Valor with Integrity Program for Emergency Responders (VIPER)

1. Valor with Integrity Program for Emergency Responders (VIPER) Presented by: Captain Lawrence Norton (Retired), PhD, LMFT, CEAP, SAP Facilitator - VIPER Program for Emergency Responders July 15, 2014

2. Valor with Integrity Program for Emergency Responders

3. Valor with Integrity Program for Emergency Responders Goals of this Presentation • Describe the Police Officer Personality • Cover LEO Problems (Including Suicide) • Discuss the Risk of Alcohol/Substance Abuse • Look at the Dangers for Addiction • Examine the Unique Challenges in Treating Police Officers

4. Valor with Integrity Program for Emergency Responders You Know You’re in Law Enforcement When • Your idea of a good time is a “man with a gun” call • You disbelieve 90 percent of what you hear and 75 percent of what you see • You have your weekends off planned for a year • You refer to your favorite restaurant by the intersection at which it’s located • You know anyone who says, “I only had two beers” is going to blow at least a .15 • Anyone has ever said to you, “There are people killing other people out there and you are here messing with me.”

5. Valor with Integrity Program for Emergency Responders You Know You’rerin Law Enforcement When • People flag you down on the street and ask you directions to strange places...and you know where they’relocated • You are the only person introduced at social gatherings by profession • People shout, “I didn’t do it!” when you walk into a room and think they’re being hugely funny and original • A week’s worth of laundry consists of five T-shirts, five pairs of socks, and five pairs of underwear • You’ve ever referred to Tuesday as “my weekend.”

6. Valor with Integrity Program for Emergency Responders On Any Given Day Cape Coral Florida Police Video

7. Valor with Integrity Program for Emergency Responders What are Some of the Personality Traits of a First Responder? Suspicious Risk Taker Insecure Authoritarian Honorable Trustworthy Cynical Hostile Secret Conservative Loyal Individualistic Efficient Prejudiced

8. Valor with Integrity Program for Emergency Responders What are Some of the Personality Traits of a Mental Health Professional (through the eyes of a First Responder)? Liberal SoftTree Hugger Neurotic Hippies Can’t Trust ThemHopeful Not Realistic Caring Scared of CopsCompassionate Out to get you off the street

9. Valor with Integrity Program for Emergency Responders The Law Enforcement Culture “You change when you become a cop. You become tough and cynical. You have to condition yourself to be that way in order to survive this job. And sometimes, without realizing it, you act that way all the time even with your spouse and kids.” A 15 Year Veteran Officer NYPD

10. Valor with Integrity Program for Emergency Responders The Law Enforcement Culture

11. Valor with Integrity Program for Emergency Responders Expectations Most Police Officers begin their career wanting to help the public, not correct or discipline the public. The public’s behavior often leads to the disciplinarian role. • Loud Party • Dog Barking • Neighbor Disputes • Family Disputes • Settling Arguments

12. Valor with Integrity Program for Emergency Responders Expectations “After 3 months on the street, I began to realize that it’s not what I expected. The big thing that hit me is I’m a social worker in a uniform. I was looking for car chases and all the things I saw on TV. They never show you the paperwork, the long hours, the shift-work, the fights with your spouse for missing dinner or working on another holiday!” - A Baltimore City Police Officer

13. Valor with Integrity Program for Emergency Responders Every 58 hours a law enforcement officer is killed in the line of duty.According to the National Law Enforcement Officers’ Memorial Fund

14. Valor with Integrity Program for Emergency Responders What Bothers a First Responder?Traumatic Events • The Abuse and / or Death of a Child • A co-worker injured or killed • Police - Officer Involved Shootings • Homicide Scenes • Suicide Scenes • Bad Car Wrecks

15. Valor with Integrity Program for Emergency Responders What Bothers a First Responder the Most? • Politics (not allowed to do their job) - Selective Enforcement of Laws *Parking Tickets (N. Broad St. vs. S. Broad St.) *Preferential Treatment for Politicians or Friends and Family of Politicians *Arrest Vacated because of Connection(s) Often, Officers will not bring this up in regular therapy session out of a sense of loyalty.

16. Valor with Integrity Program for Emergency Responders What Bothers a First Responder the Most? Police Officers are natural and proficient Crisis Interveners. They handle the major issues well. It’s the mundane, everyday issues that they find difficult to deal with • Bill Paying • Chores • Family Issues

17. Valor with Integrity Program for Emergency Responders What Bothers a First Responder the Most? “It’s not the Lions and Tigers that get the cops, it’s the Fleas and the Gnats” - Bill Kennedy

18. Valor with Integrity Program for Emergency Responders Stigmas Holding Back a First Responder from Getting Help • Being Perceived as “not in control” From the day a police officer first enters the police academy they are told to always be in control and to not make mistakes • Being Branded as Weak • Losing the Badge and Gun • Alienated from Peers

19. Valor with Integrity Program for Emergency Responders Stigmas Holding Back a First Responder from Getting Help • Hidden problem • Culture message: “We don’t talk about suicide!” • “We solve problems – we don’t have them”

20. Valor with Integrity Program for Emergency Responders Common Problems in Law Enforcement • Longevity of Law Enforcement Officers - Most Cops live until 66 Y/O - Women 81 and Men 76 (National Ave) - Poor Diet - Shift Work - Stress (Job/Family/Both)

21. Valor with Integrity Program for Emergency Responders Common Problems in Law Enforcement • Spousal Abuse (both ways) • Depression/Anxiety • Unresolved Traumatic Stress • Type A Personality • Type Z Personality (the bum) • Often Abused as Children • Suicide (at least twice the Homicide Rate)

22. Valor with Integrity Program for Emergency Responders Common Problems in Law Enforcement • Studies have shown that law enforcement officers who experience ongoing stress are more likely to display anger, distance themselves from their family members, and have unsatisfactory marriage and family relationships. We all know an angry or Grumpy Officer. Did you ever Wonder Why?

23. Valor with Integrity Program for Emergency Responders Divorce In Law Enforcement • LEO’s have a Higher Divorce Rate than Other Professions • Cops often have Multiple Marriages/Divorces • Cops will use the “quartermaster” System of Marriage and Relationships • 40-50% of Marriages End in Divorce (American Psychological Association, 2013) • In Philadelphia, Approximately 75 % of all Police Marriages end in Divorce if the PO is Married when Coming on the Job

24. Valor with Integrity Program for Emergency Responders Post-Traumatic Stress Disorder Some General Causes for First Responders • Witnessing too much Death • Human Degradation and Man’s Inhumanity to Man • Observing Sexual Abuse and other Forms of Brutality • Police Death and/or Shooting • Discovering the Monster Within

25. Valor with Integrity Program for Emergency Responders Post-Traumatic Stress Disorder “He who fights with monsters might take care lest he thereby become a monster. And if you gaze for long into an abyss, the abyss gazes also into you.” Friedrich Nietzsche Beyond Good and Evil, Aphorism 146

26. Valor with Integrity Program for Emergency Responders Police Suicide Relative risk of workplace suicide for selected occupations 1992-2012 • Police and detectives, public service 6.99 • Military occupations 5.39 • Police and detectives, including supervisors 5.34 • Farmers, except horticultural 4.67 • Managers and administrators, not elsewhere classified 1.93 • Supervisors and proprietors, sales occupations 1.84 • Laborers, except construction 1.91 • Mechanics and repairers, except supervisors 1.82 • Cleaning and building service occupations 1.52 • Construction trades, except supervisors 0.99 Source: Bureau of Labor Statistics Census of Fatal Occupational Injuries and Current Population Survey (CFOI)

27. Valor with Integrity Program for Emergency Responders Police Suicide • Over the last 25 years, the general population suicide rate consistently hovers in the 12 per 100,000 (12 %) • Law Enforcement suicides per LE population is 17 per (100,000) • What is the highest suicide rate in the country?

28. Valor with Integrity Program for Emergency Responders Police Suicide Suicides by Year • 2008 Police Suicides: 141 • 2009 Police Suicides: 143 • 2010 Police Suicides: 145 • 2011 Police Suicides: 147 • 2012 Police Suicides: 126 Source: 2013 NSOPS (National Study of Police Suicides)

29. Valor with Integrity Program for Emergency Responders Police Suicide Profile of Suicide Cases • Average age (2012): 42 • Average years on job: 16

30. Valor with Integrity Program for Emergency Responders Police Suicide Additional Info • 91 percent of suicides were by males. • Ages 40 – 44 were most at risk. • Time on the job:  15 – 19 years were most at risk • 63 percent of suicide victims were single. • 11 percent of suicides were veterans. 2013 NSOPS (National Study of Police Suicides)

31. Valor with Integrity Program for Emergency Responders Police Suicide It may well prove impossible to develop a program that can identify and prevent 150 suicides in a force of almost a million police officers. It is clear, however, that when efforts are focused on mental health, instead of the narrower “suicide prevention,” there can be benefits that include not only suicide prevention, but fewer: • Deaths from Shootings and Accidents • Lawsuits & Complaintss • Sick Leave, On and Off-Job Injuries • Alcoholism & Substance Abuse • Criminal/Other Behaviors • Divorces • Grievances & Resignations 2013 NSOPS (National Study of Police Suicides)

32. Valor with Integrity Program for Emergency Responders Police Videos • Police Encounters • Angry Motorist • Oooops! • You Can't Make This Stuff Up!

33. Valor with Integrity Program for Emergency Responders Alcoholism/Substance Abuse • Self Medication for Trauma • Injury on duty/Pain Medication Addiction • Habituation (Culture of Drinking) • Increased Rate of Post-Traumatic Stress among First Responders leads to an Increase in Alcohol & Substance Abuse as a method of coping with occupational stressors (Austin-Ketch et al, 2012)

34. Valor with Integrity Program for Emergency Responders Alcoholism/Substance Abuse • 25-30% of LEO’s Self-Report Abusing Alcohol on a Regular Basis • 23% of Police Officers in the United States have a Serious Drinking Problem (Leino, Eskeline, Summala, & Virtanen, 2011) • Considerably Higher than the General Population Rate of 10% (National Institute of Alcohol Abuse & Alcoholism, 2014) • Which came first the Chicken or the Egg? • Most Cops fit the Dual Diagnosis Criteria

35. Valor with Integrity Program for Emergency Responders A Word on V.I.P.E.R What is V.I.P.E.R? • Valor with • Integrity • Program for • Emergency • Responders

36. Valor with Integrity Program for Emergency Responders A Word on V.I.P.E.R • The Law Enforcement/Emergency Responder Professional presents a unique challenge in providing successful treatment for treatment for alcohol and drug dependency. This group often experience increased social stigmatization because of their dependencies. Stigmatization may discourage a Police Officer/Emergency Responder from identifying themselves as Alcoholic or Addict.

37. Valor with Integrity Program for Emergency Responders Who is Eligible for V.I.P.E.R • Police Officers • Other Law Enforcement Officers • Firefighters • Emergency Medical Technicians • Corrections Officers • Combat Veterans

38. Valor with Integrity Program for Emergency Responders V.I.P.E.R • LEO’s are Reluctant to Trust and Want to be in Control • Admitting they have Problem Means they are not in Control • Fear of Stigma or Job Consequences if Honest • Don’t Want to be Seen as Weak or Broken • The Program Provides a Safe Environment in Which Law Enforcement Officers are Able to Discuss their Thoughts, Feelings, and Behaviors

39. Valor with Integrity Program for Emergency Responders V.I.P.E.R • V.I.P.E.R gives these First Responders a place to talk about Seeing Death, Tragedy and Other Situations that the General Public can only Imagine • The Atmosphere is one of Trust and Non-Judgment • The Members See they are not Alone and are Empowered to Change by Engaging in the Group Process

40. Valor with Integrity Program for Emergency Responders V.I.P.E.R • Given the Nature of the work they do, Police Officers rely Heavily on Each Other in Order to Perform their Duties Effectively • This Cultural Norm Expresses Itself in the Group Setting • The Members Support and Encourage Each Other During the Treatment Process (and After) • They Give Each Other Empathy when Appropriate But Challenge Unhealthy or Faulty Thinking

41. Valor with Integrity Program for Emergency Responders V.I.P.E.R Topics Addressed • Developing Personal Awareness • Factors that Contribute to Substance Abuse • The Progression of Use Associated with Addiction • The Physical, Emotional, Spiritual, Legal, and Employment Consequences Related to Drug and Alcohol Use • Stressors (Family/Work/Financial) • Healthy Coping Techniques & Practices to Replace Alcohol & Other Substances (Including 12 Step Meetings & Mindful)

42. Valor with Integrity Program for Emergency Responders V.I.P.E.R Intervention and Services • Safe & Supportive Environment for Recovery • Members Learn from Each Other’s Experiences • Benefit from Unique Camaraderie and Deep Understanding that Exists among First Responders • Treatment of PTSD with EMDR • Relapse Prevention Therapy (RPT) by Gorski Trained Clinician • Family/Marital Counseling

43. Valor with Integrity Program for Emergency Responders References • National Law Enforcement Officers Memorial Fund (2014). www.nleomf.org/facts/ • American Psychological Association (2013). http://www.apa.org/topics/divorce/ • Austin-Ketch, T.L., Violanti, J., Fekedulegn, D., Andrew, M.E., Burchfield, C.M., & Hartley, T.A. (2012). Addictions and the criminal justice system, what happens on the other side? Post-traumatic stress symptoms and cortisol measures in a police cohort. Journal of Addictions Nursing, 23, 22-29. doi: 10.3109/ 10884602.2011.645255 • Leino, T., Eskelinen, K., Summala, H., & Virtanen, M. (2011). Work- related violence, debriefing and alcohol consumption among police officers. International Journal of Police Science & Management, 13(2), 149-157. doi: 10.1350/ijps.2011.13.2.239 • National Institute of Alcohol Abuse & Alcoholism (2014). http://www.niaaa.nih.gov/ • National Study of Police Suicides (2013). http://www.policesuicidestudy.com/id16.html

44. Valor with Integrity Program for Emergency Responders Contact Information • Captain Lawrence Norton (Retired), PhD, LMFT, CEAP, SAP Facilitator - VIPER Program for Emergency Responders Mirmont Treatment Center 100 Yearsley Mill Road Lima, PA 19063 484-227-1406 or 800-846-4656 http://www.mainlinehealth.org/mirmont