves with the academic side of it and the mental health side of it is dumping that cup out. That means addressing the underlying trauma. It's unique for where we are in specific parts of the agency. In other words, there's a pretty coincidental thing that happens. A lot of like sexual assault investigators have a history. Understanding that maybe they need to address that before they start going over the top or falling over.

HOWARD SPIVAK: Great. Thanks. 

STEVE BISHOPP: All right. . Okay. So I have a couple of comments and suggestions particularly that deal with research. And then a question for John Violanti. My name is Dr. Steve Bishopp. I'm a Sergeant with the Dallas Police Department. I've been there right at 29 years and I’ve been involved in quite a bit of research of my own in officer mental health and use of force so that's where these questions are coming from. Anyway, so I'll start with Dan. When you were talking about mindfulness and some of the programs that are going on, I was also going to just let you know or make you aware that the University of Texas of Dallas brain centers, brain sciences is also doing a lot of work in that area and doing programs with the Dallas Police Department and some other agencies. That might be a resource or somebody to reach out to see what they've done as well. I don't know if you're aware of that. You can't always be aware of everything going on but I was just going to tell you that.

But I wanted to address a little bit about the resiliency part and this is for Chris as well, I think resiliency starts at recruiting. So if we have recruiting measures where we're finding people that are already emotionally healthy. Are they married? Are their relationships going well? What past have they experienced in college, victims of serious violent crime. I'm not talking about these, mixing them out. But this would start the resiliency issue and having people resilient coming into the job in the first place.

Next, I think Wendy, we talked about this before that sergeants are probably the most important people when it comes to officer resilience. I've been a sergeant for 19 years, so I'm particularly focused in this area. But I believe sergeants have probably the biggest impact on whether the officers come to work and want to work, feel like they're supported by supervision. We find that that variable consistently in the mental health research of stress-related issues with officers that their relationship with their supervisors is one of the biggest organizational stressors that they're going to come across.

But anyway, I wanted to make just some points about resiliency and the mindfulness training which officers who go to it—even if they are reluctant to go to it—they're coming out of it saying, “Hey, that was some good stuff. I can use that. I wish I had had that before.” So I'm just repeating your call to that because I think you're right. I guess back to John. One of the things I wanted to ask you to do, if you could talk just a little bit about your study on the life expectancy study— the one I emailed back and forth with you about awhile back—because I think that more than anything else really hammers home the physiological impact of stress on police officers in the life expectancy of police. I'll cut it off there. I had a bunch of notes but I'll leave it go at that. But I would like to hear about that and see what you had to say.

JOHN VIOLANTI: Thank you, Steve. Well, the news isn't good. I mean, look at our Buffalo sample. I'll start with that and then talk more about what we did with that. We did a police mortality cohort, which is a study of a group of police officers from 1950 to 2015. We looked what officers died from and so forth and so on. The lifespan for that particular cohort was 68.2 years. Now the average lifespan for white males, by the way, in the United States is probably around 78, 79—somewhere in that area. So they're dying at a much earlier age and they're dying more, as I mentioned before, from heart disease- and cardiovascular disease-related deaths. The other part of the study compared that sample with the national sample of life expectancy in the United States. What we found that at various ages, police officers were always at greater risk for dying than was the general population. An example between the ages of 15 and 55, they had a 40% greater chance of dying than did the average citizen in the United States. As they got older, of course, they had a greater chance of dying.

But the really interesting thing about that is that the younger officers had an increase of dying over people in the general population and dying of cardiovascular disease. So what causes a young person to have a heart attack or having some sort of a cardiovascular malfunction? Well, again, lifestyle, stress, police officers putting up with this stuff, what they put up with every day. Now the stress in policing is only one factor, what does that affect? It affects your diet. It affects your health. It affects your sleep. It affects your life. So all of these things together decrease the life expectancy of police officers. How do you stop that? Well again, wellness issues are important. Getting people well, getting officers well. Training them to be well. How to sleep, how to eat, how to deal with stress, use mindfulness, use yoga. Use what you want. But my gosh, take care of it. But yeah, it's unfortunate that they die at an earlier age than the general population.

CAITLIN THOMPSON: Hi. Caitlin Thompson with Cohen Veterans Network and prior to my work there, I oversaw the suicide prevention program for the Department of Veterans Affairs. I'm really interested in hearing Major Stiver about your experience in terms of being a veteran as well as just what research is being done for our veterans who are also going into law enforcement. I know that there are so many similarities, the sleep deprivation, the family difficulties, the substance abuse, et cetera, et cetera. So what is being done right now to better understand that and just overall what are your thoughts in terms of the overlaps? Thank you.

WENDY STIVER: I was in the Army in the '90s before a lot of the changes happened after 9/11 that led to increases in deployments and things like that in the military. And a lot of my friends who were still in the military have been deployed five, six, seven times or just even being deployed once when I was in the military was rare.

In some of my exploration here, what I found is when we talked about family support, the military already had kind of some of those concepts built in in terms of taking care of soldiers and their families or airmen and their families. As a kid growing up in the Air Force, we were very well-cared for. My dad deployed, my dad went on unaccompanied assignments and was gone. So we had great support networks that were already there back in the '70s to give away my age.

Then kind of about five years after the invasion of Iraq, the military really started looking hard at resiliency and how to build more resilient workforces because suicide numbers were going up and they were noticing the need to improve on the systems that were already there. I think that's what we're seeing in police now, and I think some of it is coming over and we're learning, or we have the ability to learn from some of the things that the military has done to build. There's a whole Air Force office of resiliency. They've got a whole group of people that are working on this. So the challenge is going to be building that into the operational structures of police departments at a time when we're struggling to recruit, we're struggling to meet our operational commitments. And I can tell you that when it comes to doing research and bringing that back into our agencies, one of the biggest challenges is that nobody has the capacity because any kind of project is viewed as a threat to operational resources. So we take a police officer away from policing to work on a project that might help us out in the long run, but we're taking a police officer away from policing. I think that's one of the big challenges.

But I have seen where the VA and the military have been looking very closely at and studying suicide and the impact on both active military members and veterans. That's a huge part of our recruiting pool. We're bringing in a lot of people from the military into policing so the better work that you're doing in the VA and the better work they're doing in the military may have some impacts on what we see in policing as we move forward.

DAN GRUPE: Just on a related note, a quick follow up. One of the teachers who teaches our mindfulness class, Chris, does a lot of teaching and coaching inside the VA too and made me aware of this whole health initiative that the VA has been rolling out, which is really a philosophical shift that puts the individual and health promotion at the center of healthcare as opposed to disease management, and is a personalized approach that integrates a lot of things we've been talking about, mindfulness, sleep, hygiene, nutrition, relationships, spirituality. But it's really person-centered and asks the veteran what matters most to you and how can we develop an individualized plan of health to promote those things that matter to them. So, I think it's something for law enforcement if they're not already looking at it, to take a look at this model.

HOWARD SPIVAK: Right.

JOHN VIOLANTI: Okay. I just wanted to add that I think one of the important things to consider is the reintegration of people coming back from war, from Afghanistan, into police work. If they were officers when they left and they went to war, and they came back, there's quite an adjustment coming back to the job of being a cop again. Things are different in the streets in Baghdad than they are in the streets of Detroit. Well, it's close but, [laugher] they're different. And different modes of dealing with people so there needs to be a reintegration process and I think most departments are doing that, a re-training, a lot having to do with driving and shooting, and everything. It has to be kind of be learned all over again. Because the military way of doing things in combat is quite different.

DR. LESTER ANDRIST: Great. Thank you for this panel. It's been really informative and excellent. I'm Dr. Lester Andrist, Director of The Public Safety Leadership Administration Program, Professional Masters Program at the University of Maryland. We have this focus on leadership for law enforcement, and other public safety officials. I just wanted to ask from any or all of you if you had one suggestion for changing organizational culture, just one implementation, something that we can implement. I think that's a huge question but I think it's a really important one. Other than just sort of rounding up people in a classroom and saying, “This is important.” Is there something that you thought about that could make that change?

CHRISTOPHER SCALLON: I do a lot of speaking at different universities. And it's always interesting when you come across a criminal justice major or something like that, who knows everything. I think the best thing you could do and what helps any organization or people learning about it, is to be honest. Here's the bad part, being honest about what we do isn't always pretty. There's a picture. Everybody wants to be a lion until it's time to do lion stuff, and then it gets pretty ugly.

I spoke with a friend of mine, a doctor who's over here at Old Dominion University, and we used to repeatedly go there. And I would tell them about the struggles. I would tell him about how hard it was to deal with certain things that I saw and how that stress affected me in doing investigations. We talk about how many children can you see physically, sexually molested to the point where they need hospitalization? I mean, how many times can you see that before you're starting to get this distaste for what humanity does to you? And again, it's just cumulative on top. That's just one thing on top of 13 others. If we allow ourselves to be real and understand that, “Hey, we have problems on our end.” Until we start recognizing that, we're not going to change anything.

You go to any agency, I always ask, "Hey, how many drunks do you have in your agency?" And they're like, "We have a couple." No, you don't. No, you don't. ”How many of your folks have thought about suicide?” "Well, not that many." “No. It's a lot. I'm here to tell you.” We have to be okay with saying it, I think ultimately.

WENDY STIVER: Yeah. I think when you talk about changing the culture, that's a really, really huge order. But there are a couple of things there. One is, I had the privilege to go down to Columbia, South Carolina and meet with some folks at the Richland County Sheriff's Office. And Sheriff Leon Lott there has done some pretty impressive things with changing the perception of that agency when it comes to the stigma of PTSD, and the things that his people have encountered. He let me sit in a room with these folks and just listen to their stories all day, and they were very patient and kind, and giving in that way. But they made it very clear we talk about this, and we talk about this openly with everybody in the agency when they come in the front door. So that's kind of helped to change the way they perceive it.

I think the other thing and the other big thing is diversifying our agencies and not just bringing in people of different cultures and backgrounds and races, and expecting them to conform to the organizational culture, but allowing them to bring their own culture into the agency. My agency just graduated from the academy, one of our first African immigrant officers. It was a big day for us and it was a big day for him. He's from Burundi. He brings a whole different culture and different ideas to the agency. I think we don't just expect him to conform but celebrate what he brings to the table. In the United States, we're looking at an average of about 12 ½ percent women in police agencies, right? We know that women bring different cultural perspectives into this job that can help change the way we think about things. So, I think that's really, really important. We've been working on it for a while, just in broad terms of diversifying our agencies, and it needs a lot more work because there's not a whole lot of research on how to do it better and what works and what doesn't.

HOWARD SPIVAK: Thanks. We're running out of time and I want to give the last few people a chance to ask questions, so...

ELIZABETH MUMFORD: Hi. My name is Elizabeth Mumford. I'm with NORC at the University of Chicago based here in Maryland. I want to just take this opportunity to thank NIJ and some people in the room who supported a national-level study of agencies and officers in terms of safety and wellness. So we have collected the agency level data. We've closed the cross sectional first wave of the officer data, and we got additional NIJ funding to follow up. We're really hoping to expand the sample.  We have the right statisticians so we have really good weights and stuff like that, but it's a challenge to get agencies and officers to participate in these studies, where we're asking a lot of sensitive questions at the national level. But we're specifically doing this to bring this data to the table to raise awareness in administrative meetings and municipal funding conversations about what the extent of PTSD is, what the extent of resilience is in the officer population, how many of them are coming from the military and what are they dealing with in their personal lives. So, I wanted to put that out there and to ask if anybody is interested to please reach out to me because we certainly would welcome inputs.

On my own, I've also studied a lot of trauma-informed care in the last five years. I will stand up like I'm at an AA meeting. I come from a history of suicidality so I'm really sensitive to these topics and making sure that we all feel comfortable talking about it. I was on a panel with CNA about three months ago, and what was raised was the issue of the stigma if you have something like this on your record, you can't retire with your weapon. And I wondered if anybody wanted to comment on this because I hadn't heard of this before and this really shocks me that we're facing this insoluble situation of somebody feeling a need to retire with a weapon but fearing that putting it on their record is going to stop that.

CHRISTOPHER SCALLON: Yeah.

WENDY STIVER: Yeah, I know.

CHRISTOPHER SCALLON: Yeah. Yeah. That's a big issue. As far as retiring with your weapon, that's a new one. This is where the problem is from the top down. If I reach out for help and I say I have an issue. I'm drinking. I can't control it. I need help. Most agencies are fairly small. We're not dealing with large agencies. But I'm not getting transferred to any specialty assignment because I'm a drunk, right? There is no concept of somebody being in recovery. And when somebody's in recovery and they slip, relapse, that's part of the recovery process, they're penalized for it. They're penalized for it. —“Listen, we want to help our officers. That guy will never work in traffic.” They're talking out of the side out of their mouths, right? So, that's why you get a lot of people doing that. And as far as the gun thing, what I've seen happen is that somebody voluntarily go to get help. And then while they're receiving help, it becomes involuntary. And depending on what state you're in, for example Virginia. If you're involuntarily held at a facility, you can't have a gun anymore. So, it's not about even having a job anymore. It's done. It's over. But different states have different things.

HOWARD SPIVAK: All right. I'm sorry, but I just got a sign that we have to wrap up so I think we're going to have to close off questions. I was asked to do a wrap up on this and I have to say there's far too much that's been talked about for me to do that. But what I will do in closing is reference for all of you the fact that NIJ has on its website a strategic research plan for safety and wellness in this area. I think a fair amount of what we talked about today is covered in that. I think there are some holes that were pointed out today which are interesting that we'll have to think about. But I encourage you to look at that and we're certainly open to feedback from any of you if you review it and have any thoughts about it. So on that note, I want to thank our panelists. They're totally wonderful. Thank you.

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