Caroline Pronai, Sharon Green-Hennessy, Ph.D.

Utilization of Mental Health Services, Barriers to Treatment, and Psychological Distress within the Law Enforcement Population

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The purpose of this study is to examine the relation between mental health service utilization among law enforcement personnel and level of psychological distress. This study also examines perceived coercion into treatment, type of treatment sought, barriers to treatment, and severity of reported psychological distress. Over the past 25 years, the growing awareness of stress-related issues from law enforcement work has led to efforts to lessen mental health problems in law enforcement personnel by promoting the use of mental health services (Alexander & Walker, 1994; Anshel, 2000). While these services can be effective in treating stress related to the job (Carlan & Nored, 2008), their effectiveness is, in part, dependent upon the officers actually utilizing the services. As a result, previous research suggests that individuals with high-risk and high-stress jobs such as law enforcement personnel may experience more symptoms of functionally impairing mental health problems, but may be less likely to seek mental health treatment for those problems (Violanti & Aron, 1993).

Data was collected via self-reported mental health distress measures such as the K6 (Kessler et al., 2003) and multiple-choice survey questions regarding barriers to and actual use of mental health services from the 2009 National Survey on Drug Use and Health (NSDUH). The sample population for the 2009 NSDUH consisted of individuals, age 12 years and older, living in the United States who did not reside in an institution and were not currently active duty military service; however a subset of 17,792 individuals was selected based on demographic variables such as occupation (i.e., law enforcement vs. non law enforcement), age (i.e., 18 years and older), and full-time work status (USDHHS, SAMHSA, 2009). The final sample consisted of 457 law enforcement officers and 17,335 non law enforcement officers with the majority of participants being male (law enforcement: 77.5%; non law enforcement: 52.9%), Caucasian (law enforcement: 57.5%; non law enforcement: 65.1% and 26 to 49 years old (law enforcement: 50.3%; non law enforcement: 48.3%).

Logistic regression models indicated that law enforcement personnel were not more likely to report higher mental distress nor do they utilize formal or informal mental health treatment services less than the general public. Finally, law enforcement personnel were not more likely to report coercion into mental health treatment than those in the general population. These unexpected results may be attributed to the presence and influence of the very factors (i.e., barriers to treatment) being examined. Law enforcement officers may have questioned the confidentiality of the research or they may not have trusted the researcher to maintain anonymity. As a result, fear of a stigma or judgment may have been present. This may have led law enforcement officers to restrict or limit their response choices, resulting in favorable self-reporting. Additionally, the results may indicate hesitation to self-report negatively or to report potentially career altering reactions to experienced stress and trauma. On the other hand, the lack in significance may have resulted from the law enforcement officer’s failure to acknowledge psychological issues or dysfunction.