PREVENTING SUICIDE AMONG
LAW ENFORCEMENT OFFICERS:
AN ISSUE BRIEF
NATIONAL OFFICER SAFETY INITIATIVES
This project is supported by Grant No. 2018-DP-BX-K001 awarded by the Bureau of Justice Assistance. The Bureau of
Justice Assistance is a component of the Department of Justice’s Oce of Justice Programs, which also includes the
Bureau of Justice Statistics, the National Institute of Justice, the Oce of Juvenile Justice and Delinquency Prevention,
the Oce for Victims of Crime, and the SMART Oce. Points of view or opinions in this document are those of the
author and do not necessarily represent the ocial position or policies of the U.S. Department of Justice.
NATIONAL OFFICER SAFETY INITIATIVES | 1
CONTENTS
Introduction .................................................................................. 2
Executive Summary ..................................................................... 3
Prevalence ..................................................................................... 4
Risk and Protective Factors ........................................................ 6
Risk Factors .............................................................................6
Protective Factors .................................................................. 8
Challenges to Suicide Prevention ............................................ 10
Cultural Barriers to Help-Seeking ...................................... 10
Lack of Training in Suicide Prevention .............................. 10
Department-Level Challenges ............................................. 11
Suicide Prevention Strategies and Best Practices .................12
Comprehensive Approaches ................................................12
Individual Strategies and Practices ....................................13
Knowledge Gaps .........................................................................18
Suicide-Related Data ............................................................18
Eectiveness of Strategies and Practices ..........................18
Suicide Prevention Among Subgroups ..............................19
Other Knowledge Gaps ........................................................19
Conclusions .................................................................................20
References ...................................................................................22
PREVENTING SUICIDE AMONG LAW ENFORCEMENT OFFICERS: AN ISSUE BRIEF
2 | NATIONAL OFFICER SAFETY INITIATIVES
INTRODUCTION
Suicide is the 10th leading cause of death in the United States, claiming more than
48,000 lives in 2018 alone.
1
Suicidal thoughts and behaviors aect persons of all ages,
leading to long-lasting eects on families, friends, workplaces, and communities. Law
enforcement professionals are not immune to this serious public health problem. Studies
suggest that suicide rates are particularly high among ocers and others in public safety
occupations.
2,3
Although the exact number of ocers who die by suicide each year is not
currently known, existing research suggests that ocers may be more likely to die by
suicide than in the line of duty.
4
On a daily basis, ocers experience job-related stressors
that can range from interpersonal conflicts to extremely
traumatic events, such as vehicle crashes, homicide, and
suicide. This cumulative exposure can aect ocers’
mental and physical health, contributing to problems such
as post-traumatic stress symptoms, substance misuse,
depression, and suicidal ideation. Law enforcement
agencies may help mitigate the impact of these stressors
by implementing eective prevention strategies, such as
building a culture of support throughout the department;
ensuring access to culturally competent mental health and
wellness services; and reducing barriers to help-seeking
within their departments, social circles, and community, as
a whole.
In 2017, Congress passed the Law Enforcement Mental
Health and Wellness Act (LEMHWA), recognizing the
importance of mental health and wellness to ocer
wellbeing and performance, supporting the expansion
of and access to mental health and wellness services.
Signed into law in 2018, the act recognizes that good
psychological health is as essential as good physical
health for law enforcement ocers to be eective in
keeping communities safe from crime and violence. Law
enforcement agencies are increasingly incorporating
these practices—such as counseling services, peer support
programs, and training on stress and wellness—into
their work.
5, 6
This issue brief is intended to inform the work of the
National Consortium on Preventing Law Enforcement
Suicide and other stakeholders working to prevent suicide
and promote mental health and wellness among law
enforcement ocers. A project of the U.S. Department
of Justice, Bureau of Justice Assistance National Ocer
Safety Initiatives Program (NOSI), the Consortium was
formed in October 2018 by the International Association
of Chiefs of Police (IACP), in partnership with Education
Development Center (EDC) and with support from the
National Action Alliance for Suicide Prevention (Action
Alliance), to raise awareness of and prevent suicides
among law enforcement ocers. To support these
eorts, this issue brief synthesizes the current state of
knowledge regarding the prevention of suicide among law
enforcement ocers.
The brief presents research findings obtained from a
broad, but not exhaustive, review of research studies
relevant to the prevention of suicide in law enforcement.
Contents include the prevalence of suicidal thoughts and
behaviors among ocers, relevant risk and protective
factors, eective strategies and best practices for
preventing suicide among ocers, and gaps in knowledge
that require additional research. These evidence-based
findings are intended to inform the development of eorts
aimed at preventing suicide and supporting mental health
and wellness among ocers.
NATIONAL OFFICER SAFETY INITIATIVES | 3
EXECUTIVE SUMMARY
This issue brief synthesizes the current state of knowledge regarding the prevention of
suicide among law enforcement ocers.
Prevalence
While the exact number of ocers who die by suicide
each year is not known, research suggests that more
ocers die by suicide each year than in the line of duty.
4
The non-profit organization BLUE H.E.L.P. has estimated
that these deaths increased from 143 to 228, from 2016 to
2019.
7
However, these numbers are likely to represent an
undercount, as they are derived from Internet searches
and volunteer reports made by family members, friends,
colleagues, and others. Moreover, suicide deaths are
often unreported or misreported due to stigma and
other reasons.
8
Risk and Protective Factors
Law enforcement ocers are vulnerable to the same
risk and precipitating factors for suicide as others in the
general population, such as mental illness, substance
misuse, social isolation, relationship problems, and legal
and financial issues. Additional factors more specific
to the law enforcement profession include exposure to
suicide and other traumatic events (e.g., child abuse,
violence, death of a colleague), easy access to firearms
and skills in their use, and organizational stressors (e.g.,
shift work, administrative burden). Protective factors
that appear particularly relevant to preventing suicide
among police ocers include access to culturally
appropriate mental health and wellness services, resilience
(particularly skills for coping with work-related stressors),
and social support.
Evidence-based Strategies and Best Practices
Research suggests that suicide prevention programs are
more likely to succeed when they are comprehensive,
i.e., they combine multiple strategies aimed at aecting
risk and protective factors at various levels of influence
(individual, interpersonal, community, societal). Examples
include the 4-component Together for Life program
conducted with police ocers in Québec, Canada, and the
11-component U.S. Air Force Suicide Prevention Program.
Police departments nationwide are increasingly adopting
practices aimed at promoting mental health and
wellness and preventing suicide and related problems
(e.g., EAP services, peer support, traumatic incident
response).
5,6
However, these practices vary dramatically
across agencies.
Knowledge Gaps
No national surveillance system currently collects suicide-
related data specific to law enforcement, such as data
on suicide deaths, attempts, and ideation. Although law
enforcement agencies are increasingly incorporating
programs and practices aimed at supporting mental
health and wellness, few programs have formally
evaluated the eectiveness of these eorts. In addition,
not much is currently known about suicide prevention
among particular subgroups of ocers, such as women,
racial and ethnic minorities, LGBTQ+ populations, military
service members and veterans, and ocers transitioning
to retirement or to another career.
Conclusions
Law enforcement agencies should implement
comprehensive suicide prevention programs that combine
multiple strategies and practices addressing areas such as:
n Leadership and culture
n Access to culturally competent mental health services
n Peer support
n Suicide prevention training and awareness
n Event response
n Family support
n Limiting access to means of suicide
n Safe and eective messaging
Agencies should also develop or enhance their data
collection systems, so that the data may be used to guide
program planning, determine the eectiveness of suicide
prevention eorts, identify lessons learned, and support
continuous improvement.
PREVENTING SUICIDE AMONG LAW ENFORCEMENT OFFICERS: AN ISSUE BRIEF
4 | NATIONAL OFFICER SAFETY INITIATIVES
PREVALENCE
Since 2008, suicide has been the 10
th
leading cause of death in the United States.
1, 9
As
suicide rates are often unreported or misreported due to various reasons, including stigma,
legal issues, and limitations associated with death investigation systems, the number of
actual deaths is likely to be higher.
8
Recent studies have also found that the suicide rate
has been increasing. From 1999 to 2016, suicide rates rose significantly in 44 states, with
25 states experiencing increases of more than 30 percent.
10
Although women are more likely than men to attempt
suicide, men are 3.5 times more likely to die by suicide
than women.
9
In part, this is because men are more likely
than women to use firearms as their means of suicide,
rather than poisoning or other lethal means of self-harm.
Groups identified as being at an increased risk for suicide
in the general U.S. population include:
11
n American Indians and Alaska Natives
n Individuals who have attempted suicide
n Individuals with mental and/or substance
use disorders
n Men in midlife and older men
n Members of the U.S. military and veterans
n Lesbian, gay, bisexual, transgender, queer, and other
sexual minority (LGBTQ+) populations
n Individuals bereaved by suicide
The exact number of law enforcement ocers who die by
suicide each year is not known, as no national surveillance
system currently collects this information. Estimates are
available from two small non-profit organizations: Badge
of Life and Blue H.E.L.P. However, these estimates are
likely to represent an undercount, as they are derived from
Internet searches and volunteer reports made by family
members, friends, colleagues, and others. According to
Blue H.E.L.P., 168 ocers died by suicide in 2017, 172 in
2018, and 228 in 2019.
7
Studies have also found that suicide rates are higher
among law enforcement ocers and others who work in
public safety than among adults in other occupations.
2,3
For example, a study that compared suicide deaths
among public safety occupations with those among
the general U.S. working population found that suicide
risk was particularly high among detectives, criminal
investigators, and police ocers.
2
Similarly, a study that
examined suicide rates by 22 major occupational groups
in 17 states using data from the 2015 National Violent
Death Reporting System (NVDRS) found that these rates
were higher among public safety occupations than among
most other occupational groups.
3
This was true for both
male and female ocers. A similar study that analyzed
2016 NVDRS data from 32 states found that the suicide
rate among females in public safety occupations (14.0
per 100,000) ranked second among all 22 occupation
groups.
12
Among males, suicide rates in the public safety
group (26.4 per 100,000) ranked eighth among all
occupations. A recent Australian study that examined
retrospective mortality data also found high suicide rates
among emergency and protective services personnel.
13
Although research suggests that suicide rates are higher
among law enforcement ocers than other groups, most
law enforcement ocers are working-age adult males—a
group known to have high suicide rates.
14
The extent to
which increased suicide risk in this population is related
to occupation, rather than other factors, is not known.
15
Law enforcement ocers represent a subset of the
population composed mainly of people identified as being
physically and psychologically fit.
16
As Ian Stanley and
colleagues note, the hiring process for ocers includes a
pre-enlistment psychological evaluation that may screen
out some individuals who may be experiencing major risk
factors for suicide such as substance misuse or mental
disorders.
16
Upon hiring, law enforcement ocers may,
NATIONAL OFFICER SAFETY INITIATIVES | 5
therefore, represent a group that is in better overall health
than the general population. High suicide rates among
ocers suggest that exposure to risk factors post hiring
may be playing a role in increasing suicide risk in
this group.
Studies suggest that suicide rates may dier among
police departments of dierent sizes. A study of 298
U.S. police departments found that suicide rates were
significantly higher in smaller departments than in large
ones.
17
The authors noted that possible reasons included
lack of access to the more comprehensive mental health
services that may be available at larger departments, and
increased workload and community visibility.
Regarding other suicide-related outcomes, such as
suicide ideation and attempts, a recent review found that
although few studies measured these outcomes among
law enforcement personnel, existing findings suggest that
the prevalence of suicidal thoughts may be higher among
law enforcement ocers than in the general population.
16
In one study, conducted with 105 ocers in an urban
police department in the United States, approximately
24 percent of ocers reported that they had ever
thought about suicide.
18
In another study, conducted with
193 ocers in a Midwestern state, almost 9 percent of
ocers reported having thoughts of suicide in the past
two weeks.*
19
In comparison, estimates from the most
recent National Survey on Drug Use and Health (NSDUH)
indicate that, in 2017, 4.3 percent of adults reported
serious thoughts of suicide in the past year.
20
The review
did not find any estimates of the prevalence of suicide
attempts among ocers.
* Suicide ideation was measured with the “yes/no” question: “Have you ever thought about suicide?” adopted from a preliminary
screening question on the Beck Suicide Ideation Scale. The question does not specify whether the person thought about his or her
own suicide or someone else’s suicide.
PREVENTING SUICIDE AMONG LAW ENFORCEMENT OFFICERS: AN ISSUE BRIEF
6 | NATIONAL OFFICER SAFETY INITIATIVES
RISK AND PROTECTIVE FACTORS
Suicide is a complex behavior influenced by risk and protective factors at multiple
levels—i.e., individual, interpersonal, community, and societal. As members of U.S. society,
law enforcement ocers may experience many of the same risk and protective factors
for suicide that aect other groups in the general population. In addition, the literature
also identifies a number of relevant factors that are more unique to the law enforcement
culture and environment.
Risk Factors
Risk factors are characteristics that make it more likely
that a person will think about suicide or engage in suicidal
behaviors.
Examples include:
21, 22
n Previous suicide attempt
n Mental disorder (most commonly, mood disorder)
n Substance use disorder
n Access to lethal means
n Social isolation
n Chronic disease and disability
n A history of physical and/or sexual abuse
n Family history of suicide
n Exposure to traumatic events in adulthood
Also relevant are precipitating factors—stressful
events that can trigger a suicidal crisis in a vulnerable
person. Examples include relationship problems, recent
interpersonal conflict, death of a loved one, and serious
financial or legal diculties.
21, 22
Research identifies several risk factors for suicide as being
particularly relevant to law enforcement ocers. For
example, a study that analyzed data from the Centers for
Disease Control and Prevention (CDC) NVDRS identified
the following variables as being closely associated with
suicide among law enforcement ocers, members of the
U.S. Army, and firefighters:
23
n Treatment for a mental health condition
n Post-Traumatic Stress Disorder (PTSD) diagnosis
n Alcohol and substance misuse
n Job problems
n Intimate partner problems
Among law enforcement ocers, the association was
particularly strong for job-related problems.
These and other risk factors identified in the literature are
discussed next.
Mental and Substance Use Disorders
Mental disorders are among the strongest predictors of
suicide attempts and deaths. A recent review estimated
that a psychiatric disorder is present in 60 to 98 percent
of deaths by suicide.
24
Some of the disorders linked to
suicide ideation or behaviors include major depression,
bipolar disorder, schizophrenia, and disorders that involve
severe anxiety or agitation, such as PTSD.
21, 25
Substance
misuse is second only to mental disorders as the most
frequent risk factor for suicide in the general population.
A review of 31 studies found evidence that alcohol use
disorders significantly increased the risk of suicide
ideation, attempts, and deaths.
26
Research on suicide among ocers suggests that drinking
is an accepted bonding practice and coping strategy
in the law enforcement culture, with alcohol use being
common.
14
In a study conducted with 1,328 full-time
ocers in Mississippi, the most common reasons for
drinking alcohol were “to celebrate and enjoy the taste,”
followed by “relaxing after a shift and relieving tension.”
27
The respondents who were most at risk for drinking
problems identified “fitting in with the group” as the top
rated reason for drinking.
Access to Lethal Means
Access to lethal means of self-harm, including work-
related access, is an established risk for suicide.
28
This risk
factor is particularly relevant to law enforcement ocers,
who use firearms as part of their daily work, are trained
on their use, and generally take their work-issued firearms
home with them.
5
While about half of suicides in the
general population involve firearms,
29
research suggests
that more than 80 percent of suicide deaths among law
enforcement ocers involve firearms—in most cases, the
ocer’s own weapon.
30
NATIONAL OFFICER SAFETY INITIATIVES | 7
Stressors Related to Law
Enforcement Profession
The literature also identifies a number of stressors
related to the law enforcement profession as potentially
contributing to suicide risk. For example, in a study that
examined sources of stress among police ocers, the top
concerns identified by ocers involved performing day-
to-day enforcement activities that put them in potentially
unsafe situations, as well as responding to less frequent
but more traumatic events.
31
Exposure to Traumatic Events. Exposure to traumatic
events is associated with an increased risk for suicide.
21
This risk factor is particularly relevant to law enforcement
ocers and others in protective services occupations,
who are more likely than people in most other professions
to be exposed to critical and traumatic incidents in their
daily work, such as motor vehicle crashes, child abuse,
or the violent death of a victim or coworker. In a survey
with 193 ocers from small to midsize departments,
ocers typically witnessed 188 such incidents during
their careers.
32
Research suggests that exposure to traumatic events
may increase the risk of PTSD among law enforcement
ocers. The acute stress caused by these events can
produce psychological and physiological reactions that
may overcome a normal person’s ability to cope. The
constant exposure to human suering and death can
take its toll on ocers, leading to a pessimistic view of
life and hypervigilance.
33
Exposure to traumatic events
has also been linked to other negative consequences
among ocers, including poor sleep quality, higher
levels of depression and anxiety, and an increased risk
for PTSD, substance misuse, and suicidal ideation.
30, 33
In
a recent survey of 15 police departments in the state of
Virginia, exposure to work-related trauma was linked to
recent suicidal thoughts, particularly among respondents
reporting multiple exposures to trauma.
34
A study by John Violanti found that some types of
traumatic exposures increase police ocer risk of
developing PTSD symptoms, which subsequently increase
the risk of high alcohol use and suicide ideation.
35
A
survey of 750 U.S. police ocers found that exposure to
critical incidents was associated with PTSD symptoms
and alcohol use.
36
Research also suggests that police
ocers have much higher rates of PTSD than the general
population.
37-39
Among police ocers, PTSD has been
found to be associated with substance-related and
addictive disorders, including alcohol use disorder.
40
Exposure to Suicide. Studies suggest that exposure to
suicide increases the risk for subsequent suicidal thoughts
and behavior.
41-43
Law enforcement ocers may see
suicide up close as they may be the first on the scene as
well as responsible for notifying family members. This
job-related exposure to suicide has been found to impact
ocers’ emotional and psychological well-being
44
and
to be associated with PTSD symptoms and persistent
thoughts of a suicide scene.
45
Shift Work. Another important stressor identified in
the literature is shift work, which has been found to be
associated with suicide ideation, particularly among
ocers who may already have other risk factors for
suicide, such as symptoms of depression or PTSD.
46
Rotating shifts can also lead to inadequate sleep, which
can make it harder for ocers to cope with stress. Among
Swiss police ocers, shift work has been associated with
sleep complaints, work discontent, and increased social
stress.
47
Researchers also note that sleep deprivation and
fatigue resulting from shift work may negatively aect
thinking and decision-making, thereby increasing suicide
risk.
30
Other related stressors include irregular work hours
and mandatory overtime.
Social Isolation. Unpredictable schedules can limit time
available for maintaining relationships with friends and
family, which can contribute to social isolation. Being
assigned to work on holidays and during special family
(e.g., birthdays, anniversaries) and/or social occasions can
make it dicult for ocers to develop social relationships
outside of the work environment. Research suggests
that other aspects of police culture may also contribute
to social isolation, such as socialization practices that
promote internal solidarity but can also lead ocers
to mistrust outsiders, creating an “us versus them”
mentality.
48
Violanti and colleagues note that low social
integration into society may make it dicult for police
ocers to develop an outside network of social support
that can help them during psychological crises.
48
Relationship, Financial, and/or Legal Problems. Personal
stressors, such as relationship problems, have been linked
to serious thoughts of suicide among police ocers.
49
In
many cases, these stressors are attributed to work-related
factors. For example, interviews with 110 ocers found
that, when asked about personal stressors, ocers often
referred to family problems that were either caused by
the job directly or linked to the job, such as alcohol use,
divorce, financial strain, unpredictable childcare needs,
and inability to socialize.
31
Other researchers note that
long hours at work and having to work during holidays
and family events can contribute to or exacerbate
domestic problems, placing an added stress on family
relationships.
33
Unaddressed work-related stress and
frustrations may also spill over to the home environment,
PREVENTING SUICIDE AMONG LAW ENFORCEMENT OFFICERS: AN ISSUE BRIEF
8 | NATIONAL OFFICER SAFETY INITIATIVES
taking a toll on ocers’ marriages or relationships with
their significant others. Other personal stressors related to
work include legal problems, such as being under criminal
or administrative investigation.
Social-Political Context of Policing. Relationships with
the public and the community can also be a source of
stress, particularly when ocers feel that their eorts
are not appreciated. Research suggests that public
confidence in the police has decreased in recent years due
to racial tensions over the use of force.
31
In a recent survey
conducted by the Pew Research Center, ocers reported
that these high profile incidents have made policing more
challenging and are leading to tense interactions with
African American communities.
50
The report also notes
that the number of fatal attacks on ocers has increased.
As a result, more than 9 in 10 ocers (93 percent) report
worrying more about their personal safety than in
the past.
Constant scrutiny from the media, particularly in the
context of a 24-hour news cycle, is yet another source
of stress.
31
The increased use of social media, combined
with personal videotaping, allows police actions to be
presented out of context and become viral stories. Other
emerging sources of stress identified by ocers include
cybercrime, terrorism, active shooters, drug epidemics,
and responding to community members who have a
mental illness.
31
Stressors Related to
Organizational Functioning
Factors related to how the work environment is organized
and functions (also referred to as “job context”) may
also increase stress among law enforcement ocers.
Researchers have noted that police departments have
traditionally been hierarchical organizations that feature
a rigid structure and authoritarian leadership.
51
Excessive
formality and rigid organizational structures can limit
autonomy and create stress.
30
Other related stressors
identified in the literature include poor leadership
practices, lack of support from supervisors, few
opportunities for advancement, poor working conditions,
arbitrary rules and regulations, and constantly changing
agendas that are poorly communicated.
23, 30
Among
female ocers, lack of support from supervisors has
been identified as a common organizational stressor.
52
Other related stressors identified in the literature include
paperwork requirements,
31
court appearances, and the
need to work a second job—all of which can take time
away from ocers’ time o duty.
52
Protective Factors
The literature also identifies several factors as protecting
individuals from suicidal thoughts and behaviors. These
protective factors are not just opposite of or the absence
of risk factors, but conditions that promote strength
and resilience and ensure that vulnerable individuals are
supported and connected with others during dicult
times, thereby making suicidal behaviors less likely. In the
general population, these factors include:
21, 22
The following are protective factors identified in
the literature as being particularly relevant to law
enforcement ocers.
Resilience
Resilience—a concept applied across health topics,
such as violence, trauma, substance misuse, and
suicide—can be defined as “the capacity and dynamic
process of adaptively overcoming stress and adversity
while maintaining normal psychological and physical
functioning”(p. 3).
53
In the context of law enforcement,
resilience can be viewed as the ability to adapt to and
overcome the eects of the stress and trauma associated
with police work. Resilience-building programs developed
specifically for people in stress-related professions can
address multiple areas, including the development of an
internal locus of control, self-awareness, self-ecacy, fear
response, emotion regulation, and problem solving.
Although more research is needed on the role of resilience
in reducing suicide risk,
54
a longitudinal study with 178
Iraq and Afghanistan war veterans found that resilience
at baseline predicted lower suicidality at three-year
follow-up.
55
While members of the military service dier
from police ocers in many ways, both groups may be
exposed to high occupational stress. Resilience building
programs may be useful in mitigating the impact of
these exposures.
n Reasons for living (e.g., responsibility for young
children, future goals)
n Being married
n Extraversion and optimism
n Cultural, religious, or personal beliefs that
discourage suicide
n Life skills (including problem solving and
coping skills)
n Having a supportive social network
n Access to mental health care
NATIONAL OFFICER SAFETY INITIATIVES | 9
Coping Skills. An area of skill development particularly
relevant to law enforcement is the development of
skills for coping with stress and trauma in positive
ways. Research suggests that the use of unhealthy
coping methods—such as alcohol and other drug use,
or aggressive behavior—is common in law enforcement
culture and can lead to negative physical and
psychological outcomes.
56
Coping skills can buer the
negative eects of stress on psychological well-being and
help ocers adjust to negative emotional situations. An
active coping style—as opposed to a passive style based
on avoidance, denial, self-blame, and distancing—may
be particularly helpful.
30, 56
This style involves having the
ability to identify specific sources of stress and develop
a plan for reducing stress and working towards resolving
the issue. Use of an active coping style has been found to
reduce the risk for suicidal behavior among ocers.
57
Family Support
Family relationships are known to protect individuals from
suicide. A study that examined suicide mortality in the
United States by marital status and other characteristics
found that having a larger family was associated with
a lower risk of suicide among both men and women.
58
Being divorced or separated, widowed, or never married
was associated with increased risk among men only. In
another U.S. study, marital discord was associated with
increased suicide ideation and attempts.
59
In a national
survey of Canadian public safety personnel, participants
who were in married or in common-law relationships were
less likely to report suicidal behaviors than participants
who reported being single or separated, divorced, or
widowed.
60
The authors note that providing social support
that can help sustain healthy family relationships may be
important in increasing resilience.
Organizational Support
As noted, research has found that law enforcement
ocers are often exposed to traumatic events as a part
of their work, and that this exposure can increase the risk
for suicide and other problems. Violanti and colleagues
note that increased organizational support, including
organizational networks, can help ocers cope with
stressful events in positive ways.
56
Fairness. Procedural fairness—or the belief that
departmental policies are applied fairly and based on
facts, and that workers are treated with dignity and
respect—is identified in the literature as an organizational
factor that can contribute to ocer well-being. A study
conducted with patrol ocers and sergeants in a large
urban police force found that ocers who worked in
departments perceived as being more procedurally
fair were less likely to experience psychological and
emotional distress or to be cynical and mistrustful about
the communities they served.
61
Results suggested that
increasing procedural justice within police departments
may improve ocer well-being, performance, and
relationship with communities.
Control Over Work Schedules. Police organizations can
help alleviate stressors related to shift work and irregular
hours by exploring changes in work schedules (e.g., work
shifts of dierent lengths). More flexible work schedules
have been found to improve ocers’ ability to integrate
work into their daily lives, promote better sleep, and
increase overall job satisfaction, a protective factor for
suicide ideation.
30
Mental Health and Wellness Services. As noted, mental
and substance use disorders are strong risk factors for
suicide. Moreover, the stigma associated with mental
illness is a known barrier to help-seeking among ocers.
As a result, increased access to quality mental health
and wellness services delivered by culturally competent
providers is fundamental to preventing suicide and
supporting ocer well-being and performance. Specific
approaches to the provision of these services are
discussed later in this paper, under Suicide Prevention
Strategies and Best Practices.
Support for Positive Social Connections. Positive
relationships with peers, and organizational support for
these social connections, have been linked with lower
stress and better coping among ocers. As discussed
later in this brief, police departments can play a key role
in supporting the development of these connections by
providing peer support programs.
PREVENTING SUICIDE AMONG LAW ENFORCEMENT OFFICERS: AN ISSUE BRIEF
10 | NATIONAL OFFICER SAFETY INITIATIVES
CHALLENGES TO SUICIDE PREVENTION
Cultural Barriers to
Help-Seeking
The literature identifies both professional norms and
gender-related cultural norms as barriers to help-seeking
among law enforcement ocers.
Norms Associated with Masculinity
Men make up the majority of law enforcement ocers
in the United States. According to the Federal Bureau
of Investigation, in 2018, 87.4 percent of U.S. ocers
were male.
62
The literature notes that some of the norms
associated with masculinity can present a barrier to
seeking help for mental health problems. As noted
in a recent review, traditional masculine gender roles
emphasize self-reliance, invulnerability, and stoicism.
63
Because negative emotions are perceived as a sign of
weakness, men may be reluctant to share information
about mental health issues with others. They are also
more likely than women to cope with mental health
problems by self-medicating with alcohol and drugs
rather than seeking care.
63
Law Enforcement Culture
The law enforcement profession emphasizes some of the
same norms as traditional masculinity, including strength,
self-reliance, and infallibility. Police ocers are trained
to see themselves as problem solvers, not people with
problems.
64
Seeking treatment for mental health problems runs
contrary to police socialization training.
30
This training
tends to instill in ocers “a sense of superhuman
emotional and survival strength to deal with adversity”
65
(p. 59). Admitting that one needs help may run contrary
to police culture and to the idea of what a successful
police ocer should be like. As noted by Stephen Wester
and colleagues, “many of the tasks associated with
seeking help from a mental health professional, such
as relying on others, admitting a need for assistance,
or recognizing and labeling an emotional problem, run
contrary to those characteristics which make a successful
police ocer while also conflicting with their socialized
gender role expectations” (p. 288).
66
Research suggests that the societal stigma associated
with mental illness and help-seeking may be particularly
strong in law enforcement.
30, 67
Police ocers rarely seek
help from psychologists or psychiatrists, even when they
have serious thoughts of suicide.
30
In the Georgia survey
discussed earlier, almost three-fourths (74.5 percent)
reported having ever experienced a traumatic event,
and yet less than half had told their agency about it.
68
Moreover, more than half indicated that if in a crisis, they
would seek help outside of their agency, rather than
from internal sources. In another recent study, ocers
reported being hesitant to ask for help with mental health
problems and suicide ideation because they feared they
would be perceived as weak, stigmatized, ignored by
their department, ridiculed, or forced to face job-related
consequences.
6
Fear of consequences—including concerns about duty
status changes and career implications—is identified in
the literature as a critical barrier to help-seeking. These
perceived consequences include stigmatization, possible
negative job outcomes (e.g., modified assignment, loss of
firearm, loss of opportunity for promotion), and perceived
weakness.
69
Unclear confidentiality laws and policies, or
lack of information about these policies may also prevent
ocers from seeking help.
Lack of Training in
Suicide Prevention
Although ocers are routinely trained on ways to ensure
the physical safety of their coworkers, they may not
always receive similar training on how to identify or
eectively respond to emotional trauma, mental illness, or
suicidal behavior among colleagues. As a result, ocers
may lack access to mental health support and suicide
awareness and prevention resources and may not always
know where to turn before a crisis occurs.
NATIONAL OFFICER SAFETY INITIATIVES | 11
Department-Level Challenges
Some police departments may lack the capacity to
provide the necessary and confidential mental wellness
training and care. Law enforcement agencies are not a
single employer that can provide large-scale centralized
services for both active duty and retired ocers. As a
result, the type and quality of mental health services
varies across agencies.
5
Some departments may lack resources to focus on suicide
prevention, particularly in the context of limited overall
funding for providing core services. Data from the U.S.
Department of Justice shows that from 1997 to 2016, the
number of full-time sworn ocers in general-purpose law
enforcement agencies increased by about 52,000 (up
8 percent) to 701,000 ocers.
70
During that same time
period, the total U.S. population increased by 21 percent,
leading to an 11 percent decrease in full-time sworn
ocers per 1,000 residents—from 2.42 in 1997 to 2.17 in
2016. In a recent survey of law enforcement ocers, 86
percent of respondents indicated that their department
did not have enough ocers to adequately serve the
community.
50
Among larger agencies (with 1,000 or
more ocers), this number increased to 95 percent. An
increased demand for services, combined with decreased
resources, may make it more dicult for law enforcement
agencies to focus on mental wellness and
suicide prevention.
PREVENTING SUICIDE AMONG LAW ENFORCEMENT OFFICERS: AN ISSUE BRIEF
12 | NATIONAL OFFICER SAFETY INITIATIVES
SUICIDE PREVENTION STRATEGIES
AND BEST PRACTICES
This section presents strategies and practices identified in the literature as having
evidence of eectiveness in preventing suicide. The list of strategies and practices is not
exhaustive and does not represent an endorsement of specific programs. We encourage
the reader to research other approaches not outlined in this brief.
Comprehensive Approaches
Systematic reviews identify a number of individual
strategies as being eective in preventing suicide in the
general population, such as providing education and
training, reducing access to lethal means among people
at risk, and increasing access to evidence-based care
for suicide risk.
70, 72
Overall, this body of knowledge also
suggests that suicide prevention eorts are more likely
to succeed when they use a comprehensive approach
that combines prevention strategies addressing risk and
protective factors at multiple levels.
11
U.S. Air Force Suicide
Prevention Program
Started in 1996, the U.S. Air Force Suicide Prevention
Program (AFSPP) is a well-known example of a successful
comprehensive suicide prevention program. Developed
in response to an increase in suicide rates in the U.S.
Air Force, the program combined 11 strategies aimed at
strengthening social support, promoting the development
of coping skills, and changing policies and norms to
encourage help-seeking behaviors:
73, 74
1. Leadership involvement
2. Addressing suicide prevention through
professional military education
3. Guidelines for commanders on use of mental
health services
4. Community preventive services
5. Community education and training
6. Investigative interview policy (which addresses
the period following an arrest or investigative
review, a time of increased suicide risk)
7. Trauma stress response (originally critical
incident stress management)
8. Integrated Delivery System (IDS) and Community
Action Information Board (CAIB), which provide
a forum for the review and resolution of issues
that impact individual and family readiness
9. Limited Privilege Suicide Prevention Program,
which ensures that patients at risk for suicide are
aorded increased confidentiality when seen by
mental
health providers
10. IDS Consultation Assessment Tool (originally the
Behavioral Health Survey)
11. Suicide Event Surveillance System
Program evaluation suggested that the program reduced
the risk of suicide among Air Force personnel by one-
third.
73
Program participation was also linked to decreases
in homicide, family violence (including severe family
violence), and accidental death—other adverse outcomes
that share risk factors with suicide.
Zero Suicide Framework
The Zero Suicide framework is another example of a
comprehensive approach to suicide prevention that is
particularly well suited to closed settings—in this case,
health and health care systems. The model applies a
quality improvement and safety framework to suicide care
throughout the health system. It supports the adoption
of “zero suicides” among patients as an organizing,
aspirational, goal for health care systems and seeks to
transform suicide care through changes in leadership,
policies, practices, and outcome measurement.
NATIONAL OFFICER SAFETY INITIATIVES | 13
The Zero Suicide framework combines seven strategies:
1. Leading system-wide culture change committed
to reducing suicides
2. Training the workforce
3. Identifying individuals at risk
4. Engaging individuals with or at risk
5. Treating suicidal thoughts and behaviors using
evidence-based treatments and interventions
6. Transitioning individuals at risk safely through
and out of care
7. Improving policies and procedures through
continuous quality improvement
Together for Life Program,
Montreal, Québec
An eective multicomponent suicide program conducted
specifically for law enforcement ocers is Together for
Life (in French, “Ensemble pour la vie”), an initiative
implemented in Montreal, Québec. Started in 1996, the
program sought to prevent suicide among members
of the Montreal Police Force. All 4,178 members of the
Montreal police participated in the program, which
combined four main suicide prevention strategies:
In the 10 years before the program was started, from 1986
to 1996, the mean suicide rate among Québec police had
been 30.5 per 100,000 people per year, a rate comparable
to rates among groups of similar race and age in the
general population. In the 12 years after the program
began in Montreal, from 1997 to 2008, the suicide rate
among ocers decreased by 79 percent (to 6.4 per
100,000).
75
During this same period, suicide rates among
police ocers elsewhere in the Province of Québec
remained unchanged.
Factors identified as critical to program success included
the fact that the suicide prevention training was provided
by the Police Counseling Service, which are held in high
regard by Québec police and were perceived as speaking
the language of the police environment. The authors
also note that another element critical to success was
that the program was multi-level in nature, aecting all
levels of the police environment. In this type of closed
environment, the program may have helped change
overall perspectives regarding suicide and awareness
of sources of help. They also note that “part of the
emphasis of the training was that a suicide is not an event
aecting only the suicidal individual, but also involves
and profoundly aects the entire community. One of the
eects of this program was that suicidal behavior is seen
as less acceptable because of its implications for the rest
of the force” (p. 7).
75
Individual Strategies
and Practices
Two recent studies identify suicide prevention strategies
and practices currently being used by police departments
in the United States. The first, by Rajeev Ramchand et al.,
interviewed 110 U.S. law enforcement agencies from across
the country.
5
The second, by Megan Thoen et al., collected
data from a sample of 55 city police departments and
sheri’s oces nationwide, and also conducted online
surveys with 144 ocers.
6
Findings suggest that most
U.S. law enforcement agencies are concerned with ocer
wellness and suicide prevention and integrate them into
their work. However, the type and number of services
oered vary considerably across agencies. These and
other individual practices identified in the literature are
discussed next.
Mental Health and Wellness Services
Employee Assistance Programs (EAPs). In many
agencies, mental health services are provided mainly by
EAP or an employer-sponsored health insurance.
5, 6
Widely
used across dierent industries and professions, EAPs
provide counseling to employees on personal, family, or
1. Training of all police personnel on the nature of
suicide, identification of suicide risk, and how to
help a colleague in diculty
2. A new telephone helpline for ocers, which
asked callers to leave a message with their
contact information so they could be called back
by police volunteers trained in suicide prevention
with complete discretion
3. A full-day training session for supervisors
and union representatives, conducted by
psychologists, which focused on improving the
ability to identify ocers at risk of suicide and
how to provide help
4. A publicity campaign to raise awareness of
suicide prevention, which included articles in
internal police newspapers, posters, and
a brochure
PREVENTING SUICIDE AMONG LAW ENFORCEMENT OFFICERS: AN ISSUE BRIEF
14 | NATIONAL OFFICER SAFETY INITIATIVES
work-related matters. However, drawbacks noted in the
literature include the fact that these services may not
be located where the ocer is, be available 24 hours a
day, or staed by people with direct law enforcement
experience.
76
Ocers may be reluctant to provide
accurate assessments of mental health symptoms if they
believe the information may not be kept confidential
or could aect their employment in a negative way.
5
In
addition, Ramchand et al. (2019) also note that EAPs
may use dierent models, and assessment of their
eectiveness is limited.
Contracting with Community-Based Providers. Research
suggests that some smaller agencies contract directly
with one or more community-based mental health care
providers as a resource available to sta. In some cases,
the contracted provider is also responsible for making
return-to-duty determinations.
5
Embedded Chaplains. Chaplaincy programs are an
important piece of wellness support. Some agencies rely
on chaplains that are aliated with the agency and often
embedded within it. In most cases, the chaplains come
from a variety of faith backgrounds and provide their
services as volunteers. The chaplains often conduct ride-
along with ocers to get to know them, help respond to
critical incidents, and oversee death notifications. Clear
confidentiality rules are important to the success of
this practice.
In-House Mental Health Care. Fewer agencies oer in-
house, free mental health counseling by licensed mental
health care providers in addition to EAP services.
5
This
is more common in agencies with more than 1,000
sworn ocers. In some agencies, the service provided
is an internal EAP in which mental health professionals
(typically licensed social workers or psychologists) are
employed to oer short-term counseling or referrals. At
other agencies, mental health professionals are available
to oer long-term mental health treatment.
Experts emphasize the importance of ensuring that
mental health care is evidence-based and provided
by professionals who have specialized competency
in working with law enforcement personnel.
5
Oering
in-house behavioral health care can increase provider
awareness of the unique experiences of law enforcement.
Another approach is the provision of services by licensed
physicians who are also sworn reserve ocers.
76
This
approach can increase provider understanding of
the culture and climate of the department, while also
allowing providers to get to know the ocers they serve.
Ramchand and colleagues note that mental health care
providers should ideally be assigned to either oer
counseling or conduct return-to-duty investigations, but
not both duties, which could present a barrier to
help-seeking.
5
Special Programs to Address Substance Misuse.
Some of the larger agencies surveyed by Ramchand
and colleagues reported oering specific programs to
address substance misuse among ocers.
5
Examples
included oering direct linkages to regional outpatient
and inpatient substance use services covered by the
agency’s insurance plan, and/or oering closed Alcoholics
Anonymous meetings.
Routine Mental Health Checks. Another approach
discussed in the literature is the conduct of an annual
mental health check. Although this approach could
potentially support the early detection of mental health
issues and reduce stigma associated with help-seeking,
more research is needed on the eectiveness of this
practice and the best way to implement this approach
(i.e., voluntary or mandatory; frequency, individual or
group environment; by clinicians, peers, or supervisors).
76
Wellness Services and Programs. Wellness services and
programs have become more common among agencies
but can vary tremendously in scope and content. Some of
the larger agencies report having entire units dedicated
to the health and wellness of ocers and their family
members.
5
In the Ramchand et al. 2019 study, an agency
of nearly 3,000 ocers had a six-member mental health
unit that was primarily responsible for responding to
mental health-related calls. This was in addition to the
agency’s in-house mental health services, volunteer-run
peer support, and family assistance programs. In response
to an increase in mandatory overtime, one agency
reported having instituted a “restorative sleep policy”
that created sleep rooms and encouraged ocers to take
naps during their lunch breaks. Other programs were
smaller in scale. Three programs mainly disseminated
messages related to health and wellness. Another
program, conducted by an agency of 60 ocers, focused
on increasing participation in the agency’s peer support
team, providing training to ocers and their families,
and identifying appropriate specialists in the county’s
contracted EAP to work with ocers.
Training Programs
Mental Health and Suicide Prevention. Most police
agencies report that they provide some type of training
related to mental health and suicide prevention.
5
Relevant topics include critical incident response, stress
reduction, and wellness. Studies suggest that these
types of programs are well-received and are linked to
improvements in knowledge, attitudes, confidence.
76
As discussed earlier, this type of training was one of
four components of the Québec program that showed
evidence of eectiveness in reducing suicide rates.
75
NATIONAL OFFICER SAFETY INITIATIVES | 15
Resilience Training. Resilience training programs have
been shown to increase confidence in handling stressful
situations, reinforcing coping skills, and teaching ocers
to remain calm when faced with unknown events.
78
These
programs allow ocers to be better prepared for critical
incidents by building stress reduction techniques that
law enforcement can use during an event to respond
more eectively and more safely. They can also promote
healthy habits that police work can interfere with, such
as exercising regularly, eating and sleeping well, and
socializing with family and friends.
Best practices for using police training programs as a tool
to develop resilience and improve health outcomes are
discussed in a 2014 paper by Konstantinos Papazoglou
and Judith Andersen.
79
The authors suggest that training
curricula should incorporate mental and physical health
eects of exposure to critical incidents, normal responses
to trauma, and the value of peer support and other
programs that can be used independently or together
with formal treatment programs. They also recommend
that training programs incorporate relaxation techniques
and a mind-body approach to resilience training (e.g.,
yoga, tai chi, and mindfulness training).
Mindfulness Training. Violanti and colleagues identify
mindfulness training—an approach that helps individuals
bring their attention on experiences occurring in the
present moment without judgment—as a new intervention
that may be useful in police work.
14
Benefits can include
stress management and improved ability to cope with
trauma and crisis. Findings from a recent review suggest
that, among people at a high risk for suicide, mindfulness-
based interventions may be eective in improving
attentional control, problem solving, and response to
stress.
80
Although few studies have focused specifically
on law enforcement ocers, findings are promising. In a
recent study, a mindfulness-based intervention designed
to address police stress was found to increase resilience
and reduce stress, burnout, anger, fatigue, and sleep
disturbance.
81
Another study conducted with police
ocers found that a mindfulness-based intervention
reduced psychological strain, health complaints, and
negative aect; and also improved mindfulness and
self-care.
82
Identifying Persons at Risk
Identifying individuals who may be at an increased risk
for suicide and connecting them with sources of help
is a well-established strategy for preventing suicide.
However, doing so in a workplace setting—particularly
in law enforcement—can be challenging due to the
barriers to help-seeking noted earlier. Policies on how to
identify ocers at risk must ensure that the information
is confidential and is not used in ways that will aect
ocers’ employment.
Gatekeeper Training. Gatekeepers are individuals in
one’s community who can informally identify persons
at risk and connect them to sources of support. In law
enforcement, peers and chaplains often fulfill this role. In
order to do so eectively, gatekeepers must be trained
on how to identify and eectively respond to suicide
risk. A recent review of gatekeeper training for suicide
prevention in the U.S. military found evidence that these
programs can improve knowledge, attitudes and beliefs,
and self-ecacy.
83
Similarly, a study conducted with police
ocers in three European regions found that a four-hour
gatekeeper training session improved ocer knowledge,
attitudes, and confidence in dealing with depression and
suicidal behaviors.
84
Formal Screening Programs. Another approach to
screening focuses on reviewing administrative data to
identify ocers at risk.
5
In the recent survey conducted
by Ramchand et al., six agencies reported having an
established procedure for proactively identifying ocers
at increased risk for suicide and other adverse outcomes
(e.g., excessive use of force).
5
In most cases, the agencies
had monitoring systems in place that alerted agency
leaders when an ocer reached a threshold of indicators.
However, the eectiveness of this approach is not yet
known.
5
Peer Support
Peer support is one of the oldest and most common
practices used by police departments.
5
At first used
primarily to help ocers exposed to shootings and other
critical incidents, peer support and mentoring programs
can also help ocers respond to personal stressors, such
as a divorce, a death in the family, or an illness; facilitate
the transition to retirement; and enhance overall health
and wellness.
14, 76
Large agencies are more likely to oer
peer support programs than small or medium ones, and
the type and extent of support can vary substantially
across agencies.
6
In some cases, the program is overseen by an agency
psychologist or other mental health professional; in
others, by agency leadership. A recent report to Congress
recommended that peer support programs:
76
n Be led by ocers whom people in the
organization trust and admire, working in
consultation with professional mental
health specialists
n Be perceived as being independent
of management
n Provide ongoing and continued training and
oversight of peer mentors
n Have clear confidentiality rules
PREVENTING SUICIDE AMONG LAW ENFORCEMENT OFFICERS: AN ISSUE BRIEF
16 | NATIONAL OFFICER SAFETY INITIATIVES
Agencies unable to support an in-house program
can consider alternative models, such as regional or
statewide collaborations that use volunteers from multiple
departments or networks of retirees, and rank-and-file
organizations and labor unions. Smaller agencies may
also form strategic partnerships with local first responder
agencies to oer joint services, or join with neighboring
law enforcement agencies that oer a peer support
program, or develop partnerships with community-based
organizations that do so.
5
Family Support
Providing support to families is another strategy for
supporting the overall health and wellness of law
enforcement ocers. These eorts can help ocers
maintain healthy relationships with their spouses or
partners and provide social support systems for ocers
who are not in a relationship. In addition, family-centered
programs can also alert family members to the warning
signs of depression, substance misuse, PTSD, and suicide,
so that families can identify signs of trouble and connect
ocers to sources of support.
Family support is still a relatively new approach among
law enforcement agencies, with most existing programs
focusing primarily on providing support to survivors of
ocers who have died in the line of duty.
76
However,
information on approaches for supporting families may be
available from the U.S. military, which has long endorsed
the concept of family readiness.
85
DoD has developed
extensive programs to assist families. These programs
are built on the premise that ensuring that family
members are supported will give service members
peace of mind so they can perform their duties,
particularly during deployment. The programs seek to
enhance family resilience and connection to the broader
support community.
Crisis Lines
Crisis lines play a key role in supporting individuals during
a suicidal crisis and connecting them with services.
Examples include the National Suicide Prevention Lifeline,
the Crisis Text Line, the Veterans Crisis Line, and the
Military Crisis Line, a resource oered jointly by the DoD
and the U.S. Department of Veteran Aairs. Although
it is dicult to measure the eectiveness of crisis lines
because the calls are anonymous and often consist
of a single session, research suggests that crisis lines
can reduce distress among suicidal and non-suicidal
callers.
85, 87
Most recently, a study conducted in the United
Kingdom found that a telephone crisis line was eective in
reducing suicidal ideation among callers.
88
Several publicly available crisis lines staed by law
enforcement ocers are currently operational, including
Cop2Cop, Copline, and Safe Call Now.
76
Launched in
1998 by the State of New Jersey Department of Human
Services Division of Mental Health and Rutgers University,
the Cop2Cop hotline is staed by retired ocers, and
available to ocers and their families. The program has
been expanded to include all first responders. A non-
profit organization, Copline, was started in 2006 as a way
to make the Cop2Cop approach national. It is operational
24/7, and also staed by retired law enforcement
personnel. Established in 2009, Safe Call Now is another
non-profit organization that provides a confidential
24-hours crisis referral service for police ocers and other
public safety personnel and their families nationwide.
Limiting Access to Lethal Means
Although limiting access to lethal means is an eective
strategy for suicide prevention,
89
implementing this
approach in a law enforcement context can also be
challenging. When asked about restricting access to lethal
means, agencies reported providing annual training to
ocers on proper use and storage of firearms, rather than
temporarily transferring the firearms to someone legally
authorized to receive them.
5
The DoD has protocols in place that allow leaders to
arrange for military and civilian-issued weapons to be
sequestered in armories for individuals under treatment
for behavioral health conditions, or for any person who
is showing behaviors of concern.
90
However, any eort
to restrict access to lethal means among ocers should
consider potential negative consequences, including
psychological distress. Removing an ocer’s firearm
should be a temporary measure and should not represent
the end of one’s career.
Event Response Protocols
The recent study by Ramchand and colleagues (2019)
found that many police departments have policies,
procedures, and/or teams mobilized to respond to critical
incidents. A related area that is particularly relevant to
suicide prevention is postvention, or the response to the
aftermath of a suicide death. All of these event response
eorts should be trauma informed—that is, be based
on an understanding of trauma and its far-reaching
implications.
Traumatic Incident Response. This strategy involves
having policies, procedures, and/or teams in place that
can mobilize in response to a traumatic incident, such
as an ocer-involved shooting or a fatal car crash
involving a child. Traumatic response protocols are often
led by a contracted mental health professional, EAP
NATIONAL OFFICER SAFETY INITIATIVES | 17
provider, chaplain, or a senior-ranking ocer.
5
One of the
elements of traumatic incident response is a mandatory
psychological debriefing following a traumatic incident to
process the event and reflect on its impact. Although this
is considered a best practice in law enforcement, police
departments may use dierent approaches, in terms of
who should attend, how long it should last, what it entails,
and whether or not mental health professionals are
included.
31
Postvention. Postvention, or the organized response to
the aftermath of a suicide, is also an important strategy
for suicide prevention. As noted, exposure to suicide has
been found to increase suicide risk, and also has been
found to increase the risk for related problems, such
as complicated grief, major depression, and PTSD. This
exposure also increases the risk for contagion
—an increase
in suicides that can be linked to a suicide-promoting
influence, such as the suicide death of someone close or
of a media personality.
91
To prevent and address these problems, postvention
eorts should provide support to all survivors of a suicide
loss, including family members, friends, and colleagues, to
help them process the loss into their lives.
Components of postvention include:
92
n Protocols for reporting the death
n Funeral protocols for ocers who die by suicide
n Agency-held psychological debriefings,
information sessions by mental health
professionals, and plans for preventing
future suicides
n Support to bereaved family members
Relevant examples include a suicide postvention
protocol developed for the fire service,
93
and
postvention recommendations for the U.S. military,
developed in response to findings from a survey of
suicide loss survivors.
94
About Suicide Messaging
Another key element of suicide prevention is ensuring
that messages related to suicide and mental wellness are
conveyed in ways that support safety, help-seeking, and
healing. Studies suggest that the way we communicate
about suicide and mental wellness can contribute to
positive (e.g., help-seeking) or negative outcomes, such
as increased suicide risk and contagion.
95, 96
A recent spike
in suicide deaths among police ocers in New York City—
from an average of five deaths per year to 10 deaths by
mid-October of 2019—has called attention to the risk for
possible suicide contagion among ocers.
97
Suicide prevention eorts should ensure that all
communication about suicide adheres to established
guidelines regarding messaging. Resources available
online include recommendations for reporting on suicide
(https://reportingonsuicide.org) and the framework for
appropriate messaging about suicide-related content
(https://suicidepreventionmessaging.org) developed by
the National Action Alliance for Suicide Prevention.
PREVENTING SUICIDE AMONG LAW ENFORCEMENT OFFICERS: AN ISSUE BRIEF
18 | NATIONAL OFFICER SAFETY INITIATIVES
KNOWLEDGE GAPS
The literature identifies a number of remaining knowledge gaps regarding suicide
prevention among law enforcement ocers.
Suicide-Related Data
One of the major knowledge gaps identified in the
literature is the lack of suicide-related data, including
data on suicide deaths, attempts, and ideation, as well
as on risk and protective factors, and other relevant
variables. As noted, no national system currently collects
information on suicide deaths among law enforcement
ocers in the United States. Although some estimates
of police ocer suicides are available from non-profit
organizations, the data is based on voluntary reports,
social media, personal communications, and monitoring
of the news.
The Federal Bureau of Investigation (FBI) currently tracks
line-of-duty deaths among law enforcement ocers
through its Law Enforcement Ocer Killed and Assaulted
report. Congress is currently discussing legislation,
introduced in July 2019, that would require the FBI to
also collect data on suicide deaths and attempts among
current and former ocers. The Law Enforcement Suicide
Data Collection Act would establish a Law Enforcement
Ocers Suicide Data Collection Program that would
collect this data at local, state, and federal levels.
98
The
legislation would require the FBI to submit a report to
Congress each year and publish the report on its website.
An existing surveillance system that could inform the
development of this suicide surveillance eort is the
Department of Defense Suicide Event Report, which
collects and provides similar information regarding
military personnel.
Eectiveness of Strategies
and Practices
Another critical gap in knowledge concerns the
eectiveness of particular strategies and practices for
preventing suicide among law enforcement ocers.
Although a recent review found 44 articles published from
1997 to 2016, many of these papers were case studies,
case series, surveys, literature reviews, and summaries of
expert opinion, rather than experiments assessing
the eectiveness of particular prevention strategies
or programs.
14
A recent review that focused on emergency and
protective services employees (i.e., military personnel,
police personnel, and firefighters) found only 13 studies
that met review criteria.
99
Three of the included studies
focused on law enforcement ocers: the Québec
program described earlier,
75
the U.S.-based Badge of
Life Psychological Survival for Police Ocers program
(not formally evaluated),
100
and a five-month program
conducted in South Africa.
101
Based on a meta-analysis
of six studies that provided quantitative data on suicide
deaths, the review concluded that, on average, the
programs were associated with an almost 50 percent
reduction in suicide rates over five years. However, the
authors note that study quality was poor and none of the
included studies provided data on other suicide-related
outcomes, such as attempts and ideation. The review
concluded that “given the limited number of eligible
programs identified, and the relative lack of data on long-
term outcomes following the implementation of these
programs, there is currently a lack of firm evidence on
which to ground occupational policy with respect to the
prevention of suicide in these occupational groups”
(p. 405).
99
As noted, recent studies indicate that law enforcement
agencies are adopting a wide range of wellness and
mental health practices but that these eorts are often
not formally evaluated.
5, 6
Barriers to evaluation include
lack of funding and evaluation expertise, challenges
involved in designing a formal evaluation that can detect
changes in suicide-related outcomes, and ethical concerns
associated with addressing a sensitive topic. Most of the
existing evidence comes from studies that conducted
retrospective analyses of existing data.
16
Experts note that more research is needed to
understand:
5, 14
n The eectiveness and cost of individual suicide
prevention strategies and practices, such as peer
support, regular mental health checks, use of
EAPs for suicide prevention, and providing in-
house versus external mental health services
NATIONAL OFFICER SAFETY INITIATIVES | 19
n How to best implement each practice—e.g.,
essential elements, lessons learned—and whether
the increased intensity of services and/or
combination of strategies are associated with
improved outcomes related to mental health and
suicide prevention
n How to adapt suicide prevention strategies and
programs that have been shown to be eective in
the general population or among similar groups
to best meet the needs of law enforcement
ocers
Suicide Prevention
Among Subgroups
Research suggests that more research is needed
regarding particular groups of ocers who may be at a
greater risk for suicide or have unique needs regarding
suicide prevention. Examples include:
n Ethnic and racial minorities. In 2013, more than
a quarter (27 percent) of full-time local police
ocers were members of a racial or ethnic
minority, with about 130,000 minority local police
being employed.
105
However, few studies have
focused on non-white ocers. For example,
although Asian police ocers are the fastest
growing racial demographic of ocers in the
United States, information specific to this group
is lacking.
14
Other groups of interest include
American Indian and Alaska Native populations,
which have been found to have high rates of
suicide—both in the general population and
among military service member and veterans.
106
n LGBTQ+ ocers. Research suggests that
LGBTQ+ persons may be at an increased risk of
dying by suicide.
107
Sexual minorities also have
increased rates of substance use disorders—a
major risk factor for suicide.
108
However, few
studies have focused on LGBTQ+ ocers,
particularly regarding the prevention of suicide
and related problems.
Research also suggests that suicide prevention needs may
vary across departments of dierent sizes and locations.
Most of the existing research has focused on larger
departments, such as the NYPD.
16
Although research is
limited, existing studies suggest that ocers working in
smaller police departments may be at a greater risk for
suicide due to more job demands and fewer mental
health resources.
14
Other Knowledge Gaps
Other knowledge gaps identified in the literature include:
n An assessment of the quality of care that
in-house mental health providers oer to
police ocers
5
n The role of families as risk and protective factors
for suicide.
16
n The role of resilience in reducing suicide risk and
improving mental health outcomes
54
n Murder-suicide among police ocers
109
n Ocers transitioning to retirement or to
another career. Among these ocers, the
separation from peer networks could potentially
increase the risk of social isolation and suicide.
Eorts that support the development of social
connections—such as allowing ocers to make
use of departmental peer support programs
post retirement—may potentially help protect
these ocers from suicide risk.
16
More research is
needed on the eectiveness of these approaches
and on other ways to engage these ocers, such
as opportunities to volunteer with
the department.
n Military service members and veterans. Studies
suggest that suicide rates are high among
veterans and military service members.
102,
103
Experts have also noted that some law
enforcement ocers who are former service
members may have experienced more trauma
than their peers who come from dierent
backgrounds.
104
n Female ocers. Existing research suggests that
female ocers may be more likely than their
male peers to experience depression, a risk factor
for suicide.
14, 39, 46
Social stressors may also dier.
For example, day shifts may increase concerns
with childcare and other family obligations. Some
female ocers may also experience a culture
of sexism and bullying that provides limited
support for women.
23
More research is needed to
understand the unique needs of female ocers
and how to best address those needs.
PREVENTING SUICIDE AMONG LAW ENFORCEMENT OFFICERS: AN ISSUE BRIEF
20 | NATIONAL OFFICER SAFETY INITIATIVES
CONCLUSIONS
This issue brief synthesizes research findings relevant to the prevention of suicide among
law enforcement ocers. Much of the existing literature has focused on risk factors for
suicide in this population. Some of these factors are similar to factors aecting the general
population (e.g., mental illness, substance use disorders, social isolation, relationship
problems), while others appear to be more closely related to the law enforcement
profession. Examples include exposure to daily stressors (e.g., interpersonal conflict) and
traumatic incidents (e.g. child abuse, death of a colleague), work schedules that may
increase personal stress; and issues related to how the police agency functions (e.g.,
management styles, administrative burden). In addition, the literature also identifies
several work-related barriers to help-seeking, including stigma associated with mental
illness and the fear of negative consequences.
Findings from two recent studies suggest that law
enforcement agencies are increasingly incorporating
suicide prevention practices into their work.
5, 6
Examples
include a wide range of mental health and wellness
services, peer support, critical incident response, and
support for bereaved family members. Although the types
and amount of services vary across police departments,
these eorts may be helping to decrease the stigma
associated with mental health care in the
police profession.
In a study that interviewed 110 ocers from law
enforcement agencies across the United States, more
than 85 percent of respondents noted that this stigma
has decreased over the last few years.
31
Participants also
noted that the police culture is becoming more supportive
of ocers’ mental health needs and presenting fewer
barriers to accessing care. As one ocer noted:
Particularly over the past 5-8 years, the
approach has changed significantly. It used
to be the mentality of suck it up, do your job,
you need to be tough. Now it’s shifted more
toward you [still] have to be tough, but want
to make sure that you have the resources
you need to go through it. Our stance is
someone in our department has probably
been through what you’re going through, so
if you let us know what’s going on, we don’t
need to know the details, but let us know so
we can get you help.
31
(p. 45)
Participants attributed this change to a generational
shift in the workforce, as well as deliberate eorts from
command sta.
Research on suicide prevention suggests that eorts
are more likely to succeed when they combine multiple
strategies. A relevant example from law enforcement is
the Canadian Together for Life program, which combined
four key strategies for suicide prevention: training, a crisis
line, identifying ocers at risk, and increasing awareness
via a communication campaign. The program was found
to reduce suicide rates by 79 percent.
75
Findings suggest that law enforcement agencies should
identify and implement a combination of suicide
prevention strategies that address risk and protective
factors at multiple levels of influence. Strategies and
practices to consider include:
n Leadership and Culture
Engagement of leadership in suicide prevention and in
the promotion of overall mental health and wellness.
This includes developing policies and systems related
to mental health, wellness, and suicide prevention, and
considering ways to reduce work-related sources of
stress among ocers.
n Access to Mental Health Services
Increased access to mental health and wellness
services—at a minimum through an EAP; ideally by
in-house mental health providers who are trained in
suicide prevention and understand police culture.
Services should include substance misuse prevention
and treatment, as well as stress reduction. It is
important to ensure confidentiality and that there are
no repercussions for seeking mental health services.
NATIONAL OFFICER SAFETY INITIATIVES | 21
n Peer Support
Peer support programs that train peers to recognize
and respond to signs of suicide risk by connecting
ocers to appropriate sources of help, including crisis
lines and mental health professionals.
n Training
Training on mental health, wellness, and suicide
prevention for all employees, including warning signs
and sources of help. Resilience training for ocers
that supports the development of active coping skills.
n Event Response
Event response protocols, including critical incident
response, and policies and protocols for postvention
(response in the aftermath of a suicide) that are
trauma-informed.
n Family Support
Engaging ocers’ families and providing support
to them on an ongoing basis, rather than only in
response to a critical event.
n Limiting Access to Lethal Means
Identifying appropriate ways to limit access to lethal
means among ocers who may be experiencing a
suicidal crisis.
n Messaging
Ensuring that all communication related to suicide is
conveyed in ways that prevent contagion and support
safety, help-seeking, and healing. Communication
eorts should also raise awareness of mental health
and wellness programs and supports.
Key knowledge gaps identified in the literature include the
lack of a national surveillance system for suicide-related
data on the law enforcement workforce, and the lack of
evaluation data regarding the eectiveness of particular
strategies and practices. Law enforcement agencies
should consider ways to collect and analyze data related
to suicide prevention so that this information may be used
for program evaluation and quality improvement.
PREVENTING SUICIDE AMONG LAW ENFORCEMENT OFFICERS: AN ISSUE BRIEF
22 | NATIONAL OFFICER SAFETY INITIATIVES
REFERENCES
1. Xu J, Murphy SL, Kochanek KD, Arias E. (January 2020).
Mortality in the United States, 2018. NCHS Data Brief.
355. Retrieved from https://www.cdc.gov/nchs/products/
databriefs/db355.htm.
2. Violanti JM, Robinson CF, Shen R. (2013). Law enforcement
suicide: A national analysis. International Journal of
Emergency Mental Health, 15(4), 289-297.
3. Peterson C, Stone DM, Marsh SM, et al. (2018). Suicide rates
by major occupational group - 17 states, 2012 and 2015.
Morbidity and Mortality Weekly Report, 67(45), 1253-1260.
doi: 10.15585/mmwr.mm6745a1
4. Heyman M, Dill J, Douglas R. (April 2018). The Ruderman
white paper on mental health and suicide of first responders.
Boston, MA: The Ruderman Family Foundation. Retrieved
from https://rudermanfoundation.org/white_papers/police-
ocers-and-firefighters-are-more-likely-to-die-by-suicide-
than-in-line-of-duty.
5. Ramchand R, Saunders J, Osilla KC, et al. (2019). Suicide
prevention in U.S. law enforcement agencies: A national
survey of current practices. Journal of Police and Criminal
Psychology, 34(1), 55-66. doi: 10.1007/s11896-018-9269-x
6. Thoen MA, Dodson LE, Manzo G, Pina-Watson B, Trejos-
Castillo E. (2019). Agency-oered and ocer-utilized
suicide prevention and wellness programs: A national study.
Psychological Services, [Epub ahead of print]. doi: 10.1037/
ser0000355
7. Blue H.E.L.P. (2019). Honoring the service of law enforcement
ocers who died by suicide. Retrieved from https://bluehelp.
org/.
8. Stone DM, Holland KM, Bartholow B, et al. (2017).
Deciphering suicide and other manners of death associated
with drug intoxication: A Centers for Disease Control and
Prevention consultation meeting summary. American
Journal of Public Health, 107(8), 1233-1239. doi: 10.2105/
AJPH.2017.303863
9. Centers for Disease Control and Prevention. (2017). Leading
Causes of Death Reports, 2017. Web-based Injury Statistics
Query and Reporting System (WISQARS). Retrieved from
https://webappa.cdc.gov/sasweb/ncipc/leadcause.html.
10. Stone DM, Simon TR, Fowler KA, et al. (2018). Vital Signs:
Trends in state suicide rates - United States, 1999-2016 and
circumstances contributing to suicide - 27 states, 2015.
Morbidity and Mortality Weekly Report, 67(22), 617-624. doi:
10.15585/mmwr.mm6722a1
11. U.S. Department of Health and Human Services Oce of the
Surgeon General and National Action Alliance for Suicide
Prevention. (2012). 2012 National Strategy for Suicide
Prevention: Goals and objectives for action. Washington, DC:
HHS. Retrieved from https://www.hhs.gov/surgeongeneral/
reports-and-publications/suicide-prevention/index.html.
12. Peterson C, Sussell A, Li J, Schumacher PK, Yeoman K, Stone
DM. (2020). Suicide rates by industry and occupation—
National Violent Death Reporting System, 32 States, 2016.
Morbidity and Mortality Weekly Report, 69(3), 57-62.
13. Milner A, Witt K, Maheen H, LaMontagne AD. (2017).
Suicide among emergency and protective service workers:
A retrospective mortality study in Australia, 2001 to 2012.
Work, 57(2), 281-287. doi: 10.3233/wor-172554
14. Violanti JM, Owens SL, McCanlies E, Fekedulegn D, Andrew
ME. (2019). Law enforcement suicide: A review. Policing:
An International Journal, 42(2), 141-164. doi: 10.1108/
PIJPSM-05-2017-0061
15. Violanti JM. (2018). Police ocer suicide: Oxford
University Press; 2018. Retrieved from https://
oxfordre.com/criminology/view/10.1093/
acrefore/9780190264079.001.0001/acrefore-
9780190264079-e-87.
16. Stanley IH, Hom MA, Joiner TE. (2016). A systematic review
of suicidal thoughts and behaviors among police ocers,
firefighters, EMTs, and paramedics. Clinical Psychology
Review, 44, 25-44. doi: 10.1016/j.cpr.2015.12.002
17. Violanti JM, Mnatsakanova A, Burchfiel CM, Hartley TA,
Andrew ME. (2012). Police suicide in small departments: A
comparative analysis. International Journal of Emergency
Mental Health, 14(3), 157-162.
18. Violanti JM, Fekedulegn D, Charles LE, et al. (2009). Suicide
in police work: Exploring potential contributing influences.
American Journal of Criminal Justice, 34, 41-53. doi: 10.1007/
s12103-008-9049-8
19. Chopko BA, Palmieri PA, Facemire VC. (2014). Prevalence
and predictors of suicidal ideation among U.S. law
enforcement ocers. Journal of Police and Criminal
Psychology, 29(1), 1-9. doi: 10.1007/s11896-013-9116-z
20. Substance Abuse and Mental Health Services Administration.
(2018). Key substance use and mental health indicators in the
United States: Results from the 2017 National Survey on Drug
Use and Health. Rockville, MD: Center for Behavioral Health
Statistics and Quality, SAMHSA. Retrieved from https://
www.samhsa.gov/data/sites/default/files/cbhsq-reports/
NSDUHFFR2017/NSDUHFFR2017.pdf.
21. Turecki G, Brent DA. (2016). Suicide and suicidal behaviour.
Lancet, 387(10024), 1227-1239. doi: 10.1016/S0140-
6736(15)00234-2
22. Steele IH, Thrower N, Noroian P, Saleh FM. (2018).
Understanding suicide across the lifespan: A United
States perspective of suicide risk factors, assessment &
management. Journal of Forensic Sciences, 63(1), 162-171. doi:
10.1111/1556-4029.13519
23. Roberts KA. (2019). Correlates of law enforcement suicide in
the United States: A comparison with Army and Firefighter
suicides using data from the National Violent Death
Reporting System. Police Practice and Research, 20(1), 64-
76. doi: 10.1080/15614263.2018.1443269
24. Bachmann S. (2018). Epidemiology of suicide and
the psychiatric perspective. International Journal of
Environmental Research and Public Health, 15(7). doi:
10.3390/ijerph15071425
25. Nock MK, Hwang I, Sampson NA, Kessler RC. (2010). Mental
disorders, comorbidity and suicidal behavior: results from
the National Comorbidity Survey Replication. Molecular
Psychiatry, 15(8), 868-876. doi: 10.1038/mp.2009.29
26. Darvishi N, Farhadi M, Haghtalab T, Poorolajal J. (2015).
Alcohol-related risk of suicidal ideation, suicide attempt,
and completed suicide: a meta-analysis. PLoS One, 10(5),
e0126870. doi: 10.1371/journal.pone.0126870
NATIONAL OFFICER SAFETY INITIATIVES | 23
27. Lindsay V, Shelley K. (2009). Social and stress-related
influences of police ocers’ alcohol consumption. Journal
of Police and Criminal Psychology, 24(2), 87-92. doi: 10.1007/
s11896-009-9048-9
28. Milner A, Witt K, Maheen H, LaMontagne AD. (2017). Access
to means of suicide, occupation and the risk of suicide: A
national study over 12 years of coronial data. BMC Psychiatry,
17(1), 125. doi: 10.1186/s12888-017-1288-0
29. Centers for Disease Control and Prevention. (2017). Fatal
Injury Reports, National, Regional and State, 2017. Web-
based Injury Statistics Query and Reporting System
(WISQARS). Retrieved from https://webappa.cdc.gov/
sasweb/ncipc/mortrate.html.
30. Chae MH, Boyle DJ. (2013). Police suicide: Prevalence, risk,
and protective factors. Policing: An International Journal
of Police Strategies & Management, 36(1), 91-118. doi:
10.1108/13639511311302498
31. Saunders J, Kotzias V, Ramchand R. (2019). Contemporary
police stress: The impact of the evolving socio-political
context. Criminology, Criminal Justice, Law & Society, 20(1),
35-52.
32. Chopko BA, Palmieri PA, Adams RE. (2015). Critical incident
history questionnaire replication: Frequency and severity
of trauma exposure among ocers from small and midsize
police agencies. Journal of Traumatic Stress, 28(2), 157-161.
doi: 10.1002/jts.21996
33. Violanti JM, Charles LE, McCanlies E, et al. (2017). Police
stressors and health: A state-of-the-art review. Policing,
40(4), 642-656. doi: 10.1108/PIJPSM-06-2016-0097
34. Fairfax County Police Department and United States
Marshals Service. (2019). 2019 Virginia public safety mental
health pilot survey. Fairfax, VA: Fairfax County Police
Department.
35. Violanti JM. (2004). Predictors of police suicide ideation.
Suicide and Life-Threatening Behavior, 34(3), 277-283. doi:
10.1521/suli.34.3.277.42775
36. Ménard KS, Arter ML. (2013). Police ocer alcohol use and
trauma symptoms: Associations with critical incidents,
coping, and social stressors. International Journal of Stress
Management, 20(1), 37-56. doi: 10.1037/a0031434
37. Austin-Ketch TL, Violanti J, Fekedulegn D, Andrew ME,
Burchfield CM, Hartley TA. (2012). Addictions and the
criminal justice system, what happens on the other side?
Post-traumatic stress symptoms and cortisol measures in a
police cohort. Journal of Addictions Nursing, 23(1), 22-29.
doi: 10.3109/10884602.2011.645255
38. Maia DB, Marmar CR, Metzler T, et al. (2007). Post-traumatic
stress symptoms in an elite unit of Brazilian police ocers:
prevalence and impact on psychosocial functioning and on
physical and mental health. Journal of Aective Disorders,
97(1-3), 241-245. doi: 10.1016/j.jad.2006.06.004
39. Darensburg T, Andrew ME, Hartley TA, Burchfiel CM,
Fekedulegn D, Violanti JM. (2006). Gender and age
dierences in posttraumatic stress disorder and depression
among Bualo police ocers. Traumatology, 12(3), 220-228.
doi: 10.1177/1534765606296271
40. Brunault P, Lebigre K, Idbrik F, et al. (2019). Posttraumatic
stress disorder Is a risk factor for multiple addictions in
police ocers hospitalized for alcohol. European Addiction
Research, 25(4), 198-206. doi: 10.1159/000499936
41. Maple M, Cerel J, Sanford R, Pearce T, Jordan J. (2017). Is
exposure to suicide beyond kin associated with risk for
suicidal behavior? A systematic review of the evidence.
Suicide and Life-Threatening Behavior, 47(4), 461-474. doi:
10.1111/sltb.12308
42. Hedström P, Liu K-Y, Nordvik MK. (2008). Interaction
domains and suicide: A population-based panel study of
suicides in Stockholm, 1991–1999. Social Forces, 87(2), 713-
740. doi: 10.1353/sof.0.0130
43. van de Venne J, Cerel J, Moore M, Maple M. (2017). Predictors
of suicide ideation in a random digit dial study: Exposure to
suicide matters. Archives of Suicide Research, 21(3), 425-437.
doi: 10.1080/13811118.2016.1211044
44. Koch BJ. (2010). The psychological impact on police ocers
of being first responders to completed suicides. Journal of
Police and Criminal Psychology, 25(2), 90-98. doi: 10.1007/
s11896-010-9070-y
45. Cerel J, Jones B, Brown M, Weisenhorn DA, Patel K. (2018).
Suicide exposure in law enforcement ocers. Suicide and
Life-Threatening Behavior. doi: 10.1111/sltb.12516
46. Violanti JM, Charles LE, Hartley TA, et al. (2008). Shift-
work and suicide ideation among police ocers. American
Journal of Industrial Medicine, 51(10), 758-768. doi: 10.1002/
ajim.20629
47. Gerber M, Hartmann T, Brand S, Holsboer-Trachsler E, Pühse
U. (2010). The relationship between shift work, perceived
stress, sleep and health in Swiss police ocers. Journal of
Criminal Justice, 38(6), 1167-1175.
48. Violanti JM, Ma C, Gu J, Fekedulegn D, Mnatsakova A,
Andrew M. (2018). Social avoidance in policing: Associations
with cardiovascular disease and the role of social support.
Policing: An International Journal, 41(5), 539-549. doi:
10.1108/PIJPSM-02-2017-0017
49. Berg AM, Hem E, Lau B, Loeb M, Ekeberg O. (2003). Suicidal
ideation and attempts in Norwegian police. Suicide and Life-
Threatening Behavior, 33(3), 302-312.
50. Pew Research Center. (2017). Behind the badge: Amid
protests and calls for reform, how police view their jobs,
key issues and recent fatal encounters between blacks and
police. Retrieved from http://assets.pewresearch.org/wp-
content/uploads/sites/3/2017/01/06171402/Police-Report_
FINAL_web.pdf.
51. Herrington V, Colvin A. (2015). Police leadership for complex
times. Policing 10(1), 7-16.
52. Violanti JM, Fekedulegn D, Hartley TA, et al. (2016). Highly
rated and most frequent stressors among police ocers:
Gender dierences. American Journal of Criminal Justice,
41(4), 645-662.
53. Sher L. (2019). Resilience as a focus of suicide research and
prevention. Acta Psychiatrica Scandinavica, 140(2), 169-180.
doi: 10.1111/acps.13059
54. Rocklein-Kemplin K, Paun O, Godbee DC, Brandon JW.
(2019). Resilience and suicide in Special Operations Forces:
State of the science via integrative review. Journal of Special
Operations Medicine, 19(2), 57-66.
55. Youssef NA, Green KT, Beckham JC, Elbogen EB. (2013). A
3-year longitudinal study examining the eect of resilience
on suicidality in veterans. Annals of Clinical Psychiatry, 25(1),
59-66.
PREVENTING SUICIDE AMONG LAW ENFORCEMENT OFFICERS: AN ISSUE BRIEF
24 | NATIONAL OFFICER SAFETY INITIATIVES
56. Violanti JM, Ma CC, Mnatsakanova A, et al. (2018).
Associations between police work stressors and
posttraumatic stress disorder symptoms: Examining the
moderating eects of coping. Journal of Police and Criminal
Psychology, 33(3), 271-282.
57. Burke RJ, Mikkelsen A. (2007). Suicidal ideation among
police ocers in Norway. Policing: An International Journal
of Police Strategies & Management, 30(2), 228-236. doi:
10.1108/13639510710753234
58. Denney JT, Rogers RG, Krueger PM, Wadsworth T. (2009).
Adult suicide mortality in the United States: Marital status,
family size, socioeconomic status, and dierences by sex.
Social Science Quarterly, 90(5), 1167-1185. doi: 10.1111/j.1540-
6237.2009.00652.x
59. Robustelli BL, Trytko AC, Li A, Whisman MA. (2015). Marital
discord and suicidal outcomes in a national sample of
married individuals. Suicide and Life-Threatening Behavior,
45(5), 623-632.
60. Carleton RN, Afifi TO, Turner S, et al. (2018). Suicidal ideation,
plans, and attempts among public safety personnel in
Canada. Canadian Psychology, 59(3), 220-231. doi: 10.1037/
cap0000136
61. Trinkner R, Tyler TR, Go PA. (2016). Justice from within:
The relations between a procedurally just organizational
climate and police organizational eciency, endorsement
of democratic policing, and ocer well-being. Psychology,
Public Policy, and Law, 22(2), 158-172. doi: 10.1037/
law0000085
62. Federal Bureau of Investigation. (2018). 2018 Crime in
the United States. Table 74: Full-time law enforcement
employees. Retrieved from https://ucr.fbi.gov/crime-in-the-
u.s/2018/crime-in-the-u.s.-2018/topic-pages/tables/table-74.
63. Sagar-Ouriaghli I, Godfrey E, Bridge L, Meade L, Brown JSL.
(2019). Improving mental health service utilization among
men: A systematic review and synthesis of behavior change
techniques within interventions targeting help-seeking.
American Journal of Men’s Health, 13(3), 1557988319857009.
doi: 10.1177/1557988319857009
64. Violanti JM. (2007). Introduction. In: Violanti JM, Samuels
S, eds. Under the blue shadow: Clinical and behavioral
perspectives on police suicide. Springfield, IL: Charles C.
Thomas Publishers; 3-6.
65. Violanti JM. (2007). Police suicide: Epidemic in blue (2nd
ed.). Springfield: Charles C. Thomas.
66. Wester SR, Arndt D, Sedivy SK, Arndt L. (2010). Male police
ocers and stigma associated with counseling: The role
of anticipated risks, anticipated benefits and gender role
conflict. Psychology of Men & Masculinity, 11(4), 286-302. doi:
10.1037/a0019108
67. Copenhaver A, Tewksbury R. (2018). Predicting state police
ocer willingness to seek professional help for depression.
Criminology, Criminal Justice, Law & Society, 19(1), 60-74.
68. Fleischmann MH, Strode P, Broussard B, Compton MT. (2018).
Law enforcement ocers’ perceptions of and responses
to traumatic events: A survey of ocers completing Crisis
Intervention Team training. Policing and Society, 28(2), 149-
156. doi: 10.1080/10439463.2016.1234469
69. Dowling FG, Moynihan G, Genet B, Lewis J. (2006). A peer-
based assistance program for ocers with the New York City
Police Department: report of the eects of Sept. 11, 2001.
American Journal of Psychiatry, 163(1), 151-153. doi: 10.1176/
appi.ajp.163.1.151
70. Hyland S. (2018). Full-time employees in law enforcement
agencies, 1997-2016. Statistical Brief. Retrieved from https://
www.bjs.gov/content/pub/pdf/ftelea9716.pdf.
71. Mann JJ, Apter A, Bertolote J, et al. (2005). Suicide
prevention strategies: A systematic review. Jama, 294(16),
2064-2074. doi: 10.1001/jama.294.16.2064
72. Zalsman G, Hawton K, Wasserman D, et al. (2016). Suicide
prevention strategies revisited: 10-year systematic review.
Lancet Psychiatry, 3(7), 646-659. doi: 10.1016/s2215-
0366(16)30030-x
73. Knox KL, Litts DA, Talcott GW, Feig JC, Caine ED. (2003).
Risk of suicide and related adverse outcomes after exposure
to a suicide prevention programme in the US Air Force:
Cohort study. British Medical Journal, 327(7428), 1376. doi:
10.1136/bmj.327.7428.1376
74. Knox KL, Pflanz S, Talcott GW, et al. (2010). The US Air Force
suicide prevention program: Implications for public health
policy. American Journal of Public Health, 100(12), 2457-
2463. doi: 10.2105/ajph.2009.159871
75. Mishara BL, Martin N. (2012). Eects of a comprehensive
police suicide prevention program. Crisis, 33(3), 162-168. doi:
10.1027/0227-5910/a000125
76. Spence DL, Fox M, Moore GC, Estill S, Comrie NEA. (2019).
Law Enforcement Mental Health and Wellness Act: Report
to Congress. Washington, DC: U.S. Department of Justice.
Retrieved from https://cops.usdoj.gov/lemhwaresources.
77. Marzano L, Smith M, Long M, Kisby C, Hawton K. (2016).
Police and suicide prevention: Evaluation of a training
program. Crisis, 37(3), 194-204. doi: 10.1027/0227-5910/
a000381
78. McCraty R, Atkinson M. (2012). Resilience training program
reduces physiological and psychological stress in police
ocers. Global Advances in Health and Medicine, 1(5), 44-66.
doi: 10.7453/gahmj.2012.1.5.013
79. Papazoglou K, Andersen JP. (2014). A guide to utilizing
police training as a tool to promote resilience and improve
health outcomes among police ocers. Traumatology, 20(2),
103-111. doi: 10.1037/h0099394
80. Chesin M, Interian A, Kline A, Benjamin-Phillips C, Latorre
M, Stanley B. (2016). Reviewing mindfulness-based
interventions for suicidal behavior. Archives of Suicide
Research, 20(4), 507-527. doi: 10.1080/13811118.2016.1162244
81. Christopher MS, Goerling RJ, Rogers BS, et al. (2016). A pilot
study evaluating the eectiveness of a mindfulness-based
intervention on cortisol awakening response and health
outcomes among law enforcement ocers. Journal of Police
and Criminal Psychology, 31(1), 15-28. doi: 10.1007/s11896-015-
9161-x
82. Krick A, Felfe J. (2019). Who benefits from mindfulness?
The moderating role of personality and social norms for
the eectiveness on psychological and physiological
outcomes among police ocers. Journal of Occupational
Health Psychology, advance online publication. doi: 10.1037/
ocp0000159
83. Burnette C, Ramchand R, Ayer L. (2015). Gatekeeper training
for suicide prevention: A theoretical model and review of the
empirical literature. Rand Health Quarterly, 5(1), 16.
NATIONAL OFFICER SAFETY INITIATIVES | 25
84. Arensman E, Coey C, Grin E, et al. (2016). Eectiveness
of Depression-Suicidal Behaviour Gatekeeper Training
among police ocers in three European regions: Outcomes
of the Optimising Suicide Prevention Programmes and
Their Implementation in Europe (OSPI-Europe) study.
International Journal of Social Psychiatry, 62(7), 651-660. doi:
10.1177/0020764016668907
85. National Academies of Sciences, Engineering, and Medicine.
(2019). Strengthening the military family readiness system
for a changing American society. Washington, DC: The
National Academies Press. Retrieved from https://doi.
org/10.17226/25380.
86. Gould MS, Kalafat J, Harrismunfakh JL, Kleinman M. (2007).
An evaluation of crisis hotline outcomes. Part 2: Suicidal
callers. Suicide and Life-Threatening Behavior, 37(3), 338-
352. doi: 10.1521/suli.2007.37.3.338
87. Kalafat J, Gould MS, Munfakh JL, Kleinman M. (2007). An
evaluation of crisis hotline outcomes. Part 1: Nonsuicidal
crisis callers. Suicide and Life-Threatening Behavior, 37(3),
322-337. doi: 10.1521/suli.2007.37.3.322
88. Tyson P, Law C, Reed S, Johnsey E, Aruna O, Hall S. (2016).
Preventing suicide and self-harm. Crisis, 37(5), 353-360. doi:
10.1027/0227-5910/a000390
89. Yip PS, Caine E, Yousuf S, Chang SS, Wu KC, Chen YY. (2012).
Means restriction for suicide prevention. Lancet, 379(9834),
2393-2399. doi: 10.1016/S0140-6736(12)60521-2
90. U.S. Department of Veterans Aairs and U.S. Department of
Defense. (2019). VA/DoD clinical practice guideline for the
assessment and management of patients at risk for suicide.
Version 2.0. Retrieved from https://www.healthquality.va.gov/
guidelines/MH/srb/.
91. Cheng Q, Li H, Silenzio V, Caine ED. (2014). Suicide
contagion: A systematic review of definitions and research
utility. PLoS One, 9(9), e108724. doi: 10.1371/journal.
pone.0108724
92. International Association of Chiefs of Police. (2017). Breaking
the silence on law enforcement suicides: IACP National
Symposium on Law Enforcement Ocer Suicide and Mental
Health. Washington, DC: Oce of Community Oriented
Policing Services. Retrieved from https://www.theiacp.org/
resources/document/law-enforcement-suicide-prevention-
and-awareness.
93. Gulliver SB, Pennington ML, Leto F, et al. (2016). In
the wake of suicide: Developing guidelines for suicide
postvention in fire service. Death Studies, 40(2), 121-128. doi:
10.1080/07481187.2015.1077357
94. Ho TE, Schneider KG, Wortman JA, et al. (2018). Postvention
in the U.S. military: Survey of survivors of suicide loss from
2010-2014. Seaside, CA: Defense Personnel and Security
Research Center. Retrieved from https://apps.dtic.mil/docs/
citations/AD1048434.
95. Sinyor M, Schaer A, Nishikawa Y, et al. (2018). The
association between suicide deaths and putatively harmful
and protective factors in media reports. Canadian Medical
Association Journal, 190(30), E900-e907. doi: 10.1503/
cmaj.170698
96. Ortiz P, Khin Khin E. (2018). Traditional and new media’s
influence on suicidal behavior and contagion. Behav Sci Law,
36(2), 245-256. doi: 10.1002/bsl.2338
97. Romine T, Hanna J. (October 16, 2019). The number of NYPD
ocer suicides this year rises up to 10 CNN.
98. U.S. Congress. (2019). H.R.3735 - Law Enforcement Suicide
Data Collection Act. Retrieved from https://www.congress.
gov/bill/116th-congress/house-bill/3735/text.
99. Witt K, Milner A, Allisey A, Davenport L, LaMontagne AD.
(2017). Eectiveness of suicide prevention programs for
emergency and protective services employees: A systematic
review and meta-analysis. American Journal of Industrial
Medicine, 60(4), 394-407. doi: 10.1002/ajim.22676
100. Levenson RL, Jr., O’Hara AF, Clark R, Sr. (2010). The Badge
of Life Psychological Survival for Police Ocers Program.
International Journal of Emergency Mental Health, 12(2),
95-101.
101. Welch J. (1998). Life Savers: A suicide prevention programme
helping South African Police Service (SAPS) to cope with
post-apartheid era. People Management, 4, 46-48.
102. Kang HK, Bullman TA, Smolenski DJ, Skopp NA, Gahm GA,
Reger MA. (2015). Suicide risk among 1.3 million veterans
who were on active duty during the Iraq and Afghanistan
wars. Annals of Epidemiology, 25(2), 96-100. doi: 10.1016/j.
annepidem.2014.11.020
103. Department of Defense. (2018). DoDSER suicide event
resport: Calendar year 2017 annual report.
104. Hartley TA, Violanti JM, Mnatsakanova A, Andrew ME,
Burchfiel CM. (2013). Military experience and levels of
stress and coping in police ocers. International Journal of
Emergency Mental Health, 15(4), 229-239.
105. Reaves BA. (2015). Local police departments, 2013:
Personnel, policies, and practices. Bureau of Justice Statistics
Bulletin. Retrieved from https://www.bjs.gov/content/pub/
pdf/lpd13ppp.pdf.
106. O’Keefe VM, Reger GM. (2017). Suicide among American
Indian/Alaska Native military service members and veterans.
Psychological Services, 14(3), 289-294. doi: 10.1037/
ser0000117
107. Haas AP, Eliason M, Mays VM, et al. (2011). Suicide and suicide
risk in lesbian, gay, bisexual, and transgender populations:
Review and recommendations. Journal of Homosexuality,
58(1), 10-51. doi: 10.1080/00918369.2011.534038
108. Chaudhry AB, Reisner SL. (2019). Disparities by sexual
orientation persist for major depressive episode and
substance abuse or dependence: Findings from a national
probability study of adults in the United States. LGBT Health,
6(5), 261-266. doi: 10.1089/lgbt.2018.0207
109. Violanti JM. (2007). Homicide-suicide in police families:
aggression full circle. International Journal of Emergency
Mental Health, 9(2), 97-104.
PREVENTING SUICIDE AMONG LAW ENFORCEMENT OFFICERS: AN ISSUE BRIEF
26 | NATIONAL OFFICER SAFETY INITIATIVES
ABOUT THE BUREAU OF JUSTICE ASSISTANCE
The Bureau of Justice Assistance (BJA) helps to make
American communities safer by strengthening the
nation’s criminal justice system: BJA s grants, training and
technical assistance, and policy development services
provide government jurisdictions (state, local, tribal, and
territorial) and public and private organizations with
the cutting edge tools and best practices they need to
support law enforcement, reduce violent and drug-related
crime, and combat victimization.
BJA is a component of theOce of Justice Programs,
U.S. Department of Justice, which also includes the
Bureau of Justice Statistics, National Institute of Justice,
Oce of Juvenile Justice and Delinquency Prevention,
Oce for Victims of Crime, and Oce of Sex Oender
Sentencing, Monitoring, Apprehending, Registering,
and Tracking.
BJA Mission
BJA provides leadership and services in grant
administration and criminal justice policy development
to support local, state, and tribal law enforcement in
achieving safer communities. BJA supports programs
and initiatives in the areas of law enforcement, justice
information sharing, countering terrorism, managing
oenders, combating drug crime and abuse, adjudication,
advancing tribal justice, crime prevention, protecting
vulnerable populations, and capacity building. Driving
BJA’s work in the field are the following principles:
n Emphasize local control.
n Build relationships in the field.
n Provide training and technical assistance in support of
eorts to prevent crime, drug abuse, and violence at
the national, state, and local levels.
n Develop collaborations and partnerships.
n Promote capacity building through planning.
n Streamline the administration of grants.
n Increase training and technical assistance.
n Create accountability of projects.
n Encourage innovation.
n Communicate the value of justice eorts to decision
makers at every level.
To learn more about BJA, visit www.bja.gov, or follow us
on Facebook (www.facebook.com/DOJBJA) and Twitter
(@DOJBJA). BJA is part of the Department of Justice’s
Oce of Justice Programs.
ABOUT THE IACP
The International Association of Chiefs of Police (IACP)
is the world’s largest and most influential professional
association for police leaders. With more than 30,000
members in over 160 countries, the IACP is a recognized
leader in global policing. Since 1893, the association has
been speaking out on behalf of law enforcement and
advancing leadership and professionalism in
policing worldwide.
The IACP is known for its commitment to shaping the
future of the police profession. Through timely research,
programming, and unparalleled training opportunities, the
IACP is preparing current and emerging police leaders—
and the agencies and communities they serve—to succeed
in addressing the most pressing issues, threats, and
challenges of the day.
The IACP is a not-for-profit 501c(3) organization
headquartered in Alexandria, Virginia. The IACP is the
publisher of The Police Chief magazine, the leading
periodical for law enforcement executives, and the
host of the IACP Annual Conference, the largest police
educational and technology exposition in the world. IACP
membership is open to law enforcement professionals of
all ranks, as well as non-sworn leaders across the criminal
justice system. Learn more about the IACP at
www.theIACP.org.
NATIONAL OFFICER SAFETY INITIATIVES | 27
ABOUT THE EDUCATION DEVELOPMENT CENTER
Education Development Center (EDC) is a global
nonprofit organization that advances lasting solutions
to improve education, promote health, and expand
economic opportunity.Since 1958, EDC has been a leader
in designing, implementing, and evaluating powerful and
innovative programs in more than 80 countries around the
world. With expertise in areas such as suicide prevention,
early childhood development and learning, and youth
workforce development, EDC collaborates with public and
private partners to create, deliver, and evaluate programs,
services, and products. This work includes:
n Creating resources such as curricula, toolkits,
and online courses that oer engaging
learning experiences
n Conducting formative and summative evaluations
of initiatives
n Applying expertise in capacity building, professional
development, and training and technical assistance
n Providing policy advisement, information documents,
and research and analysis
n Conducting qualitative and quantitative studies to
inform our programs and assess their impact
For decades, EDC has oered evidence-based support
and resources to prevent and address violence, suicide,
and trauma across the U.S. and around the world. EDC
houses several leading centers and institutes focused
on suicide prevention, including the National Action
Alliance for Suicide Prevention, the Suicide Prevention
Resource Center, and the Zero Suicide Institute. Drawing
on this expertise, EDC leads initiatives and consults
with national and local law enforcement agencies and
departments in examining the complex issues underlying
suicide among public safety workforces, identifying
threats, and designing proactive and comprehensive
solutions. EDC brings extensive program development
expertise, quantitative and qualitative research skills,
and training and curriculum development experience, as
well as content expertise in suicide prevention, violence
prevention, trauma-informed approaches, and
substance use. Learn more about the work of EDC at
www.edc.org.
ABOUT THE NATIONAL ACTION ALLIANCE FOR SUICIDE PREVENTION
The National Action Alliance for Suicide Prevention
(Action Alliance) is the public-private partnership
working to advance the National Strategy for Suicide
Prevention and make suicide prevention a national
priority. The Substance Abuse and Mental Health Services
Administration provides funding to EDC to operate and
manage the Secretariat for the Action Alliance, which was
launched in 2010. Learn more at theactionalliance.org and
join the conversation on suicide prevention by following
the Action Alliance on Facebook, Twitter, LinkedIn,
and YouTube.
PREVENTING SUICIDE AMONG LAW ENFORCEMENT OFFICERS: AN ISSUE BRIEF
28 | NATIONAL OFFICER SAFETY INITIATIVES