Mindful or Suicidal: Recommendations for Improved Mental Health among Police Officers

Mindful or suicidal

Ewa K. Zielinska, University of New Haven

Executive Summary 

Despite multiple national initiatives, the suicide rate among police officers remains constant and higher than line of duty deaths. Recent research identifies mindfulness techniques as an effective way to improve mental health, including the risk factors of depression and suicide. While a significant portion of resources and funding are allocated to ensure the safety and physical fitness of officers, including firearms training and physical fitness programs, there is a limited number of holistic programs that ensure officers’ mental health wellness. Based on current research and pioneer initiatives, this document explores the following question: What role can mindfulness practices play in reducing the risk of suicide among police officers? The document concludes with recommendations for law enforcement agencies, including implementation of evidence-based mindfulness practices and cultivation a pro-wellness work etiquette. 

Introduction

Based on data between 1999 and 2015, the Center for Disease Control and Prevention (CDC) places suicide as the second leading cause of death among all races and sexes for ages 25-34, and fourth for ages 35-44 (CDC, 2019). Given that the mean age of police officers is about 40 years, this group is at a higher risk of suicide (DataUsa, 2019). Additionally, the inability to deal with high levels of stress and trauma associated with the job makes police officers especially vulnerable to depression and feelings of hopelessness, directly linked to the risk of suicide (BLUE H.E.L.P., 2019; IACP, 2018; Mindful Justice, 2018). Despite the lack of a central database for suicide reporting, experts argue that law enforcement officers have a 54% greater chance of dying from suicide than members of the general population. This results in an average of 160 officers taking their lives every year (Vargas, 2019; The Crime Report, 2019), placing suicide higher than line of duty deaths (Heyman, Dill, & Douglas, 2018; see Appendix A). 

Despite the high risk of suicide, an organizational culture of masculinity and toughness often prevents officers from seeking the mental health care they need. The problem is further compounded by the lack of mandatory reporting of officer suicide (IACP, 2013; Yeoman, 2017). Consequently, agencies are unable to fully access the scope of the problem and identify individuals whose mental wellness needs improvement (Vargas, 2019). A growing number of agencies, both domestic and international, recognize the importance of mental wellness (IACP, 2018) and adopt evidence-based mindfulness techniques as an effective way to improve mental health, including the risk factors of depression and suicide (Bergman, Christopher, & Bowen, 2016; Trombka et al., 2018; Yeoman, 2017). This document explores current suicide prevention programs as well as evidence-based mindfulness practices that could prove effective in suicide prevention. 

Leading Causes of Suicide 

Suicide is not caused by a single event but an accumulation of unresolved stress and trauma (The Crime Report, 2019). Research also suggests that police officers have a much lower life expectancy as compared to the general population (Violanti et al., 2013). Officers are exposed to a multitude of psychological risks associated with organizational stressors, including high job demands, decision-making latitude, organizational culture, and interpersonal relations. These risks are likely to result in prolonged stress, obesity, posttraumatic stress disorder (PTSD), cardiac arrest, or suicide (Bonner, 2000; Goh et al., 2015; Patterson, 2002; Violanti et al., 2017). For example, 9-19% of all police officers suffer from PTSD, which could have been caused by witnessing homicides and having contact with dead bodies, accident and assault victims, and abused children (Violanti et al., 2013). Additionally, female officers were more likely to show metabolic syndromes associated with stress from organizational pressure and lack of support (Hartley et al., 2011).

Other studies show consistent and troubling results. For example, police officers witness an average of 188 critical incidents through their careers (Chopko, Palmieri, and Adams, 2015). These traumatic events could include killing someone by accident, witnessing death, being held hostage, being seriously beaten, or having loved ones threatened (see Appendix B for a full list of critical incidents). Accumulated trauma leads to PTSD and depression, with rates five times higher for police officers as compared to the general population, contributing to poor physical health, impaired decision-making, and ultimately suicide (Chopko et al., 2015; Violanti et al., 2017; Heyman et al., 2018).

Officer Wellness and Suicide Prevention 

Officer suicide does not only put strain on already tight agency budgets (Violanti et al., 2013), but also limits the number of officers protecting the community (IACP, 2018). Given the high controversy of the topic, increased media coverage has been given to the mental and emotional toll of the job, as well as the need to protect those who safeguard their communities (The Crime Report, 2019). As a result, a multitude of legislations and reports recommend focusing on policies and programs that promote physical and psychological wellness of law enforcement officers (IACP, 2018).

The Law Enforcement Mental Health and Wellness Act of 2017 is designed to make mental health services more accessible to law enforcement officers (US Congress, 2018). More specifically, the Department of Justice, Department of Defense, and the Department of Veterans Affairs are tasked with developing resources that would address the mental health needs of the officers. The legislation would grant funding for developing peer mentoring pilot programs and training for mental health providers, specific to law enforcement mental health needs and supporting law enforcement officers by studying the effectiveness of crisis hotlines and annual mental health checks (US Congress, 2018).

In addition to the new legislation, the COPS Office (Kuhns et al., 2015) and the IACP (2018) provide recommendations for mental and physical wellness program implementation based on several model examples:

  1. San Antonio, TX: Performance Recovery Optimization (PRO©). This program is based on the the military program that sought to reduce and prevent psychological trauma by teaching soldiers and veterans stress management techniques that would make them more resilient to the rigors of combat. PRO© includes an eight-hour training session for cadets and a five-hour in-service training for officers, as well as an elective three-day professional development course. Although research shows that only daily practice yields long-term results (Jha et al., 2016), the program is not incorporated into the daily officer routine. Additionally, the program is mainly based on physical responses as opposed to emotional causes of stress.
  2. San Antonio, TX: Peer Support Team. The program provides an early intervention to keep stress from escalating into distress. Peer mentors specialize in topics like grief, children’s issues, acute stress disorder, and substance abuse. Although the program focuses on detecting early signs of stress, it does not teach the officers how to cope with negative emotions during high-stress critical incidents.
  3. Camden County, NJ: Wellness Coach. The program is designed to promote health and wellness by having a certified wellness coach visit police departments monthly to advise officers on topics such as exercise, fitness, and conditioning; tobacco cessation; weight loss; stress management; nutrition; high blood pressure and heart disease; diabetes; and more. Although the program emphasizes overall wellness, it does not require officers to engage in daily exercises.
  4. Reno, NV: Resiliency and wellness program. The program is designed to screen officers for early indications of heart disease and diabetes. Although the program is designed to detect physical manifestations of stress, it does not offer long-term preventive methods.

Based on the consensus of diverse organizations, there is a need for programs that improve overall mental and physical heath of officers (IACP, 2018; Kuhns et al., 2015; US Congress, 2018). However, the overwhelming number of wellness and suicide prevention programs are reactive in nature. Some programs focus on physical fitness or addressing pre-existing health conditions, while no program recommends proactive measures, including daily mindfulness practices to target the underlying causes of suicide, including stress, anxiety, and depression.

Mindfulness in Practice

The participatory medicine movement emphasizes being proactive for one’s health (identifying and countering initial symptoms), as opposed to reactive (trying to address a health problem after it occurs; usually involves hospitalization and medication). Mindfulness is based on the idea of proactive medicine and can be defined as paying attention to the present moment on purpose and without judgement. More specifically, meditation and breathing exercises heighten awareness and generate a deep state of relaxation (Kabat-Zinn, 2013; Air Force New, 2017). According to Dr. Kabat-Zinn, a leader in mindfulness practices and the creator of the Stress Reduction Clinic and the Center for Mindfulness in Medicine, Health Care, and Society at the University of Massachusetts Medical School, “by focusing on the breath, the idea is to cultivate attention on the body and mind as it is moment to moment, and so help with pain, both physical and emotional” (Booth, 2017). Research outlines a multitude of benefits of mindfulness practices, including the ability to deal with stress, chronic pain, and make decisions based on logic as opposed to emotions. 

What Does the Research Say? 

Mindfulness training involves teaching people skills to focus their attention on the present moment, without emotional reactivity. As pointed out by Dr. Amishi Jha, another leader in mindfulness research and a co-director of the University of Miami Mindfulness Initiative, strengthening our cognitive capacity makes us more likely to remain calm and focused in moments of high emotional intensity or stress. As a result, we are less likely to be affected by anger, fear, or worry (Tannen, 2018). Research shows that mindfulness can reduce organizational stress, but also improve problem solving skills and emotional resilience among high-functioning groups, including elite military forces and police officers (Bergman, Christopher, & Bowen, 2016; Jha et al., 2017; Pe et al., 2013; Schmeichel et al., 2010; Zanesco et al., 2018). 

Special Operations Forces (SOF) who participated in a month-long mindfulness course reported improved attention and working memory, which are necessary to reduce emotional reactivity and increase problem solving skills. The mindfulness program consisted of 8-hour weekly in-class trainings and 15 minutes of daily guided meditation (Zanesco et al., 2018). The findings are consistent with previous studies on military cohorts that point to increased cognitive resilience during stressful and emotionally degrading situations. Researchers argue that mindfulness training helps troops deal with the distress and emotional disturbance of deployment. More specifically, mindfulness training can help enhance one’s ability to deal with negative feelings and regulate one’s emotions, especially among high-functioning groups like police officers (Pe et al., 2013; Schmeichel et al., 2010).

Servicemembers who practiced mindfulness reported relatively constant levels of negative emotions, while those with no such training reported increased negative emotions during the pre-deployment period (Jha et al., 2017). Additionally, US Marine reservists who went through an 8-week mindfulness and decision-making training, including a total of 24 hours of class time, a 2-hour meeting, and a day-long silence workshop, were less likely to experience deceased attention, which left untreated could result in diminished performance and resilience to deal with stress. Lastly, in addition to elite military service members, police officers could benefit from mindfulness training to improve their cognitive skills (Jha et al., 2017).

In addition to building emotional resilience, mindfulness has been directly linked to depression prevention. Studies have shown that developing mindfulness skills and self-compassion creates reduced reactivity and depressive thinking among participants (Kuyken et al., 2010; 2015). Additionally, studies on mindfulness among law enforcement officers suggest that the techniques reduce organizational as well as operational stress and anger (Bergman, Christopher, & Bowen, 2016). In addition, other studies found that mindfulness had a positive impact on overall resilience, perceived stress, burnout, emotional intelligence, difficulties with emotion regulation, mental health, physical health, anger, fatigue, and sleep disturbance (Christopher et al., 2014). However, nearly all mindfulness studies suffer from a small sample size (Stetka, 2017). Nevertheless, the growing interest in the technique provides an opportunity for a large-scale randomized and rigorous test of its effectiveness among those organizations and agencies who are voluntary pioneers in mindfulness training.

Mindfulness Pioneers

The New Zealand Air Force (2017) and the US military were among the first proponents of the benefits of mindfulness. According to Woodbourne Base Psychologist Flight Lieutenant Carsten Grimm, evidence-based mindfulness training enhances officers’ attention and adaptability by helping them to stay calm and regulate their emotions. In other words, mindfulness gives officers resilience tools to better deal with the amount of workload and the emotional demands of the job. Consequently, mindfulness training has been incorporated into recruit courses and officer training, and has received a positive response. More specifically, the techniques helped officers understand how they were feeling and reacting, but perhaps most importantly how to apply these skills during work and at home (Air Force News, 2017). 

Similarly, research conducted by Dr. Jha and her colleagues (2015, 2017) has been the basis for the mindfulness techniques used by the US military and police force. The US Army emphasizes the need for strengthened cognitive and physical capabilities of their soldiers (Myers, 2015). More specifically, mindfulness is a promising technique to help soldiers deal with the psychological toll of deployment, including stress and anxiety of high-performance in high-stress situations. In general, providing soldiers with physical training is not enough to teach them how to deal with stress. The research founded by the U.S. Army Medical Research and Materiel Command, and conducted by Dr. Jha and her colleagues, shows that mindfulness meditation exercises help train and protect a serviceman’s mind against high-stress combat situations and improve overall cognitive resilience and performance (Jha et al., 2015). Similar research on active-duty Marines showed improvements in mood, memory, and attention (Jha et al., 2017). In the end, the Army and the Marines recognize the need to protect a soldier’s mind in the same way physical training prepares and protects their body. As a result, like physical exercise, daily mindfulness training can result in powerful benefits. (Myers, 2015). Given the effectives among high-performing military personness, mindfulness practices are starting to make their way into policing. 

Local police departments (PD) have recognized the research behind mindfulness and have implemented mindfulness-based programs as a part of officer training (Kim, 2017). More specifically, Tempe PD in Arizona, Hillsboro PD in Oregon, Bend PD in Oregon, El Cerrito PD in California, Dallas PD in Texas, and Madison PD in Wisconsin all see the need for a holistic and proactive approach to officer well-being (Kim, 2017; Kozlowska, 2017; Spoon, 2016; Suttie, 2016). More specifically, mindfulness practices have the potential of reducing depression, PTSD, alcohol abuse, and promoting awareness and compassion for the high-stress job of the officer (Kim, 2017).

For example, Madison PD, with cooperation of the University of Wisconsin-Madison and funding from the National Institute of Justice (NIJ), is measuring the effectiveness of implementing one guided session per week for two hours, focusing on a variety of practices including meditation, mindful movement (walking, yoga), and group discussions about practices and teachings. Officers also are given additional exercises for outside of the sessions. Although the research is ongoing, the initial results were marked as promising (Spoon, 2017).

Another example is Bend PD in Oregon, which believes in prioritizing officer wellness. Given that officers are exposed to a multitude of negative events on a daily basis, the agency has implemented a wellness screening test and mindfulness training. Mindfulness training is one of several wellness incentives at the Bend PD, ranging from 10-minute mindfulness sessions to yoga classes, peer mentoring, and a psychologist on staff. Every program is data-driven and addresses an area the officers finds most problematic, including sleeplessness, lack of energy, focus, and likelihood of certain injuries. Specifically, mindfulness training helps officers prepare for potentially violent situations by maintaining a clear-mind. The department is actively engaged in promoting the benefits of mindfulness and providing training to other in and out of state PDs (Peacher, 2018).

The need to address officer well-being and reduce stress associated with the high demands of the job can be expressed by adopting a holistic approach to mental and physical health. More specifically, mindfulness-based practices could help officers effectively deal with stress, anxiety, and excessive reactivity associated with their job.

Recommendations

Current legislation and reports emphasize peer mentoring and annual mental health checkups, but do not propose national and evidence-based program development (IACP, 2018; US Congress, 2018). Given the effectiveness of holistic practices, this document proposes the implementation of mindfulness practices to help officers with stress and trauma management.

The U.S. Department of Justice should do the following:

  • Support continuing research into the effectiveness of an annual health check for officers, encompassing mental health, fitness, resilience, and nutrition (IACP, 2018).
  • Fund additional research into holistic approaches for occupational stress reduction (IACP, 2018).

Law enforcement agencies should do the following:

  • Raise awareness about suicide and mental health risks among law enforcement officers and create a culture of support and understanding (IACP, 2014).
  • Promote proactive attitudes towards health, safety, and wellness, including stress management at every level of the organization (IACP, 2014; Kim, 2017; Kozlowska, 2017; Spoon, 2016; Suttie, 2016).
  • Promote educational initiatives targeted at police managers on how best to recognize and manage situations in which occupational stress is a factor (Bonnar, 2000). This would also include mindfulness training (Mindful Badge Initiative, 2019).
  • Implement a screening tool to identify risk factors, with sensitivity to overt and subtle cues of officer distress (IACP, 2018; Peacher, 2018).
  • Adopt a standardized and evidence-based mindfulness technique that can be later tested for effectiveness (Jha et al., 2017; Violanti et al., 2017; Zanesco et al., 2018).
    • Incorporate a mindfulness component into recruit training. This would help future officers overcome the culture of toughness and recognize the benefits associated with mindfulness (IACP, 2014; Air Force News, 2017).
    • Implement a daily mindfulness practice to facilitate long-term benefits of mindfulness training (Jha et al., 2017; Myers, 2015; Violanti et al., 2017).
    • Seek a research partner to evaluate the effectiveness of mindfulness training (Jha et al., 2017; Spoon, 2017).
  • Offer counseling and referral services for specialized needs (US Congress, 2018; Peacher, 2018).

Mindfulness Program Design

Police departments can implement an on-sight evidence-based Mindfulness-based Mind Fitness Training (MMFT) with elements of application to the operational environment (e.g., decision making under pressure, such as during counterinsurgency operations, and maintaining self-awareness and emotion regulation during difficult encounters with local populations). The training would be a combination of class time, meetings, day-long silence workshops, yoga, and daily 10-minute guided meditations. The exercises are focused on building emotional resilience, cultivating attentional control, and increasing tolerance of challenging experiences. Predicted outcomes include reduction in stress, trauma, and depressive thoughts, but also increased awareness and improved decision-making skills.

One example of a model evidence-based approach to mindfulness is The Mindfulness Badge Training based in Hillsboro, OR that incorporates various training strategies, including workshops, leadership training, executive coaching, assessment and planning for organizations, immersion training, and workshops. The initiative appears cost-effective and is based on sustainable and local training models (The Mindfulness Badge Training, 2019).

Benefits:

  • Multitude of benefits ranging from stress reduction to improved decision-making that is evidence-based (Christopher et al., 2014; Bergman, Christopher, & Bowen, 2016; Jha et al., 2017; Zanesco et al., 2018).
  • Decreased number of officer suicides (IACP, 2014).
  • Organizational shift that promotes holistic well-being and mental health. Establishing a working culture of openness, inclusion, and wellness (IACP, 2014).
  • Prevention of resource depletions associated with crisis management. It might be more cost effective to treat an officer with mental health issues than to train a new one (IACP, 2014). Additionally, agencies can apply for NIJ funding and implement mindfulness practices based on already existing programs and research (Spoon, 2017; The Mindfulness Badge Training, 2019).

Challenges:

  • Only long-term or daily mindfulness practices are likely to yield long-term benefits (Zanesco et al., 2018).
  • Resistance associated with organization culture of toughness and stigma of mental illness (IACP, 2014; Yeoman, 2017).

Conclusion: 

Preventing officer suicide requires a proactive and holistic approach to mental and physical heath (Air Force New, 2017; IACP, 2014; Kabat-Zinn, 2013). Existing suicide prevention programs are mostly focused on physical fitness or reactive responses to stress, including peer mentoring and suicide hotlines (IACP, 2018; Kuhns et al., 2015; US Congress, 2018). Recent research points to mindfulness practices and their effectiveness in stress management. Results have showed that mindfulness can reduce organizational stress, but also improve problem solving skills and emotional resilience among high-functioning groups, including elite military forces and police officers (Jha et al., 2017; Violanti et al., 2017; Zanesco et al., 2018). As a result, several police departments have been implementing mindfulness-based practices as a proactive and cost-effective way to improve officer mental resilience (Kim, 2017; Kozlowska, 2017; Spoon, 2016; Suttie, 2016).

Consequently, this document outlined several recommendations for the DOJ and law enforcement agencies, including raising awareness about suicide and mental health, promoting a culture of acceptance and understanding, and the implementation of standardized and evidence-based mindfulness techniques (see the Mindfulness Program Design as an example of evidence-based program design). Lastly, both benefits and challenges of introducing mindfulness practices were listed.

Annotated Bibliography

Bergman, Aaron L., Christopher, Michael S., Bowen, Sarah. (2016). Changes in Facets of Mindfulness Predict Stress and Anger Outcomes for Police Officers. Mindfulness, 7(4), 851-858.

This study investigates the impact of mindfulness on stress and anger among police officers. A sample of 62 police officers from a medium-sized city on Pacific-Northeastern US, underwent a Mindfulness-Based Resilience Training (MBRT) program. Results demonstrated that mindfulness significantly reduced organizational stress, operational stress, and anger.

Bonnar, A. (2000). Stress at work: The beliefs and experiences of police superintendents. International Journal Stress Management, 2, 285–302.

The study identifies stress-induced mental illness as a growing occupational hazard for police officers. What is more, previous research points to the lack of stress and mental illness prevention assistance. This qualitative study found that acceptance or tolerance of management practices likely to cause stress.

Booth (2017). Master of mindfulness, Jon Kabat-Zinn: ‘People are losing their minds. That is what we need to wake up to’. The Guardian. Retrieved from https://www.theguardian.com/lifeandstyle/2017/oct/22/mindfulness-jon-kabat-zinn-depression-trump-grenfell

An interview with Dr. Kabat-Zinn, the leader in mindfulness practices, and the creator of the Stress Reduction Clinic and the Center for Mindfulness in Medicine, Health Care, and Society at the University of Massachusetts Medical School. Dr. Kabat-Zinn discusses health benefits of mindfulness practices.

Chopko, B.A., Palmieri, P.A., & Facemire, V.C. (2014). Prevalence and predictors of suicidal ideation among U.S. law enforcement officers. Journal of Police and Criminal Psychology, 29(1), 1-9.

The study identifies a multitude of traumatic events that increase the risk of suicide among police officers. These critical incidents could include mistake that injures / kills colleague, mistake that injures/kills bystander, colleague killed intentionally, colleague killed accidentally, being taken hostage (see Appendix A for a complete list).

Christopher, Michael S., Goerling, Richard J., Rogers, Brant S., Hunsinger, Matthew, Baron, Greg, Bergman, Aaron L., Zava, David T. (2016). A Pilot Study Evaluating the Effectiveness of a Mindfulness-Based Intervention on Cortisol Awakening Response and Health Outcomes among Law Enforcement Officers. Journal of Police and Criminal Psychology, 31(1), 15-28.

This pilot study examined the effectiveness of a mindfulness-based intervention on police officer stress. The study used a sample of 43 police officers who completed an 8-week Mindfulness-Based Resilience Training (MBRT) program. The findings indicate a significant improvement in self-reported mindfulness, resilience, police and perceived stress, burnout, emotional intelligence, difficulties with emotion regulation, mental health, physical health, anger, fatigue, and sleep disturbance.

DataUsa. (2019). Police officers. Retrieved from https://datausa.io/profile/soc/333050/

The website provides the most recent statistics on police officers in the US.

Goh J, Pfeffer J, and Zenios, SA. (2015). Workplace stressors and health outcomes: health policy for the workplace. Behavioral Science & Policy, 1(1), 43–52.

The study found that health effects of psychosocial workplace stressors, including job insecurity increases the odds of reporting poor health by about 50%, high job demands raise the odds of having a physician-diagnosed illness by 35%, and long work hours increase mortality by almost 20%.

Hartley TA, Knox SS, Fekedulegn D, Barbosa-Leiker C, Violanti JM, Andrew ME, Burchfiel, CM. (2012). Association between depressive symptoms and metabolic syndrome in police officers: Results from two cross sectional studies. Journal of Environmental and Public Health, 2012(861219), 1–9.

The study explores the association between depressive symptoms and metabolic syndromes in male and female officers from Buffalo, NY and Spokane, WA. Consistent with previous studies, the results show that about 13% of male and female officers suffer from depression.

Heyman, Dill, & Douglas. (2018). The Ruderman White Paper on Mental Health and Suicide First Responders. The Ruderman Family Foundation. Retrieved from https://rudermanfoundation.org/white_papers/police-officers-and-firefighters-are-more-likely-to-die-by-suicide-than-in-line-of-duty/ 

First responders (policemen and firefighters) are more likely to die by suicide than in the line of duty. In 2017, there were at least 103 firefighter suicides and 140 police officer suicides. In contrast, 93 firefighters and 129 police officers died in the line of duty. Suicide is a result of mental illness, including depression and PTSD, which stems from constant exposure to death and destruction.

IACP (International Association of Chiefs of Police).(2014). IACP National Symposium on Law Enforcement Officer Suicide and Mental Health: Breaking the Silence on Law Enforcement Suicides. Washington, DC: Office of Community Oriented Policing Services.

The report urges agencies to recognize officer health as an issue directly related to officer safety. More specifically, special attention should be given to law enforcement officer deaths by suicide, which were twice as high as compared to traffic accidents and felonious assaults during 2012. The document presents recommendations for creation of more health-oriented police departments.

IACP. (2018). Practices in Modern Policing: Officer Safety and Wellness. International Association of Chiefs of Police: Alexandria, VA. Retrieved from https://www.theiacp.org/sites/default/files/2018-11/IACP_PMP_SafetyandWellness.pdf

The IACP provides officer wellness and safety recommendations. In addition, various health and wellness programs implemented by police departments through the nation are discussed.

Jha, Amishi P., Morrison, Alexandra B., Parker, Suzanne C., & Stanley, Elizabeth A. (2017). Practice Is Protective: Mindfulness Training Promotes Cognitive Resilience in High-Stress Cohorts. Mindfulness, 8(1), 46-58.

The study investigated the benefits of mindfulness practices on a sample of US Marines during highly stressful period of pre-deployment. The results suggest that mindfulness training prevents attention depletion, which could result in the diminished performance and resilience to deal with stress.

Jha, AP, Morrison, AB, Dainer-Best, J, Parker, S, Rostrup, N, Stanley, EA. (2015) Minds “At Attention”: Mindfulness Training Curbs Attentional Lapses in Military Cohorts. PLoS ONE, 10(2), e0116889. Retrieved from https://doi.org/10.1371/journal.pone.0116889

This study founded by the US Army, investigates the benefits of mindfulness on a sample of elite military personnel. The findings suggest positive impact of mindfulness on resilience against high-stress combat situations and improved cognitive resilience and performance.

Mindful Badge Training. (2019). Training. Mindful Badge Indicative: Hillsboro, OR. Retrieved from https://www.mindfulbadge.com/training/.

The Mindfulness Badge Training based in Hillsboro, OR is an evidence-based approach to mindfulness training that incorporates various training strategies, including workshops, leadership training, executive coaching, assessment and planning for organizations, immersion training, and workshops. The initiative is cost-effective and based on sustainable and local training models.

Kabat-Zinn, Jon. (2013). Mindfulness Meditations in Everyday Life and Exercises and Meditations. BetterListen! LLC.

Dr. Kabat-Zinn’s mindfulness training includes guided instruction in mindful walking, sitting meditation, mindful hatha yoga, and also Kabat-Zinn's responses to questions from workshop participants, which may help deepen both one's understanding and commitment to the cultivation of mindfulness.

Kuhns, Joseph B., Maguire, Edward R., Leach, Nancy R. (2015). Health, Safety, and Wellness Program Case Studies in Law Enforcement. Washington, DC: Office of Community Oriented Policing Services. Retrieved from https://www.publicsafety.gc.ca/lbrr/archives/cnmcs-plcng/cn36413-eng.pdf           

The report discusses case studies of various safety and wellness-oriented programs through the US law enforcement agencies with a goal of program and policy improvement.

Kuyken W., Watkins E., Holden E., White K., Taylor RS., Byford S., Evans A., Radford S., Teasdale JD., Dalgleish T. (2010). How does mindfulness-based cognitive therapy work? Behavioral Research and Therapy, 48(11), 1105-1112.

Kuyjen and colleagues (2010;2015) explore the impact of mindfulness on depression. The study found a significant positive impact of mindfulness and self-compassion on symptoms and relapse of depression.

Kuyken W., Hayes R., Barrett B., Byng R., Dalgleish T., Kessler D., Lewis G., Watkins E., Brejcha C., Cardy J., Causley A., Cowderoy S., Evans A., Gradinger F., Kaur S., Lanham P., Morant N., Richards J., Shah P., Sutton H., Vicary R., Weaver A., Wilks J., Williams M., Taylor RS., Byford S. (2015). Effectiveness and cost-effectiveness of mindfulness-based cognitive therapy compared with maintenance antidepressant treatment in the prevention of depressive relapse or recurrence (PREVENT): a randomised controlled trial. Lancet, 386(9988), 63-73. 

Kuyjen and colleagues (2015) explore the impact of mindfulness on depression. The study found significant positive impact of mindfulness on depression relapse.

Patterson, George T. (2002). Reconceptualizing traumatic incidents experienced by law enforcement personnel. Australasian Journal of Disaster Trauma Studies, 2001(2).

This literature review focuses on law enforcement stress and attempts to classify stressful work events. The study concludes that traumatic incidents are usually ranked as highly stressful and can be reconceptualized as a separate category of stressful work events and situations experienced by law enforcement personnel. The author recommends keeping track of stressful events through the officer career and tailoring treatment.

Pe, M. L., Raes, F., & Kuppens, P. (2013). The cognitive building blocks of emotion regulation: ability to update working memory moderates the efficacy of rumination and reappraisal on emotion. PLoS One, 8(7), e69071.

Maintaining emotional health depends on one’s ability to regulate emotions. The results indicate the ability to update emotional information in the working memory can moderate the effect of high arousal negative emotions and help regulate one’s emotions.

Peacher, Amanda. (2018). Bend Police Incorporate Yoga, Mindfulness Into Officer Wellness Program. Oregon Public Broadcasting. Retrieved from https://www.opb.org/news/article/bend-police-yoga-wellness-mindfulness/

The article discusses Bend’s Police efforts to improve officer wellness through wellness screening, yoga, mindfulness, peer mentoring and more. The program is designed to have a holistic approach to wellness and address any health risks and needs of officers, including sleep deprivation, shoulder injuries or excessive use of force.

Royal New Zaeland Air Force. (2018). Air Force News: Making Mindfulness a way of life. Defence Public Affairs: Wellington, New Zealand. Retrieved from http://airforce.mil.nz/downloads/pdf/airforce-news/afn207.pdf

New Zealand Defence Force (NZDF) has been the pioneer in taking a holistic approach to heath and wellness of their officers. Most recently, they have been implementing evidence-based mindfulness practices to help their officer deal with emotions and make better logic-driven decisions.

Schmeichel, B. J., & Demaree, H. A. (2010). Working memory capacity and spontaneous emotion regulation: high capacity predicts selfenhancement in response to negative feedback. Emotion, 10(5), 739-744.

The study investigates the impact of high working memory capacity (WMC) on the ability yo regulate one’s emotions after a negative feedback. The results suggest that with a greater WMC might do better at spontaneous self-regulation of emotions.

Spoon, Marianne. (2017). Mindful Policing Research Expands with New Grant from National Institute of Justice. Center for Healthy Minds: University of Wisconsin, Madison, WI. Retrieved from https://centerhealthyminds.org/news/mindful-policing-research-expands-with-new-grant-from-national-institute-of-justice

The author discusses the mindfulness training initiative implemented by the Madison PD and University of Wisconsin and founded by the NIJ grant. The polit study hopes to investigate the impact of mindfulness practices on burnout, depression, and anxiety symptoms.

Stetka, Bret. (2017). Where's the Proof That Mindfulness Meditation Works? Scientific America. Retrieved from https://www.scientificamerican.com/article/wheres-the-proof-that-mindfulness-meditation-works1/

The author outlines some of the main limitation of mindfulness studies, including sample size, randomization and rigor in defining mindfulness. Based on interviews with mindfulness researchers, the author provides recommendations for mindfulness research improvement.

Tannen, Janette Neuwahl. (2018). The ‘best prospect’ for ensuring success in demanding roles. University of Miami New: University of Miami, Coral Gables, FL. Retrieved from https://news.miami.edu/stories/2018/11/ensuring-success-in-demanding-roles.html 

The article explores recent research on mindfulness conducted by University of Miami Associate Professor of Psychology. Dr. Jha’s research on elite military service members found that mindfulness training can increase cognitive performance among high-performance groups during highly stressful periods of pre-deployment.  

The Center for Disease Control and Prevention (CDC). (2019). Leading Causes of Suicide. Retrieved from https://webappa.cdc.gov/cgi-bin/broker.exe 

The Center for Disease Control and Prevention (CDC) outlines 10 leading causes of death by age group between 1999 and 2015.

Trombka, Marcelo, Demarzo, Marcelo, Campos Bacas, Daniel, Beira Antonio, Sonia, Cicuto, Karen, Salvo, Vera, Cesar Almeida Claudino Felipe, Ribeiro, Letícia, Christopher, Michael, Garcia-Campayo, Javier, and Sica Rocha, Neusa. (2018). Study protocol of a multicenter randomized controlled trial of mindfulness training to reduce burnout and promote quality of life in police officers: the POLICE study. BMC Psychiatry, 18, 151. 

This ongoing study investigates the impact of mindfulness training versus a waitlist control in improving quality of life and reducing negative mental health symptoms in police officers. The results are to follow.

US Congress. (2017). Law Enforcement Mental Health and Wellness Act of 2017. Retrieved from https://www.congress.gov/bill/115th-congress/house-bill/2228?q=%7B%22search%22%3A%5B%22H.R.+2228%22%5D%7D&r=18

The most recent legislation designed to address the health and wellness crisis among law enforcement agencies, including 22 recommendations to make substantial efforts to reduce suicide and integrate mental health professionals into law enforcement agencies. Some of the stogies include annual mental health checks for law enforcement officers, expansion of peer mentoring programs, and ensuring privacy considerations for these types of programs.

 

Violanti, J.M., Fekedulegn, D., Hartley, T.A., Andrew, M.E., Gu, J.K., and Burchfiel, C.M. (2013).  Life expectancy in police officers: a comparison with the US general population. International Journal of Emergency Mental Health and Human Resilience, 15(4), 217–228.

Police officers have a much lower for police officers as compared to the general population because of the exposure to a multitude of psychological risks associated with organizational stressors, including high job demands, decision-making latitude, organizational culture and interpersonal relations.

Zanesco, Anthony P., Denkova, Ekaterina, Rogers, Schott L., MacNulty, William K., Jha, Amishi P. (2018). Mindfulness training as cognitive training in high-demand cohorts: An initial study in elite military servicemembers. Progress in Brain Research, 244(2019), 323-354.

The study investigates the impact of mindfulness training (MT) on cognitive performance in elite military forces. Based on 4-week MT practice, participants reported improved attention and working memory outcomes. Researchers suggest MT as an effective cognitive training tool for elite military personnel.

 

Appendix A

Adopted from Vargas. (2019). More police officers committed suicide last year than were killed in line of duty. Behind the Badge. Retrieved April 20, 2019 from https://behindthebadge.com/more-police-officers-committed-suicide-last-year-than-were-killed-in-line-of-duty/ 

Appendix B

Table 1: Critical Incidents in the Law Enforcement Profession (Chopko et al., 2015)

Critical Incidents

Mistake that injures / kills colleague

Mistake that injures / kills bystander

Colleague killed intentionally

Colleague killed accidentally

Being taken hostage

Being seriously beaten

Being shot at

Colleague injured intentionally

Kill or injure in the line of duty

Badly beaten child

Sexually assaulted child

Trapped in life-threatening situation

Severely neglected child

Threatened with a gun

Your loved ones threatened

Seriously injured intentionally

Life-threatening man-made disaster

Exposed to AIDS or other diseases

Colleague injured accidentally

Shoot at suspect without injury

Threatened with knife / other weapon

Mutilated body or human remains

Life-threatening natural disaster

Life threatened by toxic substance

See someone dying

Making a death notification

Being seriously injured accidentally

Life-threatening high speed chase

Sexually assaulted adult

Animal neglected, tortured, killed

Decaying corpse

Life threatened by dangerous animal

Body of someone recently dead

Badly beaten adult


Adopted from Chopko, B.A., Palmieri, P.A., & Facemire, V.C. (2014). Prevalence and predictors of suicidal ideation among U.S. law enforcement officers. Journal of Police and Criminal Psychology, 29(1), 1-9.

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