“THINGS ARE CHANGING POLICE MENTAL HEALTH AND ...

[Pages:390]"THINGS ARE CHANGING:" POLICE MENTAL HEALTH AND PSYCHOTHERAPEUTIC HELP-SEEKING WITHIN AN EVOLVING POLICE CULTURE

by

Breanne Faulkner

A thesis submitted in conformity with the requirements for the degree of Doctor of Philosophy

Department of Applied Psychology and Human Development Ontario Institute for Studies in Education University of Toronto

? Copyright by Breanne Faulkner 2018

"THINGS ARE CHANGING:" POLICE MENTAL HEALTH AND PSYCHOTHERAPEUTIC HELP-SEEKING WITHIN AN EVOLVING POLICE CULTURE

Doctor of Philosophy Breanne Faulkner

Department of Applied Psychology and Human Development University of Toronto 2018

Abstract

Due to repeated trauma exposure and significant ongoing sources of operational and organizational stress, police officers are vulnerable to mental health problems, including PTSD, depression, and other Operational Stress Injuries (OSIs). In recent years, police organizations have made efforts to build awareness and the address mental health needs of their membership, and Ontario legislation has attempted to address gaps in access to services among first responders. As such, aspects of traditional police culture which may be incompatible with psychotherapeutic help-seeking, such as norms of hegemonic masculinity, authoritarianism, and emotional control have been challenged. The current study aimed to explore the lived experiences of Ontario police officers with regard to job-related psychological distress and helpseeking, and to elucidate the complex role of contemporary police cultural norms in shaping help-seeking behaviours. In-depth research interviews were conducted with 18 police officers of various occupational ranks and roles. A constructivist grounded theory approach was utilized toward the development a model of psychological help-seeking within the contemporary police culture. Results demonstrated that although most officers reported that "things are changing" within the police cultural and institutional context, themes of weakness versus strength, us versus other, safety and suitability for the job, and co-constructed silence continue to pervade many of their experiences and perceptions of psychological difficulties, constraining help-seeking

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behaviours and often delaying help-seeking. Specific factors interfering with help-seeking included issues with accessibility, education, and awareness, but more prominently, identity issues, a fear of work-related consequences, and skepticism and mistrust, especially of mental health treatment providers. Establishing trust and reducing stigma via leadership and peer access points to community service providers were important facilitating factors. Psychotherapeutic service engagement often resulted in a shift away from policing as a fundamental component of identity, as well as a greater level of comfort with help-seeking, challenges to previously-held stigmas, and most powerfully, an inclination to share these experiences with one's peers and thereby challenge the culture of silence. A model of the influence of the police culture on psychotherapeutic help-seeking among police is presented, and theoretical implications, as well as implications for prevention and intervention with police are outlined.

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Acknowledgements

The work recorded in this document could only ever have been conceived of, endured, shaped, and finally stitched together with the generous support, insights, and wisdom of a number Very Important People.

First and most emphatically, thank you to my brilliant and kind supervisor and forever academic mentor, Dr. Abby Goldstein. I have grown into a researcher under your guidance and by your example. I am grateful for your willingness to join me on this endeavor which has meant so much to me, despite it being far outside of both of our comfort zones. As always, your thoughtful feedback and challenging questions helped me to formulate my ideas and push myself beyond what I could have imagined.

I thank my esteemed committee members, Dr. Charles Chen and Dr. Lana Stermac, for your time and thoughtful comments, which have greatly strengthened the quality of this final document. In particular, Charles, my sincere appreciation for your patience and generosity in helping me develop the constructivist grounded theorist in me. Thank you to Dr. Roy Gillis, for your early and ongoing kindness in this journey, and for being present for the final hurdle. Finally, thank you to Dr. Elizabeth Donnelly for your willingness to share your expertise and insights on this project with me. It was an honour to have each of you be a part of this process.

Thank you to my research volunteers, Danielle, Juhie, Naomi, Yeonkyung, Megan, A.J., and Isabel for their assistance with transcription of research interviews.

To my cherished friends and family ? thank you for your continuous love and support through this long and sometimes painful eight years. Mom, Dad, Kaley, Cody, Carol, John, Betty, Nic, Caylen, Lade, OG Nat, Sarah, JO, Ash, Tatijana, Alanna, Nan, and Gram.

To Alex. I literally would not have survived this process without your patience, empathy, generosity, insights, or organizational and technical skills. Thank you for being my partner in every way possible during the last six years, for forcing me to leave the house, to eat greens, to go to bed, and to laugh. Most importantly, thank you for tolerating six months of weekday Breanne and numerous minx pants phases. Your love made this happen and I am forever grateful.

Finally, thank you to each of my amazing participants. First, for your service. And second, for your courage, your honesty, and your trust. I will never forget your stories, and I will do my best to ensure that others do not forget either.

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Dedication I would like to dedicate this dissertation to my mother and father. Mom, thank you for giving me my lightness, my empathy, and my creativity, and for your constant, vocal (over the top) support. Dad, thank you for giving me my seriousness, my ambition, and my resilience, and for your constant, quiet (over the top) support. You are both my heroes for your humanity: your vulnerability and strength. Thank you for teaching me that I should strive to embody both and for providing me the tools to do so.

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Table of Contents

Acknowledgements ...................................................................................................................... iv Dedication ...................................................................................................................................... v Table of Contents ......................................................................................................................... vi List of Tables ................................................................................................................................ xi List of Figures.............................................................................................................................. xii List of Appendices ...................................................................................................................... xiii Chapter 1 Introduction................................................................................................................. 1 Chapter 2 Literature Review ....................................................................................................... 7

Stressors Associated with the Police Role .................................................................................. 7 Psychological Correlates of Policing ........................................................................................ 15

Defining operational stress injury (OSI). .............................................................................. 15 Burnout.................................................................................................................................. 18 Isolation and relationship discord. ........................................................................................ 20 Hypervigilance and posttraumatic stress............................................................................... 23 Depression............................................................................................................................. 25 Alcohol use disorders............................................................................................................ 26 Suicide................................................................................................................................... 28 The Context of Culture ............................................................................................................. 31 Psychological Help-Seeking Among Police ............................................................................. 38 Individual factors. ................................................................................................................. 47 Systemic factors. ................................................................................................................... 50 Institutional factors. .............................................................................................................. 53 Cultural factors...................................................................................................................... 57 Rationale for the Current Study ................................................................................................ 60 Research questions. ............................................................................................................... 61 Chapter 3 Methodology .............................................................................................................. 63 Rationale for Grounded Theory Design.................................................................................... 64 Constructivist grounded theory. ............................................................................................ 67 Situating Oneself as the Researcher.......................................................................................... 70

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Methods for the Current Study ................................................................................................. 74 Selection and recruitment...................................................................................................... 74 Procedures. ............................................................................................................................ 79 Data analysis. ........................................................................................................................ 83

Chapter 4 Results Participant Summary and Portraits .......................................................... 88 Chapter 5 Results Narratives of Police Culture....................................................................... 99

Narratives of Police Culture ................................................................................................... 101 Camaraderie. ....................................................................................................................... 101 Duty..................................................................................................................................... 105 Effectiveness. ...................................................................................................................... 106 Fairness and Compassion.................................................................................................... 108 Power and Control. ............................................................................................................. 111 Toughness Ethic. ................................................................................................................. 114

Women in Policing ................................................................................................................. 116 Mechanisms and Variations in Cultural Adherence ............................................................... 120

Implicit Mechanisms........................................................................................................... 120 Explicit Mechanisms........................................................................................................... 122 Cultural Spectrum. .............................................................................................................. 123 Chapter 6 Results Workplace Stressors and Outcomes of Stress ........................................ 126 Workplace Stressors ............................................................................................................... 127 Corrosive Stressors. ............................................................................................................ 129 Implosive Stressors. ............................................................................................................ 136 Explosive Stressors. ............................................................................................................ 142 Cultural Stressors. ............................................................................................................... 147 Outcomes of Workplace Stress ............................................................................................... 149 Worry and Anxiety.............................................................................................................. 149 Posttraumatic Stress Symptoms .......................................................................................... 151 Cognition and Perception.................................................................................................... 153 Mood, Energy, and Self-Concept........................................................................................ 158 Health-Related Outcomes. .................................................................................................. 163 Disconnection and Relationship Strain. .............................................................................. 164 Work and Career Impacts. .................................................................................................. 166

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Positive Outcomes............................................................................................................... 168 Chapter 7 Results Coping, Responses, and Buffers to Stress ............................................... 170

Self-Maintenance .................................................................................................................... 171 Acceptance. ......................................................................................................................... 172 Meaning and Purpose.......................................................................................................... 173 Perspective. ......................................................................................................................... 178 Individual Therapy. ............................................................................................................. 180

Self-Regulation ....................................................................................................................... 181 Preparation and Certainty.................................................................................................... 181 Relying on the Role............................................................................................................. 182 Processing and Expression.................................................................................................. 183 Control and Avoidance. ...................................................................................................... 185 Drinking to Cope................................................................................................................. 189

Relationship Orientation ......................................................................................................... 190 Connection. ......................................................................................................................... 191 Hiding and Isolation............................................................................................................ 198

Work-Life Balance and Boundaries ....................................................................................... 200 Job Satisfaction. .................................................................................................................. 200 Balance................................................................................................................................ 201 Boundaries. ......................................................................................................................... 203 Identity Orientation. ............................................................................................................ 204

Passive Coping........................................................................................................................ 207 Chapter 8 Results Mental Health and Help-Seeking in the Culture.................................... 210

Culture Now and Then............................................................................................................ 211 "Things are Changing."....................................................................................................... 211 Problems and Barriers to Change........................................................................................ 214

Narratives in the Culture ......................................................................................................... 216 Labels and Judgement. ........................................................................................................ 217 Safety and Suitability. ......................................................................................................... 218 Us versus Other. .................................................................................................................. 220 Weakness and Strength. ...................................................................................................... 223 Straddling Cultural Positions. ............................................................................................. 225

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