CONN – Let’s talk PTSD… or not?
October 19, 2015 By Stephanie Conn
We have become increasingly aware of the impact of chronic stress and trauma on first responders over the last few years. Due to anti-stigma campaigns and the courage of many to speak about their experiences, we talk about mental health issues more now than we ever have.
Overall, this is a welcome shift, and I hope it continues until the stigma is finally lifted. Despite the benefits, there could be unintended negative consequences to all of this talk. Are you still there? Bear with me and I will explain what I mean.
Some of the discussions about PTSD and other mental health issues in first responder work has been framed in a way that makes them sound as if it’s inevitable that you will develop them. I don’t doubt that the reason for the strength of these discussions is owed to decades of these issues being downplayed or ignored by others.
Mental health issues are still being downplayed and ignored, placing the onus of proof on persons who are already suffering. However, these discussions and some of the organizational responses may be unintentionally inflating the perceived incidence rates for these difficulties.
Organizational practices that send a pathology-based message (Do this debriefing/ training or you will get PTSD) are a disservice to officers who would otherwise be well with their own coping and wellness strategies.
Psychological research may also be adding to the perception of police officers being unwell.
Research with police populations, similar to the general population, has largely been disorder focused and deficit-based, highlighting difficulties instead of strengths. It offers us a skewed view of officers, their coping skills and their potential to be resilient.
The media also perpetuates the notion that police officers are not doing well. Consider the nature of news headlines. Which do you think would grab more attention: “PTSD rates in police are escalating” or “Only a small percentage of police officers have PTSD”? The last isn’t nearly as exciting. Exciting headlines sell.
The majority of first responders do not develop PTSD or other mental health disorders. This holds true even after recognizing that mental health issues are underreported in policing. Recent research (including my own) shows that officers are taking measures to cope better and have healthier lifestyles.
Many folks have come to my office, having read about a mental health difficulty, oftentimes informed by Dr. Google, and believe that they have one disorder or another. Oftentimes, their “symptoms” are normal responses to abnormal events and will go away on their own or with some small changes in thinking or coping styles. Unfortunately, I think this trend of “What’s wrong with me?” is exacerbated by insurance companies who require a diagnosis before they will reimburse for counselling.
With regard to mental health training and debriefings offered by police organizations, don’t throw out the baby with the bathwater. These practices are still helpful to many officers by empowering them with information that normalizes their responses and connects them to resources if they decide they need them. It is the manner in which they are offered that makes all the difference in the world.
When I offer organizational training and speak with officers and call-takers about reactions to traumatic events, I am cautious not to propose that PTSD or other mental health issues are inevitable. Instead, I alert them to the idea that they could develop PTSD, depression or burnout, given an abundance of risk factors combined with the absence of protective factors.
There isn’t a magical formula as to which risk and protective factors evolve into PTSD. It is a highly complex and individual situation. Risk factors include lack of social support, history of traumatic events, the perception of threat to life during the incident, coping styles and even genetic susceptibility. Aside from the absence of risk factors, some protective factors include the presence of social support, positive personalities and an overall satisfaction with life.
It is also important to remember that police officers can develop PTSD or another mental health issue and still be resilient. It is this resilience, coupled with support, which will allow them to heal. As I have said before, resilience isn’t something you have or don’t have, it is a process that you commit to every day. It requires making the decision that you will take care of yourself and then doing it continuously.
I am not proposing we stop talking about PTSD and other mental health issues affecting police. I am proposing that we also discuss the resilience demonstrated by those afflicted with these issues and the resilience of their fellow officers.
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