Destigmatizing Mental Health Treatment Among Law Enforcement

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Destigmatizing Mental Health Treatment Among Law Destigmatizing Mental Health Treatment Among Law

Enforcement O6cers Amidst the Blue Wall of Silence Enforcement O6cers Amidst the Blue Wall of Silence

Jason Yerk

Walden University

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Walden University

College of Psychology and Community Services

This is to certify that the doctoral dissertation by

Jason R. Yerk

has been found to be complete and satisfactory in all respects,

and that any and all revisions required by

the review committee have been made.

Review Committee

Dr. Grace Telesco, Committee Chairperson,

Criminal Justice Faculty

Dr. Nancy Blank, Committee Member,

Criminal Justice Faculty

Chief Academic Officer and Provost

Sue Subocz, Ph.D.

Walden University

2024

Abstract

Destigmatizing Mental Health Treatment Among Law Enforcement Officers Amidst the

Blue Wall of Silence

Jason R. Yerk

MA, American Military University, 2015

BS, Southwest Florida College, 2012

Dissertation Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Philosophy

Criminal Justice

Walden University

May 2024

Abstract

Law enforcement officers are continuously presented with high risk/high stress

encounters throughout their career. However, mental health issues among police officers

are often minimized or overlooked, so the danger of burnout, depression, heightened

anxiety, along with PTSD are substantially increased. This qualitative study examined the

perceived obstacles and challenges that officers face based on the officers’ lived

experiences that prevent them from seeking mental health treatment. The study also

investigated how, if at all, stigmatization plays a role in preventing them from seeking

mental health treatment. Labeling theory was the framework used for this study. The

research employed purposeful sampling with 11 law enforcement officers who served in

the Southwest Florida region. Semistructured interviews with participants were

conducted using snowball sampling. Data was analyzed using Saldana’s (2011) coding

process and included two research questions focused on the perceived obstacles and

challenges that officers faced based on their lived experiences that prevent them from

seeking mental health treatment (RQ1) and how stigmatization played a role in

preventing or keeping officers from seeking mental health treatment (RQ2). Themes

identified throughout the study included scheduling issues, self-medication, fear of forced

evaluations, perceived loss of dependability, perceived weakness, and perceived loss of

advancement. This research has illustrated some of the obstacles that prevent officers

from seeking mental health treatment and provides law enforcement agencies with

information for positive social change to alter the negative perception of stigma as it

relates to officer self-seeking mental health assistance.

Destigmatizing Mental Health Treatment Among Law Enforcement Officers Amidst the

Blue Wall of Silence

Jason R. Yerk

MA, American Military University, 2015

BS, Southwest Florida College, 2012

Dissertation Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Philosophy

Criminal Justice

Walden University

May 2024

Dedication

This dissertation is dedicated to the brave men and women of law enforcement

who continually battle the demons both externally and internally in order to keep us all

safe. May this dissertation help reduce the stigma related to mental health treatment so

that officers don't have to endure the pain in silence.

Acknowledgments

To my wife, Dr. Melanie Yerk, thank you for being my greatest fan and supporter

throughout this entire process. It was your encouragement and support that made over

coming any and all of life’s obstacles possible throughout this journey. It was your

encouragement and belief in me that made this journey possible, and I cannot express

how grateful I am for your unconditional support.

To Dr. Grace Telesco, it has been a blessing and an honor to have you as my

dissertation chair guiding me through this process. Your expertise both in field and as a

doctoral chair has been invaluable throughout the dissertation process. Thank you for the

countless hours of questions and guidance you have provided as you have remained the

calm within the storm. I am forever grateful that you were my dissertation chair.

To Dr. Blank, thank you for all your qualitative expertise throughout this doctoral

journey. I appreciate all your feedback and assistance throughout the process.

 
i 
Table of Contents 
List of Tables .......................................................................................................................v 
List of Figures .....................................................................................................................vi 
Chapter 1: Introduction to the Study....................................................................................1 
Introduction ....................................................................................................................1 
Background ....................................................................................................................3 
Problem Statement .........................................................................................................4 
Purpose Statement..........................................................................................................5 
Purpose of Study ............................................................................................................6 
Research Questions ........................................................................................................7 
Theoretical Framework ..................................................................................................7 
Nature of Study ..............................................................................................................8 
Definitions......................................................................................................................8 
Assumptions...................................................................................................................9 
Scope and Delimitations ..............................................................................................11 
Limitations ...................................................................................................................11 
Significance..................................................................................................................12 
Summary ......................................................................................................................13 
Chapter 2: Literature Review .............................................................................................14 
Introduction ..................................................................................................................14 
Literature Search Strategy............................................................................................15 
Theoretical Foundations...............................................................................................16 

 
ii 
Police Mental Health Issues .........................................................................................19 
Police Stress .......................................................................................................... 19 
Organizational Stress ............................................................................................ 22 
Personal Stress ...................................................................................................... 30 
Anxiety.................................................................................................................. 32 
Depression............................................................................................................. 34 
Police Suicide........................................................................................................ 36 
Subcultural Stigma .......................................................................................................39 
Self-Stigma............................................................................................................ 39 
Organizational Stigma........................................................................................... 42 
Strategy and Solutions .................................................................................................45 
Organizational Support ......................................................................................... 45 
Peer Support .......................................................................................................... 48 
EAP  ................................................................................................................... 52 
Summary and Conclusion ............................................................................................53 
Chapter 3: Research Method..............................................................................................59 
Introduction ..................................................................................................................59 
Research Design and Rationale....................................................................................60 
RQs  ................................................................................................................... 61 
Research Design.................................................................................................... 61 
Phenomenon.......................................................................................................... 62 
Methodology ................................................................................................................62 

 
iii 
Population ............................................................................................................. 62 
Participant Selection ............................................................................................. 62 
Participant Recruitment Strategy .......................................................................... 63 
Instrumentation ..................................................................................................... 64 
Data Collection ..................................................................................................... 65 
Data Analysis Plan ................................................................................................ 66 
Role of Researcher .......................................................................................................67 
Reflexivity (Managing Relationships) .........................................................................67 
Ethical Assurances .......................................................................................................68 
Issues of Trustworthiness.............................................................................................69 
Credibility ............................................................................................................. 70 
Transferability ....................................................................................................... 70 
Dependability ........................................................................................................ 71 
Confirmability ....................................................................................................... 71 
Summary ......................................................................................................................72 
Chapter 4: Results ..............................................................................................................73 
Introduction ..................................................................................................................73 
Participants...................................................................................................................74 
Data Analysis ...............................................................................................................75 
Results ..........................................................................................................................79 
RQ1  ................................................................................................................... 81 
RQ2  ................................................................................................................... 84 

 
iv 
Summary ......................................................................................................................88 
Chapter 5: Discussion, Conclusions, and Recommendations ............................................89 
Interpretation of the Findings.......................................................................................89 
RQ1  ................................................................................................................... 89 
RQ2  ................................................................................................................... 92 
Limitations of the Study...............................................................................................94 
Recommendations for Future Research .......................................................................95 
Recommendations for Practice ....................................................................................96 
Implications..................................................................................................................97 
Implications for Positive Social Change ............................................................... 97 
Implications for Practice ....................................................................................... 98 
Theoretical Implications ....................................................................................... 99 
Conclusion .................................................................................................................100 
References ........................................................................................................................102 
Appendix A: Qualitative Instrument................................................................................111 
Appendix B: Recruitment Flyer .......................................................................................113 
 
   

List of Tables

Table 1. Category Development ....................................................................................... 80

List of Figures

Figure 1. Code to Theme................................................................................................... 78

Chapter 1: Introduction to the Study

Introduction

The profession of law enforcement has long been known to be an occupation in

which officers are continuously presented with high risk/high stress encounters

throughout their career. While officers are exposed to such dangerous and violent

encounters, it is understood that putting their life at risk while in service is a very real and

dangerous expectation of their chosen profession (Velazquez & Hernandez, 2019). These

high stress levels and exposure to traumatic stress along with potential deadly encounters

are key factors in officers physical and mental well-being (Soomro & Yanos, 2018). Due

to the over-exposure of these high stress/risk incidents, officers suffer from a higher rate

of anxiety, depression, PTSD, and thoughts of suicide than the general public or

professions without traumatic exposure (Soomro & Yanos, 2018; Velazquez &

Hernandez, 2019).

This continual exposure to fatal encounters in 2022 led to 247 in the line of duty

deaths, with officers having an average of 15 years of service (The Officer Down

Memorial Page [ODMP], 2022). This nationwide statistic states that 38% were felonious

in nature while the reaming 62% were incidents such as vehicle accidents, vehicle

pursuit, or duty related illnesses (ODMP, 2022). In comparison, during the same year

(2022), there were 161 reported officer involved suicides, where the deceased had an

average of 16.5 years of service (Blue H.E.L.P., 2022). Officer deaths by suicide are

expected to be higher as these are only reported numbers that are not mandated by federal

reporting regulations (Blue H.E.L.P., 2022).

Mental health issues among police officers are often minimized or overlooked, so

the danger of burnout, depression, heightened anxiety, along with posttraumatic stress

disorder (PTSD) are substantially increased (Hartford Courant, 2022). During times when

stress is heightened by outside factors such as the COVID-19 pandemic, police officers

are particularly vulnerable due to altered social/societal norms (Stogner et al., 2020). On

average, 25% of police officers have had suicidal thoughts due to their continual

exposure to traumatic experiences in the performance of their duties (Hartford Courant,

2022). These statistics increased during the pandemic when they were deemed “essential

workers” with minimal personal protection equipment and ever-changing threats based

on the virus (Hartford Courant, 2022; Stogner et al., 2020).

In addition to work-based traumatic exposures, research has shown that there is a

negative stigma associated with officers who speak out and seek assistance for mental

health treatment (Bikos, 2020; Hartford Courant, 2022; Soomro & Yanos, 2018). This

stigma is present due to the police subcultural belief that if officers need to seek outside

assistance, then they are perceived as weak and unable to be trusted as backup in future

high stress dangerous situations (Soomro & Yanos, 2018). This warrior mentality not to

display any signs of weakness is engrained in officers from the beginning of their careers

when they are told that any outward displays of weakness or loss of control, both

physically and mentally, could jeopardize their future career path (Soomro & Yanos,

2018). This developed sense of masculinity is created through the police subculture due

to the intensity of work and traumatic exposure in an effort for officers to cope with the

immense pressure they face daily (Bikos, 2020).

Chapter 1 introduces the study as well as present the background as it relates to

police officers suffering from a higher risk of mental health disorders and suicide based

on the attached stigma within the police subculture. This chapter will also addresses the

blue wall of silence that perpetuates this stigma of weakness inside the subculture for

those that seek help. In addition, Chapter 1 includes the problem statement, purpose of

study, research questions, theoretical framework, nature of study, definitions,

assumptions, scope and delimitations, limitations, significance of study, as well as the

summary.

Background

The research focusing on police officers’ mental health has clearly indicated that

there is a greater chance of officers developing mental health disorders such as PTSD,

depression, or thoughts of suicide than the general public (Soomro & Yanos, 2018;

Velazquez & Hernandez, 2019; Violanti et al., 2021). With known heightened mental

health symptoms, there is also a negative stigma that spreads throughout the police

subculture where seeking help is perceived as a weakness that could be perceived by

other officers that they are not suitable backup, or something is wrong with them

(Soomro & Yanos, 2018). In addition to these consequences, there is an institutional fear

of being removed from certain high-risk units, being overlooked for promotion, or even

forced out of law enforcement completely (Bikos, 2020).

The primary objective of this research was to understand the stigma that police

officers face within the subculture of policing, whether it is self-imposed, social, or

organizational in nature when seeking mental health treatment. Each of these stigmas

highlights that officers often do not seek mental health treatment in fear of a perceived

perception of weakness, which is the number one reason officers avoid seeking treatment

(Wheeler et al., 2018). Reducing these subcultural stigmas is expected to promote

psychological wellness, mitigate mental illness among officers, and reduce officer suicide

(Ramchand et al., 2018).

This study was designed to help close the gap by destigmatizing mental health

treatment among those who suffer from any number of mental health issues due to their

continual exposure to traumatic stress while performing their duties. The hope is that

officers who self-seek mental health assistance will be destigmatized by other officers

and supported by the organizational subculture, which will increase officer mental well-

being. Researchers have not fully addressed the mental health stigma attached to seeking

mental health treatment and the impact of the subculture of policing on officers’ self-

seeking perspective. Thus, this study helps fill the gap by obtaining the perspectives of

the officers themselves on help seeking behaviors.

Problem Statement

The subculture of law enforcement includes a stigma around seeking mental

health help, which, according to Wheeler et al. (2018), causes officers not to self-seek

mental health assistance in fear of been perceived as weak and unable to handle job

related duties. Continuous exposure to traumatic stress without the proper coping

mechanisms could cause long term mental health related issues that manifest into

physical illness throughout the officer’s career (Wheeler et al., 2018). Additional research

(Bikos, 2020; Hartford Courant, 2022; Soomro & Yanos, 2018) has indicated that

officers choose not to self-report and seek help for mental health problems due to the

well-found fear of perceived weakness or professional consequences they may face from

both their peers and organization.

The law enforcement subculture is based on principals of masculinity where

showing emotional control is considered a form of strength. This type of organizationally

instilled values perpetuates the stigma related to self-seeking mental health treatment as a

form of weakness that will cause officers to internalize traumatic stress (Velazquez &

Hernandez, 2019). Within the law enforcement subculture, officers express this

masculinity by imposing dominance and a defensive solidarity among peers to comply

with organizational norms due to the strong influence agencies have over their officers

(Habersaat et al., 2021). As a result, officers are prone to depersonalization or emotional

numbing, which could also have a negative impact on an officer’s ability to maintain

interpersonal friendships or intimate partner relationships (Velazquez & Hernandez,

2019). A gap in the literature was identified relating to how officers’ willingness to seek

mental health treatment is related to the stigma from the subculture’s blue wall of silence.

Purpose Statement

In this qualitative study, I examined the perceived obstacles and challenges that

officers face based on the officers’ lived experiences that prevent them from seeking

mental health treatment. I also investigated how, if at all, stigmatization plays a role in

preventing them from seeking mental health treatment.

Purpose of Study

In response to the apparent need for law enforcement officers to self-seek mental

health assistance, the purpose of this study was to analyze the stigmas and obstacles to

asking for mental health treatment that exist within the law enforcement subculture and to

identify potential pathways for officers to obtain mental health treatment that they deem

as acceptable. Throughout the study, I examined the perceived obstacles and challenges

that officers face based on their lived experiences that prevent them from seeking mental

health treatment, and the role that stigmatization plays in preventing or keeping officers

from seeking mental health treatment was explored based on officers’ lived experiences.

The mental health stigmas that are prominent in law enforcement subculture,

including self-stigma and organizational stigma, were thoroughly examined throughout

this study. I also conducted a thorough analysis of the problems associated with police

work. These included police stress, organizational stress, personal stress, anxiety,

depression, and police suicide. Strategies and solutions that have been implemented by

law enforcement agencies throughout the nation were evaluated for effectiveness and

acceptance by officers. These approaches allowed me to provide strategic

recommendations for successful agency implementation of mental health services and

programs to support law enforcement officers’ mental health (see Hartford Courant,

2022; Stogner et al., 2020; Velazquez & Hernandez, 2019).

My goal is to provide officers with a more comfortable avenue to self-seek

mental-health treatment to combat the stressors brought on by the continuous traumatic

stress exposures they encounter during their careers. By contributing to this literature, it

is expected that officers will have access to fundamental methods to positively change the

police subculture to provide a positive experience to self-seek mental health assistance

for traumatic stress. This opportunity for both individual officers and organizations could

lead to increased organizational support for officers by promoting positives mental health

outcomes, thus reducing stress disorders, depression, forced retirement, or even suicide

(Ramchand et al., 2018).

Research Questions

The following research questions (RQs) were used to understand the subcultural

stigma related to officers’ help seeking behaviors for mental health in the field of law

enforcement.

RQ1: What are the perceived obstacles and challenges that officers face based on

their lived experiences that prevent them from seeking mental health treatment?

RQ2: Based on the lived experiences of officers, how, if at all, does stigmatization

play a role in preventing or keeping them from seeking mental health treatment?

Theoretical Framework

Labeling theory was the framework used for this study. This sociology of

deviance study was based on the work of Becker in 1963 and his perception of

sociological theory where he observed deviants and their behavior (Becker, 1997).

Labeling theory is an approach including agents of social control and the stigmatic

stereotypes that they assign to groups or individuals in ways that could alter their

behavior (Becker, 1997). According to Becker (1997), there are consequences related to

external constructs or judgments that alter the way an individual views their self- concept.

This view is relevant as it imposes a self-fulfilling prophecy that indicates that the

behavioral patterns conducted by offenders are likely to promote wrongdoing or alter

other individual behavior (Payne et al., 2018).

Nature of Study

To address the RQs in this qualitative phenomenological study, I conducted

purposeful sampling to include active law enforcement officers in the southwest Florida

region. Interviews were conducted using both in-person and Zoom interviews with

current officers of varied levels of law enforcement experience. Memoing was also used

to record my perceptions of the how the participants displayed nonverbal communication

during the questioning along with any other pertinent information observed. Interviews

were conducted with 11 participants when saturation was reached. The use of a

qualitative methodology provides the researcher with the opportunity to understand the

participants’ lived experiences by assessing their responses to open ended questions,

which are presented in a semistructured interview design (Rubin & Rubin, 2011). To best

ascertain in-depth information about self-seeking mental assistance from the sample, the

qualitative methodology was appropriate for this research.

Definitions

Mental health treatment: This encompasses a wide range of interventions and

support aimed at improving mental well-being. It includes therapy, counseling,

medication, and other forms of professional assistance for mental health conditions

(Payne et al., 2018).

Peer support programs: These programs involve trained peers or colleagues

offering emotional and psychological support to police officers facing mental health

challenges. Peer support can help reduce stigma by providing a more relatable source of

assistance (Payne et al., 2018).

Police officers: Members of law enforcement agencies responsible for

maintaining public order, enforcing laws, and ensuring the safety of communities (Payne

et al., 2018).

Resilience: The ability to bounce back from adversity and maintain mental well-

being in the face of stress or trauma. Resilience-building programs are often implemented

to help police officers better cope with the challenges of their profession (Payne et al.,

2018).

Stigma: Stigma refers to negative attitudes, beliefs, and stereotypes that lead to

discrimination and social exclusion. In the context of mental health treatment among

police officers, stigma often involves societal or internalized biases against seeking help

for mental health issues (Payne et al., 2018).

Stigmatization: The act of treating someone unfairly or negatively because of their

mental health condition or their decision to seek mental health treatment (Payne et al.,

2018).

Assumptions

The subculture of law enforcement does not lend itself to an open platform where

officers feel comfortable to self-seek assistance and discuss their mental health concerns

with other officers or supervisors. This is based on the negative stigma on mental illness

within law enforcement and on those who self-seek mental health assistance. The

assumptions below include the attitudes held by officers toward self-seeking mental

health assistance and directly relate to the theoretical context that is explored in the

literature review found in Chapter 2:

1. Police officers are less likely to discuss their continual exposure to

traumatic and stressful incidents that cause mental health concerns more

so than the general public (Rief & Clinkinbeard, 2021).

2. Police officers understand that mental health concerns such as anxiety or

depression could escalate and lead to officer involved suicide (Violanti et

al., 2018).

3. The police subculture is known to include feelings of suspicion and

skepticism, and, therefore, officers are concerned that if they speak to

someone confidentially, their mental health issues could be shared within

their agency (Violanti et al., 2018).

4. Police officers are more reluctant to discuss mental health concerns with

individuals who are not familiar with the police subculture and the stigmas

attached to the police culture (Lambert et al., 2021).

5. Due to the negative stigma officers present within police culture, officers

are concerned they may be placed on administrative leave and pushed into

forced medical retirement for not being mentally fit for duty (Bullock &

Garland, 2017).

These assumptions represent my anecdotal experience, which is also supported by

the literature (see Bullock & Garland, 2017; Lambert et al., 2021; Rief & Clinkinbeard,

2021; Violanti et al., 2018).

Scope and Delimitations

The purpose of this study was to analyze the stigmas and obstacles that exist

within the law enforcement subculture and identify potential pathways for mental health

treatment that they may deem as acceptable. Researchers have suggested that continued

exposure to traumatic stress has an impact on mental health for police officers and that

there is a negative stigma associated with receiving treatment (Grupe, 2023; Stuart, 2017;

Yasuhara et al., 2019).

This study focused on police officers located in the southwest region of Florida

who had a varied levels of experience in law enforcement. I conducted in-person

interviews or Zoom interviews if face-to-face was not available with 11 officers or until

saturation is attained. The participants of this study were selected using purposive

sampling from a sample population in the southwest Florida regain. The inclusion criteria

for this study ensured that all the participants had been exposed to similar traumatic stress

events based on population demographics and geographic locations. These inclusion

criteria were assumed to be relevant in order to assure that shared experiences reported

would include those that are most accurate and detailed.

Limitations

Possible limitations to this research were the participants’ willingness to remain

truthful due to the negative stigma as it related to self-seeking mental health assistance

within the subculture of law enforcement. Possibilities existed that the participants would

not fully believe the confidential nature of the research, and, therefore, answers could

have been skewed in order to conform to the police subculture that seeking mental health

assistance is a sign of weakness as not to disrupt the status quo.

Another potential limitation of the research was that a vast number of officers

may have chosen not to participate in the study due to variety of reasons based on the

police subculture and negative stigma associated with the topic of research. This study

was limited to voluntary participants who were willing to speak out, despite the stigma

associated with the research, to attain valid saturation.

Significance

To promote positive social change, I hope to provide police officers and law

enforcement agencies information to alter the negative perception of stigma as it relates

to officer self-seeking mental health assistance. Allowing agencies to have the ability to

understand how self-stigma is viewed within the subculture could facilitate change in the

methods used for officers to self-seek mental health assistance. The long-term benefit of

the expected results of the study can be used to eliminate both self and organizational

stigmas associated with helping seeking behaviors for mental health within the field of

law enforcement through the implementation of policy change.

I expected to uncover information including ways to reduce the negative stigma

within the field of law enforcement and improving the overall mental health crisis within

policing. This improvement of mental health could also increase officer productivity

levels due to the increased treatment of mental health issues.

Summary

A vast amount of research has pointed to a negative mental health stigma related

to police officers who self-seek mental health assistance within the subculture of law

enforcement. This is based on officers’ well-founded fear of becoming labeled by fellow

officers as weak along with the organization’s perception of being incapable of doing

their job thus being forced to retire or quit. This study addressed the gap in the research

on barriers to seeking mental health treatment including the stigmas characteristic of

police subculture. The focus of Chapter 2 is an in-depth literature review related to the

negative stigmas and the impact they have on officers’ help seeking behaviors for mental

health treatment.

Chapter 2: Literature Review

Introduction

The profession of law enforcement is one of the most challenging and stressful

occupations due to the repeated exposure to death, violence, and acute and chronic

stressful events at work. There has been a direct correlation between job-related trauma

and stress and PTSD, substance abuse, depression, and suicide or suicide ideation in law

enforcement officers. These combined factors negatively impact the mental and physical

well-being of law enforcement officers and cause them to exhibit far more mental health

symptoms than that of civilian employees (Craig et al., 2018). These exposures cause

police officers to experience elevated stress levels and increase their risk of mental health

consequences such as burnout, anxiety, depression, somatization, and PTSD (Violanti et

al., 2018). In addition, research has shown that working under the stressful conditions

that law enforcement officers do increases the risk for new mental health conditions to

emerge and exacerbates preexisting mental health issues (Rief & Clinkinbeard, 2021).

In addition to the job stressors, police officers are subject to administrative and

organizational pressures that exist in police subcultures. Historically, officers who have

sought treatment have been labeled, ostracized, and treated as outsiders within their own

organization (Paoline III & Gau, 2022). This subculture that exists within law

enforcement agencies is created by both self-stigma that officers personally feel and

organizational stigma that results from the negative stigma from law enforcement

organizations and environmental factors related to officers seeking mental health

treatment (Grupe, 2023). Research involving law enforcement agencies throughout the

nation has identified that police organizations are unknowingly promoting stigmas that

deter officers from seeking mental health treatment. Despite the apparent need for

emotional and mental health support, a large percentage of law enforcement officers do

not seek mental health treatment due to the fear of being labeled and the negative stigmas

associated with seeking treatment (Velazquez & Hernandez, 2019).

This literature review was conducted to further explore the primary causes for law

enforcement officers’ stressors, mental health symptoms, stigmas associated with seeking

mental health treatment, and the analysis of programs that have been implemented

throughout agencies to support officer mental health. The stressors examined include

police work-stress and organizational stress. The primary mental health symptoms

analyzed include anxiety, depression, and police suicide. The stigmas that examined

include subculture stigma, which encompasses self-stigma and organizational stigma.

The mental health support programs explored include organizational support and training,

peer support programs, and employee assistance programs (EAP).

Literature Search Strategy

To effectively examine research and data that had been previously collected and

analyzed regarding the apprehensions officers have with seeking mental health treatment

and support, a thorough literature review was conducted. This primarily involved the

review of information from a variety of databases housed within the Walden University

Library.

Once related research articles were identified, they were evaluated for appropriate

and relevant content and academic rigor and validity. In addition to the research articles

that were evaluated from the Walden University Library, a thorough review of

dissertations that were published by Walden University doctoral graduates was

conducted. The criteria for the dissertation review included similar content to this

literature review and recency of publication. All publications reviewed had a focus on

recency with a target of a publication date no more than 5 years prior to the literature

review. Due to the limited number of published articles related to law enforcement

officers’ mental health, associated stigmas, and current programs available through

internal agencies, it was necessary to use some literary resources outside of that target

time-period. Discretion was used to determine appropriateness, applicability, and validity

of the resources.

The following search terms were used in this literature review when seeking

research articles to evaluate police officer mental health, police mental health stigma,

officer stigma and seeking mental health, self-stigma, police organizational stigma,

police anxiety, police depression, police suicide, police traumatic experiences, traumatic

stress, PTSD, police stress, peer to peer support, organizational support, employee

assistance program (EAP), and law enforcement mental health support.

Theoretical Foundations

Law enforcement officers hold one of the most challenging positions in society

today, as they face extreme situations frequently while protecting and serving their

communities. The impact that these repeated exposures to crime and terrible acts of

violence would have on the officers’ mental health seems evident. However, despite the

apparent need, a large percentage of officers do not seek mental health treatment due to

the labeling and stigmas associated with seeking treatment (Abdullah & Brown, 2020).

The labeling theory founded by Becker in the 1960s is evident in law enforcement

agencies’ perceptions of mental health treatment for officers across the nation. The roots

of the labeling theory according to Becker (1997) trace back to both conflict theory and

symbolic interactionism. The conflict theory aspect determines who is labeled and who

makes the decision to label others. The symbolic interactionism perspective of the

labeling theory focuses on the perceptions and evaluation of a person’s behavior (Craig et

al., 2018).

The founder of the labeling theory, Becker, wrote a book about the theory entitled

“Outsiders” in which he discussed how those who were labeled were considered to be

outsiders. He used this term to describe those who were labeled as being outside of the

“normal” members of a specific group. Becker (1997) explained that these individuals

who were labeled as being outsiders were treated differently and often ostracized from

the group. Applying the labeling theory to law enforcement agencies’ perspectives of

mental health treatment, it is evident that officers may be labeled as weak, incapable,

inferior, or somehow less competent to perform their duties than officers who do not seek

mental health treatment (Augustyn et al., 2019).

Due to the labeling associated with mental health treatment that exists in many

law enforcement agencies, many officers elect not to seek treatment. In many situations

where officers have sought treatment, they are labeled, ostracized, and treated as

outsiders within their own organization (Augustyn et al., 2019). This subculture that

exists within law enforcement agencies is created by both self-stigma that officers

personally feel and organizational stigma that exists throughout the organization.

Researchers have hypothesized that “defensive projection” may be a driving factor in this

labeling and stigmatization of officers who seek treatment (Zoubaa et al., 2020).

According to Zoubaa et al. (2020), defensive projection occurs when an

undiagnosed person who exhibits mental health symptoms but has not sought treatment

endorses more stigma as a result. These individuals project their own defensive responses

to mental health treatment onto others who do seek treatment because they also need

treatment but fear the consequences and stigmas of doing so. Research findings have

indicated that a greater emphasis be placed on normalizing mental health treatment in

order to reduce instances where people reject others, often when they are struggling with

accepting aspects of themselves. These antistigma interventions are recommended to

reduce labeling and stigmatization that occurs when officers seek mental health treatment

(Zoubaa et al., 2020).

The labeling theory is evident throughout law enforcement agencies across the

nation and has created a culture of both self-stigma and organizational stigma to exist.

Although the nature of the job of police officers clearly exposes them to extreme

situations involving violence and crime on a frequent basis, agencies have not adopted

sufficient support mechanisms to provide officers with mental health treatment that is

safe to seek (Craig et al., 2018). Instead, many agencies label officers as incapable and

either remove them from their positions or deny them promotions if they have sought

mental health treatment (Zoubaa et al., 2020). This internal stigma and labeling that exists

in most agencies aligns with the labeling theory and the challenges that it causes

individuals once they are perceived as outsiders (Becker, 1997).

Police Mental Health Issues

Police Stress

Law enforcement has been deemed as one of the most challenging and stressful

occupations worldwide due to acute and chronic stressful events at work, exposure to

violence and death, and the physical and psychological demands placed on the officers.

These repeated exposures negatively impact the mental and physical health of officers

and often lead to impaired psychosocial well-being, poor physical health, self-harm, and

poor functioning (Duran et al., 2018). In addition, PTSD has been increasingly reported

by law enforcement officers and has stemmed primarily from stress of the role,

administrative and organizational pressure, and physical and psychological stressors. The

results of a research study indicated that officers who demonstrate higher active or lower

passive coping skills are better able to cope with the stressors of the job. Those with low

active and high passive coping skills are more likely to be impacted by PTSD (Violanti et

al., 2018).

Research has indicated that the success of a law enforcement agency is dependent

upon the appropriate understanding of the stressors within the organization. There are

two generally accepted source of stressors in law enforcement. According to Lambert et

al. (2021), these include operational stressors, which are comprised of the job content,

and organizational stressors, which is the job context. Operational stressors include the

pressure to make critical decisions quickly and effectively, perform in life-threatening

situations, and have repeated exposure to violence and death. Organizational stressors

include lack of agency support, demanding shifts that often include nights and weekends,

overtime requirements, poor relationships resulting from the job schedule and physical

and emotional demands of the job, training deficiencies, and sometimes challenged

relationships with coworkers and supervisors (Duran et al., 2018).

Research studies have identified two primary coping strategies used by law

enforcement officers. According to Allison et al. (2022), these include problem-focused

coping and emotion-focused coping strategies. Problem-focused coping strategies

directly address the source of the stress, whereas emotion-focused coping strategies

incorporate distraction and acceptance techniques to manage stress. Research studies

have proven that officers who use problem-focused coping demonstrate better coping

skills and have a better overall wellbeing (Allison et al. 2022). Those who use the

emotion-focused coping strategy report more psychological distress and increased

smoking and alcohol consumption. Additional coping strategies that researchers have

identified include simply seeking social support from coworkers, supervisors, and family

members. It is also recommended that officers get an adequate amount of high-quality

sleep each day to assist with stress management (Duran et al., 2018).

Law enforcement officers have also demonstrated better coping skills and job

satisfaction rates when they feel that their psychological contract fulfilment has been met.

A psychological contract is the trust between the law enforcement officer and his or her

colleagues and supervisors. Research has indicated a direct correlation between positive

psychological contract fulfilment and job satisfaction rates, decreased work-related

anxiety and depression, and an increased level of trust and fairness between employees. If

employees feel as though there is a psychological contract breach, there is an imbalance

in the employment relationship, which increases psychological stressors at work (Duran

et al., 2018).

A study was conducted in the southern region of the United States that focused on

the impacts of the internal and external work environment and personal character traits on

police officer stress (Paoline III & Gau, 2022).. The study involved 349 officers who

worked at the street-level in the southern United States. The findings of the study

indicated that the officers’ perceived danger, cynicism toward the public, and suspicion

of citizens all contributed to increased office stress. The findings also indicated that

support from law enforcement supervisors mitigated stress levels and had a direct

correlation of officers’ abilities to cope with job stressors. Based on the findings of their

study, the researchers recommended that police administrators understand the impact that

they have on their officers’ abilities to cope with stress. In addition, it is recommended

that law enforcement trainers and supervisors provide new officers with a variety of

patrol areas and avoid prolonged assignments in higher-stress environments when

possible (Paoline III & Gau, 2022).

Officers experience acute stress as an innate factor of their police professions,

which impacts their psychological and physiological responses to stress. Much research

has been conducted regarding the psychological, cognitive, and behavioral results of

stressors; however, limited research exists regarding the impacts of stress on officers’

physiological responses to stress. A study was conducted to examine the autonomic,

endocrine, and musculoskeletal responses to acute stress (Anderson et al., 2019). The

study involved both humans and animals and clearly indicated a positive correlation

between high levels of acute stress and skill decay in these areas. The research also

indicated that training exercises that were designed to be evidence-informed and robust

can mitigate skill decay in officers and ultimately improve officer safety (Anderson et al.,

2019).

According to Stogner et al., (2020) it is evident that law enforcement is one of the

most mentally taxing professions due to the threats of violence, rotating and

nontraditional shifts, need for continuous hypervigilance, and often a lack of support

from the communities that they serve. In addition to the existing stressors, the COVID-19

pandemic only added to the stress of being police officers. Agencies required officers to

enforce COVID-19 restrictions within their communities while continuing to perform

their normal duties. The added stress impacted the mental health of officers, and there

was a notable impact on officer resiliency, misconduct, and overall mental health. The

impacts of the pandemic were comparable to the HIV epidemic that surfaced in the 1990s

and the 911 aftermath in 2001 (Stogner et al., 2020).

Organizational Stress

The law enforcement profession has been noted as one of the most high-risk and

high-stress occupations due to the dangerous situations that officers face frequently as

they risk their lives to protect and serve their communities. The continued exposure to

these types of situations causes police officers to experience elevated stress levels and

increases their risk of mental health consequences such as burnout, anxiety, depression,

somatization, and PTSD. In addition, research has shown that working under the stressful

conditions that law enforcement officers do increases the risk for new mental health

conditions to emerge and exacerbates preexisting mental health issues. Despite the

apparent stressors that first responders have at the police and organizational level and the

emotional and mental strain that is caused by the nature of the job, a large percentage of

law enforcement officers do not seek mental health treatment. A study was conducted to

identify the reasons behind officers’ apprehension to seek mental health treatment

(Velazquez & Hernandez, 2019) The study focused on the type of duty-related trauma

that law enforcement officers face, the level of influence that mental health stigma has

among officer culture, and the intervention strategies that are currently in place to support

their mental and emotional health of police officers (Velazquez & Hernandez, 2019).

According to Velazquez & Hernandez (2019) their research concluded that there

is a strong, negative stigma from law enforcement organizations and environmental

factors related to officers seeking mental health treatment. In addition, the researchers

identified a direct correlation between job-related trauma and stress and PTSD, substance

abuse, depression, and suicide or suicide ideation. The research identified the

organizational factors having the most negative impact on officers’ mental health to be

environmental factors of the job, abiding by law enforcement and social culture

ideologies, and the continuous exposures to crime and violence on the job. Although the

researchers identified the long-term results of these ideologies and negative exposures to

materialize in PTSD, substance abuse, depression, or even suicide, it was found that law

enforcement agencies throughout the nation are unknowingly promoting stigmas that

deter officers from seeking mental health treatment (Velazquez & Hernandez, 2019).

The researchers identified that despite the apparent need for officers to seek

mental and emotional treatment, there are apparent barriers to doing so. In addition to the

stigma-related apprehensions that officers have, they also face other barriers including

delaying treatment, difficulty in pursuing treatment, not fully emerging in prescribed

regimens, and often never identifying the symptoms of mental health issues. The

researchers concluded that there are two great areas of need in order to bridge the gap that

exists between the officer’s needs and the treatment currently being sought. Those

include reducing the stigma associated with officers’ self-seeking mental health treatment

and the identification of police officer trauma-related mental health (Velazquez &

Hernandez, 2019).

One of the greatest challenges that officers face today is the organizational stress

associated with the job that, in addition to the innate demands of the law enforcement

profession, include expectations of officers by the internal agencies. One of the

expectations is that law enforcement officers are unbreakable, both physically and

mentally. This causes an unrealistic expectation for officers to avoid seeking mental

health treatment despite the obvious need for such support in a profession such as this.

Researchers Bullock and Garland examined the findings of qualitative study focusing on

mental health stigmas within the law enforcement profession. They identified that there

was an extremely high amount of pressure throughout internal agencies to avoid mental

health treatment. They found that those who sought treatment were often isolated,

alienated, demoted, or held back from promotions. In addition, they identified an internal

stigma for seeking mental health treatment and identified a strong correlation between the

sociological framework for Goffman and the modified labeling theory where officers

were labelled for seeking mental health treatment. The labels included weakness,

inferiority, inability to complete their police duties, and mental instability (Bullock &

Garland, 2017).

Despite the challenging mental and physical requirements of police work, the

expectation by the internal agency for the officer to remain unaffected by the continuous

exposure to violence and crime causes a great deal of stress. As a result of this unrealistic

expectation to not need any emotional or mental support and the high demands of the job

that take a toll on one’s mental health, officers often choose to self-medicate through the

use of alcohol, cigarettes, or other vices that are not healthy for their bodies or minds.

Internal pressure often causes officers to internalize their stress which leads to physical

challenges for the officers as well (Bullock & Garland, 2017).

Organizational stress exists in many aspects of the law enforcement profession,

some including internal agency stressors. One strong internal stressor for officers is the

trust associated with the political agendas of many in the industry. Whether it is

perceived or factual, many officers believe that there are agendas among other officers

and management to advance and there is often concern that he or she may be a casualty

of these agendas. A study was conducted to examine the effects of trust within law

enforcement agencies. The focus was on management trust, supervisor trust, and

coworker trust. The study assessed the impact of the level of trust on job autonomy,

perceptions of training and preparation, perceived dangers of the job, and overload and

underload of work associated with the job. The population sample for this study included

827 police officers from two districts (Lambert et al., 2021).

The findings of the study indicated that the most significant trust relationships for

offers involved their co-workers and their direct supervisor. There was a strong

relationship between the trust of these groups and the officers and their corresponding

stress levels. The trust relationship with higher-level managers had less significance on

the associated job stress. Perceptions of the job as being dangerous and the work overload

had strong positive implications for officer stress levels, whereas role underload

demonstrated insignificant effects. The overall outcomes of the study indicated that in

order to reduce stress and improve the mental health of law enforcement officers, it is

essential that agencies foster relationships that build trust among coworkers and

supervisors. In addition, increasing the officers’ job autonomy, providing higher quality

and quantity of training, and reducing work overload and perceptions of the job being

dangerous have all proven to reduce stress and improve the overall mental health of law

enforcement officers (Lambert et al., 2021).

Additional studies have been conducted to allow law enforcement agencies

greater insight into how to assist with mitigating organizational stress and improve

overall mental health. A study was conducted to assess the current knowledge held by

public safety personnel including law enforcement officers of available programs and to

assess the associated stigmas of self-seeking mental health assistance. The study involved

the use of questionnaires and categorized the public safety personnel into various

categories in order to compare the knowledge and stigmas among departments (Krakauer

et al., 2020).

The findings of the study indicated that corrections officers reported the greatest

level of knowledge of mental health programs available to them and the least amount of

stigma for seeking mental health treatment. Firefighters and law enforcement officers

reported the lowest level of knowledge regarding mental health support available to them

and the highest rates for internal agency stigma. The researchers concluded that agencies

need to greatly improve their communication to public safety personnel regarding the

available mental health services that are available to them internally. They also concluded

that by communicating the available support and not villainizing it that there should be a

reduction in the negative perception of such services and the associated stigmas. The

researchers recommended that internal agencies strategically integrate mental health

services and programs throughout their units to better support officers and to reduce the

negative stigmas associated. They also noted that there should be no internal

ramifications for seeking treatment, such as loss of promotion, alienation, or negative

treatment as a result (Krakauer et al., 2020).

Smith (2021) investigated factors related to organizational stress, excessive

heightened emotional exhaustion, and increased organizational cynicism among law

enforcement officers. The study involved 281 active police officers and spanned a period

of three months. Officers were provided with online surveys and were asked to provide

open-ended responses to questions. The results of the data were analyzed, and the two

significant factors that were identified as contributors to organizational stress, emotional

exhaustion, and organizational cynicism was organizational support and employee voice

climate (Smith et al., 2021).

Through the completion of this study, the researchers identified that officers

contributed exhibited excessive organization cynicism, experienced emotional

exhaustion, and felt increased levels of organizational stress to the lack of organizational

support and a feeling of their voice not being heard. The study revealed that by increasing

organizational support and improving the employee voice climate that officers should

exhibit a healthier attitude toward the organization and demonstrate an increased level of

confidence in the members of their leadership teams. It is recommended by the

researchers that law enforcement agencies across the globe identify areas of stress that

are impacting their officers and remediate those with a change in behavior within the

organization. They concluded that failure to do so may result in employee dissatisfaction,

decreased well-being, and poor job performance. The researchers also theorized that by

improving organizational support and creating a positive employee voice climate,

turnover may be reduced, and officer mental health and job performance is expected to

improve (Smith et al., 2021).

Despite the apparent stressors that first responders have at the police and

organizational level and the emotional and mental strain that is caused by the nature of

the job, a large percentage of law enforcement officers do not seek mental health

treatment. A study was conducted to identify the reasons behind officers’ apprehension to

seek mental health treatment. The study focused on the type of duty-related trauma that

law enforcement officers face, the level of influence that mental health stigma has among

officer culture, and the intervention strategies that are currently in place to support their

mental and emotional health of police officers (Velazquez & Hernandez, 2019).

The findings of this research study concluded that there is a strong, negative

stigma from law enforcement organizations and environmental factors related to officers

seeking mental health treatment. In addition, the researchers identified a direct correlation

between job-related trauma and stress and PTSD, substance abuse, depression, and

suicide or suicide ideation. The research identified the organizational factors having the

most negative impact on officers’ mental health to be environmental factors of the job,

abiding by law enforcement and social culture ideologies, and the continuous exposures

to crime and violence on the job. Although the researchers identified the long-term results

of these ideologies and negative exposures to materialize in PTSD, substance abuse,

depression, or even suicide, it was found that law enforcement agencies throughout the

nation are unknowingly promoting stigmas that deter officers from seeking mental health

treatment (Velazquez & Hernandez, 2019).

The researchers identified that despite the apparent need for officers to seek

mental and emotional treatment there are apparent barriers to doing so. In addition to the

stigma-related apprehensions that officers have, they also face other barriers including

delaying treatment, difficulty in pursuing treatment, not fully emerging in prescribed

regimens, and often never identifying the symptoms of mental health issues. The

researchers concluded that there are two great areas of need in order to bridge the gap that

exists between the officer’s needs and the treatment currently being sought. Those

include reducing the stigma associated with officers’ self-seeking mental health treatment

and the identification of police officer trauma-related mental health (Velazquez &

Hernandez, 2019).

Personal Stress

Law enforcement officers face a tremendous amount of stress which stem from

the nature of the job as well as organizational stress caused by agency’s interactions

with officers and bureaucracy (Krakauer et al., 2020). In a sample of 832 officers

from two different police departments in the Midwest, Rief & Clinkinbeard (2021) found

that in addition to the general stress of police work, officers also face personal stress,

some of which is caused by their perception of whether they “fit” into the organization

or even the law enforcement profession itself. The research examined the correlation

between law enforcement officer’s perceptions of “fit” in their organizations and the

outcome of stress. The findings of the study indicated that there was a strong correlation

between officers perceived organizational fit and their stress levels. For those who did not

feel as though they do fit in their organization or in the profession, there was a high level

of stress exhibited. Additionally, there was a positive correlation between the

organizational fit and overall job satisfaction and turnover rates.

Rief and Clinkinbeard (2021) concluded that if officers felt that they were a good

fit for the organization and the profession, their stress level was mitigated significantly.

Conversely, those who felt as though they did not belong either in the organization, the

profession, or both, exhibited much higher levels of stress, sometimes as much as twice

as those who perceived themselves as being a good fit. The researchers noted that

perceived stress and organizational fit were both strong predictors of turnover

contemplation and overall job satisfaction. Based on their findings, the researchers

strongly recommend that agencies prioritize organizational culture and ensure that it is

inclusive and supportive of the officers who are employed there.

Stressors that officers face are often internalized and ultimately cause them a great

deal of personal stress. As a result of this continuous internalization of stress and repeated

exposures to stressful situations due to the police work and the organizational stressors,

law enforcement officers develop personal health issues at a greater rate than the general

population (Violanti et al., 2018). A study was conducted that analyzed the personal

stress of police offers and the corresponding adverse health conditions and mortality rates

over a period of 68 years. The researchers who conducted this study analyzed health and

mortality rates of police officers from 1950 to 2018 and analyzed 1,853 police deaths that

spanned across that time-period (Violanti et al., 2021).

The findings of this research study indicated that law enforcement officers had

significantly higher mortality rates resulting from adverse health conditions. The most

prominent conditions noted that led to the increased officer mortality rates included

circulatory system diseases, cirrhosis of the liver, mental disorders, and malignant

neoplasms. The study also concluded that officers who were white males were the most

prone to adverse health conditions that led to their mortality. Black male and female

officers of all races demonstrated lower mortality rates resulting from adverse health

conditions. The authors concluded that continuous exposure to stressors caused adverse

health conditions to develop. These conditions ultimately led to the death of the officers

at a much higher rate than was evidenced in the general population (Violanti et al., 2021).

The law enforcement profession exposes officers to violent and volatile situations

on a continual basis. The stress that results from that repeated exposure materializes in

the physical and mental health of officers (Violanti et al., 2021). A research study was

conducted to further analyze the relationship between police offers’ self-reported stress

and their corresponding health reports. The study also assessed the correlation between

dysfunctions in the basal cortisol profiles and their relationship to social desirability. The

study involved 77 policy offers who completed questionnaires that measured perceived

stress and mental and somatic health symptoms as well as social desirability. In addition,

saliva samples were provided for cortisol concentration analysis (Habersaat et al., 2021).

The findings of this study indicated a strong correlation between officer stress and

adverse health conditions and symptoms. The results of the saliva analysis indicated a

strong correlation between the dysregulation of the hypothalmic-pituitaryadrenal. This

verified the hypothesis that officers who seek social approval by inflating one’s capacities

(pretending) causes increased work-related stress and causes the officer to be more prone

to stress-related disease. The researchers strongly recommend that law enforcement

agencies become aware of the impacts of the stress that police work and the

organizational stress associated with the position has on an officer’s personal stress level

and overall mental and physical well-being (Habersaat et al., 2021).

Anxiety

The repeated exposures to violence, crime, death, and life-threatening situations

that are part of the law enforcement profession predispose officers to higher levels of

anxiety and mental health issues. Conditions such as anxiety, depression, and PTSD are

far more prevalent in law enforcement officers and first responders compared to other

professions. A survey was administered in 2017 that included 2,004 police officers,

paramedics, EMTs, and firefighters and focused on the self-identification of mental

health symptoms. The results of the survey indicated that 85-percent of those surveyed

reported having experienced mental health related symptoms. Despite the large

percentage of respondents who acknowledged the symptoms, only 34-percent of the

respondents stated that they have been diagnosed as having a mental disorder (Axelrod,

2018).

The research report indicated that the stigma of weakness when seeking mental

health treatment is the primary reason for first responders to avoid mental health

treatment. This fear of being ostracized or treated differently due to the stigmas that are

associated with mental health treatment adds to the anxiety that the officers already have.

Licensed psychologist Stephanie Conn indicated that although there have been

improvements made regarding officers seeking assistance for anxiety and mental health

issues due to generational changes, a stigma of weakness still exists. Conn recommends

that agencies encourage officers to recognize the anxieties that they are experiencing and

to voice their need for mental health treatment (Axelrod, 2018).

Conn recommended that agencies adopt a model that encompasses three common

mental health resources to include EAPs, peer support, and critical incident stress

management. Although Conn felt that all three resources are needed, she strongly

recommended the peer support and critical incident stress management models for law

enforcement officers who are experiencing anxiety and other mental health symptoms.

Conn provided a strong rationale for these support systems to be offered through law

enforcement agencies where officers are employed. She felt that the officers would be

more encouraged to seek assistance if their agencies were offering and promoting these

resources among the organization. She theorized that this would assist the officers with

their anxiety and would reduce some of the current stigmas associated with mental health

treatment (Axelrod, 2018).

Depression

Due to the nature of the law enforcement profession and the continuous exposures

that officers have with traumatic incidents, extreme violence, and crime, the risk for

officers to develop depression is of great concern. A study involving 242 police officers

from Buffalo, New York, were evaluated over a period of 10 years (2004-2014) to

identify factors that predispose officers to depression. Personality characteristics

including coping abilities, hardiness, social support, and protective factors were

examined. The study revealed that officers with previous depression symptoms and/or

diagnosis had a 95% probability of experiencing recurring depression after entering the

profession of law enforcement. The study indicated that for officers who were free of

depression prior to entering the profession, there was a 23% chance that they would

experience onset depression as a result of being a police officer (Jenkins et al., 2018).

The study also analyzed the personality characteristics of officers and compared

those with the propensity for the onset of depression. The findings of the study indicated

that officers who demonstrated strong coping skills, hardiness, and had social support

were less likely to experience depression. Conversely, officers who passive coping skills

and who experienced neuroticism were far more likely to experience the onset of

depression as a result of their professional experiences (Jenkins et al., 2018).

Depression affects approximately 6.7% of adults in the United States. This

statistic is more than double for that for police officers due to sustained exposures to

critical incidents that they face on a continuous basis. Some reports indicate that 16 to

23% of police offers exhibit depressive tendencies. Research indicates that depression

resulting from occupational-related stress can be mitigated through the use of effective

coping skills and hardiness of an officer. Those who demonstrated positive coping

behaviors which included planning, acceptance, and seeking support demonstrated fewer

symptoms of distress and corresponding depression. Officers who possess negative

coping behaviors which include self-blame, disengagement, and denial are more likely to

experience psychological distress and depression. The strongest personality trait that was

noted to correlate with positive coping skills is an officer’s hardiness. This is the set of

beliefs or attitudes about oneself that provide motivation and courage to allow the officer

to endure stressful situations and transition problematic events into opportunities (Allison

et al., 2019).

A study involving heart rate and physical activity monitoring was conducted to

measure the impact of stress on law enforcement officers and the direct correlation to

depression. The results of the study indicated that officers exhibit anticipatory stress prior

to their shift in anticipation of the events that they will face while at work. That is then

followed by high levels of stress when faced with critical incidents while performing

their duties as a law enforcement officer. The researchers identified a direct correlation

between perceived occupational stress and depression. They found this to be even more

profound in first-year officers who are learning to cope with the stressors of the job

(Allison et al., 2019).

Police Suicide

Despite the dangerous nature of the job and the high potential for police officers

to die feloniously or accident, officers in the United States are twice as likely to die by

suicide than in the line of duty. This statistic is alarming and one that is a result of the

culminating mental factors of the law enforcement profession. Repeated exposure to

violence, crime, death, and destruction takes a toll on the mental health of law

enforcement officers, thus causing officers to be at an increased risk of PTSD,

depression, and suicide. Despite the apparent need for mental health treatment to possibly

prevent suicide and/or suicide ideation, there are several barriers including shame and

stigma that often prevent officers from seeking treatment. Similar barriers exist which

prevent families from openly discussing the suicide of a loved one. In addition, the

majority of law enforcement officer suicides are not reported by local or mainstream

media, thus further contributing to the silence and lack of awareness surrounding officer

suicide (Heyman et al., 2018).

An analysis was conducted by researchers involved 97 documents which spanned

from 1997 to 2016 which focused on the factors leading to officer suicide including the

stressors and associated personal problems. The results of the literary analysis indicated

that the stressors identified included traumatic events, work shift, organizational support,

lack of fit within the organization, and stigma associated with seeking mental health

treatment. The problems that were identified as leading to suicide and/or suicide ideation

included alcohol dependency and problems associated with domestic relationships which

were hypothesized as stemming from stressful working conditions.

Based on the results of the literary analysis, the researchers recommended that

law enforcement agencies implement mental health treatment options that are anonymous

and non-punitive to the officers’ careers. They also recommend that agencies begin to

combat the stigmas that exist and ensure that supervisors encourage officers to seek

mental health treatment, even as a preventative measure. The results of this study

strongly indicate that the silence that exists in the agencies throughout the nation is

contributing to this vicious cycle which is costing far too many officers their lives.

Officers are paying the ultimate price because they are not being supported within their

agencies and are being shamed into an avoidance behavior that is only evident when it is

too late (Violanti et al., 2019).

In an effort to better support agencies throughout the United States to prevent

officer suicide, a study was conducted involved 110 law enforcement agencies

throughout the United States. The study invited 177 agencies to participate, and 110

accepted the invitation and fully participated. The study involved qualitative interviews

that assessed the mental health services offered by each agency. The services were

grouped into one of four categories which included minimal, basic, proactive, and

integrated services. The minimal services included a municipal employee assistance

program. The basic category involved mental health, critical incident response, and

training services. The proactive category involved in-house mental health care, substance

misuse, programs, embedded chaplains, peer support, health and wellness programs, and

screenings. The integrated category included an integration of services into day-to-day

operations. The types of services offered by each agency varied but fell into one of the

aforementioned categories. Although more agencies offered more of the minimal and

basic services, some do offer proactive and integrated services (Ramchand et al., 2018).

Despite the level of agency support, the researchers found a strong apprehension

for officers to seek treatment due to the stigma associated with seeking mental health

treatment at any level. Based on these findings, the researchers recommend that agencies

not only provide the services to support officer mental health and combat officer suicide

but also promote the use of the services. In addition, they recommend that law

enforcement agencies make a strong effort to change the culture to support officers

seeking mental health treatment. This culture shift should encourage more officers to

seek the necessary treatment to support their emotional and mental well-being and should

result in reduced officer suicides across the nation (Ramchand et al., 2018).

The profound issues associated with police mental health which include police

stress, organizational stress, personal stress, anxiety, depression, and police suicide

validate the need for this study to examine the perceived obstacles and challenges that

officers face based on their lived experiences that prevent them from seeking mental

health treatment. It is also essential that this study investigate how, if at all, stigmatization

plays a role in preventing them from seeking mental health treatment. By further

examining the role of stigmatization and the perceived obstacles that officers face when

self-seeking mental health treatment, safe and amenable pathways may be identified and

recommended for officers to seek mental health treatment (Violanti et al., 2019).

Subcultural Stigma

Self-Stigma

The stigmas associated with law enforcement officers seeking mental health

treatment are the primary reasons that mental health is not addressed. Officers fear the

perceived weakness, the lack of trust from fellow officers, and the self-image of

weakness or inadequacy that may be associated with mental health treatment. As a result,

they often disregard the apparent mental health symptoms and allow their mental health

issues to remain untreated (Wheeler et al., 2018). A study was conducted involving 641

participants to identify specific mental illness stigma and the associated factors. The

primary factors that were examined for the purpose of this study included self-care,

perceived dangerousness, social distance, predicted police behavior, and treatment

amenability (Yasuhara et al., 2019).

The results of the study indicated that there is a lack of self-care due by

participants as a result of avoidance and denial. Due to the self-stigmas associated with

mental health treatment, law enforcement officers may ignore or hide their mental health

symptoms. This leads to a lack of treatment amenability as evidenced in the study as

well. There was a strong correlation between social distance and perceived mental health

issues. Ultimately, participants avoided contact with others in an attempt to hide their

personal struggles with mental health. Perceived dangerousness was related to social

distancing to avoid situations where mental health issues may become evident. The study

recommended that future research be conducted regarding predicted police behavior.

Their early findings led to the conclusion that additional police training be provided to

both officers and agencies regarding the importance of mental health treatment. The

researchers hypothesized that this would assist with the de-stigmatization of mental

health treatment for law enforcement officers (Yasuhara et al., 2019).

The stigma surrounding mental health treatment is evident in non-law

enforcement sectors but is significantly greater in the law enforcement population.

Approximately 25% of non-law enforcement members of society experience some form

of mental illness throughout their lives (Smith & Applegate, 2018). This number is

significantly greater in law enforcement officers with as many as 85% indicating that

they have experienced mental health symptoms. Despite the alarming statistics in both

populations, there is such a negative stigma associated with mental health treatment that

both shy away from seeking treatment (Abdullah & Brown, 2020) .

The stigma for law enforcement officers is greater than that of the public and

often comes with punitive consequences ranging from demotion to isolation from their

colleagues and supervisors. There are two types of stigmas for the general population,

public stigma and internalized or self-stigma. Public stigma is defined as the stereotypes

and ideologies that the public has in references to mental health treatment. Internalized or

self-stigma is one’s own shame and how the individual internalizes the public stigma

(Smith & Applegate, 2018). In law enforcement, organizational stigma is an added

component which includes the stigma within the law enforcement agency regarding

mental health symptoms, conditions, and treatment (Abdullah & Brown, 2020).

A study was conducted involving 257 participants and focused on self-labeling

and the negative implications of stigma. The researchers sought to find the correlation

between labeling oneself as having a mental illness and the negative effects of

anticipated, internalized, and self-stigma. Of the participants in the study, 202 admitted to

having experienced symptoms of anxiety, depression, or posttraumatic stress disorder,

while 52 indicated that they had not experienced these symptoms. The study found that

the participants who indicated that they had not experienced any of these symptoms of

mental illness held higher levels of prejudice, stereotypes, discrimination, stigmas and

were more likely to be single, young males. The study concluded that there was a strong

positive correlation between self-labeling and stigma. The researchers noted that the

findings were consistent with the modified labeling theory in that self-stigma may inhibit

someone from adopting the mental illness label and if the label is adopted may increase

one’s vulnerability as a result (Fox & Earnshaw, 2023).

Although labeling and stigmas are evident in our society, the mental health

stigmas among Law enforcement officers are even greater. A study was conducted to

further analyze the mental health stigmas that exist among law enforcement officers. The

study involved 296 and were evaluated based on personal PTSD symptoms, measures of

trauma exposures and established criteria for dimension of stigma which included

attitudes toward seeking help, negative stereotypes, attributions, and intended behavior.

The results of the study confirmed the researchers’ hypothesis that officers experience

higher rates of PTSD symptoms related to their significant levels of trauma exposure.

Despite these findings, the researchers concluded that police officers have a much higher

propensity to have negative stereotypes, biases, and stigmas related to mental illness and

those exhibiting symptoms including PTSD. The researchers found that officers need to

become more self-aware of their symptoms, reduce their stereotypes, and seek treatment

(Soomro & Yanos, 2018).

The recommendations of the researchers included training of police officers, law

enforcement agencies, and the entire policing community regarding the need for officers

to self-reflect and identify their mental health needs. They also noted the importance of

the agency support so that officers are encouraged to identify their mental health needs in

a safe environment where they will not be labeled, and stigmas will not be applied. If this

environment does not change, the researchers hypothesize that the cycle of officer self-

neglect and denial of their own mental health will continue. This will only continue the

police suicide rates and poor mental and physical health conditions with which they live

every day (Soomro & Yanos, 2018).

Organizational Stigma

Law enforcement officers have a strong belief in ideologies that are often in

conflict with self-treatment and mental health acknowledgment. There are traditional

masculine values and expectations that often shame and ridicule those who seek

treatment. Seeking such treatment may cause speculation regarding the officer’s fitness

for duty. As a result, law enforcement officers often suppress, hide, or avoid their

emotions. They do so in many cases by engaging in destructive behaviors, abusing

alcohol, and sometimes even abuse drugs (Grupe, 2023).

The organizational stigma is a strong deterrent for law enforcement officers to

seek mental health treatment. There is a fear by officers that they will be perceived as

weak by their supervisors, that they may not be promoted or may be demoted or removed

from specialty units, they may be forced into early retirement, or they may lose their

position completely after being forced out. Eighty-five percent of law enforcement

officers indicate that they avoid disclosure of any mental health symptoms to their

supervisor or manager due to a fear of the ramifications. Sixty-two percent of law

enforcement officers indicated that they would expect discrimination by their peers and

supervisors if they disclosed mental health issues. Sixty-two percent of officers also

noted that they would not want to have a supervisor or manager who had a mental illness

(Stuart, 2017).

Due to the organizational stigmas that are evident in the agencies and within the

officers’ personal biases, there is a strong culture of anti-mental health treatment in law

enforcement. It has been identified that 55% of law enforcement officers believe that

there is maltreatment of colleagues who have disclosed a mental illness, disorder, or who

are seeking mental health treatment. As a result, most officers choose not to disclose to

their supervisor or manager if they are experiencing mental health issues (Burzee et al.,

2022). These attitudes regarding mental health are prevalent across the nation and are

hypothesized to be a result of masculine values that are stereotypical in law enforcement

agencies. This cultural and the social norms within the sub-culture of law enforcement

have perpetuated long-standing stigmatized beliefs surrounding mental health and

treatment. There are negative attitudes, biases, and stigmas that exist throughout the

nation and throughout the ranks of law enforcement agencies (Bailey, 2021).

A study was conducted involving 257 commissioned and civilian police

employees in a Midwestern U.S. city of mid-size. The study surveyed the participants

regarding their perceptions of self-seeking stigmas that exist in their agencies. The results

of the study indicated that mental health issues that police officers have are exacerbated

by the negative beliefs and attitudes regarding mental health. The results of the study also

indicated that there is a strong negative correlation between the mental heal help-seeking

stigma and help-seeking behaviors and attitudes. This ultimately reduced mental health

help being sought by officers (Grupe, 2023).

Based on the findings of the study, the researchers recommend the structural

equation model which supports mindfulness training for law enforcement officers and

agencies. The proposed model and corresponding training include revamping policies,

practices, and providing interventions of law enforcement agencies to allow them to

positively influence mental health treatment and encourage help-seeking behaviors. This

is hypothesized to improve the overall well-being of the agencies’ employees and the

communities that they serve (Grupe, 2023).

Renewed focused is being placed on officer mental health, and agencies are

beginning to realize the importance of changing the current culture to one that is

supportive of mental health treatment. Twenty-five percent of police officers have had

suicidal ideations on at least one occasion, and this directly correlated to the not only the

trauma, stressors, death, and danger that officers face daily, but also the neglect from

their own agencies to support their mental health and encourage help-seeking behaviors

(Hartford Courant, 2022). With such emphasis and new research focused on this, it is

hopeful that agencies across the globe will begin to support their officers (Hartford

Courant, 2022).

The subculture stigmas including self-stigma and organizational stigma that exist

in law enforcement agencies support the need for this study to examine the perceived

obstacles and challenges that officers face based on their lived experiences that prevent

them from seeking mental health treatment. It is also essential that this study investigate

how if at all stigmatization plays a role in preventing them from seeking mental health

treatment. By further examining the role of stigmatization and the perceived obstacles

that officers face when self-seeking mental health treatment, safe and amenable pathways

may be identified and recommended for officers to seek mental health treatment (Violanti

et al., 2019).

Strategy and Solutions

Organizational Support

To combat the high rates of officer suicide and mental and physical ill-health of

officers, many law enforcement agencies across the globe have begun to examine their

role in providing greater levels of officer support. Agencies have begun to promote office

well-being and encourage the reduction of emotional exhaustion. They have done so

through the implementation of work-place interventions that promote job resources,

provide a supportive and equitable organizational climate that is founded upon shared

values. Agencies have also begun to foster officer mental health in the context of the

work stressors. These approaches allow agencies to provide support not just through

decreasing job demands but by supporting the officers and mitigating some of the work

stressors that are innate to the job (Wolter et al., 2018).

To gain a better understanding of an officer’s frame of mind, it is essential for

agencies and mental health professionals to better understand how officers process stress,

life threatening situations, and the extreme levels of violence to which they have grown

accustomed. A current practice that has been adopted by some law enforcement agencies

is to identify the personality traits of an officer and place them in the most appropriate

unit within the organization (van der Meulen et al., 2017). Hardiness, resilience,

psychological capital, extroversion, conscientiousness, self-esteem, and strategic coping

skills are traits that allow an officer to be able to handle higher levels of stress and may

be a better personality fit for specific, high-risk units that are innately more stressful.

Personality traits that include having innate challenges handling stress, neuroticism, and

lower self-esteem may be a better fit for roles in the courts, local agencies, and minor

patrolling positions. Researchers recommend that human resources departments analyze

the personality traits of an officer when hiring and placement decisions are made

(Janssens et al., 2018; Parent-Lamarche & Marchand, 2019).

The way in which an officer copes with stress is of strong importance to law

enforcement agencies. This allows them to make hiring decisions through human

resources and ensure that the officers are aligned best with the units that they are assigned

to serve. A study was conducted to identify the ways in which officers and their family

members cope with life-threatening situations and how their agencies recognize and

support coping mechanisms. The findings of this study indicate that officers experience a

loss of self and identity when their lives are threatened. They often incorporate protective

measures that have been instilled in them to be resilient in these situations and

compartmentalize the dangers as part of the job. This allows the officers to regain a sense

of control and maintain composure, even in the most volatile of situations (Sigad, 2020).

Research also revealed that officers experience extreme emotional strain from

repeated exposures to violence and crime. This often transcends into their personal lives,

thus causing high divorce rates and strained relationships with family and friends.

Through the development of an understanding of how officers manage and cope with the

job stressor, law enforcement agencies are better able to identify support programs and

structures that will help alleviate some of the mental ill-health and hopefully reduce

officer suicide rates (Sigad, 2020).

Suicide prevention strategies are one of the primary focus areas for law

enforcement agencies. Based on research conducted by the Air Force Suicide Prevention

Program and that of the Montreal Police Department’s Together for Life Suicide

Prevention Program, law enforcement agencies are able to incorporate best practices.

These programs identified pre-employment psychological screenings, employee

assistance programs, peer support programs, and gatekeeper training programs as

extremely beneficial as suicide prevention strategies and are highly recommended for

agencies to adopt across the globe (Bernier, 2018).

Research involving 55 agencies throughout the nation indicated that nearly 25%

of officers did not know if their agency offered any mental health or counseling

programs. Another 35% did not feel that their agencies support officer mental health and

wellness. The officers who indicated that they did feel supported reported higher levels of

overall well-being and significantly less stress. However, 12.4% of officers indicated that

they were likely or very likely to attempt suicide at some point in their lives (Thoen et al.,

2020).

A study identified an extremely effective training program known as Blue

Wellness for agencies to implement to provide better support toward their officer’s

mental and emotional wellness. The purpose of this program is to improve the attitudes of

officers toward mental health awareness, treatment, and emotional wellness for

themselves and their colleagues. The program is agency-sponsored and supports

introspection, peer support, and group interactions. Participants in this program exhibited

increased positivity toward emotional and mental wellness based on the results of the pre-

and post-test comparisons. The greatest increase in improved mental health attitudes was

identified in higher-ranking officers who worked in non-urban departments. There was

also a marked improvement in mental health attitudes found in the officer group that was

identified as cynical. There was less improvement in the officers demonstrating lower

levels of cynicism, thus indicating a potential lower level of need for improvement

(Drake, 2021).

Peer Support

Peer support is one of the most effective forms of social, emotional, and

psychological support from which officers have benefited. The stigma of mental health

treatment does not seem to be associated strongly with peer support programs; therefore,

peer support is more accepted by officers and therefore has been an extremely successful

tool to support officers’ mental health. Results of a study involving 162 officers who

were involved in a peer support model that was integrated into their agencies

demonstrated extremely positive results. The research study indicated that participants

exhibited improved overall psychological well-being, had reduced levels of strain, and

demonstrated a positive attitude toward their mental health and social support network of

fellow officers and agency-employed chaplains. The participants also indicated that they

felt lower rates of burnout and PTSD and attributed this with being able to talk about

their work experiences with peers who could understand their trauma and exposures more

easily than civilians (Schantz et al., 2020).

It is essential that law enforcement officers and agencies recognize the importance

of proactive maintenance required to support officers’ mental and physical well-being.

Since law enforcement, as a profession, values and requires fortitude and emotional and

physical strength, often beyond what can be given by any officer, it takes a toll on the

men and women who are courageous enough to accept the challenge. The price that

officers pay to protect and serve is often that of their own health, physically and mentally,

and is often not recognized until the damage is already done. To provide longevity to

officers’ careers and improve their quality of life and their relationships, it is necessary

for a meso-level change to take place within law enforcement agencies. The regressive

way of thinking is diminishing in some agencies but is alive and well in far too many

("Responding to a Colleague in Crisis," 2018).

The consequences for officers to receive mental health treatment have been

detrimental for a long period of time and is often rooted in the official policies within the

agencies. As a result, it is important for law enforcement agencies to identify a way for

officers to seek treatment with which they are comfortable. One of these ways is peer

support, and it is highly recommended due to the success rate and the rate of officer

acceptance. Since officers are apprehensive about seeking mental health treatment, peer

support offered by colleagues or chaplains retained by the agencies, has been widely

accepted and extremely successful. The highly effective response and effectiveness rates

are partly attributed to the fact that officers feel safe when speaking to their peers and

unsafe when speaking to mental health counselors. Due to the positive response to peer

support, it is highly recommended by researchers that agencies adopt an integrated peer

support model which includes staffed chaplains and fellow officers to provide peer

support ("Responding to a Colleague in Crisis," 2018).

The police departments in Ontario, Canada recognize the importance of peer

support and have implemented internal peer support programs within their law

enforcement agencies. The Ontario agencies hinged their program on the Policy

Feedback Theory (PFT) which argues that when policies are established and

corresponding resources are dedicated to support specific programs, it will structure the

activity and support of participants. In pairing this theory with the research analyzed

regarding peer support, the Ontario law enforcement agencies adopted a peer support

program which includes a fully integrated peer support program where officers share

experiences and discuss their work encounters with their peer(s) in a safe space. The

outcome of this peer support program implementation has been very successful and has

resulted in a reduction in mental health stigma and contributes to the enhanced mental

health literacy among officers. In addition, the internal policy adoption has demonstrated

a commitment by the organization to its officers’ mental health through peer-support. The

Ontario peer-support model has been one for agencies to follow globally and potentially

adopt to support their officers (Milliard, 2020).

Agencies across the nation have begun to explore peer support options to support

officers’ mental well-being (Van Hasselt et al., 2019) . One of the most successful peer

support programs is known as Peers as Law Enforcement Support (PALS). This program

was built on the ideology that consulting with a peer decreases officer resistance to seek

assistance for psychological and mental health issues. In addition, the peer support model

does not seem to carry the same stigma as seeking assistance through a traditional mental

health counselor (Van Hasselt et al., 2019).

The PALS program values the importance of officer peer support and the empathy

of the officer providing support to those in need. As a result, the peer support model is

voluntary, and the volunteers who participate are trained using a four-pronged approach.

The peer support volunteers are trained to identify risk factors for substance abuse,

anxiety, depression, PTSD, and suicide. They are also trained to spread the message of

admission for the need for mental health support is not a sign of weakness to perpetuate

the culture of acceptance throughout the agency for seeking peer support. Peer support

volunteers are trained to ensure that officers feel comfortable with the support provided

and that their contacts remain confidential so that officers’ privacy is respected. Lastly,

the volunteers are trained regarding additional resources that are available such as

psychiatrists, psychologists, and family/marriage counselors to which officers may need

to be referred if additional support is needed (Van Hasselt et al., 2019).

EAP

EAPs are an effective resource offered by law enforcement agencies and many

other organizations to support their employees. EAP programs tend to have less of a

stigma attached than traditional mental health treatment but are still underutilized in the

law enforcement sector. These programs offer assistance through online, telephone, or in-

person counseling services with professionals (Milot, 2019). Employees may either self-

elect to partake in the EAP services or may be mandated to do so by a manager referral or

organizational requirement. In law enforcement agencies, EAPs are available in most

organizations but are not as advertised or utilized as they should be. Agencies that do

promote EAPs still find that officers are hesitant to utilize them for fear of loss of

anonymity and resulting stigmas that may be applied to them. EAPs are still utilized more

frequently than traditional mental health counseling services but not as frequently as peer

support by law enforcement agencies (Milot, 2019). t There appears o be an opportunity

for more support of EAPs within the organizations that may assist with reducing

psychological stigmas associated with EAPs (Milot, 2019).

The effectiveness of EAP programs has been a question posed by law

enforcement agencies and other organizations. Although EAPs are readily available, and

they are common knowledge to most employees, many do not take advantage of them.

An examination of 17 studies was conducted to evaluate the effectiveness of EAPs

throughout North America. The results of the analysis indicated that, when utilized, EAP

programs are effective in supporting employees’ overall well-being. In addition, there

was a correlation between self-sought EAP services and presenteeism. The employees

who utilized the programs also exhibited improved health, well-being, and productivity

as a result. Employees who seek out EAP services recognize their need for assistance and

benefit from the program. The analysis identified the greatest area of opportunity is for

employees who do not utilize the services to do so. The examiners determined that

additional research needs to be conducted to identify how to motivate employees to seek

self- treatment, especially in the field of law enforcement (Joseph et al., 2018).

Summary and Conclusion

Throughout this literature review, the primary mental health challenges of law

enforcement officers were examined and found to be PTSD, substance abuse, anxiety,

extreme stress, depression, and suicide or suicide ideation in law enforcement officers.

Each of these factors correlated with job stressors and were examined closely throughout

this review to identify factors that may help to mitigate corresponding mental health

issues. The stressors that were analyzed included police work-stress stemming from daily

traumatic exposures and organizational stress resulting from fears associated with lack of

acceptance or from not fulfilling unrealistic emotional, mental, and physical expectations

of law enforcement agencies (Craig et al., 2018).

The subcultural stigma, including self-stigma and organizational stigma that exist

in law enforcement agencies and the biases that are strongly held by the officers

themselves and organizations were closely examined. It was found that law enforcement

agencies throughout the nation have identified that police organizations are unknowingly

promoting stigmas that deter officers from seeking mental health treatment. The stigmas

that were examined included subcultural stigma. Subcultural stigma encompasses self-

stigma and organizational stigma which stems from the agency’s attitude and

expectations regarding mental health. The fear of being labeled and the negative stigmas

associated with seeking treatment prevents a large percentage of law enforcement officers

from seeking mental health treatment despite the apparent need for officers to obtain

additional emotional and mental health support (Velazquez & Hernandez, 2019).

An analysis of programs that have been implemented throughout agencies to

support officer mental health was also explored. These include organizational support and

training, peer support programs, and EAP. Each of these programs provided some level

of benefit to officers, however, some were underutilized while others are gaining traction.

The use of traditional mental health treatment was found to be highly underutilized by

law enforcement officers due to multiple factors. The stigmas associated with traditional

mental health treatment were a strong deterrent that prevented officers from seeking

assistance officers. When this traditional treatment was sought, officers often found that

there was a lack of understanding by the mental health counselor regarding their

perspectives. These combined factors cause traditional mental health treatment to be an

underutilized resource.

Treatment offered by organizational support provided through training programs

has been shown to be effective in supporting a more accepting culture but did not solve

the issue of the individual mental health treatment needed by officers. Overall,

organizational support is needed to change the climate of mental health treatment stigma

but needs to occur in conjunction with more individual treatment options. The most

effective organizational support options were found to be pre-employment psychological

screenings, employee assistance programs, the inclusion and promotion of peer support

programs, and gatekeeper training programs. These were all found to be helpful in

officers’ mental well-being and aided in the suicide prevention rates (Bernier, 2018).

Agencies also found that understanding how officers manage and cope with job stressors,

they are better able to identify support programs and structures that will help alleviate

some of the mental ill-health and potentially reduce officer suicide rates (Sigad, 2020 ).

EAPs offer mental health treatment through online, telephone, or in-person

counseling services with professionals. EAP programs may be employee- elected or

mandated by managers. The literature review indicated that this is a highly underutilized

benefit, and the majority of law enforcement officers who access EAP services are

mandated by their supervisors to do so. This mandate may result from alcoholism, drug

abuse, or other behaviors that require treatment. Often, the EAP treatment option will

save an officer’s career if they agree to treatment and mitigate the negative behavior.

Officers who would self-elect to participate in an EAP are hesitant to utilize them for fear

of anonymity and resulting stigmas that may be applied to them. Although EAPs are

utilized more frequently than traditional mental health counseling services, they are not

as frequently sought out as peer support by law enforcement agencies.

The results of the literature analysis indicated that peer support was the most

effective form of social, emotional, and psychological support from which officers have

benefited. The organizational and self-stigmas that officers have traditionally associated

with mental health treatment does not seem to be as much of a factor with peer support.

As a result, peer support is more widely accepted by officers and has resulted in officers

improved overall psychological well-being, had reduced levels of strain, and

demonstrated a positive attitude toward their mental health and social support network of

fellow officers and agency-employed chaplains. Participants who were involved in peer

support programs demonstrated lower rates of burnout and PTSD and directly correlated

with their improved mental health with being able to talk about their work experiences

with peers who could understand their trauma and exposures more easily than civilians or

mental health professionals (Schantz et al., 2020).

The literature recommended peer support programs that involved colleagues or

chaplains retained by the agencies, as officers feel safe when speaking to their peers and

unsafe or uncomfortable when speaking to mental health counselors. The policy feedback

theory (PFT) is also recommended in conjunction with the peer support programs. The

PFT indicates that when policies are established and corresponding resources are

dedicated to support specific programs, it will structure the activity and support of

participants. It is recommended that agencies combine cultural support such as the PFT

which will allow for agency culture and support of the program with a fully integrated

peer support program. This will encourage officers to share experiences and discuss their

work encounters with their peer(s) and/or appointed chaplains retained by the agencies in

a safe space (Milliard, 2020).

When adopting a peer support model, it is recommended that agencies utilize a

model such as the PALS program. In this program, officers who value the importance of

officer peer support and are able to empathize with their fellow officers are selected to be

peer supporters on a volunteer basis. The peer support volunteers should be trained to

identify risk factors for substance abuse, anxiety, depression, PTSD, and suicide. Peer

support volunteers should be trained to ensure that officers feel comfortable with the

support provided and that their contacts remain confidential so that officers’ privacy is

respected and should promote the use of the program throughout the agency. It is also

recommended that the volunteers be trained regarding additional resources that are

available such as psychiatrists, psychologists, and family/marriage counselors to which

officers may need to be referred if additional support is needed. Through the

implementation of this model nationwide, law enforcement officers may finally be

provided with the mental health support systems needed to help mitigate the emotional

damage that is caused by their job exposures and extreme stressors to which they are

subjected daily (Van Hasselt et al., 2019).

The need for safe and amenable pathways for officers to seek mental health

treatment support the need for this study which explored the perceived obstacles and

challenges that officers face based on their lived experiences that prevent them from

seeking mental health treatment. It is essential to investigate how, if at all, stigmatization

plays a role in preventing them from seeking mental health treatment. By further

examining the role of stigmatization and the perceived obstacles that officers face when

self-seeking mental health treatment, effective programs were identified and

recommendations offered for best implementation practices (Violanti et al., 2019).

Chapter 3: Research Method

Introduction

The purpose of the qualitative phenomenological study was to uncover the

perceived obstacles and challenges that officers may encounter bases on their lived

experiences as well as the stigmatization within the subculture of law enforcement that

prevents officers from self-seeking mental health treatment. It is understood that police

officers’ continual exposure to dangerous conditions that could turn into violent

encounters is part of their chosen profession (Velazquez & Hernandez, 2019). This

continual traumatic stress that officers face while in the line of duty could affect the

mental well-being of officers and increase the risk of mental disorders such as anxiety,

depression, PTSD, or thoughts of suicide (Soomro & Yanos, 2018). This research

focused on the negative stigma experienced by officers who self-seek mental health

assistance along with the negative impact it could have on officers and on the

organizations they serve.

This study continues to support and promote Walden University’s vision of social

change by seeking to provide a better understanding how officers can more effectively

self-seek mental health assistance without the negative impact of the stigmas associated

within the law enforcement subculture. Chapter 3 includes a description of the research

design, the role of the researcher, the methodology, and issues of trustworthiness along

with the summary.

Research Design and Rationale

To obtain the required information from research participants, I employed a

phenomenological design, as highlighted in Chapters 1 and 2. This qualitative approach

provided research subjects with the opportunity to share personal experiences and

feelings as they relate to self-seeking mental health assistance and the associated stigma

that is part of the subculture of law enforcement. As explained by Isaacs (2014),

qualitative research is designed to gain an in-depth understanding based of traditions of

social problems by those who have experienced them first-hand.

Open-ended questions relating to self-seeking mental assistance were used and

allowed the respondents to voice their perspectives and share their views on seeking

mental health treatment within the context of the organizational stigma against seeking

mental health treatment. In creating this context, the respondents were able to share

personal stories of lived experiences from within the subculture of law enforcement and

how they relate to the willingness of officers to self-seek mental health assistance. The

findings from this study uncovered themes of the lived experiences of the research

participants and created a story of viewpoints that described perceived obstacles and

challenges that officers face that may prevent them from seeking mental health treatment.

The use of qualitative research allowed me to conduct interviews with the

research participants and provided the opportunity for respondents to share their personal

perspective of events to be recorded. Research participants were also able to explain the

context of their answers and the impact of their decision to seek or not seek mental health

treatment and how this decision affected both their personal and professional

relationships (see Agazu et al., 2022).

RQs

RQ1: What are the perceived obstacles and challenges that officers face based on

their lived experiences that prevent them from seeking mental health treatment?

RQ2: Based on the lived experiences of officers, how, if at all, does stigmatization

play a role in preventing or keeping them from seeking mental health treatment?

Research Design

Phenomenological research is based on the assumption that shared lived

experiences have similar meaning to those who have experienced the same phenomenon

(Agazu et al., 2022). Once the phenomenon is identified, the shared perceptions of

respondents are collected and analyzed to create a profound understanding of the social

phenomenon being studied (Isaacs, 2014). As explained by Rubin and Rubin (2011),

qualitative research is used to acquire deep and impactful data to form a comprehensive

explanation of the desired phenomenon of the negative stigma that exists within law

enforcement as it relates to self-seeking mental health treatment.

I conducted semistructured in-person interviews with 11 participants. Data

collection stopped when saturation was achieved, and no new codes or themes emerged

from the data during the data analysis phase. This research was designed to gain a better

understanding of how the stigma associated within the law enforcement subculture

affected officers’ decisions to seek mental health assistance in either a positive or

negative way. Only through the phenomenological approach could a clear story be

reported by the research participants.

Phenomenon

Aguza et al. (2022) argued that phenomenological research assumes that there is

an essence of similarity though shared phenomena that are commonly experienced by a

group of individuals. My goal was to understand the negative stigma associated with

police officers who self-seek mental health assistance within the subculture of law

enforcement. I examined the perceptions and lived experiences of these officers and the

challenges and obstacles they face in self-seeking mental health assistance.

Methodology

Population

The sample was drawn from the Southwest Florida region of law enforcement

officers for this research. Within this population, a variety of law enforcement officers

are present, including patrols, investigations, analysts, and other specific units within the

agency. The patrol division is the largest entity within these organizations who are

exposed to a variety of traumatic encounters while conducting their related duties.

Participants were chosen from the patrol division.

Participant Selection

In an effort to collect a purposeful sampling group, I sought 12 current law

enforcement officers who served in the Southwest Florida region and who met the

following inclusion criteria to participate:

• Research participants were certified law enforcement officers who currently

worked within the capacity of patrol.

• Officers had a minimum of 5 years of experience working in the capacity of

patrol.

I excluded civilian employees and investigative positions from the sample

because the selected sample was exposed to more traumatic exposures, which lends

relevance and credibility to this study. The exclusion criteria for this study included the

following:

• Individuals who were not law enforcement officers.

• Officers who had less than 5 years of experience working in the capacity of

patrol.

• Individuals who did not agree to be audio recorded during their semistructured

interviews.

The research participants work in a variety of communities with different crime

rates and different socioeconomic statuses within the selected geographic region. I made

contact with participants through LinkedIn and Facebook law enforcment groups by

posting flyers on the social media platform. Once a participant agreed to participate in the

study, snowball sampling was used to recruit additional participants. Data collection

continued until data saturation was reached.

Participant Recruitment Strategy

I employed snowball sampling for the purpose of this study to gain an organic

sampling group, avoiding bias based on the dynamic method of recruitment. According to

Noy (2008), snowball sampling is when the researcher accesses individuals by means of

the contact information provided by the other individuals in a repetitive process. The

sampling strategy then continues to snowball until the researcher has achieved saturation

and discontinues the process.

I contacted police officers who worked in the Southwest Florida region via

LinkedIn and Facebook groups who began the snowball sampling process with

individuals who met the designated criteria within their perspective agencies. Research

has indicated that the use of snowball sampling is one of the most effective means of

gaining access to individuals inside a “hidden population” such as the subculture of law

enforcement and extracting data from them (Noy, 2008).

Instrumentation

I used the interview process and followed Walden University’s interview

practices. I developed the interview questions based on the attained information from the

literature found in the literature review. See Appendix A for the interview questions.

Each interview was intended to be face-to-face though Zoom was used when necessary.

The semistructured interview was intended to last no more than 60 to 90 minutes. The

research participants were able to choose the location of the interview to provide a

comfortable and private environment.

At the conclusion of each interview, I reviewed the recorded answers to validate

that data provided by the sample. I also used memoing to record perceptions of nonverbal

communication from the sample population during the interview process along with any

other pertinent information which needed to be collected. Memoing was used to

document my thoughts and feelings to be discussed with peers and my research

committee as a means to reduce interviewer bias.

Data Collection

I conducted the interviews, and all corresponding memo data are stored on a

secure computer device protected by both biometric and password security measures.

With permission of the participant, each interview was recorded, as the use of interviews

reduces the risk of missing critically important information as well as providing

proof/evidence of the study if ever needed in the future. Audio recordings are also useful

when conducting data analysis to represent a real time interpretation of the interview,

especially when aligned with memoing.

In preparing for potential loss of data on the computer device, a secondary USB

hard drive was encrypted with a full copy off all interviews and memos for a duration of

5 years, as required by Walden University’s Research guidelines to preserve and maintain

academic integrity. The USB will be stored in a locked file cabinet where I am the only

person who has access.

During the interview process, all research participants were again reminded that

they were participating on a voluntary basis and in no way were they obligated to

complete the interview if they did not want to. All research participants were advised that

withdrawal of participation and consent at any time would not result in any negative

consequences or actions by me. Research participants remained confidential, and any

answers given are not personally identifiable. Subject IDs were used instead of names, so

no data are attached to a name. In addition, confidentiality was maintained at all times;

interviews were conducted in private, and, as noted above, all data are stored safely.

Once the interview concluded, I reminded participants about a resource identified

on the consent form, a Florida Licensed Mental Health Counselor who has worked with

law enforcement officers for 2 decades. The mental health counselor agreed to be the

mental health resource for this dissertation by offering a free counseling session for

participants should they choose to reach out. They could call using the phone number

provided on the consent form if they chose to do so. The mental health resource is also

able to provide other resources that they have access to, based on the participants’

specific needs as they see fit as a licensed mental health counselor.

Data Analysis Plan

During the process of data analysis, the data were examined in detail, interpreted,

and coded in order to discover patterns and themes. The initial coding used line items

codes. Second cycle coding, according to Saldana (2011), includes combining codes to

create categories and then combining categories to create themes.

During this analysis, I used process coding in conjunction with nvivo coding

techniques, which allowed me to refine codes and integrate them with other identified

codes. According to Saldana (2011), this method allows for developing summary

categories collected data through the participant’s response so that indexing topics can be

established by identifying key words, phrases, topics for their worth, or significance.

I created themes based on the selective coding by evaluating the response patterns

of each research participant in order to determine if the codes could be further

disseminated or categorized. This process was repeated until data saturation was attained.

Participants were thanked for their time at the conclusion of each semistructured

interview. This marked the conclusion of their participation. I will email all participants a

summary of the study findings once the study is completed.

Role of Researcher

In conducting this research, I sought out and identified the participants, conducted

all interviews, and analyzed and interpreted the data I was solely responsible for the

completion of all aspects of study as it related to this research project.

Reflexivity (Managing Relationships)

As with any research study, the credibility of the researcher is explained though

self-reflexivity to be transparent about any potential information that could be perceived

as bias during the research (Agazu et al., 2022). It is through this self-reflexivity that the

researcher must disclose any personal background information that could influence the

study to maintain the researcher’s trustworthiness and credibility along with any firsthand

exposure to the topic of the study.

Full transparency was used through the entirety of this study in accordance with

guidelines set forth by Walden University. As it relates to the bias, my former profession

as a law enforcement officer within the state of Florida could have resulted in bias. To

minimize the risk of bias, I was mindful to separate previous work experiences, as to not

influence the outcome of current research and document feelings about the research

through memos and discuss possible sources of bias with peers and the dissertation

committee.

I have never held a supervisory or influential title or relationship to any of the

research participants, nor am I currently a law enforcement officer in any capacity.

Research participants understood that their participation was strictly voluntary in nature

and that they were able to withdraw from the research at any time without authorization

or consequence to their personal or professional career. All participants were made aware

that there was no compensation for their voluntary participation in this study. It should be

noted that at no time did I have any involvement with any form of self-seeking mental

health assistance nor any of the listed solutions within the research.

Ethical Assurances

I worked with Walden University’s IRB in order provide the participants with the

appropriate consent forms as well as follow the recommended guidelines to maintain the

confidentiality of the participants. All forms provided by the IRB (#11-06-23-0657017)

will be included in the appendix portion of the research paper and hard copies used by the

participants will be stored for a term of 5 years in secured safe at the researcher

residence.

I explained the nature of the research to all participants in detail as well as

informed them that none of the questions were designed to elicit a response of personal

traumatic experiences. These questions are designed to elicit the general perception of

law enforcement officers as it relates to self-seeking mental health and not the traumatic

experiences which caused them to seek that assistance, if in fact they sought assistance.

All research conducted and participants interviews will be developed and

analyzed within the theoretical framework utilized along with the literature review.

Semistructured interview questions were presented in an open-ended format so that

research participants could elaborate their answers based on experiences they have

encountered. Data were collected through the process of memoing. Once interviews were

completed, the participating respondents were thanked for their voluntary participation in

the study.

Through the completion of this study, it is understood that I would do no harm to

the participant who voluntarily shared their lived law enforcement experiences. As a

result, once the interview was concluded, I reminded participants that about the resource

that is identified on the consent form, a Florida Licensed Mental Health Counselor who

has worked with law enforcement officers for two decades. The mental health counselor

has agreed to be the mental health resource for this dissertation by offering a free

counseling session for participants should they choose to reach out. They may call using

the phone number provided on the consent form. The mental health resource is also able

to provide other resources that they have access to based on the participants specific

needs as they see fit as a licensed mental health counselor.

Issues of Trustworthiness

For the purpose of this study, the researcher will achieve trustworthiness by

incorporating strategies to ensure credibility, transferability, dependability, and

confirmability throughout the study. Utilizing this lens, the researcher is able to uphold

the integrity of the respondents who were used to provide a high level of value to this

viable topic. Throughout the research process any issues that may be identified will be

made transparent to establish the trustworthiness of the research. The researcher will also

implement other strategies designed to overcome any potential threats towards the

accuracy of the research designed to alter the outcome.

Credibility

In qualitative research, credibility refers to the extent to which the findings of a

qualitative study accurately and faithfully represent the participants' experiences, the

phenomenon being studied, and the researcher's interpretations (Agazu et al., 2022).

Qualitative research studies face several forms of bias which can be negated through the

researcher’s careful practices of data collection, analyzation, and interpretation of data as

it is presented by the researcher (Agazu et al., 2022). The researcher must be vigilant not

to recruit participants who have a personal or professional connection with themselves,

otherwise they may inadvertently create a bias within the conducted study. The simple

fact that the researcher has worked in the field of law enforcement could also be

perceived as bias based on shared experiences while working patrol. It is for this reason

that the researcher will disclose his professional background to maintain validity (Sumari

et al., 2021).

Transferability

Transferability is the extent to which the findings of a study can be applied or

generalized to other settings, contexts, or populations beyond the immediate research

context (Sumari et al., 2021). Transferability is demonstrated if the researcher is able to

collect rich data that can be used to clearly describe the studied phenomenon and also

yield potentially useful data that could be utilized beyond the original study (Sumari et

al., 2021). The researcher will carefully describe the phenomenon and research problems

that are outlined and discuss at length throughout the literature review as well as the

design selection of researcher participants who are knowledgeable within the

phenomenon of study. The researcher will achieve transferability by documenting all

study procedures in detail (Sumari et al., 2021).

Dependability

Dependability is defined as the degree to which the research process, procedures,

and findings are consistent, replicable, and stable over time (Sumari et al., 2021). The

researcher will ensure dependability through the use of documented data collection

methods, such as interviews and memo taking. The researcher will also use an audit trail,

meaning they will maintain detailed documentation of the entire research process,

including data collection procedures, coding decisions, analytical techniques, and any

changes made along the way (Sumari et al., 2021). This documentation creates a clear

trail for others to follow and helps maintain transparency (Sumari et al., 2021).

Confirmability

Confirmability is the degree to which the findings of a qualitative research study

are dependent on the participants and the context of the research rather than on the biases,

values, or perspectives of the researchers themselves (Sumari et al., 2021). In order for

the researcher to maintain objectivity in this study, all collected data through interviews

and the use of memoing will be reviews by the research participant to eliminate any

potential researcher bias or misrepresentation of collected data. The researcher will

maintain mindfulness about prior law enforcement experiences and how they could lend

bias to the interpretation of collected data. Data is also able to be reviewed and sent to

external sources for research purposes as set forth in Walden’s Institutional Review

Board acting as another data audit.

Summary

This study addressed the gap related to the barriers and obstacles that interfere

with police officers’ ability to seek out mental health assistance due to the stigma

associated seeking help within the subculture of law enforcement. The role of the

researcher in this chapter is to explain the choice of the methodology, research design,

and data collection methods for this study. The results of this research are expected to

uncover barriers to seeking mental health treatment. It is my hope that the detailed

findings of this study can assist agencies and officers in the positive promotion of mental

health assistance by addressing the negative stigma associated within the subculture of

law enforcement.

In Chapter 4, I describe the results of the study. Codes, categories and themes are

uncovered based on the lived experiences of police officers working within the context of

organization that stigmatizes mental health treatment.

Chapter 4: Results

Introduction

The purpose of the qualitative phenomenological study was to uncover the

perceived obstacles and challenges that officers may encounter based on their lived

experiences as well as the stigmatization within the subculture of law enforcement that

prevents officers from self-seeking mental health treatment. It is understood that police

officers’ continual exposure to dangerous conditions that could turn into violent

encounters is part of their chosen profession (Velazquez & Hernandez, 2019). However,

this continual traumatic stress that officers face while in the line of duty could affect the

mental well-being of officers and increase the risk of mental disorders such as anxiety,

depression, PTSD, or thoughts of suicide (Soomro & Yanos, 2018). This research

focused on the negative stigma experienced by officers who self-seek mental health

assistance along with the negative impact it could have on officers and on the

organizations which they serve.

RQ1: What are the perceived obstacles and challenges that officers face based on

their lived experiences that prevent them from seeking mental health treatment?

RQ2: Based on the lived experiences of officers, how, if at all, does stigmatization

play a role in preventing or keeping them from seeking mental health treatment?

This chapter describes the participants who contributed to this study, as well as

the data analysis procedures that were used to identify the findings. The findings of the

study are also discussed. The chapter concludes with a summary of the findings and the

corresponding themes that were identified.

Participants

A total of 11 Southwest Florida region law enforcement officers contributed to

this research. Within this population, a variety of law enforcement officers were present,

including patrol, investigations, analysts, and other specific units within the agency.

However, all participants were chosen from the patrol division. The patrol division is the

largest entity within these organizations who are exposed to a variety of traumatic

encounters while conducting their related duties. In an effort to collect a purposeful

sampling group, I originally sought out 12 current law enforcement officers who served

in the Southwest Florida region who were able to meet the following inclusion criteria to

participate:

• certified law enforcement officers who currently worked within the capacity

of patrol

• had a minimum of 5 years of experience working in the capacity of patrol

Initially, I targeted 12 participants for recruitment; however, only 11 participants

were obtained, which still allowed me to obtain a purposeful sampling group able to

achieve data saturation. While I attempted to fill the last remaining spot through

additional recruitment, all other individuals eligible for the study either did not wish to

participate in the study or could not find the time to schedule an interview. During the

data collection, I was able to achieve data saturation with the 11 participants who were

available to participate in the research study. The 11 participants were given

alphanumeric codes (P1, P2, P3, etc.) to protect their identities.

Data Analysis

Data were analyzed using Saldana’s (2011) coding process. This coding process is

a systematic approach to analyzing qualitative data. The method used in this study

involved a detailed and rigorous process of organizing, categorizing, and interpreting data

to identify codes, categories, and themes to establish meaningful insights. I began by

becoming thoroughly familiar with the raw data, which, in the case of this study, were

interview transcripts. This initial immersion helped me gain a comprehensive

understanding of the content. The next step was to proceed to initial coding. I began

using open coding in to begin analyzing data. This involved breaking down the data into

smaller, manageable units and assigning descriptive labels or codes to capture key

concepts or ideas. Codes were short, in vivo terms derived directly from the data (see

Saldana, 2011). This phase was exploratory and allowed for flexibility in capturing a

wide range of ideas (see Saldana, 2011). Next was focused coding. As patterns began to

emerge from the initial coding, I then transitioned to focused coding. This step involved

selecting and refining specific codes that were more closely aligned with the RQs (see

Saldana, 2011). Next was category development. Once a set of focused codes had been

established, I grouped them into categories. Each of these categories provided a higher

level of abstraction and organization, helping to structure the data more systematically

(see Saldana, 2011). Categories reflected the underlying concepts or dimensions that

were important to the research.

I made sure to practice constant comparison throughout the data analysis process.

During constant comparison, new data are compared with existing codes and categories

(Saldana, 2011). This iterative process helps refine data from codes to categories and

ultimately themes to ensure a comprehensive analysis (Saldana, 2011). By constantly

comparing new information to previous codes, I was able to identify code drift before it

became too prominent. This kept the codes focused and succinct. When coding drift

began to occur, I was able to split or combine clusters of coding into categories as

necessary. Some additional codes were not pervasive enough throughout the interviews to

be incorporated into categories. For example, two participants indicated that going to the

gym could be a healthy outlet for stress. However, those comments were not common

among participants and did not directly contribute to the RQs.

In this study, I identified 20 codes were identified that were then combined further

into six categories. I created the six categories by clustering data that contained the

highest patterns of frequency that connected the codes in some unique way (see Saldana,

2011). I continued to evaluate and compare new data and existing data to achieve

category construction where common codes with similar meaning or affect were

clustered into meaningful categories. According to Saldana (2011), these central

categories ultimately identify the core of the research and become the foundation for the

creation of the primary themes.

Using these categories, I was then able to combine the data into two main

themes, which according to Saldana (2011), establishes how individuals within a group or

department expresses their thoughts and feelings. I used these categories and aimed to

identify and group the most salient and recurrent information into themes based on the

available data. Of the six established categories, I was able to condense three of the

categories into the first theme and the remaining three categories into the second theme

based on the summarization of the latent meanings within the themes (see Saldana,

2011).

As themes were developed, I established the first theme directly related to RQ1,

which asked about perceived obstacles and barriers related to seeking mental health

treatment when needed. The second established theme directly relates to RQ2, which

established the perception of stigmatization that prevents officers from seeking mental

health treatment. Figure 1illustrates how 20 codes were condensed into six categories,

which were then condensed into two primary themes.

Figure 1

Code to Theme

Results

For the purpose of this study, I determined that 20 codes were combined to create

six categories, which were again combined to reveal two main themes. There were

additional codes that were not pervasive enough to be broken down into specific

categories or create usable themes. As the additional codes did not contain enough data to

condense into categories and themes, they did not directly contribute to the asked RQs

within this study. Table 1 describes the codes that contributed to the larger themes.

Table 1

Category Development

Category name

Contributing

codes

Example quote

Scheduling issues (N

= 10)

Long hours, night

shift, family

responsibilities,

overtime

I can tell you right now, just from

working nights, if my option to seek

mental health was during the daytime,

I probably would never go. – P3

Self-medication

(N = 11)

Alcohol, legal

drugs, illegal

drugs

Officers definitely cope by drinking,

more drinking to excess. I know,

officers that, I'll be honest, have had

alcohol that fall into work. That can

affect your job, that can affect your

ability to think clearly. -P10

Fear of forced

evaluations

(N = 7)

Baker Act,

psychological

testing, desk duty,

removal of

weapon

They mask it, they keep it in they

don't want to talk about it because

they're afraid of that stigma on us,

you know that they're weak, or they're

going to have to have a fitness for

duty evaluation. They might not be fit

for the job and then thinking you

know, I only have X amount of years

before I can retire. I'm not going out

like this. - P5

Perceived loss of

dependability

(N = 10)

Partner reliability,

comradery

And then there's an expectation that

you won't be a reliable partner or

reliable backup if you seek mental

health treatment. And nobody wants

to give that impression – P1

Perceived weakness

(N = 11)

Macho culture,

perception of

mental health

treatment as

weakness, gossip

among officers,

need for self-

sufficiency

There's always that stigma of ‘this

guy is a pansy, or he doesn't have the

same mental fortitude as I do, or

perhaps that I think I do.’ And that in

and of itself is a challenge too.

Because again, you don't want a

‘coward.’ -P2

Category name

Contributing

codes

Example quote

Perceived loss of

advancement

(N = 9)

Promotion among

peers,

advancement

opportunities,

service record

There's a stigma of competency

associated with receiving professional

help. And, by virtue of that, how are

you going to advance or who's going

to want to advance you? – P11

RQ1

What are the perceived obstacles and challenges that officers face based on their

lived experiences that prevent them from seeking mental health treatment? Categories

related to this RQ include obstacles such as scheduling issues, self-medication, and fear

of forced evaluations were combined into the first theme related to barriers/obstacles.

Scheduling Issues

Scheduling mental health treatment was a barrier discussed by many (N = 10) of

the participants. This barrier came from a purely practical standpoint where the

participants reported that they either worked too many hours to seek treatment or that

they worked night shifts and could not lose sleep to attend appointments that occurred in

the daytime. Between family responsibilities, off schedules, and long hours, participants

indicated that seeking mental health treatment was undesirable.

P3 said, “Well, I can tell you right now, just from working nights, if my option to

seek mental health was during the daytime, I probably would never know. I wouldn't

have woken up early for that.” P6 shared,

Right now, I have it pretty well, but previously working night shifts when you're

working 5pm to 5am. And sleeping the majority of the day, it's hard to seek help

from three o'clock to five o'clock in the afternoon when you're awake.

In addition, P10 stated,

If I were to double in the morning, I might get two, three hours of sleep, there's no

time to eat, there's no time to work out, there's no time to cancel a doctor's

appointment today. There's no time to, you know, sometimes never told my wife

this, but sometimes I didn't even shower when I got home because she'd already

be at work, I just got to get in bed, because I was so tired. And you knew you had

to get up in two to three hours. So those are some of the issues like when you're so

stressed, you have so much to do. You just start neglecting yourself, you're

stopping at fast food restaurant just stopping at a local convenience store, you're

grabbing a burrito, you're grabbing whatever, you just, you can't take care of

yourself. And then when you don't take care of yourself, your body starts to break

down.

Self-Medication

All (N = 11) of the participants reported that many officers self-medicated rather

than seeking mental health treatment. This self-medication most often took the form of

drinking alcohol, though some participants reported officers who used marijuana or

illegal drugs to compensate for mental issues. While none of the participants believed

self-medication was a sufficient alternative for mental health treatment, they did indicate

it was a short-term solution that allowed some people to sleep or temporarily forget their

problems. P1 said, “Well, I think one of the big ones is self-medication, whether that's

through a lot of times, it's through alcohol. I'm personally a big bourbon guy, myself; I

dance with a little bit of tequila every now and then.” Furthermore, P2 reported,

I think the probably the most common coping strategy would be alcohol, and

would it be effective long term? No, it was going to just kill you in the long run,

your insights, but that would be the most effective because it's a short-term

solution. It's a short-term solution to an ongoing or long-term problem.

P11 stated, “Sometimes there are other substances that are involved, but typically with

law enforcement officers, it's going to be whatever is legal. And alcohol seems to be the

primary way of coping, or relaxing.”

Fear of Forced Evaluations

Several (N = 7) participants were concerned that if they spoke to their supervisors

or peers about mental health needs, they may trigger a required examination. These

participants often cited the Baker Act, a law that allows someone to be committed for

examination for up to 72 hours. Participants indicated they were concerned that if they

admitted to needing mental health treatment, they may either be forceable committed

through the Baker Act or that their supervisors may require them to take other mental

health testing. This could mean losing their weapons or specialized assignments. P1 said,

I'm feeling a certain way, am I going to get Baker Acted? Do I have a career

anymore? You know, because we're doing risk protection orders on guys with

mental health treatments to take guns away from and, you know, so if I go out and

I'm like, I need help, I need I'd love a 72-hour vacation.

P5 indicated,

They mask it; they keep it in they don't want to talk about it because they're afraid

of that stigma on us, you know that they're weak, or they're going to have to have

a fitness for duty evaluation. They might not be fit for the job and then thinking

you know, I only have X amount of years before I can retire. I'm not going out

like this. And they hold it in.

P10 stated,

If you express any concerns, or say, ‘Hey, I'm not feeling right ‘they’ll take you

off shift, though, give you time off. And then I've heard other officers talk about

officers that have been Baker Acted from work, or from the compound from the

prison, and how they talk about him.

RQ2

RQ2 was as follows: Based on the lived experiences of officers, how, if at all,

does stigmatization play a role in preventing or keeping them from seeking mental health

treatment? Categories related to this RQ include perceived loss of dependability,

perceived weakness, and perceived loss of advancement were combined into the second

theme related to stigma.

Perceived Loss of Dependability

Almost all (N = 10) the participants indicated that the stigma associated with

mental health treatment included the perception that if an officer needed treatment, they

were less reliable. This meant that their partners and other officers could not count on

them in a stressful situation. These participants all indicated they wanted to avoid that at

all costs and did not want to be perceived as being anything less than fully dependable.

P2 said,

Obviously, I did canine for 15 years before going into motors, canine is a very

stressful in and of itself, because you're going after the worst of the worst, hunting

them in the middle of the night with an animal; you're constantly a target. And

you don't want somebody going with you that you're not going to trust to have

your back.

P3 stated,

If I went to seek help for any of the things that I used to see as a police officer or

that I was going through, first of all I’d lose my job. I’d be scared that even if they

know it's confidential, somebody in the department is going to know that I sought

help. And then I was not going to be trusted by anybody.

P9 indicated,

If an officer makes a comment, like ‘Hey, you know, I'm having a mental issue’

the public will go and say, ‘This guy had a mental breakdown because of

whatever incident five years ago or 10 years ago or whatever, is he going to not

lose it again? Or, you know, not be able to handle my situation when the time

comes.

Perceived Weakness

Similar as being perceived as unreliable, all (N = 11) participants also indicated

that the stigma around mental health treatment meant that officers may be perceived as

weak if they sought help. This contributed to a sense of needing to be fully self-sufficient

in order to fit the mold of what a police officer should be. Participants indicated that

while they did not necessarily hold these opinions themselves, many officers still did. In

describing this, P4 said, “In my opinion, law enforcement has a tough-guy environment

where the majority would not give up their blood and would not express their true

feelings because of the stigma and the reputation that people can hold against you.”

P7 stated,

I think there's an element of handling things independently in law enforcement

that plays a great role in that you're expected to think independently to act

independently and solve problems independently. And, I think that rolls into

solving your own problems independently. If you can't do that, and you have to

reach out for help. And, I think that's looked upon as a weakness for some people

whose simply calling for backup as a weakness.

P8 indicated,

I think one is just the admitting or acknowledging a weakness, I think we always

have to be the strong one, we are the people that are there to solve other people's

problems. And so, admitting that you have a weakness or that something might be

wrong, and that you have your own problems.

Perceived Loss of Advancement

Most (N = 9) officers indicated that stigma around mental health treatment meant

that many officers avoided seeking help for fear of a negative perception that endangered

their chance of advancement. These participants indicated that the perception may be that

an officer who sought mental health treatment was not tough enough to handle intense

assignments. This meant they received fewer specialized assignments and advancements.

These positions instead went to other officers who were perceived as tougher or more

dedicated. P1 described this by saying,

But like, if I talked to a guy today, right now, I'm like, ‘This is the kind of stuff

I'm dealing with, and these are my struggles.’ And then two weeks from now, that

guy is now my captain. He now knows personal information. That could influence

his decision-making. What kind of shift does he want to put me on? Or what kind

of assignment does he want to give me—that cush assignment? Or does he want

to throw me out into the darkness and let me work night shift so he never has seen

me again.

P10 indicated,

Say I need to talk to somebody like, ‘Hey, I'm not feeling right.’ And you go to

the agency psychologist on site, I don't think they're necessarily looking out for

your best interest. They're looking out for the agency's best interest. And they're

like, ‘Yeah, this guy really shouldn't be carrying a gun, he really shouldn't be on

patrol.’ Because you just went to somebody to talk about an experience you had

because of a bad call. And that gets out; that gets around. So then, you know, if I

go talk to this person, the psychiatrist or the psychologist, I could be given desk

duty, and they’ll take my car, my patrol car, you know.

P11 said,

They don't want to be personally liable if they make a mistake and promote them

into a higher-level position. It's just a cascading effect. It's not just one thing, it

affects every facet of a law enforcement officer’s career trajectory. You know, it

could be that you're on a special team or you're in some specialized position that

requires, you know, a psychological foundation, you will no longer qualify if you

don't meet that standard.

Summary

The purpose of this study was to examine the perceived obstacles and challenges

that officers face based on the officers’ lived experiences that prevent them from seeking

mental health treatment. The study investigated how, if at all, stigmatization plays a role

in preventing them from seeking mental health treatment. A total of 11 Southwest Florida

region law enforcement officers contributed to this research. Within this population a

variety of law enforcement officers were present including patrols, investigations,

analysts, and other specific units within the agency. Data was analyzed using Saldana’s

(2011) coding process. RQ1 asked about the perceived obstacles and challenges that

officers face based on their lived experiences that prevent them from seeking mental

health treatment. Themes related to this RQ include scheduling issues, self-medication,

and fear of forced evaluations. RQ2 asked the following: Based on the lived experiences

of officers, how, if at all, does stigmatization play a role in preventing or keeping them

from seeking mental health treatment? Themes related to this RQ include perceived loss

of dependability, perceived weakness, and perceived loss of advancement.

Chapter 5: Discussion, Conclusions, and Recommendations

This qualitative study examined the perceived obstacles and challenges that the

officers face based on the officers’ lived experiences that prevent them from seeking

mental health treatment. I also investigated how, if at all, stigmatization plays a role in

preventing them from seeking mental health treatment. The following RQs were used to

understand the subcultural stigma related to officers’ help-seeking behaviors for mental

health in the field of law enforcement: What are the perceived obstacles and challenges

that officers face based on their lived experiences that prevent them from seeking mental

health treatment? Based on the lived experiences of officers, how, if at all, does

stigmatization play a role in preventing or keeping them from seeking mental health

treatment? I conducted purposeful sampling to include active law enforcement officers in

the southwest Florida region. Interviews were conducted both in-person and via Zoom

interviews with current officers of varied levels of law enforcement experience. The

following sections are discussed in this chapter: interpretation of the findings, limitations

of the study, recommendations, implications, and conclusion.

Interpretation of the Findings

RQ1

What are the perceived obstacles and challenges that officers face based on their

lived experiences that prevent them from seeking mental health treatment? Categories

related to this RQ include obstacles such as scheduling issues, self-medication, and fear

of forced evaluations and were combined into the first theme related to barriers/obstacles.

Theme 1: Category 1 - Scheduling Issues

The findings highlighted scheduling as an obstacle to participants' access to

mental health treatment. According to the participants, scheduling issues such as working

long hours and working night shifts prevented officers from attending appointments for

mental health daytime treatment. The result provides great insight that working schedules

prevent officers from seeking mental health treatment as they have limited time to attend

mental health treatment appointments. The challenge of scheduling issues can also be

observed in previous research by Velazquez and Hernandez (2019), who indicated that

working under stressful conditions, including long working hours by law enforcement

officers, does increase the risk for new mental health conditions to emerge and exacerbate

preexisting mental health issues.

The findings discovered in this research study indicated that shift work and family

responsibilities also create a challenge for police officers to seek mental health treatment.

Participants indicated that family responsibilities were more complex due to rotating

shifts and long hours, forcing police officers them to prioritize work and family before

their own mental health. These findings support previous research by Violanti et al.

(2019), which also indicated that demanding shifts to include nights, weekends, and over

time requirements prevent them from attending mental health treatment. The findings

have contributed to the previous literature by establishing that scheduling issues are

significant challenges faced by officers in their efforts to attend appointments for mental

health treatment.

Theme 1: Category 2 - Self-Medication

This study demonstrated that officers tended to self-medicate rather than

accessing mental health treatment. Participants who indicated that they self-medicated

used alcohol, marijuana, and illicit drugs to compensate for mental issues. The findings

confirm previous research, indicating that there is a tremendous expectation within the

profession to remain unaffected by continuous exposure to violence and crime, causing a

great deal of stress (Bullock & Garland, 2017). Similarly, past research also highlighted

that internal pressure is often related to officers internalizing their stress, which leads to

challenges for the officers as well (Bullock & Garland, 2017).

From an officer’s perspective, self-medication as a sufficient alternative for

mental health treatment was also reported in other studies (Violanti et al., 2018).

Concurring with current study findings, previous studies by Heyman et al. (2018)

indicated that some traditional masculine values and expectations often shame and

ridicule those officers who seek treatment. As a result, seeking such treatment may cause

speculation regarding the officer’s fitness for duty; law enforcement officers often avoid

their emotions by engaging in destructive behaviors, such as abusing alcohol to avoid

mental health treatment (Grupe, 2023).

Theme 1: Category 3 - Fear of Forced Evaluations

The participants noted that the majority of police officers feared being forced into

evaluation to ascertain their mental health status. The fear of triggering the required

examination makes the officers refrain from informing supervisors or peers about their

mental health needs.

This research study supports previous findings by Lambert et al. (2021),

indicating that organizational stress, emotional exhaustion, and lack of organizational

support for officers who self-seek mental could be subject to forced evaluations. The

stigma associated with these evaluations along with the potential punitive consequences

create a subculture of silence regarding officer’s mental health. The current study’s

findings have contributed to the previous research by establishing that officers’ fear of

forced evaluation contributes to their limited access to mental health treatment.

RQ2

Based on the lived experiences of officers, how, if at all, does stigmatization play

a role in preventing or keeping them from seeking mental health treatment? Categories

related to this RQ include perceived loss of dependability, perceived weakness, and

perceived loss of advancement were combined into the second theme related to stigma.

Theme 2: Category 4 - Perceived Loss of Dependability

According to the findings, police officers lost their dependability in the eyes of

other officers due to mental health issues. As per the participants, the stigma related to

mental health treatment included the perception that if an officer needed treatment, they

were less reliable, thus preventing them from accessing mental health treatment as they

tried to avoid being labeled as unreliable and undependable. The research found in this

study supports previous outcomes which indicated that officers’ fears of being treated

differently due to the stigmas related to mental health treatment. This only adds to the

officers’ preexisting anxiety, thus preventing them from seeking mental health treatment

(Axelrod, 2018). Although there have been improvements made regarding officers

seeking assistance for anxiety and mental health issues due to generational changes, a

stigma of weakness and loss of dependability still exists (Violanti et al., 2019).

Theme 2: Category 5 - Perceived Weakness

The findings of this study demonstrated that stigmatization leads to perceived

weakness among police officers, which keeps them from seeking mental health treatment.

Participants indicated that the stigma around mental health treatment meant that officers

may be perceived as weak if they sought help. The findings of this study also support

previous research that indicates that officers choose not to self-report and seek help for

mental health problems due to the well-found fear of perceived weakness or professional

consequences they may face from both their peers and organization (Bikos, 2020;

Hartford Courant, 2022; Soomro & Yanos, 2018).

According to the findings, police officers fear being perceived as weak officers,

which prevents them from reporting and seeking help in mental health treatment. The

stigma related to self-seeking mental health treatment is perceived as a form of weakness

that would cause officers to internalize traumatic stress (Velazquez & Hernandez, 2019).

The perception of being perceived as weak when seeking mental health treatment leads to

a lack of help-seeking among law enforcement officers. The results of this study

contribute to existing literature by demonstrating that perceived weakness due to

stigmatization prevents police officers from seeking mental health treatment.

Theme 2: Category 6 - Perceived Loss of Advancement

This research study’s outcome shows that mental health-related stigma

contributes to the fear of seeking help in mental health treatment as it negatively affects

their chance of advancement in the police department. The advanced positions in the

police department as reported by the participants in this study were given to officers with

strong mental health control, thus leading most officers to fear seeking mental health

treatment. These findings were also reported in previous studies that revealed that

officers who sought mental health treatment were often isolated, alienated, demoted, or

held back from promotions, thus preventing them from seeking mental health treatment

(Bullock & Garland, 2017). The findings have thus provided insight into how stigma

contributes to a lack of self-seeking mental health among police officers.

Limitations of the Study

A potential limitation of this research was the participants’ willingness to remain

truthful due to the negative stigma as it related to self-seeking mental health assistance

within the subculture of law enforcement. Possibilities existed that the participants did

not fully believe the confidential nature of the research, and, therefore, answers could be

skewed to conform to the police subculture that seeking mental health assistance was a

sign of weakness so as not to disrupt the status quo. This possible limitation may

negatively impact the validity and transferability of the study findings. I addressed this

perception by assuring participants of the confidentiality of their identity.

This study is not able to guarantee the generalizability as it relates to the

population of law enforcement officers nationwide. Participants were limited to officers

with a minimum of 5 years of experience who were assigned to the patrol division, thus

the findings do not represent the entire department. This research also used a sampling of

participants limited in number who were within a small geographic sampling population.

In doing so, I understand that the generalizability is limited to the sample that was

attained in this study and not the entire population of law enforcement officers

nationwide.

This study was limited to voluntary participants who were willing to speak out

despite the stigma associated with the research to attain valid saturation. The research

also focused on police officers and excluded police administrators who could provide

further information on mental health among police officers. This contributes to the

limited transferability of findings to other populations regarding mental health treatment

within the police department.

Recommendations for Future Research

This study was focused on law enforcement officers who served in the Southwest

Florida region and were working within the patrol capacity. This study was delimited to

law enforcement officers who served in the Southwest Florida region, which may impact

the generalizability and transferability of findings regarding seeking mental health

treatment among police officers. As a result, further research should be conducted in

different geographical settings to enhance the transferability of the study outcome. A

quantitative research design should also be adopted to collect statistical data for

comparison purposes with the current research results.

While the current research has provided challenges preventing law enforcement

officers from seeking mental health treatment, there is a need for additional research to

identify strategies to support police officers who self-seek mental health treatment. I

recommend that future research investigate the strategies used to promote and implement

mental health services available to police officers without the current associated stigma.

This type of study would provide significant insight into how police officers could

improve their mental health status related to stressful assignments. Additional research

may highlight the need for training programs to be adopted at the federal, state, and local

levels. The programs, if implemented, should increase officer participation rates while

reducing stigmas related to the self-seeking of treatment. The results of the research

would theoretically highlight the need for training programs, and their corresponding

implementation should mitigate some of the self-harming practices in which many

officers currently engage, including self-harm, self-medication/substance abuse, and

various mental health issues.

Recommendations for Practice

Based on the negative stigma associated with mental health treatment, agencies

should create and implement mandatory training in an effort to support officers and

reduce the stigmas associated with mental health treatment. The training programs should

provide ways to reduce stigma among police officers and encourage self-seeking methods

for mental health treatment. Providing higher quality and quantity of training, reducing

work overload, and perceptions of the job as dangerous have all been proven to reduce

stress and improve the overall mental health of law enforcement officers (Lambert et al.,

2021). As a result, education and training programs for law enforcement officers should

be implemented by police departments to reduce mental health treatment stigmas.

It is recommended that policymakers develop and implement department

protocols that support officers who self-seek mental health treatment. These protocols

should include education and training for all officer ranks in an effort to reduce the

stigma throughout the agency beginning with administration. Such actions would help

reduce stigmatization and increase self-reporting of mental health issues by law

enforcement officers without fear of negative consequences. Violanti et al. (2019)

recommended that agencies begin to combat the stigmas that exist and ensure that

supervisors encourage officers to seek mental health treatment, even as a preventative

measure.

Implications

Implications for Positive Social Change

To promote positive social change, this research has provided police officers and

law enforcement agencies with information to alter the negative perception of stigma as it

relates to officer self-seeking mental health assistance. This research also illustrates some

of the perceived obstacles and challenges that officers face based on their lived

experiences that prevent them from seeking treatment.

Allowing agencies to have the ability to understand how self-stigma and

perceived obstacles are viewed within the subculture could facilitate change in the

methods used for officers to seek mental health assistance. The long-term benefit of this

study’s results can be used to eliminate both self and organizational stigmas associated

with self-seeking behaviors for mental health within the field of law enforcement through

the implementation of policy change.

This research has uncovered information that includes ways to reduce the

negative stigma within the field of law enforcement and improve the overall mental

health crisis within policing. This improvement in mental health could also increase

officer productivity levels due to the increased treatment of mental health issues. The

findings provide great insight to police officers to understand the need to seek mental

health treatment.

Implications for Practice

The research has uncovered critical information on the negative perceptions

associated to both personal and organizational stigmas within law enforcement and how

they impact officers from self-seeking mental health treatment. With this information,

agencies can put into practice new positive mental health trainings, beginning in the

police academy and continuing throughout an officer’s career. In doing this,

organizations may be able to remove or at least mitigate the negative connotation for

mental health treatment within the subculture of law enforcement. In doing so, officers

mental health can increase and police agencies can see an increase in officer productivity.

This research highlights critical information on the negative perceptions

associated to both personal and organizational stigmas within law enforcement and how

they impact officers from self-seeking mental health treatment. With this information,

agencies can put into practice new positive mental health trainings, beginning in the

police academy and continuing throughout an officer’s career. In doing this,

organizations may be able to remove or at least mitigate the negative connotation for

mental health treatment within the subculture of law enforcement. This creation of

positive social change could increase officers’ mental health wellbeing and could

increase officer productivity and moral throughout the agency.

Theoretical Implications

This study was guided by the labeling theory founded by Howard Becker (1960).

The labeling theory was evident throughout law enforcement agencies across the nation

which has created a culture of both self-stigma and organizational stigma (Becker, 1997).

The nature of police work exposes officers to extreme situations involving violence and

crime frequently. The impact of these repeated exposures takes a significant toll on the

mental health of officers. Despite the apparent need for mental health support to mitigate

the challenges related to the position, agencies have not adopted sufficient support

mechanisms to provide officers with mental health treatment that is safe to seek (Craig et

al., 2018).

A great deal of resistance from law enforcement agencies stems from the

fundamental biases and stigmas related to mental health treatment that are harbored by

many, including supervisors and superior officers. As a result of these deep-rooted

stigmas and biases, many agencies label officers as incapable and either remove them

from their positions or deny them promotions if they have sought mental health

treatment. Howard Becker identified this type of stigmatic labelling as the Labeling

Theory. Becker defined this theory based on those who are considered to be “normal”

and those who are considered to be “outsiders.” When applying this theory to to law

enforcement agencies’ view of mental health treatment for officers, it is apparent that

those who seek treatment are viewed as “outsiders” and those who do not are considered

to be “normal” (Becker, 1997).

100

This deep-seated bias and internal stigma regarding mental health treatment for

law enforcement officers results in labeling of officers who elect to seek treatment.

Unfortunately, this labeling of the “outsiders” exists in most agencies throughout the

nation and discourages officers from seeking much-needed treatment. This subculture

within law-enforcement is two-pronged and is impacted by self-stigma that is felt at the

indivual level by officers and biases and stigmas at the organizational level. The biases

and stigmas associated with officers seeking mental health treatment align with the

labeling theory and the challenges associated with being perceived as outsiders (Becker,

1997). The current study’s findings support this theory by identifying sources of stigma

that are associated with officers who self-seek mental health treatment. These sources

where identified through data collection to include perceived loss of advancement,

scheduling issues, self-medication, fear of forced evaluation, perceived weakness, and

perceived loss of dependability.

Conclusion

This study aimed to address the gap in the research regarding barriers to seeking

mental health treatment, including the stigmas associated with seeking mental health

treatment characteristic of police subculture. This study has provided important

information regarding the need for reducing stigmatization among law enforcement

officers which would help enhance help in self-seeking mental health treatment. This

study provides great insight into how stigmatization plays a significant role in preventing

or keeping officers from seeking mental health treatment. The research found in this

study has offered the understanding that law enforcement officers face multiple obstacles

101

preventing them from seeking mental health treatment. Such obstacles include stigma-

related challenges such as fear of forced evaluation, loss of advancement opportunities,

self-medication as well as perceived loss of dependability. These stigma-related

challenges prevent law enforcement officers from seeking mental health treatment.

Further research may be conducted to determine strategies to reduce stigmatization

among law enforcement officers.

102

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Appendix A: Qualitative Instrument

The 10 interview questions asked of the research participants are provided below.

1. Can you describe a recent incident or situation where you felt particularly stressed

or overwhelmed on the job? How did you cope with those emotions afterward?

2. In your opinion, what are some of the main factors that may deter police officers

from seeking mental health treatment despite the challenges they encounter on

duty?

3. Are there any stigmas or misconceptions within the police community regarding

mental health care? How do you think these perceptions impact officers'

willingness to seek help?

4. Could you share a personal experience or story about a colleague who faced

mental health issues? What were the outcomes of their decision to seek or not

seek treatment?

5. What are some common coping mechanisms or strategies that you and your

fellow officers use to manage the stress and emotional toll of your work? Do you

think these strategies are effective in the long term?

6. Are there any specific organizational or systemic barriers that you believe hinder

police officers from accessing mental health support services? How might these

barriers be addressed?

7. How do shifts, long hours, and irregular work schedules impact your ability to

prioritize your mental well-being? Have these factors influenced your decision to

seek or avoid seeking mental health treatment?

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8. Are there particular cultural or social norms within the police force that could

discourage officers from openly discussing their mental health struggles? How

might fostering a more supportive environment change this dynamic?

9. Have you observed any changes in attitudes toward mental health within the

police force over the years? Do you think there is a growing awareness of the

importance of seeking help, or do persistent challenges remain?

10. If you could suggest improvements or initiatives to enhance mental health support

for police officers, what would they be? How do you envision these changes

positively impacting the overall well-being of law enforcement professionals?

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Appendix B: Recruitment Flyer

Caption: There is a new study to analyze the stigmas and obstacles that exist within the

law enforcement subculture and identify potential pathways for mental health treatment

that they may deem as acceptable. For this study, you are invited to describe your

perceptions of seeking mental health support.

About the Study:

• One 60 - 90 minute in-person or Zoom interview that will be audio recorded.

• To protect your privacy, the published study will not share any names or details

that identify you.

Volunteers must meet these requirements:

• Be certified law enforcement officers who currently work within the capacity of

patrol.

• Have a minimum of five years of experience working in the capacity of patrol.

This interview is part of the doctoral study for Jason Yerk, a Ph.D. student at Walden

University. Interviews will take place during MONTH 2023.

Doctoral researcher

seeking police officer to

participate in study.

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Please respond via email to XXX@waldenu.edu or call/text the researcher at XXX to let

the researcher know of your interest. After interest is expressed, the researcher will

schedule a telephone call for final screening of participants. You are welcome to forward

this to others who might be interested.