Post-traumatic stress in frontline policing

Gill Scott-Moore
Chief Executive
Police Dependants’ Trust

“We need to get to grips with posttraumatic stress in frontline policing.”

In November 2016, the Police Dependant’s Trust published its report, Police Injury on Duty. This followed completion of the World’s largest independent study into the experience of injury of both serving and former police personnel undertaken by the University of Surrey and funded by the Police Dependants’ Trust. As well as highlighting that over 80% of police officers and frontline staff will be injured during their career, it also identified that over half of all injuries sustained in the last five years included psychological injury as a direct result of their policing role.

While the risk of assault or threat in policing is the highest of all occupational groups (and five times above the average), wider research tells us policing also has some of the highest levels of occupational stress, with over 46% regarding their work as very or extremely stressful. Policing is one of the toughest jobs around – organisational stress, critical incident trauma, shift work, relationship problems and alcohol abuse are five prominent risk factors commonly associated with policing – unfortunately, they are also five of the most prominent factors found in suicidal ideation.

There are 48 police forces in the UK, with varying approaches, methodologies, and attitudes towards psychological support for frontline officers, and Police Injury on Duty showed that the current approach is not working with 86% of participants calling for more mental health support.

This is why the Police Dependants’ Trust organised this conference on Post-Traumatic Stress in Frontline Policing – to establish what gaps currently exist in the knowledge and management of trauma in UK Policing, and to identify the priorities for the service going forward.

I would like to thank all 120 delegates – police officers, occupational health professionals, medical advisors, Police and Crime Commissioners, the Home Office, police charities and psychological and clinical experts – who participated in this conference, and for making their recommendations which are summarised later in this report. I’d also like to express my thanks to Lancashire Police for providing the venue and facilities on the day, and to broadcaster and journalist Alastair Stewart without whom the day wouldn’t have run so smoothly.

These recommendations will be submitted to the NPCC and College of Policing to help develop a strategy to tackle posttrauma stress in frontline policing. This is not the end of our involvement in this process. The Police Dependants’ Trust is committed to reducing the risk of trauma related stress and long term psychological harm in UK policing.

Expert views

Priorities for the service

The afternoon session of the conference was devoted to identifying existing gaps and establishing the priorities for the service as a whole to tackle post-traumatic stress in frontline policing. Facilitated by broadcaster and journalist Alastair Stewart, a lively and open discussion raised a number of issues and agreement on some key
gaps and priorities.

There were examples of good (and bad) practice identified across the country, but the approach appeared to be ad-hoc and fragmented. It was agreed that the overarching gap was a lack of clarity on the existing National picture. There were also questions raised around the efficacy of these various interventions from a clinical perspective.

When looking at the priorities, over fifty different responses were provided, but five key themes came from conference delegates as priorities for action – the main one of which identified the need for a culture shift within the service and its attitudes towards mental health.

Whilst delegates accepted that exposure to trauma will always be prevalent within modern policing, those who are most at risk of experiencing post-traumatic stress can and should be better prepared and supported by the service at an individual, team, force, and service level. Given that frontline policing is often response
driven, there was a feeling that the potential risk of trauma can, for the most part, be identified prior to exposure.

From the Police Injury on Duty report published by the Police Dependants’ Trust, it is clear that a fear of not being believed or being badly treated results in people opting to suffer in silence. Whilst campaigns highlighting that it is “ok to talk” are encouraging, the underlying concerns about being believed or being badly treated
remain which sees the risk of suffering trauma related injury increase over time.

For individuals, it was highlighted that techniques to better manage their own mental health were not routinely available, and were hit-and-miss nationally. It was also identified that of the limited resources available, almost none of them were designed to specifically address the needs of frontline policing. Instead, programmes like TRiM, a programme created for military use within an overseas theatre, are being relied upon.

It was agreed that there should be training and targeted support for individuals to improve their own resilience and ability to process trauma, and they should have a means of being able to monitor their own mental health on an ongoing basis

It was noted that sometimes individuals are not best placed to recognise when things might affect them, or are in fact already doing so. There is a key role for supervisors to play in ensuring that staff are taking care of themselves but they often do not have the time, knowledge, training, or confidence to be able to effectively approach this, and are dependent on generic initiatives that do not reflect the specialist nature of modern policing.

Delegates recommended that training for supervisors be made a priority, and that it be done so under a national framework such as those provided by the College of Policing. This should be supplemented at force level with specific training relevant locally that is regularly updated and refreshed.

With the introduction of the Bluelight Wellbeing Framework, there will be a need to consider the specific mental health needs of employees, including a mental health risk assessment. This new framework provides Senior Management Team (SMT) with the opportunity to introduce effective screening for at-risk positions. This can not only identify those most at risk of experiencing posttraumatic stress but also enable leaders to put in control measures to reduce the impact.

Delegates highlighted numerous examples of officers being sent to multiple high-risk trauma incidents in short-time frames, and whilst they accepted that operational circumstances will mean this is sometimes unavoidable, it was suggested that mandatory steps to ensure the wellbeing of officers should become part of the routine
response.

Finally, it was recognised that the service as a whole needs to develop a joined up approach to tackling trauma exposure and posttraumatic stress in frontline policing. It is unsustainable for there to be 48 forces across the UK all running different services using different screening and care pathways. Similarly, there was a view that the lack of a universal pathway for diagnosis and action relating to PTSD within the service is having a serious and detrimental effect on individuals.

Unlike the NHS providers or the military (both have a NHS provision provided under contract), there is a reliance on the standard NHS care pathway for police. Instead of being offered referrals within 48hrs and treatment within 28days, in some cases police are facing referrals exceeding eighteen months.

The Seriously Injured Leavers Protocol (SILP) and dedicated Veterans and Reserves Mental Health Programme (VRMHP) are there to support the mental health needs of former armed forces – no such provision exists for the police, despite higher numbers needing this type of assistance.

Andy Rhodes
Chief Constable
Lancashire Police

Chair, Organisational Development and International
College of Policing

Response from the College of Policing

As I sit writing this additional piece for the PDT report I am reflecting on what has been an extraordinary 3 months for UK policing and our colleagues in the emergency services. Yet again we have seen our people and the public thrown into situations nobody should have to experience…….. yet again we have seen them demonstrate incredible courage and resilience. After the Bataclan attacks several members of our national group came together with the MPS to run
a table-top exercise that sought to test out the welfare response to a major terrorist attack.

The lessons we learnt have been brought into tragic reality over the last 3 months and the PDT conference has enabled us to place trauma exposure at the top of the agenda. I have spoken to the professionals who dedicate themselves to supporting our people in times of crisis and I have been doing my bit to pick up the lessons
they have learnt so that we can , as a service, keep improving.

When policing responds to these awful incidents the world sees the job that our people do as it happens. What they will never see are the thousands of incidents that happen 24/7 in every town in every police area …many of which involve exposure to trauma. All of which have an impact on the emotional and psychological health
of those who take the call, respond and investigate. Observers may focus solely on the physical courage and risks of police work and pay less attention to the risks to our mental health. As a service we have perhaps done too much of that in the past as well.

The PDT conference has thrown the gauntlet down by demanding we recognise exposure to trauma has always been part of the policing experience. We must now listen to those who live and breathe it as well as the experts who are committed to developing the research.

I believe we have taken the first steps to breaking the stigma with the first conference and now this publication………we can now start to talk about it openly without any fear. Trauma is part of policing ……… it’s why we are here and so we must re-frame our attitude and strive to move from a crisis response to a preventative one.

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