are not built for continual assault and punishment without it having a long
lasting influence. Cumulative trauma
etched in the hearts, minds and bodies of our first responders like a stain
that spreads to engulf all of the good around them. If you have any doubts about this, just ask the
parents, spouses and children of law enforcement officers. They see their loved ones through a special
lens. Sometimes they can’t
label what is
wrong, but they can feel it. Go
ask the first responder in your life. Watch them deny any problems. “I’m just
tired.” “I just want
to have a few drinks
and relax.” “I don’t want to talk about work at home.” If you ask them to get
help they will most likely refuse because they are afraid of the stigma.
What will my peers, chief or friends say if
they found out? “Who will
trust me on
fact is no one can handle seeing a dead or injured child and walk away without
that face living inside them forever. Add
to that the daily stress required by dealing with a hostile public year in and
year out. The violence, hatred and
neglect that is experienced on many shifts makes a small cut each time.
Like a surgeon, they learn to stuff down
their feelings so they can do their job.
is the number one reason law enforcement officers forgo mental health checks
and suffer in silence instead. This
always to their detriment. No amount
pretending it doesn’t hurt or doesn’t have a negative effect on the mind and
body to see human destruction of the most unimaginable kind makes it true.
In fact, vey few go unscathed.
officers can fight criminals they can surely learn to fight stigma.
I participated in a discussion about the Guardian versus Warrior model for
police officers. Some suggested
officers used to be trained to be peace officers, but now that has changed and
they are expected to model military style behavior. What remains the same,
regardless of which side of the discussion you fall on, is the concept of
accepting that the mind and body are one. We are affected on all levels by
release of stress hormones accompanied by the visual memory of past encounters
as well as the minds propensity to imagine future assaults can cause
anticipatory anxiety, panic attacks, clinical depression, psychological
numbness, withdrawal, distracted cognition, avoidance and rage. Feelings of
depersonalization and derealization are also common. Additionally, the officer will become hypervigilant
and suspicious. These reactions, which result in an understandable and
defensible survival mode response, may cause behavioral manifestations which
are overreaction to minor events, aggressive actions toward the public, peers
and family members and in extreme cases the person becomes overwhelmed with
these ongoing feelings and resorts to suicide. While suicide is statistically
rare it still represents a devastating outcome to a treatable phenomenon. The result of this ongoing assault is well
documented yet stigma, still, unfortunately trumps science when it comes to
seeking appropriate diagnosis and required mental health care.
decision to avoid treatment due specifically to the concept of stigma has been
tested using three statistically valid measures.
These assessment tools were originally used to assess the attitudes and
behavior of an elderly population living in rural settings. The independent
variables were: 1. Isolated rural subjects. 2. Adjacent rural subjects. and 3.
Urban subjects. The dependent variables were the scores on the specific
measures. However these tests could be used with a law enforcement population
during the pre-employment evaluation to determine the subjects’ mental elasticity
and attitudes toward maintaining health regardless of perceived stigma from
internal and external influences and belief systems.
goal would be to narrow the selection process to specific candidates who demonstrated
mental flexibility and the willingness to undergo ongoing mental health checks
and /or treatment to maintain and develop personally and professionally,
without regard to the stigma of engaging in therapy as needed.
first test is called, Self Stigma of Seeking Help (SSOSH). It is a self-reporting measure where the
subject anticipates their own reactions in the face of considering seeking help
for emotional reasons. It taps into
subjects’ level of intelligence, the effect on their self-esteem and personal
sense of psychological adequacy. This short form has the candidate rate their
agreement on a list of statements using a series of ten statements using a
5-point scale. 1 (strongly agree) to 5 (strongly disagree). Scores range from
10-50 with higher scores indicating greater self –stigma. “The SSOSH showed
good convergent validity with the anticipated benefits subscale of the
Disclosure Expectations Scale and Intentions to Seek Counseling Inventory.
Internal consistency was adequate in the current sample ( = .75)”
As a result, our psychologists who
specialize in assessment could utilize this measure to help predict which
officers would be likely to seek help if needed and this would be an additional
variable to use during the initial selection process.
next measure is the Perception by Others for Seeking Psychological Help
(PSOSH). “The PSOSH consists
of 21 items
that follow the statement, ‘Imagine you had a problem that needed to be treated
by a mental health professional. If
sought mental health services, to what degree do you believe that the people
you interact with would …”Participants rated their agreement with a series of
statements (e.g., think of you in a less favorable way) using a 5 point scale
that ranges from 1 (not at all) to 5 (a great deal.) Scores range from 0 to 84,
with higher scores indicating levels of public stigma. The scores also related positively to the
scores on the Stigma of Seeking Psychological Health Scale.r = .31, p <
.001) and the (SSOSH, r = .37, p < .01)
The PSOSH was found similar to other measures
of stigma and also demonstrates validity for individuals experiencing stress,
indicating high internal validity and consistency. Internal validity for the PSOSH was excellent
in the current sample ( = .98)
This measure with its superior
performance would further identify officers that would be immune to the
reactions of others upon hearing that they were pursuing mental health
treatment. These officers would
likely to utilize therapy with the result being better overall health as well as
an increase in family harmony and an improved work life. These officers might also demonstrate better
overall resilience across the board.
third test is the Inventory of Attitudes Toward Seeking Mental Health Services
(IASMHS). It “measures an
of seeking psychological health from mental health professionals and assesses
perceptions of social contacts, including how one thinks family members, close
friends, significant others, coworkers and others would react if the person
completing the survey were to receive psychological help.” The three factors
measured are: psychological openness, help seeking propensity and indifference
to stigma. “Participants rated
with a series of statements using a 5-point scale that ranged from 0 (disagree)
to 4 (agree)”The current sample produced internal consistencies of (’s = .74-.83). This would also be
a good measure to use to support the information gathered from the other tests,
as multiple measures are always indicated when making high level decisions
related to public health and safety.
psychological, physical and situational trauma damages the whole person.
Stigma is just a word. Confront it and give
yourself a chance at normal relationships. Flexibility and openness in regards
to maintaining good mental and physical health allows for a long -term career
that is satisfying and pride producing.
It also allows for gratification and pleasure in the officers personal
life. The two build on each other and it’s a risk worth taking.
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D. L., Wade, N.G., & Ascherman, P. L.
(2009). Measuring perceptions of stigmatization by others for seeking
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