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The barriers and challenges associated with mental health help-seeking behaviors of police officers in the United States: a descriptive study

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The barriers and challenges associated with mental health help-seeking behaviors of police officers in the United States: a descriptive study

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Content The Barriers and Challenges Associated With Mental Health Help-Seeking Behaviors of
Police Officers in the United States: A Descriptive Study
Christopher D. Meek
Rossier School of Education
University of Southern California
A dissertation submitted to the faculty
in partial fulfillment of the requirements for the degree of
Doctor of Education
May 2024

© Copyright by Christopher D. Meek 2024
All Rights Reserved

The Committee for Christopher D. Meek certifies the approval of this Dissertation
Courtney Malloy
Albert “Skip” Rizzo
Patricia Tobey, Committee Chair
Rossier School of Education
University of Southern California
2024

iv
Abstract
Policing is a high-stress profession wherein police officers are frequently exposed to emotionally
distressing interactions, physical danger, and interpersonal conflict. Further, because of the
nature of policing, a masculine culture permeates the organization which expects police officers
to be strong and able to endure the mental and physical challenges associated with these
exposures without outside help. Consequently, police officers are at an increased risk of
experiencing untreated mental health challenges that translate into untoward outcomes in the
interpersonal relationships of officers and within the community. As a result, this study includes
a qualitative descriptive study wherein I explored the perceptions of 15 police officers using
semi-structured interviews to obtain their perceptions of the barriers and challenges they
experience in mental health help-seeking. I utilized Braun and Clarke’s 6-phase thematic
analysis to identify six themes. Namely, barriers and challenges associated with mental health
help-seeking behaviors in this sample included (a) inadequate management practices, (b)
inadequate systems policies, (c) lacking perceived acceptance, (d) stigma, (e) lacking a mental
health culture, and (f) an organizational culture bolstering stigma. The conclusion of this study
includes recommendations for practice and future research based on the research findings.
Keywords: mental health, help-seeking behaviors, policing, stigma, organizational culture

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Dedication
To my beloved wife Christine, your unwavering support and endless encouragement have been
the cornerstone of my journey through academia. Your patience, understanding, and belief in me
have sustained me through the challenges and triumphs of pursuing my fourth degree. Thank you
for standing by my side, for cheering me on during the late-night study sessions, and for being
my rock through it all. This dissertation is as much yours as it is mine.
To my cherished children Lexie, Cayla, and Cody, your resilience and understanding, especially
during the times when I could not be as present as I wanted to be, has been nothing short of
remarkable. Your love and acceptance of my commitment to furthering my education have
inspired me to push through even the toughest moments. Thank you for your endless love, for
understanding the importance of education, and for being the motivation behind every step I took
toward this achievement.
To my beloved mother Camille, you were my guiding light, my inspiration, and my hero.
Though you may not be here to witness this moment, your spirit and legacy live on within me.
You were nearing the completion of your own doctoral journey when you were taken from us,
but your strength and determination continue to fuel my own aspirations. I dedicate this
dissertation to you; in loving memory of the extraordinary woman you were and the profound
impact you had on my life. I finish this journey in your honor, Mom, knowing that you are with
me every step of the way.
To each of you, I give my love and gratitude.

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Acknowledgments
I extend my deepest gratitude to my dissertation committee members, whose guidance,
expertise, and unwavering support have been invaluable throughout this journey. Dr. Patricia
Tobey, your profound insights and meticulous attention to detail have significantly enriched this
work. Dr. Candace Malloy, your encouragement and constructive feedback have inspired me to
strive for excellence in my research endeavors. Dr. Albert “Skip” Rizzo, your mentorship and
scholarly wisdom have been instrumental in shaping the trajectory of this dissertation. I am
profoundly grateful for your dedication and commitment.
Furthermore, I wish to express my heartfelt appreciation to the police officers whose
service and sacrifice uphold the fabric of our society. In the face of adversity and danger, you
demonstrate unparalleled bravery and selflessness, ensuring the safety and security of our
communities. Your resilience and unwavering dedication to duty inspire admiration and respect.
I extend my deepest thanks to you and your families for the sacrifices you make each day to
protect and serve.
Finally, I acknowledge my wife and my biggest supporter, Christine Meek, whose
unwavering belief in my potential has been a guiding light throughout this journey.
Thank you to everyone who has played a part in this endeavor. Your contributions have
made this achievement possible.

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Table of Contents
Abstract.......................................................................................................................................... iv
Dedication....................................................................................................................................... v
Acknowledgments.......................................................................................................................... vi
List of Tables .................................................................................................................................. x
List of Figures................................................................................................................................ xi
List of Abbreviations .................................................................................................................... xii
Chapter One: Overview of the Study.............................................................................................. 1
Background of the Problem ................................................................................................ 1
Statement of the Problem.................................................................................................... 2
Purpose of the Study ........................................................................................................... 3
Assumptions Underlying the Problem................................................................................ 5
Significance of the Study.................................................................................................... 6
Theoretical Framework....................................................................................................... 8
Definition of Terms............................................................................................................. 8
Organization of the Study ................................................................................................. 10
Conclusion ........................................................................................................................ 10
Chapter Two: Review of the Literature ........................................................................................ 12
Overview of Officer Mental Health.................................................................................. 13
Post-Traumatic Stress Disorder ........................................................................................ 17
Prevalence of PTSD Among Police Officers.................................................................... 22
Existing Interventions for Police Officers With PTSD..................................................... 23
Barriers to Help-Seeking Behaviors ................................................................................. 25
Potential Solutions............................................................................................................ 30
Theoretical Framework..................................................................................................... 32

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Conclusion ........................................................................................................................ 38
Chapter Three: Methodology........................................................................................................ 40
The Burke-Litwin Theoretical Framework....................................................................... 40
Methodology..................................................................................................................... 41
Data Sources ..................................................................................................................... 41
Data Collection ................................................................................................................. 42
Inclusion Criteria .............................................................................................................. 43
Data Analysis.................................................................................................................... 44
Positionality Statement ..................................................................................................... 45
Ethical Considerations...................................................................................................... 47
Credibility and Trustworthiness........................................................................................ 47
Limitations of the Study.................................................................................................... 49
Conclusion ........................................................................................................................ 50
Chapter Four: Findings................................................................................................................. 51
Participants........................................................................................................................ 51
Qualitative Findings Overview......................................................................................... 52
Summary........................................................................................................................... 66
Chapter Five: Discussion .............................................................................................................. 67
Findings............................................................................................................................. 67
Management Practices and System Policies..................................................................... 68
Perceived Acceptance and Prevalence of Stigma ............................................................. 69
Mental Health Culture: Organizational Culture Bolstering Stigma.................................. 70
Recommendations for Practice ......................................................................................... 70
Application to the Theoretical Framework....................................................................... 78
Future Research ................................................................................................................ 82

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Conclusions....................................................................................................................... 83
References..................................................................................................................................... 84
Appendix A: University of Southern California Recruitment Email.......................................... 108
Appendix B: Interview Protocol ................................................................................................. 110
Research Questions......................................................................................................... 110
Introduction to the Interview .......................................................................................... 110
Conclusion to the Interview............................................................................................ 110
Appendix C: USC Information Sheet Informed Consent ........................................................... 113
Appendix D: Codebook .............................................................................................................. 115

x
List of Tables
Table 1: Participants’ Demographics and Years of Service 52
Table 2: Strategies and Principles for Bolstering a Policing Culture of Mental 71
Health and Wellness
Table 3: Burke-Litwin Change Model Levels and Examples of Recommendations by Level 81
Table B1: Interview Protocol 112
Appendix D: Codebook 115

xi
List of Figures
Figure 1: Burke-Litwin Change Model 33

xii
List of Abbreviations
CBT Cognitive behavioral therapy
EMDR Eye-movement desensitization therapy
MBSR Mindfulness-based stress reduction
NCSR National comorbidity survey replication
PTSD Post traumatic stress disorder
SNRI Serotonin and norepinephrine reuptake inhibitors
SSRI Selective serotonin reuptake inhibitors

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Chapter One: Overview of the Study
Police officers in the United States are exposed to significant stressors in the line of duty
that can result in many untoward effects at the individual, organizational, and community levels
(Department of Justice, 2023). Police officers experience a high frequency of conflict wherein
their work routinely exposes them to danger, conflict, and emotionally charged situations, which
require them to remain calm under severe duress to de-escalate and resolve conflict among
community members. Further, police officers are frequently exposed to community members
who suffer from mental health challenges and are victims of trauma. As a result, police officers
are frequently exposed to critical incidents, which is a call for an event that is “unusual, violent,
and involves a perceived threat to or actual loss of human life (Department of Justice, 2023, p.
5). As a result, police officers are at an increased risk of developing mental health challenges
associated with the stressors they experience daily (Soomro & Yanos, 2019; Trombka et al.,
2021). However, policing organizational culture is suggested by the literature to bolster stigma
regarding mental health help-seeking behaviors (Department of Justice, 2023; Jackson &
Theroux, 2023; Rawski & Workman-Stark, 2018). However, there is limited exploration of the
barriers and challenges suggested to influence mental health help-seeking behaviors of police
officers, warranting future research.
Background of the Problem
Prior research has found an association between high-stress levels, burnout, “emotional
exhaustion, depersonalization, and a sense of low personal accomplishment” (Department of
Justice, 2023, p. 5). Individuals in high-stress vocations are at an increased risk for substance
abuse and developing mental health challenges that negatively influence work performance and
overall quality of life (Turgoose et al., 2022). Within the police force, individuals with untreated

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high-stress and mental health challenges may experience more citizen complaints, exhibit
increased aggression, are more likely to support heightened force, and have other untoward
effects negatively influencing community trust in law enforcement (Department of Justice,
2023). Prior research suggests that untreated and chronic stress is associated with an increased
prevalence of disability, chronic pain, hypertension, psychiatric disorders, and substance abuse
(Lampert et al., 2016).
Prior research also suggests that chronic exposure to high-stress environments such as
those experienced by police officers negatively affects the nervous system, resulting in a state of
hypervigilance and contributing to behavioral health challenges such as the use of excessive
force (Cheng, 2024). Further, police officers who have experienced critical incidents are at an
increased risk of experiencing traumatic stress secondarily leading to post-traumatic stress (PTS)
(Department of Justice, 2023). When police officers experience a traumatic experience, they
have a physiological and psychological response. When left unaddressed, it increases the risk for
substance use disorder (SUD), the development of post-traumatic stress disorder (PTSD), and the
potential for suicide (Gilmartin, 1986). Prior research suggests a strong association between
PTSD, suicidal ideation, and suicide (Sareen et al., 2005), suggesting the importance of
addressing the mental health challenges of police officers.
Statement of the Problem
The problem this study addressed was the limited knowledge regarding the barriers and
challenges experienced by police officers regarding mental health help-seeking behaviors. In
recent years, there has been an escalated acknowledgment of the distressing experiences police
officers regularly encounter, shining a spotlight on the critical issue of mental health challenges
in this demographic. While strides have been made to ameliorate the support structures and

3
therapeutic options available to law enforcement personnel grappling with PTSD, many police
officers are suggested to be unwilling to access such services, as evidenced by the increasing
number of incidents involving the use of excessive force and high burnout rates (Baker et al.,
2023; Turgoose et al., 2022; Wright et al., 2023). Existing treatment modalities, centered on
trauma-focused psychotherapies, pharmacotherapy, and peer support programs, have
demonstrated varying degrees of success. However, discernible gaps in the current framework
persist, including a potential underutilization of emerging approaches such as virtual reality
exposure therapy and a lack of personalized treatment paths considering individual officers’
unique experiences and backgrounds. Moreover, stigmatization and a perceived threat to job
security function as substantial barriers to mental health help-seeking behaviors, suggesting a
need for a cultural shift within the police force that fosters open dialogue and prioritizes
psychological well-being. Unfortunately, minimal research explores the barriers and challenges
associated with the mental health help-seeking behaviors of police officers, warranting research.
More specifically, police organizations can have all the mental health programs and initiatives
necessary to treat police officers properly, but if they are unwilling to access these services,
having the necessary resources is a moot point.
Purpose of the Study
The central purpose of this dissertation is to explore and comprehend the various factors
that hinder officers from seeking the necessary treatment and support for mental health and wellbeing issues. In an era characterized by escalating scrutiny of law enforcement agencies, police
officers’ mental health remains a pivotal yet understudied aspect that fundamentally impacts
their overall performance and, by extension, the welfare of the communities they serve.

4
Numerous studies have sought to adapt existing mental health treatment models from
other service professions to policing, operating under the presumption that they can seamlessly
transplant existing models. However, this approach has frequently failed to acknowledge the
unique stressors, experiences, and cultures ingrained in the policing profession. Therefore, a deep
understanding of the impediments to seeking treatment from the officers’ perspectives becomes a
prerequisite to the successfully adapting and implementing treatment models from other service
professions.
This study aimed to address this significant gap in the literature by doing the following:
1. Identifying and analyzing the various cultural, policy, departmental, and personal
factors that prevent officers from seeking treatment.
2. Drawing parallels and distinctions between the barriers faced in the policing
profession and other service sectors to understand the extent to which existing
treatment models can be applied to law enforcement.
3. Developing a grounded understanding of the obstacles to seeking treatment, which
will facilitate the creation of an intervention model that is not just transplanted from
other professions but is tailored to address the specific nuances of the policing
environment.
By approaching the issue from a ground-up perspective that considers the voices and
experiences of the officers themselves, this study endeavors to foster a climate that not only
encourages seeking help but also cultivates an environment within law enforcement agencies
where those agencies prioritize the mental well-being of officers. This study positions itself as a
step towards a future where policing professionals can access necessary assistance without

5
encountering systemic barriers, promoting a healthier, more effective, and more empathetic
approach to law enforcement.
Therefore, the research questions posited in this study were as follows:
1. What barriers and challenges do police officers perceive to influence their mental
health help-seeking behaviors?
2. How does organizational culture influence police officers’ mental health help-seeking
behaviors?
Assumptions Underlying the Problem
At least six major assumptions underlie the problem:
1. Policing is at a crossroads in the United States, with demands both for justice in
applying force and for safe streets and reductions in crime.
2. Chronic, repeated, and prolonged exposure to human trauma can lead to mental health
challenges. Many police officers experience exposure to these factors, yet few police
officers receive the psychological tools to help process and deal with the trauma
exposure.
3. Signs and symptoms of service-related mental health challenges are highly correlated
with failure to de-escalate in use-of-force training scenarios.
4. Employing mental health programs and interventions could both improve police
officers’ mental health and improve community policing outcomes as they relate to
use-of-force incidents.
5. Stigma of various kinds influences police officers’ willingness to embrace mental
health treatment for themselves.

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Significance of the Study
The profession of law enforcement is often characterized by high levels of stress and
exposure to traumatic events, factors that significantly predispose officers to mental health
complications, including PTSD (Jason et al., 2011; Soomro & Yanos, 2019). While treatments
are available, numerous barriers impede the treatment-seeking pathway for many officers,
including organizational culture, perceived stigma, and systemic factors (Cheng, 2024; Drew &
Martin, 2021, 2023; Grupe, 2023; Soomro & Yanos, 2019; Wright et al., 2023). By conducting
this study, I aimed to unpack the multi-faceted barriers and challenges associated with the mental
health help-seeking behaviors of police officers. By identifying these barriers for stakeholders to
address, I endeavor not only to foster a safer, more supportive working environment for police
officers but also to engender a significant reduction in the consequences of untreated mental
health issues, including the inappropriate use of force (Cheng, 2024; Drew & Martin, 2023;
Wright et al., 2023). Exploring the perspectives of police officers to identify factors that
influence their mental health help-seeking behaviors provides invaluable information for
stakeholders seeking to bolster the mental health help-seeking behaviors of police officers.
Further, these stakeholders could use these findings by seeking to prioritize police officers’
mental health to ensure a community where safety, trust, and mental well-being are paramount.
Exploring the barriers to police officers’ mental health help-seeking behaviors is of
paramount importance for several reasons. First, police officers are frequently exposed to
traumatic incidents and high-stress situations in the line of duty, which can have a profound
impact on their mental health (Cheng, 2024). PTSD is a debilitating condition that can lead to a
range of adverse outcomes, such as reduced job performance, increased absenteeism, and even
suicidal ideation among officers (Sareen et al., 2005; Soomro & Yanos, 2019). By understanding

7
the barriers that prevent police officers from seeking appropriate treatment for mental health
challenges, including PTSD, policymakers, mental health professionals, and law enforcement
agencies can develop targeted interventions and support systems to improve mental health helpseeking behaviors, the mental well-being of officers, and promote their overall job performance
and effectiveness.
Research in this area can also help address the stigma surrounding mental health issues
within law enforcement organizations. Due to the masculine and stoic culture that often prevails
in police departments, officers may be hesitant to seek help for psychological problems, fearing
it could be perceived as a sign of weakness or vulnerability (Drew & Martin, 2021; Grupe,
2023). Identifying the specific barriers that contribute to this stigma can aid in developing
targeted awareness campaigns and training programs to reduce the stigma and promote a more
open and supportive environment for officers to seek the help they need without fear of judgment
or repercussions.
Furthermore, understanding the barriers to mental health help-seeking behaviors in the
target sample can lead to more effective and tailored interventions. Different officers may face
unique challenges when seeking or accessing mental health services, depending on factors such
as rank, departmental policies, geographical location, past experiences, race, religion, sexual
orientation, and/or gender. By recognizing these individual and organizational barriers,
organizations can implement programs and initiatives to mitigate these barriers and bolster the
mental health help-seeking behaviors of police officers. Identifying the barriers associated with
police officers’ mental health help-seeking behaviors allows stakeholders to mitigate these
barriers, thereby potentially increasing treatment uptake and adherence, leading to better

8
outcomes for the affected officers and, ultimately, a healthier and more resilient law enforcement
community.
Theoretical Framework
I used the Burke-Litwin (Burke & Litwin, 1992) theoretical framework to explore my
research questions. Three major parts constitute the key components of the framework. The first
component is transformational factors, including mission and strategy, leadership, and
organizational culture. The second component is transactional factors, including structure,
management practices, and systems. The third component is individual factors, including taskskills alignment, motivation, and individual needs and values.
The Burke-Litwin framework (Burke & Litwin, 1992) aligns with evaluating this
problem of practice because of its breadth. The problem is broad and complex, encompassing
cultural attitudes about both policing and mental health, and involving both personal components
for individual officers and institutional components for policing agencies. The Burke-Litwin
framework (Burke & Litwin, 1992) allows for an examining each facet between its three
foundational parts.
Definition of Terms
This section includes key terms which need clarity of definition.
 Clinical effectiveness measures the degree to which a treatment works in real-world
clinical use, as opposed to clinical efficacy, which measures results under ideal
circumstances (National Institute of Health, 2006).
 According to the U.S. Department of Justice (2022), de-escalation of force includes
the actions that police officers and other first responders can implement to minimize
the chances of a situation escalating into physicality, conflict, or injury and increase

9
the chance of a safe outcome for all involved. It encompasses verbal and nonverbal
techniques focused on decelerating dangerous situations, improving the first
responder’s awareness of the situation, perform threat evaluations, and improve the
ability to make decisions in rapidly changing environments.
 Police refers to “the department of government concerned primarily with maintaining
public order, safety, and health and enforcing laws and possessing executive, judicial,
and legislative powers” (Merriam-Webster, n.d.).
 According to The International Association of Chiefs of Police, police use of force is
“amount of effort required by police to compel compliance by an unwilling subject”
(National Consensus Policy and Discussion Paper on Use of Force, 2020, p. 2)
 Post-traumatic stress disorder (PTSD) is
a psychiatric disorder that may occur in people who have experienced or
witnessed a traumatic event, series of events or set of circumstances. An
individual may experience this as emotionally or physically harmful or lifethreatening and may affect mental, physical, social, and/or spiritual well-being.
(American Psychiatric Association, 2024b, p. 1)
 Service-related PTSD is PTSD suffered in the line of service by a member of the
police, military, similar agency, or a first responder.
 Stigma is defined in three categories by the American Psychiatric Association
(American Psychiatric Association, 2024a, p. 1):
 Public stigma includes the negative, discriminatory attitudes people in general
have about mental illness.

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 Self-stigma includes the negative attitudes and personal shame people with
mental illness have about themselves.
 Institutional stigma includes systems and policies that, intentionally or
unintentionally, limit opportunities for those with mental illness.
Organization of the Study
This research study includes five chapters. More specifically, this first chapter reviews
the background of the problem, presents the problem statement, the purpose of the study,
underlying assumptions, the significance of the study, the theoretical framework, definitions of
key terms, and an overall conclusion of the study. The next chapter, Chapter 2, reviews the
literature pertaining to the phenomena of interest followed by Chapter 3, the methodology. The
methodology provides a review of the theoretical framework as a lens for collecting and
analyzing the data followed by a discussion of the chosen methodology, data sources, data
collection, and analysis procedures, presents the inclusion criteria for enrollment in the study,
provides a positionality statement, discusses ethical considerations, credibility and
trustworthiness, and limitations of the study. Chapter 4, the results, provides a review of the
sample population enrolled in this study and presents the findings. Finally, Chapter 5, the
discussion chapter, reviews the overall findings as they relate to the current literature and
implications for practice and reviews the recommendations for future research.
Conclusion
The study of barriers and challenges associated with mental health help-seeking
behaviors in policing is of paramount importance, not only for the well-being of police officers
but also for the safety and trust within the communities they serve. By understanding and
identifying the barriers and challenges associated with the mental health help-seeking behaviors

11
of police officers, stakeholders in the field could mitigate these barriers to bolster police officers’
mental health help-seeking behaviors and enhance their overall resilience and job performance,
potentially leading to more effective law enforcement practices. Policymakers, law enforcement
agencies, and mental health professionals must collaborate to create a culture encouraging helpseeking behaviors and ensuring access to appropriate, confidential, and specialized care. Through
such concerted efforts, we can foster an environment where police officers can readily seek
treatment for mental health challenges, enabling them to continue their vital work while
maintaining their physical and psychological well-being.

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Chapter Two: Review of the Literature
This chapter reviews the literature at the core of my dissertation. In this chapter, I
synthesize existing literature to examine an overview of officer mental health, PTSD as a
particular mental health risk, existing interventions, and barriers to treatment. These barriers to
treatment give special emphasis to the role of stigma, though the barriers expand beyond stigma.
Mental health issues and PTSD have become significant concerns within the police
population. The unique and demanding nature of police work exposes officers to elevated levels
of stress, trauma, and violence, increasing their vulnerability to mental health challenges. Studies
have indicated that police officers are at a higher risk of experiencing mental health issues
compared to the general population. Research conducted by Violanti et al. (2017) found that
police officers exhibited elevated levels of PTSD symptoms, with nearly 10% meeting the
criteria for a diagnosis of PTSD. Moreover, studies found the prevalence of other mental health
conditions, such as depression and anxiety, to be higher among police officers when compared to
other occupational groups (Hartley et al., 2018). These findings highlight the pressing need for a
comprehensive understanding of mental health issues in law enforcement and the development of
tailored support systems to address these challenges effectively.
The impact of PTSD and other mental health issues on police officers extends beyond
personal well-being and can also affect job performance and public safety. Untreated mental
health problems may lead to impaired decision-making, decreased cognitive function, and
reduced situational awareness, all of which can compromise an officer’s ability to respond
effectively in high-pressure situations (Violanti et al., 2017). Additionally, the stigma
surrounding mental health issues within the law enforcement culture may deter officers from
seeking help or accessing available resources, perpetuating the problem further (Henderson et al.,

13
2018). Recognizing the extent of mental health challenges in the police population and
addressing these issues through evidence-based interventions and support programs are essential
steps to promote the overall well-being of police officers and maintain the integrity of law
enforcement services.
Overview of Officer Mental Health
In recent years, the mental health of police officers has emerged as a focal point of
concern in the societal discourse, underscored by an escalating body of scholarly research
delineating the multifaceted stressors incumbent on law enforcement vocations. Law
enforcement professionals operate in environments replete with chronic stressors and traumatic
incidents, rendering them susceptible to a gamut of mental health dilemmas including but not
limited to PTSD, depression, and anxiety. This literature review embarks on critically exploring
the burgeoning evidence illustrating the mental health crises permeating the police force, delving
into empirical studies, theoretical frameworks, and qualitative analyses to craft a holistic view of
the prevalent issues and prospective pathways toward mitigation. The objective is to foreground
the urgency of addressing mental health concerns in law enforcement settings, thereby paving the
way for informed interventions and policy frameworks conducive to the mental well-being and
resilience of police officers.
Research has consistently found that police officers are at increased risk for mental health
issues, particularly PTSD, depression, and anxiety. A study by Carlier et al. (2019) found that
police officers had higher rates of PTSD than the general population, with up to 14% of police
officers reporting symptoms of the disorder. Other studies have found similarly high rates of
depression and anxiety among police officers (Morrissey et al., 2017).

14
The nature of police work exerts a significant toll on the mental health of law
enforcement professionals, resulting in poor mental health outcomes. Police officers routinely
encounter highly stressful and potentially traumatic situations, such as violence, accidents, and
crime scenes, exposing them to chronic stress and trauma (Burke, 2016; Papazoglou & Tuttle,
2018). Moreover, the demanding nature of their job often requires them to work long and
irregular hours, leading to sleep disturbances and fatigue (Green et al., 2022; Vila & Kenney,
2002). Additionally, the inherent risk to personal safety and the constant need to make highstakes decisions can lead to anxiety and hypervigilance (Gilmartin, 1986) These stressors
contribute to elevated rates of depression (Njiro et al., 2021), anxiety disorders (Trombka et al.,
2021), PTSD (Syed et al., 2020), and even suicidal ideation among law enforcement
professionals (Craddock & Telesco, 2022). Law enforcement agencies must recognize these
challenges and implement evidence-based programs to support the mental well-being of their
officers.
Police officers face a plethora of traumatic events in their line of duty, including
encounters with violence, accidents, and death regularly. Such exposure to highly distressing
incidents can significantly impact their mental well-being, leading to the development of
conditions like PTSD, depression, and anxiety. The chronic and unpredictable nature of law
enforcement places officers at a higher risk of experiencing psychological distress. Studies have
shown that a substantial number of police officers exhibit symptoms of PTSD, depression, and
anxiety due to the cumulative effect of trauma exposure (Carlier et al., 1998; McCanlies &
Kalich, 2009). The stress and emotional toll of policing have prompted researchers and
policymakers to prioritize mental health support for police officers, recognizing the essential role
they play in ensuring public safety (Chopko et al., 2017). In addition, the chronic stress of police

15
work, such as shift work, long hours, and high job demands, can also contribute to poor mental
health outcomes (Hartley et al., 2017).
The stigma associated with mental health issues in law enforcement is another significant
factor that contributes to poor mental health outcomes among police officers. Police officers may
be hesitant to seek help for mental health issues due to the fear of others stigmatizing them as
“weak” or “incompetent” (Wirth et al., 2016). This stigma can prevent police officers from
seeking the help they need and can lead to negative outcomes.
The lack of resources and support for police officers is also a significant issue that
contributes to poor mental health outcomes. Many police departments do not have the resources
to provide adequate mental health services to their officers, such as counseling, therapy, or
psychiatric care. Additionally, many police officers do not have access to adequate support
networks, such as peer support groups, which can help mitigate the negative effects of police
work on mental health (Morrissey et al., 2017).
Research has shown law enforcement officers often face significant stress and trauma in
the line of duty, leading to a higher risk of mental health challenges (Kirschman, 2018; Violanti
et al., 2019a, 2019c). The demanding nature of policing, exposure to critical incidents, and the
pressure to maintain public safety can contribute to psychological distress among officers (APA,
2020). Consequently, addressing the mental health needs of police personnel has become a
crucial aspect of improving overall well-being, job satisfaction, and performance within law
enforcement agencies (Hartley et al., 2022). As a result, many have proposed various initiatives
and interventions to support the mental health of police officers and promote a healthier and
more resilient police force (Johnson & Krane, 2021). The work environments of law
enforcement professionals include exposure to highly stressful and traumatic situations on a

16
regularly, which can take a toll on their mental health. Neglecting their mental well-being can
lead to adverse consequences such as increased rates of burnout, PTSD, depression, and even
suicide. By providing adequate resources and support for mental health issues, police
departments can help reduce the stigma associated with seeking help and promote a healthier
work environment.
The literature demonstrates that providing mental health resources for officers improves
their job performance and overall effectiveness (Violanti et al., 2019b). Additionally, studies
have found that police officers who receive regular mental health support and access to
counseling services have the skills needed to cope with stress and maintain emotional resilience
in the face of challenging situations. This, in turn, leads to increased job satisfaction and reduced
absenteeism. Research by Violanti et al. (2019) highlighted mental health interventions for police
officers can enhance their decision-making abilities, communication skills, and conflictresolution capacities, resulting in improved community relations.
A study by Andersen et al. (2019) emphasized the importance of proactive mental health
programs, reporting that departments with such initiatives experience decreased disciplinary
actions and improved officer retention rates. Prioritizing the mental health of police officers
benefits individual officers and fosters a culture of support within the entire department. By
implementing policies that promote mental health awareness and intervention, police
departments can create an environment where officers feel more comfortable seeking help and
discussing their challenges openly. This shift in organizational culture has the potential to reduce
the stigma surrounding mental health issues in law enforcement and encourage early
intervention.

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Additionally, reducing the stigma surrounding mental health issues and enhancing
awareness of the risk factors for poor mental health outcomes is of paramount importance in
fostering societies where individuals feel seen, heard, and understood in all aspects of their wellbeing. By normalizing conversations about mental health and educating communities on the
array of risk factors, ranging from genetic predispositions to environmental stressors, we can
facilitate early intervention and more effective treatment strategies. Implementing school
programs and workplace initiatives that underscore the importance of mental and physical health,
can work as potent tools in dismantling pre-existing prejudices and misinformation. Moreover,
creating platforms and spaces where individuals can share their experiences openly, without fear
of judgment or discrimination, can be a powerful way to reduce stigma. Through collective effort
and a compassionate approach, we can create environments prioritizing mental health,
encouraging individuals to seek early help and adhere to treatment regimes, thereby promoting
healthier, happier societies for all.
The mental health of police officers is a critical issue that requires attention and action.
The nature of police work, the stigma associated with mental health issues, and the lack of
resources and support all contribute to poor mental health outcomes among law enforcement
professionals. Addressing these factors through increased awareness, resources, and support can
help promote the well-being of police officers and improve public safety.
Post-Traumatic Stress Disorder
Post-traumatic stress disorder, commonly known as PTSD, is a mental health condition
that can develop after experiencing or witnessing a traumatic event (Association, 2016). Police
officers are exposed to elevated levels of stress and trauma in the line of duty, which can lead to
the development of PTSD (Soomro & Yanos, 2019). Research suggests that there is a lack of

18
intervention tools specifically designed for police officers who have job-related PTSD (Craddock
& Telesco, 2022). However, for police officers, exposure to traumatic events is an inherent part
of their job. Police officers are frequently exposed to traumatic events such as violence,
accidents, and death, which can result in the development of PTSD.
Research has highlighted the prevalence of PTSD among police officers and its potential
consequences on their mental well-being. Research has shown law enforcement personnel are at
a higher risk of developing PTSD compared to the general population (Carlier et al., 2000). The
stressors inherent in their profession can lead to symptoms such as flashbacks, intrusive
thoughts, nightmares, emotional numbing, and hyperarousal, which can significantly impair their
ability to function both personally and professionally (Violanti et al., 2015).
PTSD not only affects the individual officers but can also impact the overall performance
of police departments. Officers dealing with untreated PTSD may experience reduced
productivity, increased sick leave, and a higher risk of on-the-job errors, potentially jeopardizing
public safety (Cameron & Keane, 2010). Therefore, it is crucial for law enforcement agencies to
prioritize mental health support and intervention programs to identify and assist officers dealing
with PTSD, reducing the stigma surrounding mental health concerns and promoting a healthier
work environment.
PTSD can have a profound and detrimental impact on an individual’s well-being,
severely affecting their ability to function in daily life and overall quality of life. One can get
PTSD after living through or seeing a traumatic event, such as combat experiences, natural
disasters, or interpersonal violence (American Psychological Association, 2020). The symptoms
of PTSD can manifest in numerous ways, including intrusive memories, flashbacks, nightmares,
hyperarousal, and avoidance of stimuli associated with the trauma. These symptoms can disrupt

19
an individual’s cognitive and emotional processes, leading to difficulty concentrating, making
decisions, and managing emotions. The individual may experience heightened anxiety and fear,
which can result in social isolation and avoidance of situations that trigger distressing memories.
Consequently, their relationships with family, friends, and colleagues may experience stress,
further exacerbating feelings of alienation and isolation (APA, 2013).
The impact of PTSD on an individual’s well-being extends beyond psychological
distress, affecting various aspects of their life and diminishing their overall quality of life.
Research has shown that individuals with PTSD often experience impairments in their
occupational functioning, leading to decreased productivity and an increased risk of
unemployment (Hansen et al., 2022; Jason et al., 2011). The condition may also contribute to the
development of comorbid mental health issues, such as depression and substance abuse, further
complicating the individual’s well-being. PTSD can also negatively affect a person’s physical
health, with higher rates of cardiovascular problems and chronic pain observed in individuals
with the disorder. Moreover, individuals with PTSD may struggle with sleep disturbances, which
can lead to chronic fatigue and a reduced capacity to engage in daily activities. Overall, the
debilitating impact of PTSD highlights the critical importance of early detection and evidencebased interventions to improve the well-being and quality of life of affected individuals (APA,
2013).
Multiple studies have attempted to measure the prevalence of PTSD in police officers.
For instance, Maia et al. (2007) found that approximately 15% of police officers studied showed
symptoms of PTSD. Similarly, a study conducted by Carlier et al. (1997) reported a 7%
prevalence of PTSD in police officers. Research conducted nearly 20 years later by Berger et al.
(2012) reported even higher prevalence rates, ranging between 9% to 19%. A study by Pietrzak

20
et al. (2011) found that police officers had a higher prevalence of PTSD compared to the general
population. The same study also found that officers with PTSD were more likely to have
depression and substance abuse problems. Another study by Violanti et al. (2015) found that
police officers with PTSD had higher levels of cardiovascular disease risk factors, such as high
blood pressure and cholesterol. These findings highlight the importance of addressing PTSD in
police officers.
By comparison, the lifetime prevalence of PTSD in the general population is significantly
lower. The National Comorbidity Survey Replication (NCSR) found a lifetime prevalence rate of
about 6.8% (Kessler et al., 2005), and subsequent studies have replicated comparable results
(Goldstein et al., 2016). Police officers are predisposed to a heightened risk of developing posttraumatic stress disorder (PTSD) owing to a variety of factors ingrained in their professional
environment. The frequency and intensity of exposure to traumatic events, which can involve
horrific crime scenes and violent encounters, play a significant role in enhancing the risk of
PTSD (Andersen et al., 2015). Moreover, the lack of social support within their organization or
personal lives can exacerbate the psychological toll of their experiences (Chopko et al., 2015).
The organizational culture of police departments can sometimes promote stoicism and emotional
detachment, discouraging officers from seeking help and potentially stifling constructive
dialogue around mental health concerns (Kulbarsh, 2016). Additionally, the pervasive stigma
surrounding mental health issues can further deter officers from reaching out for support,
enhancing the risk of PTSD as they might tend to internalize their trauma rather than address it
through therapy or counseling (Papazoglou & Andersen, 2014). Addressing these complex
intertwining factors necessitates a multifaceted approach to foster resilience and promote
psychological well-being among police officers.

21
Continuous exposure to trauma in the line of duty can have severe psychological
consequences for police officers, particularly those who develop PTSD. Such exposure can lead
to significant psychological distress, manifesting in symptoms of anxiety, depression, guilt, and a
reduced sense of self-worth among affected officers (Berg et al., 2019; Violanti et al., 2018a).
PTSD can harm officers’ ability to perform their duties efficiently, potentially compromising
their decision-making skills and overall job performance (Marmar et al., 2019). The debilitating
nature of PTSD can also contribute to increased rates of absenteeism, burnout, and reduced job
satisfaction, affecting the overall well-being of the officer and the effectiveness of the police
force (Gershon et al., 2019; Pietrzak et al., 2015). Therefore, it is crucial for law enforcement
agencies to recognize and address the mental health needs of their officers, providing appropriate
support and implementing interventions to mitigate the negative effects of trauma exposure and
PTSD on job performance and overall functioning.
Despite the high prevalence of PTSD in police officers, there is a lack of intervention
tools specifically designed for this population. Research has shown that cognitive-behavioral
therapy (CBT) is an effective treatment for PTSD, but it may not be well-suited for police
officers. CBT typically involves talking about the traumatic event, which may be difficult for
officers who rarely discuss their emotions (Burke et al., 2010).
Some researchers have suggested that peer support programs may be a more effective
intervention tool for police officers with PTSD (Gilmartin, 2013; Regehr & Millar, 2007). Peer
support programs involve trained peers providing emotional support, practical assistance, and
resources to their colleagues experiencing job-related stress. These programs are often wellreceived by police officers, providing a safe and supportive environment for officers to discuss
their experiences (Regehr & Millar, 2007).

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In addition to peer support programs, some researchers have suggested mindfulnessbased interventions may be effective for police officers with PTSD (Boyd et al., 2018; King et
al., 2013). Mindfulness-based interventions involve focusing on the present moment and
accepting one’s thoughts and feelings without judgment. Research shows these interventions are
successful in reducing symptoms of PTSD in other populations and may be well-suited for police
officers who need to remain focused and alert on the job (Polusny et al., 2015).
Overall, the lack of intervention tools for police officers suffering from job-related PTSD
is a concerning issue. While some interventions, such as CBT, may be effective for PTSD in
general, they may not be well-suited for police officers. To develop and assess intervention tools
tailored to the unique needs of police officers with PTSD, scholars must engage in more
research. Similarly, more research in peer support programs and mindfulness-based interventions
is necessary to determine their effectiveness for the police officer population.
Prevalence of PTSD Among Police Officers
The prevalence of PTSD among police officers varies depending on the population of the
study and the definition of PTSD used. However, research indicates that police officers are at a
higher risk of developing PTSD than the general population. For example, a study of over 4,000
police officers in the United States found that 7.7% of officers had symptoms of PTSD (Marmar
et al., 2015). Another study of Canadian police officers found that 32.6% of officers had
symptoms of PTSD (Carleton et al., 2018). These studies suggested that PTSD is a significant
issue among police officers and highlight the need for effective interventions to support them in
managing the condition.
Police officers experience exposure to a range of traumatic experiences during their
careers, such as dealing with violent and dangerous situations, witnessing accidents, and

23
experiencing various forms of abuse. These experiences can lead to the development of PTSD
and other mental health issues. The frequency and intensity of traumatic experiences encountered
by police officers can lead to chronic PTSD, with symptoms persisting for many years after the
initial traumatic exposure (Smith & Johnson, 2023). Officers suffering from PTSD often
experience recurring, intrusive memories or nightmares of the events, negative changes in
thinking and mood, and alterations in physical and emotional reactions (APA, 2013). These
symptoms can profoundly affect their professional and personal lives, leading to reduced job
performance, strained relationships, substance abuse, and an increased risk of suicide (Violanti et
al., 2018b). Despite the prevalence of PTSD in law enforcement, there is a lack of intervention
tools available for police officers who have job-related PTSD. This literature review aims to
explore the reasons behind this lack of intervention tools and to suggest potential solutions to
address this issue.
Police officers are at a higher risk of developing PTSD than the general population due to
their exposure to traumatic events in the line of duty. Carlier et al. (2000) found that the
prevalence of PTSD in police officers ranged from 7.8% to 19.2%. Similarly, Marmar et al.
(1996) found that 15.5% of police officers reported symptoms of PTSD. These studies indicate
that PTSD is a significant issue among law enforcement personnel.
Existing Interventions for Police Officers With PTSD
Law enforcement personnel, due to the stressful nature of their job, are at a heightened
risk of developing PTSD. Several intervention tools exist to help police officers manage and
mitigate the symptoms of PTSD. One such tool is trauma-focused cognitive-behavioral therapy
(CBT). CBT provides the opportunity for police officers to recognize and reframe traumatic
thoughts and memories in a safer environment (Karaffa & Koch, 2016). By recognizing triggers

24
and managing stress reactions, CBT offers police officers the tools to minimize PTSD symptoms
and improve overall well-being.
One approach under the umbrella of CBT is eye movement desensitization and
reprocessing (EMDR), which has shown efficacy in treating PTSD. EMDR utilizes back-andforth movements of the eyes to help individuals process traumatic memories and reduce their
long-term impact (Shapiro, 2018). A systematic review of randomized controlled trials
demonstrated that EMDR has a strong efficacy in reducing PTSD symptoms and is comparable
to CBT in its effect size (Cuijpers et al., 2016).
Another popular intervention tool is peer-support programs, which enable police officers
to share their experiences with colleagues facing similar challenges. These programs aim to
reduce the stigma associated with mental health issues and foster a supportive community. A
study by Chopko et al. (2015) highlighted the effectiveness of peer support, which found that
officers who participated in a peer support program reported lower levels of PTSD symptoms
compared to those who did not participate.
Mindfulness-based stress reduction (MBSR) is an additional intervention that has shown
promise in managing PTSD symptoms in law enforcement personnel. MBSR includes
meditation, body awareness, and yoga, focusing on developing coping mechanisms to manage
stress. A study by Christopher et al. (2018) found that police officers who participated in MBSR
training showed reduced PTSD symptoms and improved mental health outcomes.
Finally, pharmacological interventions such as selective serotonin reuptake inhibitors
(SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) have also shown efficacy
in treating PTSD symptoms. They work by increasing the levels of certain chemicals in the brain

25
that help regulate mood (National Institute of Mental Health, 2021). Although these medications
are not a cure, they can be an effective part of a comprehensive treatment plan.
Barriers to Help-Seeking Behaviors
Despite the high prevalence of PTSD in law enforcement, many police officers are
hesitant to seek help due to a variety of reasons. There are several interventions available to
support individuals with PTSD, including psychotherapy, medication, and self-help strategies.
However, research suggests police officers may face unique barriers to accessing and engaging
with these interventions (Burns & Buchanan, 2020). For example, police officers may be hesitant
to seek help for PTSD due to concerns about stigma, confidentiality, and the impact of seeking
help on their career (Gee et al., 2019). Additionally, the nature of police work may make it
difficult for officers to access traditional forms of therapy, such as weekly appointments, due to
scheduling constraints and the unpredictable nature of police work (Carleton et al., 2018). As a
result, interventions that focus on the needs and preferences of police officers may be more
effective in supporting their mental health.
One of the most significant barriers to seeking help is the stigma attached to mental
health issues. Society often views police officers as tough and resilient individuals who are
supposed to be able to manage anything that comes their way. For police officers, admitting they
are struggling with mental health issues can present as a sign of weakness and can damage their
reputation among their colleagues (Grupe, 2023).
A further barrier to seeking help is the fear of repercussions for admitting to having
mental health issues. Police officers may be worried that they will lose promotions, experience
demotion, or even lose their jobs if others view them as mentally unfit for the job. This fear can
lead to police officers avoiding seeking help and suffering in silence.

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Another reason is the limited research on effective treatments for PTSD in police officers.
Most studies on PTSD interventions have focused on military populations, with little research
specifically targeting the unique needs of police officers (Lavigne et al., 2018). This lack of
research has made it difficult to develop evidence-based interventions that focus on the needs of
police officers.
However, some studies have highlighted potential interventions that may be effective for
police officers with PTSD. For example, cognitive-behavioral therapy (CBT) has shown promise
in reducing symptoms of PTSD in police officers (Carlier et al., 2012). Additionally,
mindfulness-based interventions are effective in reducing symptoms of PTSD in first responders,
including police officers (Kearney et al., 2018). These interventions have the potential to be
adapted and tailored specifically for police officers, but scholars must conduct more research to
evaluate their effectiveness in the police officer population.
Stigma
Police officers often experience exposure to traumatic events and, as a result, may be at
increased risk for developing mental health issues such as depression, anxiety, and PTSD. There
is a stigma associated with mental health issues in law enforcement, which can prevent police
officers from seeking help when they need it. This literature review will examine the stigma
associated with mental health issues in police officers (Smith & Jones, 2022).
Research has found that the stigma associated with mental health issues is a significant
barrier to seeking treatment among police officers. A study by Vogt et al. (2017) found that
stigma was a primary reason police officers were reluctant to seek mental health services. Police
officers reported feeling that others would view seeking mental health services as a sign of
weakness or incompetence and that it could harm their careers.

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The culture of policing reinforces the stigma associated with mental health issues in law
enforcement. Police officers are often socialized to be tough and to manage stressful situations
without showing emotions. This culture can create a sense of shame or guilt for police officers
who experience mental health issues, leading them to believe they are somehow weak or
inadequate (Violanti et al., 2016).
The attitudes of other officers, supervisors, and department leaders can also perpetuate
the stigma associated with mental health issues in law enforcement. A study by Wirth et al.
(2016) found that police officers perceived their supervisors and colleagues as unsupportive of
mental health issues. Officers reported that their colleagues and supervisors often made negative
comments or jokes about mental health issues, which reinforced the stigma and discouraged
officers from seeking help.
Addressing the stigma associated with mental health issues in law enforcement is critical
for promoting the well-being of police officers. One approach is to educate and train police
officers, supervisors, and department leaders about mental health issues and the importance of
seeking help. By increasing awareness and reducing stigma, police officers may be more likely
to seek mental health services when they need them (Violanti et al., 2016).
A lack of understanding and support from leadership within police departments can also
perpetuate this stigma (Lavigne et al., 2018). Furthermore, police officers may be hesitant to seek
help due to concerns about confidentiality and the potential impact on their careers (Bryan et al.,
2014). A lack of understanding and support from leadership within police departments can
reinforce the stigma surrounding police officers who have PTSD. Law enforcement agencies
often emphasize a culture of strength, resilience, and emotional toughness, which can create an
environment where officers may feel hesitant or ashamed to seek help for mental health issues.

28
Additionally, the hierarchical structure within police departments may discourage open
discussions about mental health concerns, as officers may fear potential consequences or the
perception of weakness if they disclose their struggles. This lack of support from leadership can
exacerbate the stigma surrounding PTSD, leading to underreporting and untreated cases among
police officers.
Studies have shown that police officers with PTSD may experience significant barriers to
accessing mental health services, especially when they perceive a lack of understanding and
empathy from their superiors. Research by Pietrantoni and Prati (2010) highlighted how
organizational culture and leadership attitudes significantly impact officers’ willingness to seek
help for PTSD symptoms. When leaders fail to foster a supportive environment that encourages
mental health support, it can perpetuate the stigma surrounding mental health issues and further
isolate officers who are already grappling with the effects of trauma.
To combat the stigma and foster a culture of mental health support within police
departments, leadership needs to receive proper training and education on recognizing and
addressing PTSD. Implementing policies prioritizing officer well-being and removing barriers to
accessing mental health services can also be beneficial. By promoting a culture that encourages
open dialogue, support, and empathy, police departments can help reduce the stigma associated
with PTSD and create an environment where officers feel comfortable seeking the help they need
without fear of judgment or repercussions.
The stigma associated with mental health issues is a significant barrier to seeking
treatment among police officers. The culture of policing, the attitudes of colleagues and
supervisors, and the fear of career repercussions all contribute to this stigma. Addressing this

29
stigma through education and training is critical for promoting the mental health and well-being
of police officers.
Lack of Training for Mental Health
The absence of adequate training on mental health issues among law enforcement
personnel has emerged as a significant barrier to effective treatment for individuals in crisis
(Watson et al., 2017). Police officers are often the first responders during emergencies involving
people with mental health issues, and yet, they lack the necessary education and understanding of
these complex conditions. With the increasing number of individuals living with mental health
disorders, law enforcement personnel must receive training to understand, empathize, and
properly respond to mental health crises (Hails & Borum, 2003). Otherwise, these encounters
may lead to further escalation, increasing the risk of harm to the individual and the officer.
Secondly, the lack of training for law enforcement can lead to inappropriate
criminalization of mental health issues. Without a proper understanding of the nuances of mental
illness, officers may interpret symptoms as criminal behavior rather than health issues, leading to
arrests instead of referrals to appropriate treatment services (Lamb et al., 2002). This type of
response does not address the root cause of the issue. It can exacerbate the person’s mental
health problems by introducing the stress of criminal charges and possible incarceration.
Thirdly, in the absence of training, officers may lack the ability to de-escalate situations
involving individuals with mental health disorders effectively. This deficit in knowledge and
skill can lead to situations becoming violent, potentially leading to unnecessary injury or even
fatalities. It is well-documented that encounters with law enforcement can often be fatal for those
with untreated mental health issues (Morabito, 2017).

30
Lastly, the failure to provide adequate training regarding mental health issues to law
enforcement personnel significantly hinders efforts toward community-based mental health
reform. As part of the community, law enforcement plays a vital role in managing mental health
crises, yet without proper education and understanding, they become a barrier to the treatment
and well-being of individuals living with mental health disorders (Watson et al., 2017).
Inadequate Mental Health Services
Even if police officers do seek help for their PTSD, they may experience inadequate
mental health services (Lane et al., 2022; Lucia & Halloran, 2020; Schuman et al., 2023). Many
mental health professionals may not be familiar with the unique challenges law enforcement
personnel face and may be unable to provide effective treatment (Padilla, 2023; Rodriguez et al.,
2023). Additionally, there may be a lack of resources available to provide mental health services
to police officers, especially in smaller communities or rural areas (Fisher & Lavender, 2023).
Potential Solutions
There are several potential solutions to address the lack of intervention tools for police
officers suffering from job-related PTSD (Tucker, 2015; Waters & Ussery, 2007). One approach
is to reduce the stigma associated with mental health issues by increasing awareness and
education among law enforcement personnel (Bell & Eski, 2015; Drew & Martin, 2021;
Edwards & Kotera, 2021; Henderson et al., 2016; Velazquez & Hernandez, 2019). This can be
achieved through training programs and workshops that teach police officers how to recognize
the signs of PTSD in themselves and their colleagues and how to provide support and referrals to
appropriate mental health professionals (Chapin et al., 2008; Padilla, 2023; Papazoglou, 2013;
Papazoglou & Andersen, 2014; Papazoglou & Tuttle, 2018).

31
Another approach is implementing mental health services specifically designed for law
enforcement personnel. These services should have mental health professionals on staff trained
in the unique challenges faced by police officers and who can provide effective treatment (Hofer
& Savell, 2021; Steinkopf et al., 2015). Additionally, there should be adequate resources
available to provide mental health services to police officers in all areas, regardless of their
location (Page & Jacobs, 2011; Violanti et al., 2012).
Finally, technology-based interventions have been proposed to address mental health
challenges in individuals experiencing psychological challenges. More specifically, researchers
have explored the use of Virtual Reality (VR) to address PTSD (Difede et al., 2022; Eshuis et al.,
2021; Reger et al., 2016), addiction (Segawa et al., 2020; Taubin et al., 2023), Depression
(Baghaei et al., 2021; Fodor et al., 2018), suicidal ideation (Norr et al., 2018), and anxiety
(Anderson & Molloy, 2020; Horigome et al., 2020; Morina et al., 2023), amongst many other
psychological and physical afflictions resulting in empirical evidence suggesting that VR is an
effective clinical tool in addressing psychological afflictions (Emmelkamp & Meyerbröker,
2021). Of particular interest to the current study, VR has been used to address PTSD in veterans
(Rizzo et al., 2023; Rizzo et al., 2017; Rizzo et al., 2021; Rizzo & Shilling, 2017). In 2022,
nearly 25% of police officers reported a military background (Morgan & Trigg, 2022). Prior
research sampling military veterans and the use of VR in the treatment of PTSD suggests its
application in the police force is feasible and in other high-stress professions such as first
responders. Currently, an ongoing study is exploring the use of VR in police de-escalation
training (Bureau of Justice Assistance, 2024a, 2024b; NBC News, 2023), thereby allowing
officers the opportunity to obtain skills in de-escalation in highly emotional and traumatic

32
situations to reduce the incidents of excessive force, minimize trauma, and rebuild public trust
(Bureau of Justice Assistance, 2024b).
Theoretical Framework
As displayed in Figure 1, the Burke-Litwin change model (Burke & Litwin, 1992) is a
comprehensive framework designed to facilitate and understand the complexities of
organizational change. Developed by George H. Litwin and W. Warner Burke, this model
encompasses a range of factors that influence organizational transformation. One of the critical
elements within this model is organizational culture, which plays a pivotal role in shaping the
success or failure of change initiatives. Culture is the foundation upon which an organization
builds its values, beliefs, norms, and behaviors, profoundly impacting how individuals and
groups respond to change. Recognizing the significance of organizational culture in the change
process, the Burke-Litwin model (Burke & Litwin, 1992) emphasized the necessity of addressing
cultural aspects to enable effective and sustainable transformations within an organization.

33
Figure 1
Burke-Litwin Change Model
From Burke-Litwin Model of Organizational Performance and Change, by Adapt Consulting
Company (TimHJRogers), 2023, LinkedIn.com. https://www.linkedin.com/pulse/burke-litwinmodel-organizational-performance-l9ove/
The Burke-Litwin model (Burke & Litwin, 1992) postulated that transformational factors,
including mission and strategy, leadership, and organizational culture, are the major influencers
of organizational performance. In the context of police departments, these factors significantly
impact the provision of intervention tools for officers. For instance, the mission and strategy of a

34
police organization could contribute to the scarcity of these tools if the organization’s strategic
focus does not explicitly encompass the psychological well-being of its workforce. If a police
department’s mission centers on crime reduction with no specific strategy for managing officer
mental health, the availability of intervention tools for mental health challenges might be
inadequate (Burke & Litwin, 1992).
Leadership also plays a crucial role in the context of police departments. Leaders set the
tone for organizational behavior, priorities, and addressing mental health challenges (Burke &
Litwin, 1992). When leadership does not prioritize or understand the need for mental health
interventions for their officers, it is less likely organizations will implement such programs and
tools. This lack of understanding or empathy can result in the insufficient provision of resources
necessary for the development and implementation of such programs.
Moreover, organizational culture is another transformational factor influencing the
accessibility of intervention tools for mental health and well-being within police departments. If
a department’s culture promotes toughness, resilience, and stoicism, this may prevent officers
from seeking help and the organization from investing in the needed resources. The stigma
associated with mental health issues, particularly in law enforcement, can contribute to an
organizational culture that inadvertently discourages officers from seeking help, thereby
perpetuating the lack of appropriate intervention tools (Tracy et al., 2014).
The Burke-Litwin theoretical framework (Burke & Litwin, 1992) provides a valuable
lens for examining the transactional factors that influence an organization, such as police
departments. In police departments, transactional factors encompass elements like structure,
management practices, and systems. The organizational structure refers to the hierarchical
arrangement of departments and units within the police force. Management practices encompass

35
the leadership styles, decision-making processes, and communication patterns employed by
higher-ups. Lastly, systems involve the policies, procedures, and technology utilized to manage
day-to-day operations. Analyzing these transactional factors can help understand the complex
dynamics that influence the effectiveness and well-being of police officers, particularly when
addressing mental health challenges.
Despite the evident importance of addressing mental health among police officers, there
appears to be a lack of adequate intervention tools within police departments. Several reasons
contribute to this shortfall. Firstly, the organizational structure may hinder the efficient
dissemination and implementation of interventions. Hierarchical and bureaucratic structures slow
down decision-making processes, making it challenging for officers to prioritize mental health
initiatives. Secondly, management practices may not prioritize officer mental health, potentially
due to the prevailing culture that emphasizes toughness and resilience. If leadership fails to
acknowledge the importance of addressing mental health, the department’s practices are less
likely to include integrated interventions.
Furthermore, outdated or inadequate systems may cause an absence of sufficient
intervention tools. Police departments might lack comprehensive mental health programs or fail
to provide easy access to counseling and support services. Additionally, budget constraints and
limited resources may impede efforts to implement effective interventions, leaving officers
without essential support in coping with mental health challenges. Addressing these transactional
factors through organizational change and reform is crucial to facilitate the development and
implementation of interventions that support police officers’ mental health. By reevaluating and
restructuring aspects of police departments, including their structure, management practices, and

36
systems, authorities can create a more supportive and resilient work environment for officers
dealing with mental health challenges.
The Burke-Litwin theoretical framework (Burke & Litwin, 1992) offers a comprehensive
lens to analyze the individual factors affecting police officers experiencing mental health
challenges. Task-skills alignment is crucial in law enforcement, as officers must receive the
necessary skills and training to manage high-stress situations effectively. However, the
demanding and often traumatic nature of their work can lead to a misalignment between their
skills and the challenges they face, contributing to the development of mental health challenges
(Burke & Litwin, 1992).
Motivation is critical in law enforcement officers’ ability to cope with traumatic events.
In the context of mental health challenges, diminished motivation can lead to a lack of
engagement with coping strategies or interventions, further exacerbating the condition. High
stress levels and emotional exhaustion may decrease motivation to seek help or participate in
treatment programs (Burke & Litwin, 1992). Moreover, the stigma surrounding mental health
issues in law enforcement culture can hinder officers from seeking support, perpetuating the
cycle of untreated mental health challenges.
Individual needs and values significantly influence the mental well-being of police
officers. The organizational culture within law enforcement agencies may prioritize strength,
resilience, and self-sufficiency, making it challenging for officers to express vulnerability or seek
help for mental health challenges (Burke & Litwin, 1992). Moreover, the lack of resources and
interventions tailored specifically for police officers may further hinder their ability to address
and manage mental health challenges. This gap in intervention tools could result from a lack of
research and understanding of the unique challenges faced by law enforcement officers in

37
dealing with mental health challenges, making it essential to develop targeted and evidencebased support systems (APA, 2020).
External factors, such as political, economic, and technological changes, drive
transformational factors. These can cause significant shifts in the organization’s mission, values,
and culture and create new opportunities and challenges. Transactional factors, on the other
hand, are more internally focused and include organizational structure, policies, and procedures.
They provide the framework for how the organization works.
The Burke-Litwin model (Burke & Litwin, 1992) suggested that transformational factors
can profoundly impact transactional factors and vice versa. For example, changing external
political or economic factors may require a shift in the organization’s structure, policies, or
procedures to adapt to the new environment. Conversely, internal policies or procedure changes
may create a new organizational culture or value system.
The Burke-Litwin model (Burke & Litwin, 1992) operated on the thesis that a
multifaceted network of drivers ranging from external environments to leadership and
management practices influence organizational performance and change. Scholars in various
diverse realms, including healthcare, education, and governmental agencies, use the model to
introspect and analyze the factors that shape individual and group behaviors within these
contexts. In healthcare, especially in understanding the patterns of treatment avoidance in
individuals with mental health challenges, the model aids in unraveling the complex interplay of
individual values, work unit climate, and organizational culture, which could potentially
influence a person’s decision not to seek or utilize available treatments (Burke & Litwin, 1992).
This model furnishes an elaborate lens to disentangle organizational dynamics’ nuances, thereby
providing an indispensable tool in fostering environments that encourage positive health

38
behaviors and appropriate utilization of healthcare services. Through a detailed understanding of
the individual and organizational dynamics presented in this model, stakeholders can work
towards creating strategies that are cognizant of these factors, thereby promoting better health
outcomes.
Conclusion
In conclusion, the mental health of police officers is a critical concern that deserves
attention and action from law enforcement agencies, policymakers, and the broader society. The
demanding and high-stress nature of their profession places officers at a heightened risk of
developing mental health issues, with PTSD being a particular concern. Exposure to traumatic
incidents and chronic stress can lead to the development of mental health challenges, affecting
the overall well-being and functioning of police officers (Berger et al., 2012; Huddleston et al.,
2007; Maguen et al., 2009). Despite the recognition of this issue, there remain significant barriers
to seeking and receiving appropriate mental health treatment.
To address officer mental health, it is crucial to implement comprehensive and evidencebased interventions (Lancaster et al., 2016; Marshal et al., 2021). Law enforcement agencies
should prioritize establishing proactive mental health programs, including regular mental health
check-ups, stress management training, and peer support systems (Burns & Buchanan, 2020;
Rogers, 2023; Tuttle et al., 2019). Moreover, access to confidential and specialized mental health
services should be readily available to officers without fear of judgment or career repercussions
(Burns, 2014; Milliard, 2020). Tailoring interventions to meet the unique needs and challenges
law enforcement personnel face will be crucial in promoting mental health resilience within the
profession (Lanza et al., 2018).

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However, there are notable barriers to treatment that individuals must overcome. The
persistent stigma surrounding mental health in law enforcement culture often discourages
officers from seeking help, fearing potential negative consequences on their careers and
reputation (Aamodt & Stalnaker, 2001; White et al., 2016). Additionally, there may be limited
resources or inadequate support from the top levels of law enforcement organizations, hindering
the implementation of comprehensive mental health initiatives (Burns & Buchanan, 2020).
Addressing these barriers requires a multi-faceted approach involving cultural shifts within law
enforcement, de-stigmatization efforts, and increased funding for mental health services tailored
to the unique demands of policing.

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Chapter Three: Methodology
This chapter presents the theoretical framework and research methodology for
investigating the factors at a broad policy, departmental, and personal level that cause officers
suffering from mental health challenges not to seek or use treatments. The chapter discusses the
Burke-Litwin theoretical framework (Burke & Litwin, 1992) as a lens for examining the
complex interactions and interdependencies between various organizational factors and their
impact on individual behavior. I follow the discussion of the theoretical framework as a lens by a
discussion of the research design, including the sample, data collection methods, and data
analysis techniques. Finally, this chapter addresses ethical considerations.
The Burke-Litwin Theoretical Framework
For this study, I used the Burke-Litwin theoretical framework (Burke & Litwin, 1992) to
explore the factors at a departmental level that influence the mental health help-seeking
behaviors of police officers. Specifically, the framework is the foundation of examining the
transactional factors of leadership, communication, culture, and structure, as well as the
transformational factors of the external environment and mission and strategy. While Burke and
Litwin (1992) initially developed the model for organizational change, healthcare research has
used it to explain the factors contributing to patient outcomes (Kim et al., 2015; McGilton &
Boscart, 2007).
This study used the Burke-Litwin model (1992) to explain how individual skills and
abilities, individual needs and values, and motivation interact to create barriers to mental health
help-seeking behaviors. The model provides a comprehensive framework for examining the
internal and external factors contributing to barriers and challenges associated with police officer

41
mental health help-seeking behaviors, including organizational culture, leadership, and
management practices.
Methodology
The research methodology employed in this study is qualitative, as it seeks to understand
the subjective experiences and perceptions of officers regarding their perceptions of the barriers
and challenges associated with mental health help-seeking behaviors. Qualitative research is
particularly useful for investigating complex social phenomena, such as the impact of
organizational factors on individual behavior. Qualitative research methods are particularly
useful when the aim is to understand social phenomena, such as the experiences and perspectives
of individuals (Creswell, 2013). This study identified social phenomena that prevent officers
from seeking or using mental health services.
Qualitative research involves various data collection techniques, such as interviews, focus
groups, and observation. This qualitative study used semi-structured interviews and surveys to
gather data from law enforcement officers who have experienced mental health challenges and
have either not sought or have not fully utilized available treatments. Two research questions
guided the study:
1. What barriers and challenges do police officers perceive to influence their mental
health help-seeking behaviors?
2. How does organizational culture influence police officers’ mental health help-seeking
behaviors?
Data Sources
In a comprehensive study focused on police officers’ mental health help-seeking
behavior, a variety of data sources are essential to gain a thorough understanding of the

42
challenges and factors contributing to this condition. The primary data source for this research
involved collecting direct information from police officers who have experienced traumatic
incidents because of their job responsibilities. To achieve this, I utilized semi-structured
interviews, allowing me to gather personal accounts and insights into the specific traumas
officers have encountered in the line of duty and how it impacted their mental health.
Furthermore, to understand the broader context and systemic factors affecting job-related
PTSD among police officers, I examined relevant institutional data. This included records of
critical incidents, official reports, and statistics related to officer-involved traumatic events.
Moreover, I assessed organizational policies, training protocols, and support systems offered to
police officers in the aftermath of traumatic incidents to identify potential areas for improvement.
By combining these diverse data sources, I painted a comprehensive picture of the challenges
faced by police officers dealing with mental health challenges, leading to informed
recommendations for better mental health support within law enforcement agencies.
Data Collection
I collected data through semi-structured interviews via video conferencing. I audiorecorded each interview and transcribed them verbatim for analysis. I designed the interview
questions to elicit information about the factors that contribute to the underutilization of
treatments for mental health challenges among law enforcement officers. The questions were
based on the Burke-Litwin framework (Burke & Litwin, 1992), and I designed them to explore
the following areas:
1. External environment: What external factors impact the department’s ability to
provide a safe environment for police officers to seek mental health treatment for
mental health challenges?

43
2. Mission and strategy: How do the department’s mission and strategy impact the
mental health help-seeking behaviors?
3. Leadership: How does leadership in the department affect police officers’ mental
health help-seeking behaviors?
4. Organizational culture: What is the department’s culture concerning mental health
and mental health help-seeking behaviors?
5. Structure: How does the department structure influence mental health help-seeking
behaviors?
6. Systems: What systems are in place to support the provision of treatments for mental
health challenges, and how do these systems influence mental health help-seeking
behavior?
7. Work unit climate: How does the climate in different work units within the
department influence mental health help-seeking behaviors.
Inclusion Criteria
The Burke-Litwin model (Burke & Litwin, 1992) is a comprehensive organizational
change model that includes 12 dimensions: external environment, mission and strategy,
leadership, organizational culture, structure, systems (policies and procedures), management
practices, work unit climate, task and individual skills, individual needs and values, motivation,
and individual and organizational performance. I used the model to understand and address the
barriers and challenges associated with police officers’ mental health help-seeking behaviors.
Inclusion criteria for a study that uses the Burke-Litwin model (Burke & Litwin, 1992) to
understand this issue might look as follows:

44
1. Current employment: Participants must be currently employed as officers in the
police department in the country where the study is occurring. Officers who have
recently retired (within the last 6 months) can also participate to capture recent
experiences.
2. Experience of traumatic events: Participants must have had exposure to at least one
traumatic event during their service, as defined by the criteria for PTSD (APA, 2013)
in the Diagnostic and Statistical Manual of Mental Disorders (DSM 5). This does not
need to be a diagnosed experience; self-reported incidents are acceptable for the
purpose of this study.
3. No mental health treatment: Participants must not have sought professional mental
health treatment for mental health challenges at any time. This includes formal
counseling or therapy and prescribed medications for symptoms.
4. Capacity for consent: Participants must be capable of understanding the study, its
aims, the implications of their participation, and must provide informed consent.
5. Language proficiency: Participants must be proficient in English to ensure accurate
communication and understanding.
6. Number of participants: I targeted 12 to 15 police officers from an urban city with a
population of approximately 150,000.
Data Analysis
Data analysis involved a thematic analysis approach, which involves identifying patterns
and themes in the data. Thematic analysis is a qualitative research method that involves
identifying patterns and themes in data (Braun & Clarke, 2006). In addition, reflexivity is central
to Braun and Clarke’s methodology, and I performed a systematic review of the data using

45
reflexivity as the themes were developed. The Burke-Litwin model (Burke & Litwin, 1992) was
utilized as a conceptual framework for the analysis, as it provided a useful framework for
identifying the organizational factors contributing to officers’ decisions not to seek or use mental
health treatment. I conducted the analysis manually, coding the data into categories and themes.
Positionality Statement
I am a White, heterosexual male. I am the product of a working-class White single
mother who worked multiple jobs to support our little family. Throughout my formative years,
my experience of the world was consistent with having the love of my mother but not having my
mother around at critical moments due to our economic circumstances. I was able to work to put
myself through college, after which I have built a career in a predominantly upper-middle
income profession. While working in that profession, I became a survivor of the attacks at
Ground Zero on September 11, 2001 (9/11/01).
According to Douglas and Nganga (2013), Villaverde (2008) describes positionality as
“how one is situated through the intersection of power and the politics of gender, race, class,
sexuality, ethnicity, culture, language, and other social factors” (pp. 60–61). Considering this
definition, I am situated strongly as a voice of experience from the perspective of 9/11/01
survivors. My perceived class based on my profession in financial services is a source of
privilege, especially since my survivorship of 9/11/01 is rooted in my professional role at
Goldman Sachs.
Within police departments and police unions, there is a power structure built around
protecting officers (Scheiber et al., 2020). I am an outsider to these organizations, though my
race and class may help break down this barrier. Within African American and Latinx
communities, my race and class may be disadvantages in establishing relationships of trust. I

46
seek to educate on mental health issues, including to de-stigmatize seeking mental health help,
especially through providing revolutionary technology to treat conditions like PTSD. This relates
to equity and justice because it may mitigate one of the clinically identifiable reasons officers fail
to de-escalate and because it may help address PTSD in community members affected by
violence (including, but not limited to, police violence).
Douglas and Nganga (2013, p. 68) cited Ladson-Billings’ (2003) definition of
epistemology as “a system of knowing that has both an internal logic and an external validity”
(2003, p. 5). My system of knowing relative to this problem of practice includes that research
shows a link between PTSD and police failure to de-escalate peacefully (Marler et al., 2020),
victims of violence exhibit PTSD symptoms (Loucks et al., 2019), and clinically viable treatment
for PTSD exists on a technical basis (Beidel et al., 2019), yet is not widely available.
The literature centers on the voices of technologists and medical researchers. Voices that
are missing are those of social and cultural voices who may help de-stigmatize acknowledging
brain health issues and seeking treatment for brain health problems. Also missing, though I have
searched for them, are more clinical and technical voices speaking about the incidence of PTSD
within racial minority communities that have been on the receiving end of police violence.
My professional positionality affects my epistemic statement most significantly because I
seek data derived through the scientific method as a principal source of knowledge. My
childhood circumstances as affecting my epistemic statement in that I identify personally with
social stigma, even though I have overcome the underlying circumstances in adulthood. My
positionality as a survivor of Ground Zero affects my epistemic statement. The experience
instilled in me a profound sense of the value and importance of lived experience, even when the
long-term effects of that experience are difficult to quantify in the scientific method.

47
A major factor limiting my understanding of the problem is a lack of lived experience
either as a police officer dealing with PTSD-inducing violence and crime daily, or as a racial or
ethnic minority dealing with PTSD-inducing police violence daily. The best approach I am
currently aware of to navigate these limitations is to continuously interrogate my assumptions
about the work I am doing on this problem of practice to maximize the chances I am a factor for
positive change and simultaneously to use my positional advantages to advocate for greater
representation for missing voices and perspectives.
Ethical Considerations
The ethical consideration of informed consent is essential when conducting qualitative
research involving human subjects. Informed consent means that the participants in the research
project must understand the purpose, potential risks, and benefits of the study before they can
agree to participate. Participants must also understand their rights and responsibilities, including
their right to withdraw from the study. Therefore, before starting the research project, all
participants must obtain written informed consent from (Miles et al., 2020).
The study adhered to ethical guidelines, including informed consent, confidentiality, and
anonymity. I provided participants with an information sheet explaining the purpose and
procedures of the study, and they had the option to withdraw at any time without any
consequence. I maintained participants’ anonymity throughout the study, and I will not reveal
their identities in any publication. The study also adhered to the principles of beneficence, nonmaleficence, and respect for persons.
Credibility and Trustworthiness
Surveying to assess the willingness of police officers to seek mental health treatment for
mental health challenges is a critical step in understanding and addressing the mental health

48
challenges faced by law enforcement personnel. The credibility and trustworthiness of such a
survey depend on multiple factors, including the research design, sample size, data collection
methods, and ethical considerations. To ensure the validity and reliability of the findings,
researchers must employ rigorous methodologies and adhere to ethical guidelines throughout the
research process.
Firstly, a survey of police officers’ mental health attitudes requires a carefully designed
research approach. Researchers should use validated instruments and questions sensitive to the
unique experiences and stressors law enforcement personnel face. Additionally, random
sampling techniques should ensure a representative and unbiased sample of police officers from
different departments and regions. Utilizing recognized research practices strengthens the
survey’s credibility and minimizes potential biases while enhancing the generalizability of the
results.
Secondly, establishing trustworthiness demands transparency and integrity in data
collection and analysis. Researchers must clearly outline the purpose of the survey, maintain
confidentiality, and guarantee participants’ anonymity. Specifically, the researcher must ensure
that participants are fully aware of the study’s objectives and that the researcher will only use
their responses for research purposes. In doing so, the researcher fosters trust and increases the
likelihood of obtaining honest responses. Transparent reporting of the research process,
including any limitations or potential sources of bias, is also essential in building credibility and
trust with participants and the broader academic community.
To ensure the credibility and validity of the survey, researchers should consider
employing established statistical techniques during data analysis. This could include measures to
control for confounding variables and conducting appropriate inferential tests to draw

49
meaningful conclusions from the data. Peer review and publishing the findings in reputable
academic journals, following APA guidelines, further contribute to the study’s trustworthiness
and academic legitimacy.
In conclusion, conducting a survey to assess police officers’ willingness to seek mental
health treatment is essential in supporting law enforcement personnel’s mental well-being. The
credibility and trustworthiness of the survey depend on a well-designed research approach, data
collection and analysis transparency, and adherence to ethical guidelines. By employing these
practices and publishing the findings in reputable sources, researchers can contribute valuable
insights to the ongoing conversation surrounding mental health support for police officers.
Limitations of the Study
Although the qualitative methodology helps explore the experiences of study participants,
several limitations are associated with this research methodology. More specifically, the
limitations of this study are associated with researcher and response bias, a small sample size,
and non-randomized purposeful sampling (Creswell & Poth, 2016). In qualitative research, the
researcher serves as the primary data collection instrument (Creswell & Poth, 2016). Namely, as
the primary data collection and analysis tool, I interpreted study participants’ responses to derive
the themes identified in this study. Although I sought to implement strategies to bolster the
findings’ validity and reliability, it is impossible to isolate extraneous variables and subjectivity
completely. Therefore, a potential limitation of the current study is researcher bias, wherein my
pre-existing knowledge and biases could have influenced how I conducted interviews and my
interpretation of the data. Another potential limitation of the current study is a response or social
desirability bias (Bergen & Labonté, 2020). Namely, study participants may have responded to
the interview questions in a manner perceived more desirable to the researcher, skewing the

50
overall findings. In addition to researcher and social desirability bias, the current study used a
small sample size inherent with the research methodology. As a result, the research findings are
not generalizable to the general population or police officers outside the sample enrolled in this
study (Creswell & Poth, 2016). Finally, another limitation of the current study was the nonrandomized purposeful sampling method. As a result, the sample in the current study may not
fully represent the overall target population because sampling was non-randomized, influencing
the findings (Creswell & Poth, 2016).
Conclusion
This chapter has presented the theoretical framework and research methodology for
investigating the factors at a broad policy level that cause officers experiencing mental health
challenges not to seek or use treatments. The Burke-Litwin model (Burke & Litwin, 1992)
provided a useful lens for examining the complex interactions and interdependencies between
various organizational factors and their impact on individual behavior. The qualitative research
methodology enabled collection rich, in-depth data on officers’ subjective experiences and
perceptions regarding their decision not to seek or use mental health services. The next chapter
will present the study’s findings based on the analysis of the data collected.

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Chapter Four: Findings
The purpose of this current study is to explore factors that influence police officers’
mental health, help-seeking behaviors, and well-being. The mental health of police officers
remains a pivotal yet understudied aspect that fundamentally impacts their overall performance
and, by extension, the welfare of the communities they serve, suggesting the importance of this
study. Therefore, the research questions addressed by this study included the following:
1. What barriers and challenges do police officers perceive to influence their mental
health help-seeking behaviors?
2. How does organizational culture influence police officers’ mental health help-seeking
behaviors?
The Burke-Litwin change model is the comprehensive theoretical framework used in this study
to explore study participants’ perceptions and to identify transformational (long-term levers),
transactional (operational levers), and individual and personal factors (short-term levers)
influencing police officers’ mental health help-seeking behaviors. This chapter answers the
research questions according to the themes that emerged from the data. The chapter concludes
with an overall summary of the research findings.
Participants
I purposefully recruited a total of 15 police officers for the study. Table 1 includes study
participant demographics and years of service. Most study participants were male (n = 13). Years
of police service ranged from 7 to 30 years, with the majority (n = 11; 85%) of participants
serving 7 to 20 years on the police force.

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Table 1
Participants’ Demographics and Years of Service
Number Participant pseudonym Sex Years in service
1 Joe Male 7
2 Shawn Male 30
3 Jake Male 7
4 Steve Male 30
5 Braeden Male 10
6 Austin Male 8
7 Kevin Male 12
8 Jack Male 15
9 Tom Male 22
10 Sarah Female 11
11 Richard Male 20
12 Clarence Male 23
13 John Male 18
14 Joseph Male 16
15 Sandra Female 10
Qualitative Findings Overview
I conducted semi-structured interviews with 15 police officers, accumulating
approximately 12 hours of data collection. Prior literature exploring the prevalence and
challenges associated with mental health help-seeking behaviors in law enforcement revealed a
need for additional research exploring the perceptions of this population. Using the Burke-Litwin
theoretical framework (1992), I identified numerous factors associated with the mental health
help-seeking behaviors of police officers enrolled in this study. The themes identified in this
study were based on the research questions and theoretical framework used in this study.
Findings from this study allow stakeholders to identify the various factors that hinder officers
from seeking the necessary treatment and support for mental health and well-being issues. As a
result, the following section provides a review of the themes and factors associated with each

53
research question that are associated with the mental health help-seeking behaviors of police
officers.
Findings for Research Question 1
The first research question posited in this study concerned what barriers and challenges
police officers perceive to influence their mental health help-seeking behaviors. Prior research
suggested a high burnout rate for police officers due to organizational stress. As a result, an
increased emphasis has been placed on the mental health and well-being of police officers.
Several themes emerged associated with the first research question. Namely, study participants’
responses suggested there is not enough emphasis on mental health, though it is a work in
progress. The four themes identified for this research question were (a) inadequate management
practices, (b) inadequate systems policies, (c) lacking perceived acceptance, and (d) stigma
remains a barrier to mental health help-seeking behaviors. The following section provides an
analysis of each of the identified themes.
Inadequate Management Practices
Study participants suggested that management practices do not place enough emphasis on
police officers’ mental health during and after training. More specifically, I created Interview
Questions 2, 4, 6–9, and 11 to address this first research question and covered transactional
factors in the theoretical framework. Namely, these included structure, managerial practices, and
system policies and procedures. Based on participant responses, it was evident that managerial
practices were insufficient in addressing the mental health challenges of police officers in this
sample. For example, in response to the question, is there enough emphasis on police officers’
mental health in training? Sarah responded, “Not enough, and I say that because we’re still not
getting it culturally. We are not taking care of ourselves mentally.” Similarly, Richard stated:

54
You know, I think we’re lacking greatly. I’ve been approaching the 20–year mark here,
with the same sheriff’s office the entire time. You know, in my upbringing, it was zero.
There was no emphasis at all placed on mental health or well-being.
In addition, John shared the following suggesting a lack of managerial practices
emphasizing mental health: “Anybody needs to talk, but there’s no avenue other than a phone
number for EAP that, you know, you have to hunt down. It’s not posted anywhere.” John’s
statement suggested that even if an officer was willing to seek mental health services, the avenue
for accessing mental health services is inadequate. These statements suggest that, overall,
management provides limited and inadequate practices emphasizing police officers’ mental
health.
Study participants suggested that although managerial practices have bolstered
awareness, awareness is not enough to ensure police officers will seek mental health services
when needed or can gain access to mental health services. For example, Richard shared, “It’s put
out there whether it’s done in the academy, or spoken of, or you know, the emphasis is placed on
it. I don’t know that that’s being conveyed as probably as well as we should or are doing.”
Similarly, Joe stated, “So it’s like creating awareness, for people who are in training, yeah, so
there’s much emphasis on that.” Joseph declared, “I think the awareness is there. Now, whether
or not we have the correct systems in place and we’re devoting the right amount of resources to
it, that’s a whole different story.” Further, Austin stated, “When I first started, there’s virtually
nothing about the mental health and programs, and now there’s a lot more awareness of the
issues and services that are available.” Finally, Joe said, “It’s growing in, and you can kind of see
how it’s evolving within a department. The guys are getting that awareness and info that they
need to get themselves help. However, they are not using it.”

55
Overall, although study participants suggested managerial practices were inadequate in
addressing the mental health needs of police officers, study participants suggested that there have
been major improvements in law enforcement to become more focused on police officers’
mental health and well-being. However, the stigma associated with seeking mental health
services is still prevalent and persistent. Reviewing participants’ responses in conjunction with
their years of service and gender rendered no variation in participants’ responses. Namely,
Braeden, with 10 years of experience in law enforcement, stated:
Chris would come to the supervisor back in the day and say, I need help. He’s no longer
Chris the cop. He’s crazy Chris and when crazy Chris speaks up, crazy Chris becomes
isolated because everybody doesn’t want to be around crazy Chris because if you’re
around him, that’s not good. So, what does that do to Chris? It causes him to go into a
very dark place and we all know what happens then. So, we’ve made a lot of a lot of
great strides. Chris comes to me today and says, ‘Hey, I got a problem,’ we got resources.
He’s not labeled. We handle it.
In addition, Tom, with 22 years of experience, stated:
I mean, no matter how much they tell you, it doesn’t matter how much they tell you, no,
we want you to get this help, we want you to do this. I think the reality is if it boils down
to you and somebody who hasn’t sought that help hasn’t taken time off for it or whatever
the case may be. That’s the person who’s getting picked.
Similarly, Joe, with 7 years of experience in law enforcement, stated, “Just the stigma behind
mental health in the policing and how, you know, people just don’t want to seek help.”

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Inadequate Systems Policies
In addition to inadequate managerial practices, based on participant responses, it was
evident that system policies were insufficient in addressing the mental health challenges of
police officers in this sample. For example, Joseph stated, “We’ve implemented some policies,
and we’ve got some programs in place just to start to address these concerns. We are aware of
the issue, but I’m not one to say that we’re done addressing these or that we’ve done enough.”
Similarly, Steve stated, “We are moving in the right direction, but we still have a long ways to
go, and I think we let it sit in a corner and collect dust for way way too long.” In addition,
Richard stated, “We have applications our guys have apps on their phones that have resources
available to them, but I don’t know that the emphasis is placed as high as it could be, we don’t
have system policies in place.”
Study participant responses suggested a general lack of system policies to bolster the
mental health help-seeking behaviors of police officers. A review of participants’ responses
across genders and years on the force did not reveal any variations in study participant responses.
Although study participants were unaware that they were referring to inadequate system policies
in some of their statements, inadequate system policies perpetuated the failure of study
participants to feel they could seek mental health services. For example, Kevin shared, “There is
not enough help, nowhere near enough help. I have tried to get help myself, and I have tried to
get help for fellow officers and for people in the public, but there’s nowhere for them to go.” In
addition, Richard stated, “I’d say that’s the other barrier that we’ve had to overcome, that is, you
know, adapting our budgets to be able to take that stuff on.” Further, study participant Braeden
stated, “Some of these guys I think, don’t know, and I’m not speaking my agency, but I think
there’s agencies out there and officers that they don’t know where to go.” Study participants’

57
statements suggested there are not adequate system policies in place to ensure access to mental
health practitioners, allocated budget for mental health services and well-being, and policies are
in place to ensure police officers are aware of how to access available services.
However, although participants suggested system policies were inadequate, several
suggested their current organizations had some services in place. For example, 14 of the 15 study
participants asserted their organization had either a peer counseling team or a wellness program.
For example, Sarah explained, “We do have a peer counseling team. We advertise more
frequently what’s going on.” Similarly, Joseph said, “We have a peer counseling team in our
department, so we do have some structures in place.” Finally, Austin also stated that his
organization had a peer support group: “We have a really good peer support program that’s run
really well by people who know what they’re doing and are reputable.” Regarding wellness
programs, Shawn stated, “We talk about the wellness program and the things that go with it. I
think that that’s all being presented and shared, but whether or not people are paying attention to
it, I don’t know.” Further, Clarence stated, “Well, for our organization, I think we prioritize
officer wellness. We have a very robust wellness program that’s coupled with, you know, peer
support programs, critical incident, and stress debriefs.” Participant responses suggested that
their organizations had system policies to create mental health and wellness programs. However,
they are underutilized, suggesting law enforcement agencies must implement additional policies
and practices to bolster mental health help-seeking behaviors. In addition, study participants
suggested that police officers are not seeking mental health services due to several perceived
barriers and challenges mitigating mental health help-seeking behaviors, such as a perceived lack
of acceptance of mental health wellness or need and stigma.

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Lacking Perceived Acceptance
Overall, 14 of the 15 study participants suggested they perceived mental health wellness
or the need for mental health services to be unaccepted by their peers and the overall
administration. For example, Sandra stated, “So we do all the right things, but it’s just really hard
to get people to kind of engage in them because there is a low level of acceptance in the
department.” Sandra further explained that she did not perceive it was acceptable to have mental
health challenges by stating, “My peers expect me to be able to handle my duties without
complaining or having any type of emotional response to the day’s events, that makes it hard to
talk to anyone.” In addition, Clarence stated, “We have a peer support program, but it’s not
utilized very much because officers are afraid of it. There is a general lack of acceptance
regarding mental health challenges and seeking support in our department.” In addition, Kevin
stated, “The only thing that we give is an EAP packet. It’s never spoken of; there’s no
encouragement, there’s no culture of acceptance, quite the opposite.” Finally, Shawn stated, “So,
just being the tough guy isn’t going to cut it any, so there are times and places for that, but when
we’re trying to help people and serve people, I don’t think that mindset is helpful and shows a
lack of acceptance.”
Study participants suggested they perceived acceptance of mental health and overall wellbeing to be associated with a more open discussion about mental health challenges amongst
peers and within the department. For example, Steve stated, “None of the officers I know are
willing to open up about their experiences; it’s not something you want a fellow peer to think
about when you’re in a tough situation in the field.” Similarly, Jack stated, “There is no way I’m
opening up about any mental health challenges I’m experiencing. It does affect whether you get a
promotion and people do talk.” Study participants suggested the major issue was cumulative

59
stress. Namely, police officers experience stressful encounters repeatedly on a day-to-day basis,
resulting in cumulative stress that creates mental and physical health challenges for officers
living within an organizational culture that does not foster mental health help-seeking behaviors.
For example, Braeden shared his thoughts on the topic:
you know, throughout the course of the Police Academy, I think many instructors will
probably tell recruits, hey, you’re gonna see a lot of stuff, right? You’re gonna see a lot of
stuff that’s depressing. You’re gonna see a lot of stuff that the average person couldn’t
handle, but what we fail to do in law enforcement is, we fail to teach recruits how to
minimize those effects or how to navigate that. Back in the day, you went to the bar, you
drank; you talked about it, and the senior officer told you to suck it up, you got broad
shoulders, right? Deal with it kid, right? That’s what’s up.
Therefore, study participants’ statements suggested they perceived a general lack of
acceptance regarding mental health help-seeking behaviors as evidenced by a general silence or
lack of acceptance toward being able to talk about mental health challenges and the perpetuated
fear of consequences associated with self-identifying as someone experiencing mental health
challenges or issues. In addition to a general lack of perceived acceptance regarding police
officers’ mental health needs and overall well-being, study participants suggested they
experience significant barriers to mental health help-seeking behaviors due to stigma.
Stigma Remains a Barrier
Study participants suggested stigma was a significant barrier to mental health helpseeking behaviors. Study participant Jack stated, “I think there’s just a stigma attached to it.
Regardless of people coming out in the open and saying, you know, we want to provide that help
that there’s always that, like, wonder if it’s going to affect your career.” Similarly, Jack stated,

60
“If one were to take leave for mental health issues of any sort, that’s kind of a dead end to the
career there, and it usually resulted at that point into, you know, retirements that you know,
premature retirements.” Further, Richard stated, “There was no emphasis at all placed on mental
health or the well-being, and that’s kind of the stigma across law enforcement as a whole.”
Participant Sandra stated, “There’s now, I think, a stigma when people go out on a stress leave,
that they’re just trying to milk it to be off for more time.” Further, Jake stated, “To me, just the
stigma behind mental health in policing and how, you know, I don’t know what type of but just
people just don’t want to seek help.”
In addition, participant Kevin made the following statement suggesting the mitigating
influence of stigma on police officers’ mental health help-seeking behaviors, “It’s a culture of
you know you get the mark of the witch so to speak, you know in the old days the mark on the
forehead weakness.” Similarly, Clarence stated, “When I first started, it was kind of like a sore
subject to talk about, like you weren’t supposed to say anything if things were bothering you.”
Based on participants’ responses, it is evident that study participants operationalized stigma in
seeking mental health services as negative, resulting in untoward consequences associated with
career advancement and peer perceptions. More specifically, study participants perceived the
expectation of being able to manage mental health challenges quietly and without help from
outside resources. Study participants perceive that seeking mental health services would make
them appear weak or incapable of managing their jobs and could potentially result in a shortened
career path.
Summary for Research Question 1
The four major themes identified for RQ1 were inadequate management practices,
systems policies, a general lack of perceived acceptance, and stigma, which remains a primary

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barrier to mental health help-seeking behaviors within the police force. Prior research suggesting
high police officer burnout, depression, and other mental health challenges is evidence that there
are currently inadequate management practices and system policies within the law enforcement
context to support the mental health challenges experienced by law enforcement. Further, the
perception that mental health wellness is unaccepted or needed and a general persistence of
stigma also suggests inadequate managerial practices and system policies. Otherwise, stigma
would not exist due to organizational and work unit cultural change. Although it is evident from
study participants’ responses that mental health is relevant in policing, inadequate management
practices, system policies, a general lack of perceived acceptance, and the prevalence of stigma
suggest organizational stakeholders are conveying the message that mental health is not relevant
in policing. The research findings provide empirical support for prior literature regarding the
prevalence of mental health challenges in the target population and the persistence of stigma as a
mental health help-seeking barrier in police officer populations. The finding that awareness of
mental health challenges and services has been bolstered within this population is new, thereby
contributing to the literature.
Findings for Research Question 2
The second research question posited in this study asked, how does organizational culture
influence police officers’ mental health help-seeking behaviors? Prior research on law
enforcement culture suggested an overall culture of masculinity. The literature has described a
culture of masculinity as one that includes showing no weaknesses, having strength and stamina,
putting work first, and being extremely competitive. Study participants identified several of these
concepts in their responses. Therefore, all study participants suggested that organizational culture
significantly influenced study participants’ mental health help-seeking behaviors. More

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specifically, two central themes emerged for this research question, which was that a lack of a
mental health culture exists and that the current organizational culture bolsters mental health
help-seeking stigmas.
Lacking a Mental Health Culture
Study participants across all genders and regardless of years in service suggest that
policing organizational culture influenced their mental health help-seeking behaviors
significantly. More specifically, study participants reported perceptions that mental health
challenges and seeking mental health services are unaccepted since police officers must be
resilient and impervious to the traumas they experience in their line of work. Participants’
responses suggested organizational culture norms associated with a culture of masculinity, where
seeking mental health services or asking for help was a weakness, potentially jeopardizing
perceptions by peers and career opportunities. Consequently, this contributed to a lack of mental
health culture. Study participants suggested a culture of strength associated with perceived peer
conformity. More specifically, participants perceived their peers as being able to endure
workplace trauma, and therefore, it was their duty also to endure, and it would be a sign of
weakness otherwise. For example, Sarah stated, “I think, also, that historically, in law
enforcement, there has been this, this culture of, you just suck it up. Like you don’t talk about
how hard it is, and, you know, it’s seen as a weakness.” Participant Tom also stated, “The reality
and perception that it’s a, I mean, it’s a sign of weakness.” John stated, “Regardless of our
suggestion to go talk to that person, nobody is willing to talk to somebody that they know, and in
their department regard it’s a valiant effort, but it’s a band-aid that serves no purpose.” Sandra
stated, “I think the first barrier is just the stigma that goes with that and that officers might be
afraid to be vulnerable. I think that there’s part of this job is compartmentalizing your traumatic

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experiences.” Further, Austin declared, “I think one of the things is, you know, there’s the macho
as I don’t need this.” Finally, Steve also shared his opinion, saying:
I think that the biggest barrier is the peer perception. I think a lot of people, including
older generations of law enforcement officers, came up with the idea that you don’t talk
about it; you just deal with it. It’s part of the job. It’s, you know, a sign of weakness to
need help.
Similarly, Shawn stated, “I come from the older generation now where we didn’t talk about it
because you didn’t want to. You didn’t want to admit those things.” Finally, Jake stated, “If I
have to go seek this treatment, am I going to, you know, lose a chance to move up somewhere?
Are people going to judge me differently if I seek help in any way?” Study participants
suggested that the organizational culture perpetuated the perception that police officers must be
macho or show no weakness. This perception mitigates any potential for a mental health culture
regardless of the bolstered awareness perpetuated by some law enforcement agencies. In
addition, 13 of the 15 study participants suggested that the current organizational culture, as
exhibited in the culture of masculinity, bolstered stigma, further hindering police officers’ mental
health help-seeking behaviors. Namely, study participants described the culture of masculinity in
law enforcement when mentioning the need to appear strong and quiet about any challenges they
were experiencing in their mental health. Additionally, they mentioned needing to have the
overall ability to deal with any mental health challenges on their own. As a result, this culture of
masculinity perpetuates an organizational culture lacking a focus on mental health.
Organizational Culture Bolstering Stigma
Regarding the current organizational culture bolstering mental health stigma, Kevin
explained:

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The culture in policing itself is probably one of the biggest barriers, even though it’s far
more out in the open now. There is still a large enough faction of active and retired law
enforcement that will look down upon you if you were to open your mouth or say you
needed help.
In addition, study participants suggested they perceived a stigma associated with seeking mental
health services perpetuated by the organizational culture of toughness. More specifically, Sarah
stated, “It again goes back to that culture of you need to have some strength, and you need to,
you need to work your shit out because the guy next to you is somehow finding a way.” Study
participants also suggested that the stigma associated with seeking mental health services can
manifest itself in their overall career path. For example, Tom said, “If you seek this through any
official channels, regardless of what people say, it does have a negative impact on your career,
your promotions.” Several study participants echoed the perception that seeking mental health
services could jeopardize one’s career as an officer. As previously stated, participant Jake said,
“If I have to go seek this treatment, am I going to, you know, lose a chance to move up
somewhere?” Similarly, Steve asserted, “I think that stigma is still a huge, huge hurdle for our
profession, and you know, people are afraid to seek help in case it negatively affects their
career.” Participant Braeden stated, “I mean, it’s getting the label right, you get labeled, and then,
you know, I’ve seen you don’t want to go on calls with these officers because, you know,
they’ve got this stigma if you will.” Participant Jake also mentioned how the organizational
culture bolstered the stigma that seeking mental health services could negatively influence a
police officer’s career path. More specifically, Jake stated:

65
Once we can get rid of that stigma of, hey, you’re not going to lose your job. You’re not,
you know, nobody’s going to judge you, and that stigma starts to go away, then
absolutely. I think more people will start to take advantage of it [mental health services].
Finally, Clarence stated, “When I first started, it was kind of like a sore subject to talk about, like
you weren’t supposed to say anything if things were bothering you.” Study participants’
description of an organizational culture that bolsters a masculine culture bolsters mental health
stigma.
Summary for Research Question 2
Based on participants’ responses, it is evident that lacking a mental health culture
perpetuates stigma within the organization, creating significant barriers to mental health healthseeking behaviors. More specifically, stigma in seeking mental health services was associated
with study participants’ perceptions that if anyone were to find out, it could significantly
influence how their peers perceived them and their overall career path. More specifically, they
perceived it would limit their career opportunities, and their peers would judge them as weak or
incapable of managing their position as a law enforcement officer. As a result, study participants
suggested they were less willing to seek mental health services. These research findings provide
additional empirical support for prior literature regarding concerns about stigma, confidentiality,
the impact of seeking help on their careers, showing signs of weakness, and damaging their
reputation among their peers, and the concept that police culture further perpetuates the stigma
associated with seeking mental health-services thereby negatively influencing mental health
help-seeking behaviors in the target population.

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Summary
This study included a total of 15 police officers who participated in semi-structured
interviews to address two research questions regarding how relevant mental health is in the
occupation of policing and whether organizational culture prevents police officers from seeking
mental health treatment. Overall, the findings suggested that organizations have implemented
inadequate management practices and system policies to address mental health challenges within
the sample population, as evidenced by the persistence of stigma. However, there is an increase
in mental health awareness. Further, the current police culture significantly hinders the mental
health help-seeking behaviors of police officers because of a culture of masculinity wherein
police officers must be resilient, impervious to the traumas they witness and experience, show no
weaknesses, have strength and stamina, put work first, and being dog-eat-dog. The findings
suggested a culture of masculinity bolsters the persistence and prevalence of stigma associated
with mental health help-seeking behaviors. The following chapter, Chapter 5, will discuss the
implications of the research findings for practice and recommendations for future research.

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Chapter Five: Discussion
The mental health of police officers in the United States has been waning for several
decades. More specifically, the literature suggests police officers suffer significantly from
untreated job-related PTSD. Prior literature suggests that significant barriers exist for police
officers regarding mental health help-seeking behaviors. However, there is a limit to prior
literature, suggesting the need for additional research exploring the perceptions of police officers
in the United States. Therefore, the purpose of this qualitative study was to conduct semistructured interviews with police officers to garner their perspectives regarding the relevance of
mental health in policing and to determine if organizational culture hinders mental health helpseeking behaviors among police officers. The study findings reviewed participants’ perceived
barriers and challenges to seeking mental health services. I posited the following research
questions in this study:
1. What barriers and challenges do police officers perceive to influence their mental
health help-seeking behaviors?
2. How does organizational culture influence police officers’ mental health help-seeking
behaviors?
Findings
Through study participants’ narratives, I identified six themes that addressed the two
research questions posited in this study. More specifically, based upon the theoretical framework
used in this study, I identified transactional factors like inadequate managerial practices and
system policies as barriers and challenges to police officers seeking mental health services. In
addition, study participants suggested they perceived their organization was unaccepting of the
need for and behaviors toward seeking mental health services. The data suggests stigma is also a

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barrier to police officers’ mental health help-seeking behaviors. Therefore, the first four themes
identified in this study addressed the first research question posited regarding the relevance of
mental health in policing. Finally, I identified two themes associated with the second research
question regarding whether policing organizational culture influences police officers’ mental
health help-seeking behaviors. Namely, study participants suggested that their current
organizational culture did not center on mental health and that the current organizational culture
bolstered stigma, thereby hindering mental health help-seeking behaviors. The following section
provides a review of the literature as it pertains to each of the identified themes.
Management Practices and System Policies
Study participants suggested they perceived inadequate management practices and
system policies to influence their mental health help-seeking behaviors significantly. Namely,
according to Burke-Litwin’s (Burke & Litwin, 1992) theoretical framework, study participants
reported transactional factors that hinder mental health help-seeking behaviors. More
specifically, study participants suggested inadequate managerial practices and system policies
regarding bolstering an environment or organizational culture centered on bolstering mental
health acted as a significant barrier to police officers’ mental health help-seeking behaviors.
Study participants suggested that although their organization had bolstered overall awareness
regarding mental health, managerial practices, and system policies were inadequate in ensuring
police officers felt comfortable enough and were aware of how to access mental health services
when needed. Overall, the data suggested managerial practices and system policies significantly
hindered police officers’ mental health help-seeking behaviors by making it difficult for police
officers to follow through with mental health help-seeking due to inadequacies in practices and
policies. These research findings are consistent with prior literature regarding barriers to mental

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health help-seeking behaviors within organizations (Genrich et al., 2022; Kelloway et al., 2023)
but provide new insights within the context of law enforcement organizations. Therefore, these
research findings contribute to the literature by providing empirical support for previous findings
while offering new ones within the law enforcement context.
Perceived Acceptance and Prevalence of Stigma
Study participants suggested that a general perception of their organization not accepting
that police officers do not need mental health services and the prevalence of stigma for seeking
mental health services also significantly hindered study participants’ mental health help-seeking
behaviors. The perceived lack of acceptance and stigma were associated with study participants’
perceptions of the law enforcement culture, which I discuss in the following section. Overall, a
perception that acceptance is lacking; and stigma is prevalent is consistent with prior research
exploring law enforcement’s mental health help-seeking behaviors (Cheng, 2024; Grupe, 2023;
(Sareen et al., 2005; Soomro & Yanos, 2019). Therefore, these findings provide additional
empirical support for prior research exploring barriers to seeking mental health help-seeking
behaviors (Grupe, 2023; Jackson & Theroux, 2023; Jetelina et al., 2020). Therefore, these
findings provide empirical support for prior research supporting these two identified themes.
The first four themes identified in this study support the first research question posited
regarding the perceived barriers and challenges influencing mental health help-seeking behaviors
in police officers. Study participants suggested inadequate managerial practices, system policies,
a lack of acceptance, and the prevalence of stigma all significantly influenced their behaviors.
These findings are consistent with previous research and provide empirical support and new
findings in the context of law enforcement.

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Mental Health Culture: Organizational Culture Bolstering Stigma
Study participants suggested the current police culture significantly hindered study
participants mental health help-seeking behaviors because of a culture of masculinity wherein
police officers are expected to be resilient, impervious to the traumas they witness and
experience, showing no weaknesses, have strength and stamina, putting work first, and being
dog-eat-dog (Rawski & Workman-Stark, 2018). Therefore, the research findings provide
empirical support for prior literature regarding a law enforcement culture not conducive to
mental health help-seeking behaviors (Jackson & Theroux, 2023; Jetelina et al., 2020). More
specifically, a culture that bolsters masculinity creates stigma toward seeking mental health
services by making police officers fear appearing weak or unable to perform their duties if they
seek mental health services (Drew & Martin, 2023; Jackson & Theroux, 2023). Prior research
also suggested stigma to be a significant barrier to mental health help-seeking behaviors in this
population (Drew & Martin, 2021; Grupe, 2023; Soomro & Yanos, 2019). Therefore, the current
findings provide empirical support for prior literature regarding the policing organization culture
bolstering stigma and not exhibiting a culture of mental health wellness.
Recommendations for Practice
The research findings provide insights into organizational factors that influence the
mental health help-seeking behaviors of police officers enrolled in the study. Based on
participants’ responses, there are several implications for the research findings. First, and in
accordance with recommendations from the Department of Justice, principles and practices at the
managerial and system policy levels should focus on (a) eliminating stigma associated with
mental health and other barriers to mental health help-seeking, (b) leadership needs to
demonstrate acceptance of mental health services and prioritize psychological health and well-

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being, (c) policy needs to be used to advance health and well-being, and (d) policies and
practices need to be placed that strengthen protective factors against stressors, trauma, and
negative health outcomes (Department of Justice, 2023). These recommended strategies for
fostering a culture of mental health and wellness in law enforcement require changes at the
transactional and transformational levels. Namely, fostering a culture of wellness and
psychological health and well-being, including changes in managerial practices and system
policies, can facilitate an accepting environment that bolsters mental health help-seeking
behaviors. According to the Justice Department, the principles described in Table 2 can support
the four strategies outlined in this section. Based on the findings of this study and theoretical
framework, transactional factors (organizational structure, management practices, systems, or
policies and procedures) must effectively bolster an organizational culture of mental health and
well-being.
Table 1
Strategies and Principles for Bolstering a Policing Culture of Mental Health and Wellness
Strategy Principles
Eliminating stigma associated with
mental health and other barriers to
mental health help-seeking.
 Facilitate positive perceptions surrounding
mental health and help-seeking.
 Improve trust and confidence in services
offered.
 Reduce apprehension associated with the
utilization of behavioral health services and
normalize help-seeking.
 Use a strategic communication plan.
 Improve access to behavioral health services
by expanding the network of qualified mental
health professionals.
 Improve access by creating opportunities and
adjusting work schedules for personnel to
practice self-care and utilize services during
work hours, within reason.

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Strategy Principles
 Adopt a shared service approach to address
barriers to access due to resource constraints.
 Utilize technology to minimize barriers to
access.
Leadership needs to demonstrate
acceptance of mental health services
and prioritize psychological health and
well-being.
 Strengthen leadership skills.
 Define strength as being willing and
committed to self-care, mental health support,
and intervening with other colleagues to
prevent harms.
 Invest in institutionalize and create
infrastructure for multi-dimensional
occupational health and wellness programs.
 Advance efforts by being strategic,
intentional, and thoughtful.
 Increase skills and confidence among the
workforce to demonstrate care, concern, and
emotional support for colleagues.
 Use data to find specific health risks,
protective factors, and opportunities for early
intervention.
Policy needs to be used to advance health
and well-being.
 Engage in practices that
eliminate/reduce/mitigate occupational
stressors using evidence-based/evidenceinformed approaches.
 Accurately describe mental and physical
health symptoms and conditions and how they
do/do not impact work readiness, fitness,
suitability, and career continuity.
 Establish policies that provide guidance on
preparing for and responding to critical
incidents and other duty-related exposures to
harm.
 Support personnel in their recovery and return
to work.
 Protect against harm to self.
 Reinforce confidentiality and privacy
protections associated with utilizing peer
support/behavioral health services.
 Use evidence-based/evidence-informed
protocols and procedures that guide agency
response after a death by suicide or attempted
suicide of personnel (also known as
postvention).

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Strategy Principles
Policies and practices need to be placed
that strengthen protective factors
against stressors, trauma, and negative
health outcomes.
 Equip personnel with specific knowledge,
skills, and abilities at the start and throughout
the entire life cycle of the individual’s career
into retirement.
 Offer and provide mental health support and
services.
 Protect against short and long-term negative
health effects of trauma and substance use.
 Eliminate, reduce, and mitigate risk for
suicide.
Note. Adapted from Practices to Foster a Culture of Wellness and Psychological Health and
Well-being of Law Enforcement Agency Personnel, pp. 35–36, 2023, Department of Justice.
Recommendation 1: Eliminate Stigma
Based on the recommendations provided by the Department of Justice pertaining to
fostering an organizational culture in law enforcement that bolsters mental health and well-being,
several strategies have been outlined to achieve the recommendation of eliminating stigma
within law enforcement (Department of Justice, 2023). Namely, stakeholders in law enforcement
should seek to “facilitate positive perceptions surrounding mental health and help-seeking”
(Department of Justice, 2023, p. 35). Accomplishing this task would require ‘buy-in’ from upper
management and a proactive approach toward bolstering awareness and acceptance of seeking
mental health services. In addition, stigma can be mitigated by ensuring police officers are
confident of and trust in the services offered within the organization (Department of Justice,
2023). The best way to ensure confidence and trust is to provide police officers an assurance of
their confidentiality and provide anonymous evidence of the effectiveness of utilizing a mental
health service or program. In addition, the Department of Justice has recommended that law
enforcement agencies take action to normalize mental health help-seeking behaviors and

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implement policies and practices that reduce “apprehension associated with the utilization of
behavioral health services” (Department of Justice, 2023, p. 35). Additional strategies
recommended to mitigate stigma within law enforcement include (a) using a strategic
communication plan, (b) improving “access to behavioral health services by expanding the
network of qualified mental health professionals,” (c) improving “access by creating
opportunities and adjusting work schedules for personnel to practice self-care and utilize services
during work hours, within reason,” (d) adopting a shared service approach to address barriers to
access due to resource constraints,” and (e) utilizing “technology to minimize barriers to access”
(Department of Justice, 2023, p. 35).
Recommendation 2: Leadership Exemplify Acceptance
The second recommendation for bolstering a culture of mental health in law enforcement
is ensuring “buy-in” by leadership to create a top-down effect. More specifically, leadership
must demonstrate acceptance of mental health help-seeking behaviors, access, and use to bolster
an organizational culture of mental health. Therefore, I recommend several strategies for
achieving this. Namely, organizations need to strengthen leadership skills regarding mental
health. Further, the definition of strength within law enforcement culture must be redefined to
emphasize that strength is associated with commitment to self-care and identifying and actively
participating in peers’ mental health. Specifically, officers should intervene when they notice a
peer is struggling. To ensure leadership is exhibiting behaviors and rhetoric toward the
acceptance of mental health as normalized, it is also essential that law enforcement agencies
invest in infrastructure supporting “multi-dimensional occupational health and wellness
programs” (Department of Justice, 2023, p. 35). Leadership should be intentional and strategic in
their efforts to advance a culture of mental health within law enforcement organizations. Finally,

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at the individual level, police officers need to receive education on mental health challenges to
increase their skill sets in recognizing when a challenge arises and bolster their confidence in
their ability to address it. Increasing the skills and confidence amongst police officers will
demonstrate that leadership cares about the mental health and well-being of police officers and
foster a work environment of care, concern, and emotional support. Management practices
should also focus on building trust by training management to ensure confidentiality. Finally, it
is recommended that leadership ensures data is collected regularly within their organization to
explore “specific health risks, protective factors, and opportunities for early intervention”
(Department of Justice, 2023, p. 35). Data collection can occur by leadership ensuring regular
surveying of police officers to assess their current state and needs.
Recommendation 3: Policy Must Promote Mental Health
The third recommendation for fostering an organizational mental health culture is to
ensure that system policies advance mental health (Department of Justice, 2023). The
Department of Justice has recommended several strategies to ensure organizational policy
advances mental health, including using evidence-based or informed practices that eliminate or
mitigate occupational stressors. For example, several participants in the study suggested they
feared losing their jobs or having their peers not want to work with them because of seeking
mental health services. The Department of Justice has confirmed that there are currently policies
and laws in place within law enforcement that reinforce this fear and act as a barrier to mental
health help-seeking behaviors (Department of Justice, 2023). Therefore, ensuring policies that do
not reinforce these types of fears, which fuel stigma towards mental health help-seeking
behaviors, is essential for fostering a mental health organizational culture in law enforcement.
Additional strategies for ensuring organizational policies foster a mental health culture are

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ensuring the impact of mental health conditions on work readiness, suitability, fitness, and career
continuity. Namely, management must implement a policy that addresses the rhetoric used by
leadership and key stakeholders within law enforcement to facilitate change toward mitigating
the use of language that reinforces the stigma associated with mental health help-seeking
behaviors. For example, leadership should not use terms or language associated with mental
health and “impairment, risk, or disqualification from the job unless it is supported by science”
(Department of Justice, 2023, p. 46).
Other strategies for fostering an organizational culture of mental health include
“establishing policies that provide guidance on preparing for and responding to critical incidents
and other duty-related exposures to harm, support personnel in their recovery and return to work,
protect against harm to self, reinforce confidentiality and privacy protections associated with
utilizing peer support/behavioral health services, and use evidence-based/evidence-informed
protocols and procedures that guide agency response after a death by suicide or attempted suicide
of personnel (also known as postvention)” (Department of Justice, 2023, p. 36). These strategies
require law enforcement agencies to implement evidence-based or informed “education and
training to personnel, managers, peer support members, and chaplains” (Department of Justice,
2023, p. 48). Ensuring proper training and awareness for leadership and police officers is
essential in addressing several of the recommended strategies posited by the Department of
Justice. Finally, a policy should be implemented that requires law enforcement agencies to
“invest in, institutionalize, and create infrastructure for multi-dimensional occupational health
and wellness programs” (Department of Justice, 2023, p. 35).

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Recommendation 4: Implement Policies and Practices to Strengthen Protective Factors
Finally, the Department of Justice recommends implementing strategies focused on
bolstering policy and practices that strengthen protective factors for police officers to mitigate
the untoward effects associated with mental health challenges. For example, the Department of
Justice recommends that law enforcement agencies offer education and training associated with
“specific knowledge, skills, and abilities” that help build resilience and ensure police officers
have the tools necessary to address mental health challenges in the field and beyond. Therefore,
by ensuring police officers have the mental health support and services necessary to bolster
resilient factors, protective factors will increase. Namely, ensuring fitness centers are available
for physical health, offering health screening on-site, ensuring policies that afford officers time
to use physical and mental health facilities, implementing policies that address work/life balance
and responsibilities, implementing policies and practices that mitigate “short and long-term
negative health effects of trauma and substance use,” and reducing, eliminating, and mitigating
risk factors associated with suicide (Department of Justice, 2023, p. 35). For example, law
enforcement should review current “policies and procedures related to personnel
discipline/investigations and improve processes and organization/system issues, including
unreasonable administrative delays in return-to-duty authorization, as these can contribute to
psychological harm and suicide risk” (Department of Justice, 2023, p. 46).
Recommendation 5: Implement Policies That Require the Use of VR Technology in Deescalating Training and the Assessment and Treatment of Mental Health Challenges in the
Police Force
In 2023, the U.S. Department of Justice (DoJ), Office of Justice Programs, Bureau of
Justice Assistance offered a Virtual Reality De-escalation Site-Based Initiative to be awarded to

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applicants from “state, local, campus, and tribal law enforcement to enhance training via the
utilization of fully immersive virtual reality-based technology” (Bureau of Justice Assistance,
2024a, p. 1). The DoJ and Bureau of Justice Assistance sought to encourage law enforcement
organizations to apply for the VR grant for the training of police officers to improve police
officers “responses to individuals in crisis and improve the de-escalation skills of participants”
(Bureau of Justice Assistance, 2024a, p. 1). Therefore, it is recommended that police
organizations take advantage of such grant initiatives to implement VR training to ensure police
officers have the skill set and tools necessary to diffuse situations that could become increasingly
traumatic for all those involved. Further, policies should be implemented to require the use of
VR assessment and subsequent treatment of police officers suffering from the untoward effects
associated with cumulative stress acquired in the line of duty. Prior research suggests VR is an
effective clinical tool in the assessment and treatment of many psychological and physical
challenges (Difede et al., 2022; Eshuis et al., 2021; Reger et al., 2016) and could be an effective
tool in minimizing stigma by introducing practices that normalize metal health assessment and
identifying police officers in the need of treatment.
Application to the Theoretical Framework
Based on the principles outlined in Table 2, change at every level of the theoretical
framework is necessary to create an organizational culture fostering mental health and wellbeing. All levels of the organization should emphasize the importance of mental health with a
top-down approach to acceptance wherein senior leadership and managers demonstrate
acceptance of mental health services and prioritize psychological health and well-being.
Transformational factors such as mission and strategy, leadership, and organizational culture
must focus on mental health and police officers’ well-being within law enforcement

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organizations to create a culture that bolsters mental health help-seeking behaviors amongst this
population, as illustrated in Table 3. Fostering a mental health culture requires a change in the
rhetoric used regarding mental health, which can be implemented in policy and practice and
bolstered by leadership’s rhetoric. Therefore, a law enforcement organizational mission should
not focus only on crime reduction but also on police officers’ mental health and well-being to
promote resilience and reduce burnout in the profession. Further, the organization’s strategic
focus should explicitly encompass the psychological well-being of its workforce. By ensuring a
mission and strategic focus on police officers’ mental health and well-being, the availability of
intervention tools will be adequate (Burke & Litwin, 1992).
Regarding transactional factors, organizational structure must ensure efficient
dissemination and implementation of mental health interventions. Further, hierarchical and
bureaucratic structures should speed up decision-making processes, thereby prioritizing mental
health initiatives for officers. Management practices should also prioritize police officers’ mental
health by bolstering a culture of mental health and well-being. Therefore, leadership must
acknowledge the importance of addressing mental health issues to ensure department practices
integrate interventions.
Regarding individual and personal factors, bolstering mental health within police officer
populations would require ensuring police officers have the proper skills and training to manage
high-stress situations effectively. Therefore, at the policy and practice level with police
organizations, police officers must be provided the tools necessary to develop “protective factors
against stressors, trauma, and negative health outcomes” (Department of Justice, 2023, p. 36). In
addition, ensuring police officers have proper motivation toward self-care will ensure they have
the coping skills necessary to mitigate the untoward effects associated with experiencing

80
traumatic events in the workplace. Finally, individual needs and values significantly influence
the mental well-being of police officers. More specifically, ensuring management understands
police officers’ individual needs and values, such as work/life balance, familial responsibilities,
and financial challenges, can inform policy and practice as it pertains to ensuring police officers
are meeting their individual needs to mitigate external stressors that could lead to mental health
challenges.
Overall, the themes identified in this study highlight the need for organizational culture
change to facilitate an environment that mitigates stigma associated with mental health helpseeking behaviors and culminates in an environment of acceptance. Law enforcement agencies
need to eliminate the current organizational culture that expects masculinity and self-reliance to
create a culture of mental health acceptance and focus on well-being. Only through
implementing practices and policies focused on bolstering an organizational culture of mental
health and well-being at the transformational, transactional, individual, and personal levels will
an environment that bolsters mental health help-seeking behaviors within law enforcement be
possible.

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Table 3
Burke-Litwin Change Model Levels and Examples of Recommendations by Level
Burke-Litwin change model level Recommendation
Transformational factors Mission and strategy should focus on
mental health and well-being
Leadership buy-in should focus on
education and training on mental health,
and the use of appropriate rhetoric to
mitigate stigma.
Bolstering an organizational culture of
mental health and wellness should be done
by reducing stigma, ensuring leadership
buy-in, implementing practices and
policies that advance mental health, and
bolstering protective factors.
Transactional factors Structure should include investing in,
institutionalizing, and creating
infrastructure for multi-dimensional
occupational health and wellness
programs.
Management practices should include
building trust by training management on
how to ensure confidentiality.
System policies and procedures should
include reviewing policies and procedures
related to personnel
discipline/investigations and improving
processes and organization/system issues,
including unreasonable administrative
delays in return-to-duty authorization, as
these can contribute to psychological harm
and suicide risk.
Individual and personal factors Ensure police officers receive the education
and training necessary to bolster
protective factors.
Implement policies that bolster police
officers’ motivation toward self-care and
mental health help-seeking behaviors.
Ensure policies and practices are
implemented that account for the
individual needs and values of police
officers. For example, ensuring work/life
balance.

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Future Research
There are several recommendations for future research, involving changing the
population sampled and exploring each theme identified in this study in more depth. Regarding
changing the population sampled, future research should consider conducting a qualitative
phenomenological study exploring the lived experiences of police officers managing mental
health programs regarding police officers’ mental health help-seeking behaviors, access, and use.
Prior research suggested a need for additional research exploring the effectiveness of mental
health programs currently in place. Further, future research should include the perspectives of
minority police officers regarding mental health help-seeking behaviors. Garnering the
perspectives of minority police officers could potentially identify additional barriers and
challenges not identified in the current study. Another recommendation for future research would
be to conduct a phenomenological study exploring the lived experiences of mental health
practitioners across multiple states in law enforcement to garner a broader perspective regarding
the barriers and facilitators experienced by police officers regarding mental health help-seeking
behaviors, access, and use.
This research problem also warrants a quantitative study. Namely, recommendations for
future research include interventional studies wherein law enforcement agencies could
implement different programs and policies and conduct assessments on data related to attendance
to these programs based on implemented policies. Therefore, future research should explore the
effectiveness of implementing distinct types of programs and policies in law enforcement to
bolster mental health help-seeking skills. For example, research could explore the effectiveness
of implementing a peer counseling program with system policies requiring police officers to
attend several mental health self-care events quarterly or monthly. Assessing the effectiveness of

83
implementing multiple types of programs and policies could provide better information to
stakeholders on the most effective practices for bolstering law enforcement’s mental health helpseeking behaviors.
Conclusions
Fifteen police officers enrolled in this study and participated in semi-structured
interviews to identify their perceptions regarding the barriers and challenges associated with
mental health help-seeking behaviors. Study participants suggested several barriers and
challenges associated with mental health help-seeking, which were associated with inadequate
managerial practices, system policies, and an organizational culture that exhibited a general lack
of acceptance toward mental health help-seeking, thereby bolstering stigma toward mental health
help-seeking behaviors. Research findings suggested an overall need to address organizational
culture at all levels of the theoretical framework, including transformational, transactional,
individual, and personal levels. Only by addressing organizational culture at all three levels is it
possible to implement the change necessary to successfully mitigate the current law enforcement
culture that bolsters stigma and negatively influences police officers’ mental health help-seeking
behaviors toward an organizational culture that bolsters mental health and well-being in this
target population. This section included several implications for practice, and recommendations
for future research.

84
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Appendix A: University of Southern California Recruitment Email
My name is Chris Meek, and I am a student at the University of Southern California. I am
conducting a research study on why there are a lack of intervention tools to help police officers
suffering from job-related PTSD. Your participation is completely voluntary, and I will address
your questions or concerns at any point before or during the study. I am recruiting individuals
who meet these criteria:
1. Recent employment: Participants must be or have been employed as officers in the
police department within the last 5 years.
2. Experience with traumatic events during your service as a police officer and your
current or past experience with mental health treatment. I will assess these criteria
using the screening survey link found at the end of the document.
3. You are over 18 years old.
If you decide to participate in this study, I will ask you to do the following activities:
1. Complete a prescreening survey to see if you meet the criteria for this study. At the
end of the survey, I will ask you to enter your email address where I can contact you
to schedule the interview.
2. Participate in a 1:1 online Zoom interview via USC’s Zoom platform that will take
45–60 minutes.
3. Review your interview transcript via email for 10–15 minutes.
Please note that I will not share actual names or data with your employer or anyone else. I
will publish the results in my dissertation, and I will not identify any participant in the results. I
will take reasonable measures to protect the security of all your personal information. I will de-

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identify all data prior to any publication or presentations. I may share your data, de-identified,
with other researchers in the future.
If you are interested in participating in this study, please click this link:
https://usc.qualtrics.com/jfe/form/SV_4HhJsDt4U7hLSIu. If you have any questions about this
study, please contact me at meekchri@usc.edu.
Thank you!
Chris Meek
Meekchri@usc.edu.

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Appendix B: Interview Protocol
This section includes the interview protocol I used for this study. It includes the research
questions, the communication with the participants, and the questions used in each interview.
The population for the interviews were police officers.
Research Questions
1. How relevant is mental health in the occupation of policing?
2. Does organizational culture affect police officers from seeking mental health
treatment?
Introduction to the Interview
My name is Chris Meek, and I am preparing a dissertation as part of my doctoral program
at the University of Southern California. The topic of my dissertation is mental health in
policing. The purpose of the interview I would like to conduct with you is to gain your insights
and observations about (a) how relevant mental health is in the occupation of policing and (b)
whether and how organizational culture in the profession of policing affects decisions by
individual police officers to seek or not to seek mental health care and treatment. Do you consent
to this interview? May I record our interview so that I can ensure my records are as accurate as
possible? (RECORD) Thank you for agreeing to be part of this survey and allowing me to record
our conversation. I will be more than happy answer any questions you may have about the
interview or related topics. I will not use any names in this survey. (Thank you). Before we
begin, please tell me a little about yourself. Why did you join the police force?
Conclusion to the Interview
That concludes the questions I have for you as part of this interview. Are there any other
topics or observations you would like to cover before we conclude? Are there any questions

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about this interview that you have for me? Thank you for your willingness to participate in this
interview, and for sharing your expertise and insights. I will share a copy of my dissertation with
you upon its conclusion in the months ahead.

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Table B1
Interview Protocol
Interview questions RQ
addressed
Key concept addressed
1. Some people say policing is not much
different than soldiering? Do you agree
or disagree? Why or why not?
RQ2 Transformational factor
(mission and strategy,
leadership)
2. There are more and more statistics being
published about mental health in the
policing profession. How much
emphasis is put on officer mental health
during training?
RQ1 Transactional factor
(management practices)
3. What are the barriers that get in the way
of officers’ mental health needs being
tended to?
RQ2 Transactional factor
(management practices)
4. How much attention is paid to the
stresses of the job by the department?
RQ1 Transactional factor
(management practices)
5. Does the stigma of needing mental health
support play into account officers NOT
seeking treatment?
RQ2 transformational factor
(mission and strategy,
leadership)
6. Do you feel if an officer seeks treatment,
it will affect their chance of a
promotion?
RQ1 and
RQ2
transactional factor
(management practices)
7. Are cadets weeded out early if they have
a pre-disposition to mental health issues
or show personality traits, or is that
something the department does not look
at during training?
RQ1 Transformational factor
(mission and strategy,
leadership)
8. Should we pay more attention to the
screening process?
RQ1 Transactional factor
(management practices)
9. Are there strategies for prevention? RQ1 Transactional factor
(management practices)
10. Do you feel more officers will seek
treatment if we break down the stigma
and call it ‘training’ or job readiness?’
RQ2 Transformational factor
(mission and strategy,
leadership)
11. Are there trigger words that affect an
officer’s mental health like ‘deescalation?’
RQ1 Transactional factor
(management practices)
12. Do you feel the duties of policing have
become too broad?
RQ2 Transformational factor
(mission and strategy,
leadership)

113
Appendix C: USC Information Sheet Informed Consent
My name is Chris Meek, and I am a student at the University of Southern California.
I am conducting a research study on why there are a lack of intervention tools to help police
officers suffering from job-related PTSD. The name of this research study is “The Impact of
Police Officers Not Seeking Mental Health Treatment.” I am seeking your participation in this
study.
Your participation is completely voluntary, and I will address your questions or concerns
at any point before or during the study.
You may be eligible to participate in this study if you meet the following criteria:
1. Current employment: Participants must be currently employed as officers in the
police department in the country where I am conducting the study. Officers who have
recently retired (within the last 5 years) can also participate to capture recent
experiences.
2. Experience with traumatic events during your service as a police officer and your
current or past experience with mental health treatment. I will assess these criteria
using the screening survey link found at the end of the document.
3. You are over 18 years old.
If you decide to participate in this study, I will ask you to do the following activities:
1. Complete a prescreening survey to see if you meet the criteria for this study. At the
end of the survey, I will ask you to enter your email address so I can contact you for
scheduling the interview.
2. Participate in a 1:1 online interview via USC’s Zoom platform that will take 45–60
minutes.

114
3. Review your interview transcript via email for 10–15 minutes.
I am researching this topic (PTSD, no previous treatment for PSTD, etc.) out of personal
interest and experience. However, I am not a mental health professional, and I will not be
reporting the information you share with back to your department nor a mental health
professional. I will publish the results in my thesis. I will not identify participants in the results. I
will take reasonable measures to protect the security of all your personal information. All data
will be de-identified prior to any publication or presentations. I may share your data, deidentified with other researchers in the future.
If you have any questions about this study, please contact me at meekchri@usc.edu. If
you have any questions about your rights as a research participant, please contact the University
of Southern California Institutional Review Board at (323) 442-0114 or email hrpp@usc.edu.

115
Appendix D: Codebook
Research question Area of conceptual
framework
(a priori code)
Code
(thematic codes)
Initial codes
RQ1: What barriers and
challenges do police
officers perceive to
influence their mental
health help-seeking
behaviors?
Transactional
factors
Inadequate
management
practices
Significant emphasis
Not enough emphasis
on management
practices
Lack of awareness
Awareness programs
Inadequate
systems policies
Budget
Accessibility
Transformational
factors
Stigma persists. Fear it will affect career
and peer perceptions
Confidentiality
concerns
Fear of being perceived
as weak
Lack of willingness to
seek help
Willingness to open up
Perceived pressure to
conform to norms
Culture of strength—no
weakness
Lack of leadership
support
Lack of structure to
support mental health
needs.
Individual and
personal factors
Lack of perceived
acceptance
Lack of perceived
leadership support.
Lack of perceived
structure to support
mental health needs.
Mental health services
not related to law
enforcement.
Viewed differently if
can’t handle the job.

116
Familial responsibilities
RQ2: How does
organizational culture
influence police
officers’ mental
health help-seeking
behaviors?
Transformational
factors
Organizational
culture leads to
stigma.
Fear it will affect career
and peer perceptions.
Confidentiality
concerns
Fear of being perceived
as weak
Lack of willingness to
seek help
Willingness to open up
Perceived pressure to
conform to norms
Culture of strength—no
weakness
Lacking a culture
of mental health
Mental health services
are not related to law
enforcement.
Lack of leadership
support
Lack of structure to
address mental health
needs

Abstract (if available)

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Asset Metadata

Creator Meek, Christopher D. (author)

Core Title The barriers and challenges associated with mental health help-seeking behaviors of police officers in the United States: a descriptive study

School Rossier School of Education

Degree Doctor of Education

Degree Program Organizational Change and Leadership (On Line)

Degree Conferral Date 2024-05

Publication Date 05/21/2024

Defense Date 05/08/2024

Publisher Los Angeles, California (original), University of Southern California (original), University of Southern California. Libraries (digital)

Tag first responders,help-seeking behaviors,mental health,OAI-PMH Harvest,organizational culture,Police,policing,PTSD,stigma,Suicide

Format theses (aat)

Language English

Contributor Electronically uploaded by the author (provenance)

Advisor Tobey, Patricia (committee chair), Malloy, Courtney (committee member), Rizzo, Albert "Skip" (committee member)

Creator Email chris.meek@me.com,meekchri@usc.edu

Permanent Link (DOI) https://doi.org/10.25549/usctheses-oUC113953635

Unique identifier UC113953635

Identifier etd-MeekChrist-12995.pdf (filename)

Legacy Identifier etd-MeekChrist-12995

Document Type Dissertation

Format theses (aat)

Rights Meek, Christopher D.

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