Written by: Nicole Florisi, Law Enforcement Subject Matter Expert – Investigative Focus

There is a great deal of stigma attached to post-traumatic stress disorder (PTSD) in the first responder community. With all the “talk” of officer wellness, officer mental health, and resiliency there is not the decrease in negative outcomes that one would like to see overall. Why is that? In some cases, it is the label of having a disorder. Words are powerful and there is a distinct difference in the word disorder versus injury. In other cases, it is nothing more than checking the boxes and “talk” about what should be done to increase positive outcomes. We know where talking gets us. Nowhere, just like it does in the training environment. If we do not teach, implement, and model the skills we want first responders to have, we are not doing what is best.

There is a large focus on the “management” of PTSD and a lot less focus on the areas of prevention and mitigation. There is weakness in the training and application of resiliency skills for first responders to succeed. We have come to a point where individuals stigmatize the word resiliency. If you do not want your officers to have the grit and resiliency to move through the trauma they experience, you are part of the problem.

Barriers to Seeking Help

I was contacted a few months ago by an officer who had the experience of handing a case involving the burned bodies of children. He was struggling (his words) and looking for someone to talk with that would be able to support him while he worked through these events. Unfortunately, the clinician he originally saw started crying when he was sharing the events that brought him to treatment. The clinician told this officer that they could not treat him, as the events that he saw were too “overwhelming for them.”

I am proud beyond belief that this officer still sought treatment. The individuals in his department were not supportive either. He was told by someone in upper management that seeing burned bodies was part of the job and he was weak. That person told this officer that PTSD was “a bunch of crap for people who couldn’t handle life.” And we wonder why officers experience challenges in the recovery process.

On an anecdotal level, I have spoken with several first responder psychologists and therapists. The main barrier to treatment that officers face is not usually moving through the critical incident. The barrier is agency betrayal. Sit with that for a minute. We should provide an environment where it is emotionally safe for first responders to work through their experiences.

Supporting Officer Wellness

The book One Badge, One Brain, One Life: Preventative Maintenance for Your Brain While in the Line of Duty is a fantastic resource for all law enforcement. This book provides information, education, and practical skills to reduce and mitigate symptoms of trauma. You can purchase the book here: One Badge One Brain One Life | Tapia Counseling & P (drrobbie.org)

At VirTra, our V-VICTA® curriculum supports officer wellness. It provides a foundation for coping and resiliency skills that can mitigate traumatic symptoms. VirTra simulators can be a part the process of reintegration for officers after a critical incident. This entails having a framework rooted in best practices that minimizes the risk of enhancing dissociation, derealization, and depersonalization that can accompany traumatic experiences. Both education and conversation are part of reducing stigma. No matter your rank or your role, you can be part of the solution.

June is a fun month for society. People celebrate summer, fresh produce, long days and relaxation. While this time is enjoyable, it is also a time to remember that June is PTSD Awareness Month. June 27th is specifically designated as PTSD Awareness Day. This month, we encourage people to take some time to think of and care for veterans, police officers, victims of abuse and other individuals they may know who are suffering the effects of trauma.  

Law enforcement personnel specifically are in the unique position where they may work with individuals suffering from PTSD. They may be suffering from PTSD while simultaneously helping those with the disorder. After all, due to the nature of the job, officers may experience PTSD after responding to difficult, traumatic or troublesome calls. According to a past study, 35% of officers met the criteria for PTSD1. Now compare this to PTSD among the general population—3.6% for men and 9.7% for women2—and it is easy to see why PTSD is being discussed more in departments and why special care must be taken for our officers. 

Learning About PTSD

Officers must be taught to recognize PTSD symptoms and know how to help those affected, including their co-workers. This is where VirTra can help. To help educate officers, VirTra created the curriculum “Mental Illness Training: A Practical Approach”, which is a combination of classroom and science-based simulation training. The curriculum includes 15 training hours though lessons such as PTSD, as well as other mental illnesses, including: depression, suicide, anxiety, crisis de-escalation and more. Officers learn the material in a classroom setting before engaging in simulated scenarios to practice recognizing the signs and communicating with the subject. 

Mental health training for officers is an essential addition to any department’s curriculum. Mental health and PTSD are becoming increasingly more discussed, and as such, improving departments. Help us take care of your society and officers by increasing PTSD awareness and training.  

Talk to a VirTra representative to get started. 

 

References: 

1. Austin-Ketch TL, Violanti J, Fekedulegn D, Andrew ME, Burchfield CM, Hartley TA. (2012). Addictions and the Criminal Justice System, What Happens on the Other Side? Post-traumatic Stress Symptoms and Cortisol Measures in a Police Cohort. Journal of Addictions Nursing, 23(1), 22–29.
2. Kessler RC, Chiu WT, Demler O, Merikangas KR, Walters EE. (2005). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62, 617-627.

As a member of law enforcement, think for a moment about how many people you interact with daily and how many people you talk with in one shift. Effective communication is a critical piece of the job. We interact with individuals from all walks of life. That includes individuals who have mental illness. The key to effective communication is behavior recognition to choose the best communication style for the individual and the situation.

When it comes to interacting with individuals who have mental illness, choosing the communication style that best fits the situation is the best course of action. We do not communicate with a diagnosis, but with a human being.

The question we should ask ourselves: does the diagnosis itself matter? In most cases, it does not.

A diagnosis is informative at best. What is more important from a law enforcement perspective is we choose the right type of communication for an individual and the behavior exhibited at the time of interaction. The risk comes from misreading behaviors from individuals and not from whether a person has a diagnosis or not.

However, there is a large part of the population that has a diagnosis for a mental illness at any given time. According to the National Institute of Mental Health, nearly one in five adults in the U.S. have some type of mental illness. Mental illness is a broad term – there are many symptoms that accompany different diagnoses. Awareness of behavior is a key factor in how an officer interacts with any person, mental illness or not.

Types of Mental Illness & Disorders

Mental illness doesn’t discriminate. Some disorders are genetic and others are caused by chemical imbalances in the brain. They can be influenced by many factors, environment included.

Law enforcement officers interact with individuals who may have one or more of the following diagnoses:

• Anxiety
• Autism Spectrum Disorder
• Crisis and crisis-like behavior
• Dementia and Neurocognitive Disorders
• Depression
• Expression of suicidal ideation
• Schizophrenia
• Substance Use
• Trauma & PTS
• Traumatic Brain Injury (TBI)

Choosing the Best Communication Strategy

It is important to emphasize that members of law enforcement should not attempt to diagnose; the goal is familiarization of behaviors. Individuals who have a serious mental illness may find themselves more likely to have an encounter with police. In fact, persons who have a mental illness are more likely to be victims of a crime. That doesn’t mean there are not interactions that have violence, volatility, and instability. But that comes from anyone we deal with and is not relative to mental illness alone.

Some strategies for dealing with crisis or crisis-like behavior may include:

• Actively listen
• Speak calmly
• Be non-judgmental
• Allow individuals to express their emotions if safe to do so
• Try to distance a person from whatever or whoever is causing them distress (redirection)

Another critical component of understanding mental illness is intervention. When possible, encourage individuals to seek help. Knowing what is available and providing information lays a foundation for showing you care and that there is hope.

Never sacrifice safety for a behavioral health intervention. We have a responsibility to the individual, the public, and to ourselves. Abandoning sound tactics is never the answer.

Substance Use Disorders & Dual Diagnosis

Dual diagnosis is a known problem – one where a person experiences both a mental illness and a substance use disorder simultaneously. People use substances for various reasons. There is an correlation of trauma and substance use.

Some diagnoses such as schizophrenia or bipolar disorder may have behaviors that mimic substance use.  Recognizing the differences is not necessarily possible. That is why addressing behavior is the key.

Autism

Autism spectrum disorder affects the way a person socializes, speaks and acts. It is called a spectrum for a reason – there are some people with autism that have barely noticeable traits, while others are entirely nonverbal and rely on a caregiver to help them communicate.

There have been instances where a person on the autism spectrum have experienced difficulties and trauma as officers thought that drugs played a part in the behavior rather than there was a foundation of miscommunication. The number of similar incidents involving members on the spectrum creates the notion that there is a lack of training in this field.

Why Simulation Training Helps

When designed and tested correctly, simulation training provides a realistic environment for law enforcement members to practice in. Video-based simulation is even better, as it features real people and allows officers to pick up on subtle visual cues (such as facial expressions and small movements) that cannot be replicated with CGI.

The right kind of simulator has high-definition video, numerous scenario branching options and thorough debrief capabilities. When interacting with an on-screen subject, officers should practice to recognize various behaviors and choose the appropriate verbal techniques for that situation.

Much more than hardware, the vital part of simulation training is the quality of the content. Do officers truly learn something from what they are experiencing in the simulator? VirTra ensures content quality and skill transfer by submitting all curriculum – including our Mental Illness and Autism Awareness courses – to IADLEST for NCP certification.

VirTra’s Solution

Working and creating partnerships with industry experts has assisted VirTra in creating coursework that benefits law enforcement. With 15 hours of mental illness curriculum and 2 hours of autism curriculum, police trainers can have effective training at their fingertips. The pre-made curriculum doesn’t just include the scenarios, but also student handouts, instructor manuals, testing materials and more. It is intended to make the instructor’s job easier with coursework that can be used right out of the box.

In 2021, the state of Utah began requiring that law enforcement members obtain training hours solely dedicated to autism awareness, thanks to the Utah Attorney General’s Office. Some of the hours involve the use of a VirTra training simulator due to its immersive qualities and the detailed course structure.

“The beautiful thing about the system is that we can change the dialogue, we can change the reaction, the response and we can make it harder [or] better depending on how the officer is navigating this situation. We worked with families with children with autism spectrum disorder; we worked with experts in the education field, in the medical community, to behavioral scientists, to actually try to create and develop these modules.” – Sean Reyes, Utah Attorney General (Quote: ABC News)

By having the officers at your agency become familiar with the concepts of mental illness and autism spectrum disorder, they are keeping both themselves and their communities safe. It allows agencies to build trust and confidence from the community by making an effort to understand all members within it.

If you wish to learn more about VirTra’s coursework and how we combine simulation technology and adult learning, contact us.

 

Article originally published by Officer.com

Running towards dangerous situations that others run from is a critical component of law enforcement. However, performing these difficult tasks often makes officers susceptible to physical harm, and just as important, significant trauma and long-lasting mental health impacts.

To prepare for life in the field—and to keep their mental health, sanity and abilities up—officers must learn to build resilience. An increase in resilience helps individuals to be less impacted by negative events, recover faster and experience post-event growth. However, discussing resilience is easy. The process of actually building resilience takes time, energy, diligence and dedication.

Types of Resilience

Before building resilience, one must understand the different types and where an increase is most needed. Below is a list of the four areas an officer must focus on, as described in this PoliceOne article:

• Mental—The ability to cope with unique mental stressors and challenges
• Physical—The ability to create and sustain healthy behaviors necessary to enhance health and wellbeing
• Social—The ability to participate in healthy social networks that promote overall wellbeing and optimal relationships
• Spiritual—The ability to strengthen a set of beliefs, principles or values that sustain one’s sense of purpose

By developing resilience in multiple areas, an individual better develops mechanisms for protection against experiences that can be overwhelming or those that may result in mental health difficulties. This mental health reservoir of strength, so to speak, is what can give an officer extra strength to get them through the most difficult of events.

Building Resilience

There are multiple ways of building resilience, but as noted by Dr. Lucy Hone, it often boils down to three main principles:

Understanding Bad Things Happen

While this sounds like common sense, it is a principle one should circle back to often. When difficult situations occur, it helps knowing that suffering is a part of the human experience. Granted, difficulties in law enforcement are different from day-to-day difficulties, but the similarity is there.
Changing your mindset to reflect this helps remove the “why me” attitude and getting lost in your own troubles. Instead of focusing on oneself, work on building resilience in one of the categories mentioned above: mental, physical, social or spiritual.

Properly Placing Your Attention

One of the most important learnable skills in building resilience is focusing on the things you can change and accepting those you cannot. This ties in with the ability to move on—resilient individuals learn from the difficult moments and continue on, looking to the future armed with new knowledge, rather than dwelling on the past.

This is much easier said than done. People are naturally hard-wired for focusing on the negatives, such as threats and weaknesses, even one’s own. Naturally, the brain reacts accordingly, stress levels increase and resiliency diminishes. Take time to learn from the situation’s lessons, then leave the past in the past.

Self-Reflection

Self-reflection is most important immediately after a difficult situation. Ask yourself: is what I’m doing helping or harming me? This applies to various contexts such as thoughts, actions and decisions. If an individual is spending too much time reflecting on the traumatic incident in a “why me” manner, it is causing more harm than good and must be changed.

However, if the reflection was in a structured, educational manner—such as analyzing decisions that were well made or others that could have been improved—it may be doing good rather than harm. Officers must be self-reflective and attentive to see if they are increasing or weakening their resilience.

Result of Resilience

Resilience can be seen in an officer’s actions, not just during the difficult situation, but beyond. Oftentimes, resilience builds self-esteem and optimism as one’s outlook changes to seeing problems as a growth opportunity. In addition, an officer may have an increase in flexibility. Since resilient people often plan for multiple outcomes and are prepared to handle each, if an unexpected outcome arises, they have the ability to quickly readjust their priorities.

After all, if an officer is inflexible and cannot process an event that does not fit their pre-conceived outcome, they may experience higher stress, which quickly erodes resilience. Lastly, resilience manifests itself in the ability to move on, which was discussed earlier. Resilient people can accept and learn from critical incidents, then move on. These officers often have a strong social support network where they can discuss events, thus decreasing internalizing and suppressing frustrations. Social is one of the types of resilience mentioned in the second section, and like each type mentioned, it significantly impacts one’s ability to remain resilient.

Another way to build resilience is practicing difficult situations in a safe, controlled environment, such as within the VirTra simulator. Training after this manner allows officers to understand and prepare for stressful situations and teaches them how to handle the event—both in terms of actions and personal well-being. To learn more, please contact a VirTra representative.