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Only about a third of police officers with a mental health diagnosis sought support for their condition, a survey of a department in Texas found.

Among the 434 police officers in Dallas-Fort Worth who responded to the survey, 12% (n=54) reported receiving a mental illness diagnosis within their lifetime, with about half of these cases being a current diagnosis, reported Katelyn Jetelina, MPH, PhD, of the University of Texas Health Science Center at Houston School of Public Health, and colleagues.

However, only 35% of these officers with a current mental health diagnosis sought mental health services within the past year, the group wrote in .

Some factors that were tied to a higher odds of a lifetime mental illness diagnosis among police officers included being female (adjusted odds ratio [aOR] 3.20, 95% CI 1.18-8.68), and being either divorced, widowed, or separated versus those who were married (aOR 3.52, 95% CI 1.35-9.19).

Similarly, military veteran officers were more likely to have been diagnosed with a mental illness versus non-veterans (aOR 3.25, 95% CI 1.38-7.67). Likewise, more experienced officers -- particularly those with over 15 years of experience in the field -- had more than a seven times higher chance of being diagnosed (aOR 7.42, 95% CI 1.02-54.01).

Additionally, 26% of the officers (n=114) screened positive for symptoms of mental illness within the past 2 weeks, while 17% of those who screened positive for mental health symptoms reported using mental health services within the past 12 months.

"To our knowledge, this is the first survey study to analyze mental illnesses, symptoms of mental illness, and mental health care use among officers at a large, urban police department," the authors stated. "Of note, 26% of officers had a positive screening result but had no prior mental illness diagnosis. This theme was largely reflected in the focus groups, with participants stating that they became accustomed to the stress and traumatic events at work and became 'numb to it.'"

"This is concerning because if officers are unaware of how their work is impacting their mental health, they are unaware that they should seek treatment," they added.

Participants included police officers who responded to the survey in January and February 2020. Five focus group sessions with 18 officers were done earlier in 2019.

The mean participant age was 37, about 82% were male, and half were white. The researchers pointed out that it was unclear whether these findings could be generalized to other types of law enforcement agents.

Screened-for symptoms included depression, anxiety, post-traumatic stress disorder (PTSD), and/or suicidal ideation/self-harm. The majority of the current mental health symptoms among officers were related to PTSD (61%) and depression (44%).

As for the officers who did seek mental health treatment, those who were experiencing suicidal ideation or self-harm were more likely to seek help (aOR 7.66, 95% CI 1.70-34.48), the authors found.

Three of the top reasons why police officers stated they didn't seek mental health services included concerns about confidentially, mistrust of psychologists who might not understand their line of work, and stigma and fear of losing their job.

"Influenced by the police culture, officers may feel that if they admit mental health problems and seek help, they will be less trusted by peers and supervisors and may lose opportunities for promotions," explained John Violanti, PhD, of the State University of New York in Buffalo, in an . "This problem can be alleviated by establishing a greater trust between officers and police administration."

Police officers are particularly fearful that their supervisors will discover information about their mental status, Violanti noted, and suggested that peer support programs could allow officers to first talk confidentially with their coworkers before seeking professional help.

Jetelina's group recommended contracting with an outside, independent mental health agency to annually screen officers for mental health conditions.

"Policing is an essential occupation to preserve the rule of law, and those who serve in law enforcement deserve proper protection from the mental strain associated with this task...[it] is a matter of psychological survival," Violanti concluded.

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