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Exploring the usefulness of Fitness-for-Duty Evaluation in assessing suicide risk among police officers. Review of global and US suicide rates, factors associated with police officer suicides, and a current study analyzing suicide data.
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Can the Fitness-for-duty Evaluation be useful in assessing risk of death by suicide for police officers? Daniel Hollar, PhD Bethune-Cookman University Inger Daniels, PhD Daninger Solutions, Inc.
Assessing the problem: • World Rates • WHO (2015)1 • 788,000 in 2015 • 10.7 per 100,000 population (vs 13.42 per 100,000 in U.S.) • United States2 • 10th leading • 44,965/yr; 123/day • $69 Billion/yr • Gender • Men 3.53x > women • Race/Ethnicity • White males, 7 of 10 suicides in 2016 • highest in middle age — white men • 1. World Health Organization (2015) • 2. American Foundation for Suicide Prevention (2018).
Global LEO Suicide rates • Suicide in police officers: a survey of nations (Lester, 1992) • 1980-1989, 7 of 26 countries police suicide rates above gen. pop. • 1991, of 588 cases in UK there were significant increases among security personnel (Darragh, 1991) • 1994, Rome, Italy- male officers 1.97x higher general male pop. (Forastiere et al. 1994) • 1995, Australian police correlated with stress, health, domestic problems, intense occupational difficulties(Cantor, et al., 1995) • 2000, Quebec, Canada- twice gen. pop.; 20-39 yrs old (Charbonneau, 2000) • 2002, job related problems- < traumatic events, PTSD sympt., alcohol abuse, aggressive behavior(Gershon et al., 2002) • 2003, study in South Africa found correlations btwn. ideation and incoherence (ineffectiveness at work)
U.S. LEO Suicide Rates • National Occupation Study (Guralnick, 1963) • male police = 1.8x white males gen. pop. • suicides = 13.8% deaths for police vs. 3% deaths in other occupations • 1996 study of US military, < security and law enforcement specialists (Helkamp, 1996) • Types of Police work • Detectives, Crim Inv and correctional • traumatic exposure --> increased alcohol and more ideation
National Occupational Mortality Surveillance (NOMS) (Violanti, John; 2009)
REVIEW OF LITERATURE Profile of LEO completed suicides: O'Hara AF1, Violanti JM, Levenson RL Jr, Clark RG Sr. (2013) • Avg. age 42 y.o. • 17 years in the job • 80% firearm • Marital Status: 63% single (divorced or never married) • 11% Veterans • Gender: 87% male, 13% female • Violanti, J.M., Robinson, C.F., Shen R. (2013) • Race: White males (85%) , White females (5%) Hispanic males (7%), Hispanic females (no data) Afr. Am. males (4%), Afr. Am. Females (< 1%) • Detectives/police/Crim. Inv. (44%); Correctional officers (28%)
Factors Associated with Increased LEO Risk 63 quantitative studies First responders U.S., Canada, Australia, Norway, London, Ireland, Germany & South Africa.(Stanley, I.H., Hom, M.A., & Joiner, T.E.; 2016) Departmental charges Previous attempt Marital problems/family issues Financial crisis Terminal illness Mental health problems (hopelessness/depression and PTSD) Alcohol use/abuse
Research Questions: Do police officers who attempt or commit suicide exhibit characteristics that differ from their counterparts who do not attempt or commit suicide? Can FFD be helpful in identifying which officers are at most risk for or best protected from suicide?
Sample Data • N = 204 (currently available; 2007-2019) • Suicide Ideation = 39 • Suicide Attempt = 7 (male = 5, white = 4, avg. age = 37) • Suicide Completion = 2 (male= 2, Hispanic =1, White= 1, avg. age =35.5) • Average age = 44 (min = 25, max = 63) • Average Years of Service = 15.1 (min = 3 years, max = 41 years) • Male = 64% (132 officers) • White = 48% (98 officers) • Black = 30% (62 officers) • Hispanic = 9% (18 officers) • Other = 13% (26 officers)
Attempted/Completed Homicidal Threat
Matched Sample Analysis:Years Service and Number of FFD Evals
Matched Sample Analysis: Job Performance Referrals
Matched Samples: History of Homicidal Threats
Conclusions • In our sample, FFD officers who attempt or commit suicide indeed differ from officers who do not: • Younger • FFD referral for suicide • History of suicide ideation • FFD evals may be helpful in predicting unreported suicidal ideation among officers • History of homicidal threat • History of alcohol abuse • FFD referrals based on violent behavior • Greater number of FFD evals • Younger age • More years of service
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References Adelson, R. (2006). Nationwide survey spotlights U.S. alcohol abuse. APA Monitor, Washington D.C.: American Psychological Association 37 (1): 30-31. DeBroeck, L. D. (2016). Exploring the conceptual overlap of the cognitive and affective theories of suicide. Fink-Miller, E. L. (2015). Provocative work experiences predict the acquired capability for suicide in physicians. Psychiatry research, 229(1), 143-147. Harris, Reginald (2016). "Suicide in the workplace," Monthly Labor Review, U.S. Bureau of Labor Statistics, December, https://doi.org/10.21916/mlr.2016.54. Joiner Jr, T. E., Hollar, D., & Orden, K. V. (2006). On Buckeyes, Gators, Super Bowl Sunday, and the Miracle on Ice:“Pulling together” is associated with lower suicide rates. Journal of Social and Clinical Psychology, 25(2), 179-195. Joiner, T.E. (2005). Why People Die by Suicide. Cambridge, MA: Harvard University Press. Lester, D., & Gunn, I. J. F. (2012). Perceived burdensomeness and thwarted belonging: An investigation of the interpersonal theory of suicide. Clinical Neuropsychiatry, 9(6), 221-4. Nademin, E., Jobes, D. A., Pflanz, S. E., Jacoby, A. M., Ghahramanlou-Holloway, M., Campise, R., & Johnson, L. (2008). An investigation of interpersonal- psychological variables in Air Force suicides: A controlled-comparison study. Archives of Suicide Research, 12(4), 309-326. Ribeiro, Jessica, D., & Joiner, T.E. (2009). The Interpersonal-psychological theory of suicidal behavior: current status and future directions. Journal of Clinical Psychology, Vol. 65 (12), 1291-1299 Van Orden, K. A., Witte, T. K., Cukrowicz, K. C., Braithwaite, S. R., Selby, E. A., & Joiner Jr, T. E. (2010). The interpersonal theory of suicide. Psychological review, 117(2), 575. Van Orden, K., Merrill, K., & Joiner, T. (2005). Interpersonal-psychological precursors to suicidal behavior: A theory of attempted and completed suicide. Current Psychiatry Reviews, 1, 145-152.