It’s been a little over a month since the killings of five law enforcement officers, four of them from the Dallas Police Department, and Lt. Alexander Eastman is on the lookout for its impact on the mental health of the force.
Eastman, a trauma surgeon at UT Southwestern Medical Center, DPD SWAT member and the department's deputy medical director, said that the response plan to deal with psychological trauma had to be scaled up "for something that was previously unheard of."
Though Chief Brown considered it, there’s no mandatory counseling. If they choose, police officers are able to seek out confidential counseling with any of the in-house psychologists or the 35 peer-support personnel. There are several 24/7 hotlines officers can call if they experience a mental crisis. DPD personnel are also free to seek counseling outside of the department. Any of those services received would be confidential.
Ensuring mental wellness has long been an under-appreciated task for the heads of police agencies. Displaying stoicism is deeply ingrained in the professional culture of police officers and other emergency-response personnel.
Eastman and Deputy Chief Christina Smith, who is spearheading the effort with Eastman, said that the department's current practice requires officers involved in shootings on duty to have a psychological screening afterward with one of the three in-house psychologists. But these screenings are no replacement for treatment, and Eastman said only a “tiny fraction” of those who are screened after an incident follow up with therapy.
Many receive solace from others on the force. “I know for me, in the 18 days after (the shooting) where I didn't have a day off, I spent a lot of time with my peer workers with the SWAT team,” Eastman said. “There was a ton of informal therapy that went back and forth by being together. I think that’s really important.”
The use of psychological first aid, a combination of peer response and evidence-based practice is a way to intervene before problems manifest, Eastman said. The program was developed after the 9/11 attacks, in which 72 responding officers were killed.
“We’ve pushed some training out to every department supervisor to say here’s what you look for, here’s how you handle it, here’s when it crosses over from being a normal reaction to a stressful situation to something that might need some intervention,” Eastman said. “I think we have a great platform by which officers and supervisors look after each other. ... We would like to intervene before we ever hit the PTSD phase.”
However, studies show that professional intervention greatly helps those struggling with issues like post-traumatic stress disorder, depression and alcohol abuse. These problems can appear years after a catastrophic event, something that departments are likely not prepared for.
A report released in April by the National Alliance of Mental Illness and the Office of Community Oriented Policing Services, found that few departments have long-term mental health care practices in place. Called “Preparing for the Unimaginable: How chiefs can safeguard officer mental health before and after mass casualty events,” the report was compiled after the mass shootings in Newtown, Connecticut, Charleston, South Carolina, and San Bernardino, California.
“Cumulative PTSD can be difficult to treat because you’ve got so much to deal with,” Sergeant Andy O’Hara, a retired California Highway Patrol officer, wrote in the report. He has witnessed horrendous accidents with decapitations and dismemberments, responded to murders and suicides, seen injured and abused children and faced assault throughout his career. “I compare all the things that happen on a regular basis in police work to bee stings," he wrote. "One is tolerable, but as they build up, the pain becomes overwhelming.”
The traumatic death of one of his officers was the last straw. O’Hara became suicidal. He was hospitalized, which later led to regular therapy. “You don’t cure PTSD; you learn to manage it,” O’Hara wrote. “It never occurred to me to get into therapy during my career; I had never even heard of therapy. But it works pretty well. If I had gotten therapy back then, I might not have had to retire.”
The report aims to show that the long-term negative outcomes from a traumatic event can be managed or avoided entirely by “building a resilient agency, promoting healthy coping strategies, and providing proactive support from a mental health professional.”
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Eastman thinks DPD can lead the way in developing best practices for long-term impacts of traumatic events. A key aspect, he said, is borrowing the concept of resiliency training from the military.
“Certainly the Navy SEALs people hold up as the hallmark example because they build resiliency training into every level of the organization,” Eastman said. “We’re not Navy SEALs, but we’ve tried to build in some really good resiliency training at every opportunity we get, everything from the police academy to ongoing training to beyond. ... I won’t begin to tell you I've got it all laid out yet, but we’re not too proud to steal from people who have shown us the way.”
The hurdle commanders in the department are working on now, though, is combating the stigma of talking about the psychological impact of being a cop.
“Emotional reactions are normal. It’s OK to be upset, it’s OK to cry, it’s OK to feel anxious,” Eastman said. “There will be triggers as we go on. It crosses the line when you can’t eat, you drink, your family relationships or other relationships are struggling, your work performance is struggling. Police officers are people too. We’re trained to fight through and work through some of those normal emotional reactions to not have a degradation in our performance out there, but the piper has to get paid at some point.”