Magazine article Clinical Psychiatry News

Police and PTSD

Magazine article Clinical Psychiatry News

Police and PTSD

Article excerpt

Because of the nature of their work, police officers would seem to be prime candidates for the development of posttraumatic stress disorder. What is it about some police officers that makes them more likely to develop PTSD? What treatment approaches have you found to be effective for these patients?

Environment Causing Underreporting?

Exposure to trauma is inevitable in police work. Data show that one-third of police officers exposed to various work-related traumatic events develop significant symptoms of PTSD. In my opinion, the prevalence of PTSD is more common than has been reported. Several factors that may prevent police officers from seeking help or assistance include fear of denunciation, negative consequences on job responsibilities (such as losing one's weapon and a change of assignment), and perception of failure and personal weakness.

I have diagnosed and treated several police officers for PTSD who were initially reluctant to come for help in the mental health clinic. They all presented with the chief complaint of sleep disturbance, but after psychiatric evaluation were found to have significant symptoms of PTSD. Some refused to be labeled as having PTSD because of the fear of losing their job or a promotion.

In addition to psychopharmacologic treatment, I have found that PTSD peer groups are beneficial. Participation helps patients gain insight and understand that they are not alone. This helps to decrease the stigma and guilt associated with PTSD in police officers.

S. Faiz Qadri, M.D.

Omaha, Neb.

Taking on Too Much Responsibility

The most stressful moments in our world are borne by those with the lion's share of life's responsibility. At times we ask our heroes to be gods, and sometimes they forget that they are human.

We know that trauma places human beings at risk for PTSD. The less control you have over a situation, the greater the risk. What we sometimes forget, or perhaps don't want to remember, is that people assume varying levels of responsibility for their environments. People who take on the most, so to speak, tend to enter professions that will give them everything they ask for--and more. Sometimes it's too much.

Our icons and idols are evoked from the deepest cauldrons of our superegos--spirits with all the fortitude, conviction, and ability to stand toe to toe with the twisted fates.

[Unconsciously] taking on that persona, these men and women find themselves trapped and slowly constricted into an ideal. And as time goes on, the ideal receives more support than the human being.

Eventually something breaks it, and we blame a trauma. We look for a way to start putting the puzzle back together. We look for a way to make it right, but sometimes we have to understand that maybe it wasn't all right to begin with. And that's where I begin.

John W. Grace, M.D.

Crystal River, Fla.

Dr. Fink replies:

A police officer's job is extremely difficult, and the potential for PTSD is great. I don't have information about the number of police in the United States who get PTSD, but whatever the number is, I'm surprised it isn't higher.

Supposedly, a police officer should be trained to withstand the overwhelming types of trauma that may result in the onset of severe PTSD. Realistically, though, one has to look at a police force and not assume that all the officers on the force are identical to the one officer who lives in one's neighborhood. In Philadelphia, the force consists of more than 8,000 people who come from all walks of life with different histories and different levels of experience. They come from all classes and bring all of their prejudices, beliefs, and attitudes with them to the job, and they don't understand the mores and family structures of people who are different from themselves and their loved ones. Over the years, they learn a great deal about the communities where they work, but it takes effort and a will to change attitudes and beliefs. …

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