Results from this study suggest that intrinsic (i.e. officer characteristics) and extrinsic (i.e. situational, environmental, civilian, and supervisor) factors converged to produce stress in law enforcement officers, and thus increase the likelihood of adverse event occurrence. Our findings highlight how stress comes from multiple levels of the organization. This is the first study to qualitatively examine how officers from urban, suburban, and rural law enforcement agencies characterize the stressors that patrol officers face on a daily basis. Results from this study are consistent with past quantitative studies, which have demonstrated that multi-level factors influence LEO-civilian interactions that result in adverse events, like use of force (20, 21) escalation of force (22) and injury (20). In this study, it is notable that we found officers only civilian behavior was reported as a contributing influence for officer stress; not civilian personal factors, like civilian appearance (e.g. race/ethnicity; tattoos; body mass index). Our previous studies of adverse events have also supported this finding that indicators of civilian behavior (e.g., presence of a firearm at the scene, civilian displayed active aggression, substance impairment or displaying symptoms of mental illness) were more robust predictors of adverse events than civilian appearance [removed for masked review]. Clearly, while officer-civilian interactions are complex and likely affected at multiple levels, civilian behavioral indicators are routinely documented and may be more objectively actionable through system-level interventions.
Continuous exposure to stress and risk for adverse events (e.g. injury) is not unique to police officers. The framework used in this study to identify accelerators and decelerators of cumulative stress was originally devised by Meuwisse and colleagues, with the goal of using their injury prevention recursive model to inform primary, secondary, and tertiary prevention strategies for sports injury (16, 17). The injury prevention recursive model considered the implications of repeated exposure and whether such exposure predicts injury or recovery from injury. Results from the present study suggest that officers’ experiences fit the constructs of the recursive model of injury. Officers identified several accelerators of cumulative stress, including burnout and pressure to respond to subsequent calls for service. Multiple decelerators were also mentioned; interestingly, some were nominated in a stepwise fashion: taking a break; change mental state before next call; and, seek care for their own mental health. These indigenous practices suggest that an intervention is possible because officers are aware of the occupational hazards and stressors they experience in the course of their occupation.
Themes identified in our data provide many opportunities for future interventions tailored for LEOs that target those multi-level factors that accelerate or decelerate the effects of cumulative, cyclical stress. First, front-line patrol supervisors can be educated on effective leadership strategies that can be used to simultaneously address occupational demands, such as increasing officer productivity and lowering response times, while balancing officer needs at the individual level, including stress levels. Past literature has shown that leadership-generated stressors substantially impact officers’ mental health and effectiveness in doing their job (23). In other occupations, it has also been shown that when workers are less stressed, their productivity and job satisfaction incrementally increase. Second, evidence-based solutions used in other occupations, like mindfulness or mediation, can be tested to see if such strategies successfully manage anticipatory stress when responding to calls for service and the aftermath of high-stress calls for service. For example, short breathing exercises might be routinely incorporated into existing time used for drafting a report after officers respond to a high-stress call for service.
A third implication of this work involves the use of technologic advances that may have great potential to systematically break the cycle of stress among LEOs. The computer-aided dispatch (CAD) system can equip officers with the knowledge of the complexity of calls by, for example, triangulating information such as time of day, type of call, and responding officer characteristics, to create a stress continuum scale. When the scale is highest, the CAD system could inform the officer en route to the call. Furthermore, CAD can be programmed to interrupt this repetitive, cumulative process by restricting the number of consecutive high-intensity calls to which an officer is permitted to respond. Finally, the chronic mental health needs of LEOs need to be evaluated. This starts with estimating the prevalence of undiagnosed mental health problems among LEO’s and evaluating how current services do and do not work on this unique population. Additional research is critically needed in all these areas to test the feasibility, acceptability, and effectiveness of reducing stress, and thus reducing adverse events between officers and the communities they serve.
This study should be considered in light of several limitations. First, because officers were recruited from a single geographic area, [removed for masked review] metroplex, the generalizability is limited. However, we did recruit from multiple departments that serve urban, suburban and rural communities; this breadth is rare in this field of research and strengthens external validity. Moreover, the demographic accrual of our study sample does represent the demographic composition of the participating departments. Second, participants for our study were recruited using convenience sampling; as a result, officers who self-selected to participate might be more forthcoming or have unique experiences related to stress compared to the general population of officers. In light of these limitations, nonetheless, our study was the first to gather qualitative data on the cumulative stressors experienced by patrol officers. Data collection efforts were theoretically guided by the injury prevention recursive model and pour results point to several opportunities for to test stress reduction interventions.