Photos by Jim MacMillan, Philadelphia Daily News

“The only thing necessary for evil to triumph
is for good men to do nothing.”Edmund Burke

In the United States, there are over 17,000 separate law enforcement agencies with 740,000 sworn officers serving in varying roles. There is an average of 165 line-of duty deaths each year. In 2006, 145 officers died in the line of duty; 60 of these officers were feloniously slain. Law enforcement officers average 56,292 assaults and 16,138 injuries per year. (National Law Enforcement Officers Memorial Fund, Inc., 2007; Uniform Crime Reports, 2006).

Research have found between 3% – 17% of police officers to have post traumatic stress disorder (PTSD) at any given time. (Boyd, 1994; Harvey-Lintz & Tidwell, 1997; Robinson, Sigman & Wilson, 1997). Officers working in assignments that rarely deal with death, automobile accidents, domestic violence calls and traffic stops will clearly not have the same rates of PTSD as in officers who deal with the most violent, evil and horrific aspects of the job. For example, college campus police were found to have levels of PTSD similar to the general public (Lambert, 1997). Officers in other countries have also been found to have high levels of PTSD; Australia, 8.3% (Higgins, 1996); Germany, 5%, with 39% experiencing intrusive memories (Teegen, Domnick & Heerdegen, 1997).

For the law enforcement officer who often works alone, where violent attacks can come from anywhere and where split-second decisions can result in death of a citizen, a perpetrator or oneself, the job stressors and potential to be traumatized are tremendous.

Unlike fire department personnel, where a group of officers generally respond, usually with a supervisor on the scene, a law enforcement officer is frequently on his/her own during a traumatic incident. Further, when a law enforcement officer is involved in an action that injures or kills a citizen or a perpetrator, there is invariably an investigation. Supervisors or members of a “Shooting Board” or Internal Affairs Office commonly investigate the incident. These investigators can second-guess decisions that were made in a split second during situations of extreme threat. Research has consistently found that a positive level of support following a critical incident can decrease the likelihood of the development of PTSD. However, for many law enforcement officers, the reaction of their own department following their involvement in a traumatic incident is not experienced as supportive and, in some cases, may become even more traumatic than the actual incident (Horn, 1991). Comments by the news media, reviews by citizen boards, and legal actions in the courts can compound the impact of the trauma. Officers incur additional stress from required yearly physical exams, re-qualifying with weapons, and often-required disclosure of finances and personal relationships.

In many departments, officers who seek psychological help can be sent for a fit-for-duty examination to evaluate whether he or she has emotional or physical problems. The results of these examinations can lead to being assigned to the “rubber gun squad”, having their weapon confiscated, being placed on disability, or even fired. In other words, in many departments rather than their department assuming responsibility for an officer being traumatized by job-related experiences, he or she may face restricted duty or dismissal from the job. The fear of being sent for a fitness-for-duty exam keeps many officers from seeking the assistance that would improve their job performance.

“The worst part of a critical incident sometimes is not the critical incident but what happens afterwardBbecause they feel like they’ve done the best they possibly could under the set of circumstances that existed at the point they made the decision. Yet, they are second guessed, maybe all the way to the Supreme Court for a decision they made in a split second.” (Horn, 1991; page 143).

Additional stress comes from an increasing tendency of criminals and the citizens to file civil suits against police officers for their actions. Studies have shown a dramatic increase of lawsuits alleging police misconduct. Even such tasks as investigating traffic accidents, which are routinely handled on a daily basis by officers, have the potential to give rise to significant levels of PTSD (Mitchell, 2000).

A recent research study (Neylan, et. al., 2002) found that although only 7% of officers could be classified as having PTSD, 45% were having sleep difficulties typical of patients seen in insomnia clinics (Boyd, 2002). In this study, stresses related to their work environment were strongly associated with sleep quality; sleep disturbances were associated with symptoms of PTSD. “These high rates of insomnia are particularly alarming, because sleep deprivation can drastically hinder mental and physical performance” (Thomas Neylan, MD, 2002).

Surviving spouses of officers killed in the line of duty were also found to have levels of PTSD equivalent to prisoners of war and hostages, regardless of whether the death of their spouse was due to a homicide or was accidental (Stillman, 1986).

Incidents Most Likely to Traumatize Law Enforcement Officers

• Witnessing the death of a law enforcement officer or viewing the body at the scene, especially when the victim was a friend or partner. Trauma is often increased if the officer believed he or she should have protected the person who died, or if the dead officer was temporarily serving in place of the officer. When an officer imagines him or herself as the dead officer, then visualizes the impact that their death would have on those they love, the traumatic impact of this event is greater.A reasonable belief that death or critical injury was imminent and certain.
• An officer accidentally kills or wounds a bystander, especially if the victim is a child.
• An officer fails to stop a perpetrator from injuring or killing someone after the initial encounter.
• Killing or wounding a child or teenager, even if the life of the officer was threatened by the person injured or killed.
• Viewing the body of a child victim, particularly if the officer has children and even more so if the officer’s child is the same age and sex of the victim or if the child victim is similar in some other way to the officer’s child, such as appearance, clothing, toys, or school. The impact of this experience is often increased if the body has deteriorated, if the child was tortured and/or if the officer hears a graphic confession from the murderer, especially when pain was intentionally inflicted on the child.
• When a dead victim becomes personalized, rather than just an unknown body, through interaction with grieving family members or friends, or from information gained from the scene, news reports, search warrants, and so on. Continued association with the pain of survivors through an investigation and trial (and often long after) also can personalize the dead victims.
• The terror of being caught in a violent riot. Trauma may be increased when children are present in the crowd and the officer cannot use deadly force to defend him or herself for fear of hurting the children.
• An officer is blamed or told he or she is responsible for the death of an innocent bystander, law enforcement officer or a child victim by his or her department, family members of the victim, or the media. Guilt, such as feeling responsible for violence or death, whether irrational or based on fact, usually intensifies symptoms of PTSD. Events such as exchanging shifts with another officer who is killed while working the exchanged shift or responding to a call minutes after an officer is killed can intensify symptoms of PTSD when the officer blames him or herself for the event. (“It’s my fault he/she is dead; I should not have taken sick leave.” or “If I had been there, he would not have gotten killed.”)
• Particularly bloody or gruesome scenes. Horror of the crime and/or the suffering of the victims. Length of exposure to crime or accident scenes that involve decaying and dismembered bodies, especially when children are victims.
• Observing an event involving violence or murder, but not being able to intervene (i.e., “I watched him kill her. She was screaming for my help but there was nothing I could do.”)
• Feeling responsible for someone’s life (i.e., a crisis or hostage negotiator, attempting to resolve a potentially lethal situation, especially if the event drags on for hours). Symptoms may occur even when victims are rescued as a result of stress hormones released during long negotiations.
• An undercover assignment in which the officer is constantly “on-guard” because of the likelihood of being hurt, killed, or discovered. This is particularly a problem if the officer grew up in a family where he or she had to always be “on-guard” against physical, emotional, or sexual abuse, because the undercover experience mirrors the fear of the childhood experience.
• When an “informant” or “asset” developed by an officer is murdered for providing information to law enforcement.
• When suspects who have been indicted, are being tried, or are incarcerated threaten the officer and/or the officer’s family with violence and are deemed capable of carrying out these threats.
• Inappropriate response of management to an officer’s involvement in any of the above critical incidents can significantly increase their traumatic impact.
• Being referred to as a “Hero” after being involved in an incident where other officers died or were critically wounded. Being labeled a hero when fellow officers died at the scene can dramatically increase feelings of guilt and PTSD symptoms.

These incidents were compiled by combining research with the hundreds of stories of law enforcement officers treated by Dr. Davis.

© 2003; 2007; Dr. Davis gives permission for this article to be duplicated and used for training and/or educational purposes provided she is acknowledged as the author.