Preparing for the Unimaginable Preparing for the Unimaginable

How chiefs can safeguard officer mental health before and after mass casualty events
	
As law enforcement executives it is our duty to keep 

our officers safe and healthy. Thank you to those that 

contributed to this important resource that helps us tackle 

the topics of resiliency as well as the effects of a mass 

casualty incident on officers’ mental health both during 

and in the time that follows.

— Terrence Cunningham, Chief of Police, 

Wellesley (Massachusetts) Police Department 

and President of the International Association 

of Chiefs of Police 

The mental health of our officers should be of the utmost 

importance. Whether issues are brought about by life 

circumstances, tragedy, critical incidents, or on-the-job 

stress, it is incumbent upon us as leaders to acknowledge 

the realness of the situation and to provide opportunities 

for help. As agency heads, we have the opportunity to 

provide permission to our agencies to speak openly and 

candidly about the mental health of our members.

— Colonel Matt Langer, Chief of Police, 

Minnesota State Patrol

This project was supported by cooperative agreement 2013-CK-WX-K038 awarded by the Office of Community Oriented 

Policing Services, U.S. Department of Justice. The opinions contained herein are those of the author(s) and do not 

necessarily represent the official position or policies of the U.S. Department of Justice. References to specific agencies, 

companies, products, or services should not be considered an endorsement by the author(s) or the U.S. Department of 

Justice. Rather, the references are illustrations to supplement discussion of the issues. The Internet references cited in 

this publication were valid as of the date of publication. Given that URLs and websites are in constant flux, neither the 

author(s) nor the COPS Office can vouch for their current validity. 

Recommended citation:

National Alliance on Mental Illness. 2016. Preparing for the Unimaginable: How Chiefs Can Safeguard Officer Mental 

Health Before and After Mass Casualty Events. Washington, DC: Office of Community Oriented Policing Services.

ISBN: 978-1-935676-90-4 

Published 2016
Contents

Letter from the Director. vi

Foreword: Leadership When the Unimaginable Occurs.ix

Foreword: Mental Wellness Needs New Focus xi

Preface ........ ............... ............................. .

.............................

..............................................................

... xiii

Acknowledgments ........... ..... xv

How to Read This Guide. xi

Part One. Why Mental Wellness Matters to You and Your Agency1

1. Understanding Trauma and Resiliency .... 3

Stories from the field 3

Police officers aren’t immune to trauma ......

......

......

......

......

 ...........................

13

The immediate impact of traumatic events 14

The long-term impact of trauma 16

Unresolved trauma is an officer safety issue .. 17

Psychological resilience 19

Do we need to change law enforcement culture to promote resilience? 21

Part Two. Preparing for a Mass Casualty Event.23

2. Recommendations for Enhancing Resilience in Your Agency Today 25

Take a personal interest in officer wellness 25

Form a work group to recommend officer wellness programs and education 27

Support the creation of an officer peer support program 28
Find the right mental health service providers to support your officers

32

Review your psychological services policies and procedures 33

3. Planning the Incident Response for a Mass Casualty Event41

Assign a mentazl health incident commander 41

Build close partnerships with first responder agencies 

....................................

..................

..................

..................

..................

and other leaders in your community.

44

Make a regional or statewide plan 47

Why you need a media strategy 49

4. Building Your Media Team and Strategy for a Mass Casualty Event 49

How to plan an effective media strategy: Be prepared. Be proactive. Own your narrative. ....... 54

What to include in your media plan ....... .......................................... ...........

............................

.......

............................

.......................... .....................

.....

.....

.......................

.......................

...............

...............

......................................

55

Part Three. Managing a Mass Casualty Event and Its Aftermath...... 57

5. Immediate Incident Response .......... 61

Managing challenges for your agency and your community 61

Managing challenges and stressors for officers ....... 63

Managing leadership challenges ..................... 66

Immediate incident response checklists67

6. The First Weeks: From Chaos to a New Normal ................ 73

Managing challenges for your agency and your community73

Managing challenges and stressors for officers 81

Managing leadership challenges ................... 90
7. The First Months ...... ................................................................ .......

...................................

...................................

........................ ........................... ........

...................................................

........................ ...........................

93

Managing challenges for your agency and your community 93

Managing challenges and stressors for officers 94

Managing leadership challenges...... 98

Tips for helping officers to heal ...... ......

......

.................................

.......

.......

.......

..........................

.....

.....

. . .. . . . . . .

.....................

.....................

..........

..........

.............

.............

100

8. The Long Haul ..................... 101

Managing challenges for your agency and your community101

Managing challenges and stressors for officers 104

Managing leadership challenges....... 108

Handouts and Other Resources 111

Chief Edwards’ Story: Overcoming PTSD

Lori Kehoe’s Story: The Impact of Trauma on Law Enforcement Spouses

Sgt. O’Hara’s Story: Managing Cumulative PTSD and Helping to Prevent 

Officer Suicide

Sgt. DiBona’s Story: Using His Personal Struggles to Help Other Cops

Too Much, Too Ugly: Understanding the Trauma Contamination for Law 

Enforcement Officers

“This Shouldn’t Be Bothering Me:” Common Myths about Police Officers’ 

Responses to Traumatic Events

The Mental Health Incident Commander’s Role during the Immediate 

Response to a Mass Casualty Event

How to Assist a Fellow Officer after a Critical Incident

Resources.

139

Organizations 141
Key Word Index.

143

About the Authors 145

About NAMI 147

About the COPS Office 148
 

vii

Letter from the Director

Dear colleagues,

It’s hard to imagine that an incident as horrific as those that occurred in Newtown, Charleston, 

and San Bernardino could occur in our own communities. Indeed, events of this kind are rare. 

But they do happen, and law enforcement leaders must be prepared not only for a possible incident but also for the aftermath that would follow. 

Though most agencies have trained and equipped their officers for immediate response to 

mass casualties, few have prepared their personnel for the psychological fallout. Tragic events 

can have a profound effect on first responders, who may suffer emotional distress that lingers 

long afterward, leading to personal problems, alcoholism, post-traumatic stress disorder, and 

even suicide.

To help the Newtown (Connecticut) Police Department cope with the murder of 26 people, 

including 20 children, at Sandy Hook Elementary School, the COPS Office reached out to the 

National Alliance on Mental Illness (NAMI) to provide guidance. Preparing for the Unimaginable is the result of NAMI’s work with Newtown’s police chief, Michael Kehoe. 

This unique publication offers expert advice and practical tips for helping officers to heal emotionally, managing public reaction, dealing with the media, building relationships with other first 

responder agencies, and much more. But what makes this handbook especially helpful are the 

case studies and stories from the field contributed by chiefs, officers, and mental health professionals who have lived through traumatic incidents. 

We especially want to thank Chief Kehoe for his commitment to this effort, which required 

reliving a traumatic event. He and the other law enforcement professionals who contributed 

their personal experiences deserve our thanks for being open about this issue and sharing their 

lessons learned. 

It is our hope that this handbook will be read by police chiefs and sheriffs throughout the country. Though Preparing for the Unimaginable focuses on mass casualty incidents, traumatic events 

arise in everyday police work as well, and their effect cannot be overstated. 
Preparing for the Unimaginable: How Chiefs Can Safeguard 

Officer Mental Health Before and After Mass Casualty Events

viii

The COPS Office is dedicated to promoting all aspects of officer wellness and safety, and as the 

Final Report of the President’s Task Force on 21st Century Policing noted, the wellness and 

safety of law enforcement officers is critical not only to themselves, their colleagues, and their 

agencies but also to public safety. We applaud NAMI for bringing the critical issue of officer 

mental health to the forefront with this eye-opening publication.

Sincerely,

Ronald L. Davis

Director

Office of Community Oriented Policing Services
 

ix

Foreword: Leadership When 

the Unimaginable Occurs

The Sandy Hook Elementary School shooting on December 14, 2012 caused a collective pause 

in the United States because of the brutality of the actions against the most vulnerable members 

of society. As the events unfolded and the world became aware of the devastation that occurred 

in an elementary school, police officers throughout the state of Connecticut were already busy 

handling a multitude of important responsibilities required when a tragedy befalls a community. 

The ability of media to quickly share the news of tragic events adds to the stress and trauma 

normally associated with highly critical events. Law enforcement must initially respond to these 

events to mitigate the dangers inherent in the crisis. Then they must successfully navigate the 

aftermath, including daily intrusions and reminders of the tragedy from the media and offers of 

assistance from hundreds of well-intentioned community members and visitors arriving with 

stuffed animals, flowers, food, and other gifts. 

In addition to responding to traumatic events, dealing with the scope and duration of the aftermath of tragedies is one of the most important concerns of police chiefs and sheriffs throughout 

the country. 

Ensuring the mental wellness and health of first responders has long been an underappreciated 

task for the heads of police agencies. U.S. law enforcement has learned from tragic events over 

the years and now trains to respond to threats with the best equipment and practices known 

today. However, many chiefs are not prepared to deal effectively with the intense scope and 

unanticipated duration of the aftermath of these events, and many chiefs are unaware of the 

impact such events will have on their communities and the officers in their agencies.

The Sandy Hook Elementary School shooting was an unprecedented event in my career in law 

enforcement. Coping with the aftermath of the incident raised my awareness of how traumatic 

experiences affect the mental health and wellness of officers; thus, I asked the National Alliance 

on Mental Illness to work with me on developing this guide, which will provide chiefs and sheriffs with awareness and guidance on best practices for safeguarding the mental health and wellness of first responders in the early moments of critical events and during the long aftermath. 

This guide will also raise awareness for the many stressors associated with critical events. 
Preparing for the Unimaginable: How Chiefs Can Safeguard

Officer Mental Health Before and After Mass Casualty Events

x

As chiefs or sheriffs, we can make a difference in the quality of life our brave men and women 

will experience from hire to retire and beyond. Protecting the health and wellness of officers 

under our command is as important as any training an officer gets throughout his or her career. 

Our officers make many sacrifices during their careers, and their emotional well-being should be 

among our top priorities. 

Michael Kehoe

Chief of Police (ret.), Newtown, Connecticut
 

xi

Foreword: Mental Wellness 

Needs New Focus

The overwhelming probability is that you will not need this guide. The likelihood of a mass casualty event is so low that no law enforcement agency has been able to develop expertise in dealing 

with such incidents, let alone the traumatic psychological aftermath they have on first responders. But when these events do occur, they can have a wide-ranging impact on your agency and 

your officers. Should the unimaginable happen, having thought-through officer support will 

be invaluable. You can take action to prepare. The steps in this guide will benefit your agency 

even if you never experience a mass casualty event, because all officers are exposed to traumatic 

events throughout their careers. 

The goal of this guide is to provide law enforcement executives with best practices regarding first 

responder mental health—best practices learned from colleagues unfortunate enough to have 

experienced a mass casualty event. The National Alliance on Mental Illness brought together 

chiefs, mental health professionals, and others with first-hand knowledge to provide readers 

with a concise compendium of what worked and what did not. 

This guide is chronologically organized, beginning with pre-incident preparation and concluding 

with long-term aftercare. It provides chiefs and command staff with concrete tools to set up a 

mental health response structure now, when there is time. Trauma is an occupational hazard for 

first responders, yet officer mental health is a topic that often does not receive proper attention. 

It has become clear that psychological trauma is every bit as devastating as physical trauma, and 

the cumulative nature of these events can lead to post-traumatic stress disorder, alcoholism, 

divorce, depression, suicide, and other emotional problems that manifest years after the events 

occurred. This is why law enforcement agencies must explore long-term care. 

First responder mental health needs new focus. Each year more and more officers suffer because 

they have not received proper psychological support. Officers are reluctant to request assistance 

for fear of being branded mentally weak or in the belief that seeking help will negatively impact 

their career. Administrators fail to provide this support because of a lack of understanding. 
Preparing for the Unimaginable: How Chiefs Can Safeguard

Officer Mental Health Before and After Mass Casualty Events

xii

We hope that by sharing our experiences and lessons learned through this guide, we can contribute to a better understanding of officer wellness in the aftermath of these events and support 

other chiefs through a major challenge of leadership. We want to foster change in the way law 

enforcement agencies support officer wellness now, whether or not they ever experience a mass 

casualty event, and, ultimately, to help keep more good officers on the job. 

John Edwards

Chief of Police, Oak Creek, Wisconsin 

Michael Kehoe

Chief of Police (ret.), Newtown, Connecticut 

Marc Montminy

Chief of Police, Manchester, Connecticut

Daniel Oates

Chief of Police, Miami Beach, Florida
 

xiii

Preface 

On December 14, 2012, the Sandy Hook Elementary School shooting in Newtown, Connecticut—which left 26 dead, including 20 first-grade students—shocked the nation. It was one of 

the deadliest mass shootings in U.S. history, and the outpouring of support from people around 

the country and around the world was overwhelming. The Sandy Hook event reignited several 

debates: gun control, school safety, and the role of mental health services in ensuring public 

safety. While little has changed on these fronts, the lasting legacy of Sandy Hook may be the new 

light it shed on police officer mental health. 

Many people would say that police officers have the strength and stoicism to bear a great deal 

more than the average citizen, and that is probably true. But any person who comes face to face 

with the horrors of a mass casualty event will be deeply affected, and many will need support to 

move past it. While they may be more resilient, law enforcement officers also quietly deal with 

an outsized share of our society’s violence and death. As a result, too many officers struggle with 

alcoholism, post-traumatic stress disorder, and depression. It has become increasingly evident 

to police leaders that every officer deserves support to deal with the stresses and horrors that are 

part of the job. 

In 2013, the U.S. Department of Justice’s Office of Community Oriented Policing Services 

reached out to us at the National Alliance on Mental Illness (NAMI) to provide assistance to the 

Newtown Police Department. NAMI is the nation’s largest grassroots mental health organization; 

we provide education, support, and advocacy to improve the lives of people living with mental 

health conditions and their families. We, along with our more than 900 local NAMI affiliates and 

state organizations in communities across the country, have a long history of partnering with law 

enforcement agencies to improve responses to community members in mental health crisis. 

In Newtown, our charge was different: to support officer mental health. After meeting with 

Michael Kehoe, then chief of police in Newtown, as well as other community leaders, it became 

clear that this community had many mental health resources already available and a healthy 

skepticism about another offer of help from an outside organization unfamiliar with the community. Kehoe said if NAMI wanted to do something with a lasting impact, we should write a 
Preparing for the Unimaginable: How Chiefs Can Safeguard

Officer Mental Health Before and After Mass Casualty Events

xiv

playbook for chiefs on how to safeguard officer mental health in the early days after a mass casualty event. He said that events like Sandy Hook rewrite the rules—for dealing with the media, for 

coordinating with other agencies, and for officer mental health. His hope was that other chiefs 

would benefit from the lessons he learned. 

With Chief Kehoe’s leadership, we convened an expert advisory group of police chiefs who had 

experienced mass casualty events in their communities, along with the mental health professionals who advised them, to gather lessons learned and guidance for other chiefs. After the expert 

advisory group meeting, we also sought guidance from numerous police leaders, mental health 

professionals, and trauma and media experts. Finally, we reviewed the research on what works to 

help people recover from trauma. 

Mass casualty events, despite their frequency in the news, are relatively rare in the career of a 

police chief. With that in mind, the guidance offered in this publication should be understood as 

lessons learned combined with research about what has worked. Our recommendations are not 

gospel truth. Our hope is to contribute to the conversation about police officer wellness and to 

support chiefs who face these incidents in the future. 

Laura Usher

Manager, Criminal Justice and Advocacy

NAMI

Stefanie Friedhoff

Expert Consultant

NAMI

Sam Cochran

Major (ret.)

Memphis (Tennessee) Police Department

Anand Pandya, MD

Expert Consultant

NAMI
 

xv

Acknowledgments 

NAMI, the National Alliance on Mental Illness, is particularly grateful to the Office of Community Oriented Policing Services (COPS Office) for their support and guidance throughout this 

project. We particularly wish to thank Kimberly Nath, our project manager, for championing 

the cause of officer mental health and supporting us every step of the way. We also owe special 

thanks to retired Chief Michael Kehoe of Newtown, Connecticut, for his vision and leadership 

and to the other chiefs and mental health professionals who shared their time and expertise as 

part of NAMI’s expert advisory group. This guide is possible only because of their willingness to 

share first-hand experiences. 

The expert advisors included the following:

zzMichael Kehoe, chief of police (ret.), Newtown, Connecticut, who oversaw the response to 

the Sandy Hook school shooting in 2012 

zzJohn Edwards, chief of police, Oak Creek, Wisconsin, who oversaw the response to the Sikh 

Temple of Wisconsin shooting in 2012

zzMarc Montminy, chief of police, Manchester, Connecticut, who oversaw the response to the 

workplace shooting at Hartford Distributors in 2010

zzDaniel Oates, chief of police, Miami Beach, Florida, who oversaw the response to the Aurora 

Century 16 Theater shooting in 2012 when he was chief of police in Aurora, Colorado

zzJames Rascati, licensed clinical social worker, whose company, Behavioral Health Consultants, LLC supported Chief Montminy after the Hartford Distributors shooting and Chief 

Kehoe after the Sandy Hook Elementary School shooting

zzJohn Nicoletti, PhD, police psychologist, Nicoletti-Flater Associates, PLLP, who was involved 

in the responses to the Columbine High School shooting in 1999, the Aurora Century 16 

Theater shooting in 2012, and several other mass casualty and active shooter incidents
Preparing for the Unimaginable: How Chiefs Can Safeguard

Officer Mental Health Before and After Mass Casualty Events

xvi

We also thank the many law enforcement officers, medical and mental health professionals, 

colleagues, and friends who provided expertise, personal experience, and review of this guide: 

James Baker, Director, Advocacy, International Association of Chiefs of Police 

Amanda Burstein, Manager, Advocacy, International Association of Chiefs of Police

Ron Clark, RN, MS, APSO, Sergeant (ret.), 

Connecticut State Police; Chairman of 

the Board, Badge of Life

Kit Cummings, Lieutenant (ret.), Blacksburg (Virginia) Police Department; Law 

Enforcement Peer Specialist, Virginia 

Law Enforcement Assistance Program

AJ DeAndrea, Sergeant, Arvada (Colorado) 

Police Department

Mark DiBona, Patrol Sergeant, Seminole 

County (Florida) Sheriff’s Department; 

Director, Badge of Life

Frank Dowling, MD, Clinical Associate 

Professor of Psychiatry, State University 

of New York (SUNY) at Stony Brook 

University; Medical Advisor, Police 

Organization Providing Peer Assistance

Ken Duckworth, MD, Medical Director, 

National Alliance on Mental Illness

Alexander Eastman, MD, MPH, FACS, 

Lieutenant and Deputy Medical Director, 

Dallas Police Department

Douglas Fuchs, Chief of Police, Redding 

(Connecticut) Police Department

Melissa Glaser, LPC, Community Outreach 

Coordinator, Newtown Recovery and 

Resiliency Team

Ingrid Herrera-Yee, PhD, Manager, Veterans, 

Military and Advocacy, National Alliance 

on Mental Illness

Ron Honberg, JD, Senior Policy Advisor, 

National Alliance on Mental Illness

Valerie Hunter, MA, LMFT, OTR, National 

Director, Organization Development and 

Talent Management, National Alliance 

on Mental Illness

Lori Kehoe, RN

Matt Langer, Colonel, Chief of the State 

Patrol, Minnesota 

Gary MacNamara, Chief of Police, Fairfield 

(Connecticut) Police Department
 

Acknowledgments

xvii

Catherine Martin-Doto, PhD, Corporate 

Psychologist, Psychological Services, 

Toronto Police Service

Karen Meyer, Inspector, Ontario Provincial Police

Andy O’Hara, Sergeant (ret.), California 

Highway Patrol; Founder, Badge of Life

A.D. Paul, Sergeant, Plano (Texas) Police 

Department

Frank Petrullo, Director, Police Organization 

Providing Peer Assistance

Louise Pyers, Executive Director, Connecticut 

Alliance to Benefit Law Enforcement

Scott Ruszczyk, President, Newtown Police 

Officer’s Union

C.J. Scallon, MPsy, Director, Critical Incident 

Stress Management / Peer Support Unit 

Sergeant, Norfolk (Virginia) Police Department; Vicarious Trauma Fellow, Northeastern University and the International 

Association of Chiefs of Police

John Violanti, PhD, Research Professor, 

Department of Epidemiology and Environmental Health, University of Buffalo 

 

xix

How to Read This Guide

This guide was written for law enforcement executives but with two different types of readers in 

mind. You may be interested because you want to build resiliency in your agency and prepare for 

a mass casualty event. In that case, you will have some time to read carefully and make a plan to 

ensure officer mental wellness is a priority. Alternatively, you may be reading this guide because 

a mass casualty event has occurred and 

you need guidance. You do not have time 

for in-depth discussion—you need to 

know what other chiefs recommend, and 

you need to know it fast. 

To assist both types of readers, this guide 

offers nuanced explanations and narratives as well as quick facts, tip sheets, and summaries. We hope you can quickly find what you 

need via the detailed table of contents and the keyword index. 

Trauma experts distinguish between the before, during, and after of a traumatic event. Where 

you are on this timeline, as an individual and as an agency, determines what information you 

need. That’s why this guide is structured like a timeline. 

Chapters 1–4 deal with what you need to know to prepare to support officers before a 

mass casualty event. The only time you have to prepare for a mass casualty event is before 

one occurs. Thus, these chapters provide chiefs with the information they need to start building 

a more resilient force and preparing for a mass casualty event. Chapter 1 explains why officer 

mental wellness is important to any law enforcement agency and defines what we mean by psychological trauma and resiliency. Chapter 2 includes recommendations for building resiliency in 

your agency—these are valuable steps regardless of whether you ever experience a mass casualty 

event. Chapter 3 lays out specific steps for preparing for a mass casualty event, and chapter 4 

discusses what you need to know about working with the media during a high-profile incident 

and how to prepare now.

Chapter 5 includes what you need to know during a mass casualty event. This is the most 

important chapter for chiefs in an immediate crisis. It offers fast and practical advice and helps 

everyone understand what is instantly needed during a mass casualty event. 

Where you are on this timeline, as an 

individual and as an agency, determines 

what information you need.
Preparing for the Unimaginable: How Chiefs Can Safeguard

Officer Mental Health Before and After Mass Casualty Events

xx

Chapters 6–8 deal with the aftermath of a mass casualty event. These chapters deliver 

crucial details on the aftermath of a mass casualty event and will guide chiefs through the long 

struggle toward a new normal. These chapters identify new challenges that your community 

and your agency, your officers, and your leadership will face, as well as strategies for addressing 

those challenges. The chapters are laid out chronologically, but we did not attach specific time 

frames to each chapter because situations evolve differently in each community. Chapters 6–8 

are also important for chiefs who are preparing their agencies for a mass casualty event and thus 

are interested in a fuller picture of the challenges they may face. While these chapters do not 

provide a comprehensive summary of every possible challenge that occurs after a mass casualty event, they do run the gamut from how to deal with outsiders visiting your community to 

how to resolve internal conflicts. Separating officer wellness from this array of issues is difficult 

because officers can feel traumatized by the incident, then stressed by the overwhelming workload, and then left behind if their command staff doesn’t seem supportive.

The handout section at the end of this guide provides resources that we have assembled for

various situations along the timeline. For example, you can distribute them now for educational 

purposes or use them to help support officers after a traumatic incident. They are meant to be 

copied, shared, and discussed. 

In the end, officer mental wellness is not a subject that can be tackled in a few bullet points. We 

hope this comprehensive guide will allow you to access critical information from various angles, 

either piece by piece or in one complete read. 
Part One. 

Why Mental Wellness Matters 

to You and Your Agency

Contents

1. Understanding Trauma and Resiliency.3

Stories from the field 3

Chief John Edwards’ story: Overcoming PTSD 3

Lori Kehoe’s story: The impact of trauma on law enforcement spouses 6

Sergeant Andy O’Hara’s story: Managing cumulative PTSD and helping 

to prevent officer suicide. 

Sergeant Mark DiBona’s story: Using his personal struggles to help other cops10

Police officers aren’t immune to trauma 13

The immediate impact of traumatic events 14

The long-term impact of trauma 16

Unresolved trauma is an officer safety issue.17

Psychological resilience 19

Do we need to change law enforcement culture to promote resilience? 21

 

1
Preparing for the Unimaginable: How Chiefs Can Safeguard

Officer Mental Health Before and After Mass Casualty Events

2
 

3

1 Understanding 

Trauma and Resiliency 

For many chiefs, the prospect of a mass shooting in your backyard is enough to start asking 

questions about officer mental wellness. The truth, however, is that day-to-day police work 

includes enough stress and exposure to trauma for chiefs to be concerned about every officer’s 

mental wellness, whether or not you ever experience a mass casualty event. With that in mind, 

the following stories share some officers’ experiences confronting and overcoming mental 

health concerns. 

Stories from the field

Note: The following stories are available in the handouts section in a photocopier-friendly 

format for distribution.

Chief John Edwards’ story: Overcoming PTSD

John Edwards is the chief of police in Oak Creek, Wisconsin. He oversaw the 

police response to the 2012 shooting at the Sikh Temple of Wisconsin, where 

a white supremacist killed six worshippers and injured four others, including 

a police officer.

In 1989, I had been on the job for four years. One night, I was working the third shift when I 

came across an individual at a truck stop off the interstate. There was a car in a back area, where 

I would normally run into prostitutes, and I saw two people in the backseat. 

When I saw the car, I felt something was wrong. They train us to trust the hairs on the back of 

our necks. I started to walk around the car, and I saw an Indiana plate. I knew immediately who 

it was. The FBI was looking for an escaped prisoner who had tried to shoot a sheriff’s deputy in 

Indiana and taken a hostage before fleeing north with a prison employee who helped him escape.
Preparing for the Unimaginable: How Chiefs Can Safeguard

Officer Mental Health Before and After Mass Casualty Events

4

As I was walking around the car, the driver got out of the backseat and came around the other 

side with two guns. He shouted, “Put your hands up! Get on the ground! Get on the ground!” 

Later on, when interviewed, he admitted that his plan was to get me on the ground, handcuff 

me, and then execute me. 

I decided not to lie down on the ground. I had my hands raised, and I knew the gun would 

not penetrate my vest. I was young and agile, so I turned, put my head down, and ran. I knew 

I would get shot in the back. A bullet went 

through my jacket and my badge. Another hit 

me in the hand, which threw me off balance. 

I got behind a car, and I took my gun out to 

engage him. But he was already in the car, 

leaning out the open window and pointing his 

guns back in my direction. I was going to shoot him, but I saw two people just behind him at the 

gas station in the line of fire, so I ran to my car and chased him on the expressway, into the next 

county south. 

He and his accomplice stopped at a farm and holed up in a barn. His accomplice was a psychiatrist, and she had medication on her. They both took medication and overdosed. When they 

were found, they were unconscious but alive. 

When he went to trial, the jury found him guilty of reckless use of a weapon but not guilty 

of attempted murder. They said if he’d been trying to kill me, he would have hit me more 

than twice. 

When these things happen, you either get angry, or you go into a shell. A doctor asked me later 

what I would have done if I had been able to stop them. I would have shot them both. That’s not 

what you are supposed to do, but I was just so angry that they had tried to kill me.

Right afterward, I was at the hospital. There was nothing life-threatening about my injuries, but 

it hit me that I almost died. I went back to the police department, and they interviewed me right 

away. Later, we found out that my interview was completely wrong. I swore that the woman’s 

hair was white blonde, and it was actually black. I got tunnel vision and focused on the gun. I 

could probably still tell you the serial number on that gun, but I got all the other details wrong. 

Now I know that there’s an adrenaline dump during these incidents, and a rest period is needed 

to remember correctly. 

They said if he’d been trying to 

kill me, he would have hit me more 

than twice.
Part One. Why Mental Wellness Matters to You and Your Agency 

1. Understanding Trauma and Resiliency

5

Afterward, I was treated like a hero. I got a letter of commendation and an award ceremony. That 

was really hard because I knew I screwed up. I approached the car wrong. I didn’t see his hands. 

The whole time I was thinking, “Shit, this is wrong. This is wrong.” But I still did it. The hero 

label is a pretty heavy burden to put on somebody who knows they made a mistake. 

When I got back to work after two months of medical leave, the chief called me into his office. 

The chief was a World War II vet, and his whole office was a memorial to World War II. He said, 

“I always like to talk to someone who has tasted a bit of the lead. You hear about these doctors, 

but you don’t need doctors. You just need to suck it up.”

So I did. I sucked it up for about two years. I was paranoid on calls. I was hypersensitive. It got 

so bad that once an elderly man asked me to unlock his car for him, and I made him stand 50 

feet away. 

I couldn’t sleep. Once, my wife moved in her sleep, and I jumped up on top of her and grabbed 

her by the throat. 

When a new chief came in, I decided I couldn’t take it anymore. I told him I needed help, that 

I had to go see someone. He took my gun and badge away for seven months. He said he wasn’t 

letting anyone get a disability on his watch. I had just gotten married, and my wife was pregnant. 

I went to several doctors, and they all said, “This guy isn’t lying. He does have PTSD,” but that 

wasn’t enough for the chief. Post-traumatic stress disorder wasn’t as well known back then. The 

mayor got wind of what the chief had done and intervened. I was finally able to get my job back 

and get reimbursed for all that time. 

More than 20 years later, the Sikh Temple shooting brought back my PTSD. It was about two 

or three days after the shooting, and I went to the hospital to see Lieutenant Brian Murphy, the 

officer who was shot during the incident. His wife was sitting next to him in the hospital room. 

He couldn’t communicate, so I took her out into the hallway and tried to explain the disability 

benefits to her. A few nights later, I woke up at 3 a.m., and my bed was soaked. I was sweating 

profusely, crying uncontrollably, shaking, and trembling, just like after my shooting. The scene 

of Brian in the hospital bed is what brought it all back. It was a snapshot of many years before 

when I was in the hospital after my shooting, my wife was in the chair next to me, and my sergeant came in to talk to me and my wife. 
Preparing for the Unimaginable: How Chiefs Can Safeguard

Officer Mental Health Before and After Mass Casualty Events

6

When I came into work, I called my captains into my office, and I broke down. I told them, “You 

cannot tell the officers; the supervisors can’t know.” But I wanted the captains to know so they 

could watch out for me. 

The Milwaukee area has police officer support teams to assist officers after a critical incident. 

I called in a lieutenant from Milwaukee to come to one of my staff meetings and talk with the 

supervisors about what they were feeling. The room was very quiet. At that point, I felt that I 

had to tell them what had happened to me. I told them that I didn’t want them to have to deal 

with that. It was important for them to know it’s okay if it happens, and don’t suck it up. 

I went to see a psychologist who works with us at the police department. I spent about three 

hours talking, getting a tune-up. It reassured me and got me back on track.

One of the things I’m doing now is trying to create a branch of the city employee assistance 

provider (EAP) to provide six visits to a psychologist or psychiatrist for police- and fire-related 

PTSD. The city pays for it, but they don’t look at the medical records. This is not part of the disability determination process, and we control the network of doctors, so we know that officers 

can’t use it to game the system. The goal is that early intervention can make it not as severe as it 

was for me and can prevent worker’s comp claims down the line. n

Lori Kehoe’s story: The impact of trauma on law enforcement spouses 

Lori Kehoe, RN, is a former hospice nurse and advocate for her adult son with 

special needs. She is also the wife of Michael Kehoe, the retired chief of police 

who oversaw the law enforcement response to the 2012 Sandy Hook school 

shooting in Newtown, Connecticut.

December 14, 2012, the day of the Sandy Hook school shooting, was very long. I did not expect 

Mike to come home that night. After all, they had cots at the police department; they had uniforms and showers. When he did arrive home at midnight, he talked and talked until he passed 

out in the middle of a sentence. At 6:00 a.m., he was out the door. I offered to answer phones or 

e-mail. His answer was “no, I got it covered.” I offered to make him breakfast, and the answer—

which became a common phrase in our home—was “no, I got it covered.” It was rare that he 

needed me for anything.

This became the schedule: 6:00 a.m. to midnight. Mike was not available to talk on the phone, 

so our time was from midnight to two in the morning, when he would talk and tell me every 

little detail of the day. Each night it was necessary for Mike to decompress, and I saw it as my 
Part One. Why Mental Wellness Matters to You and Your Agency 

1. Understanding Trauma and Resiliency

7

job to be available and to listen and do whatever he needed. He would continue to literally fall 

asleep talking. When Mike started yelling in his sleep, I could tell he was reliving the incident. 

This schedule lasted for about four months, and it became extremely isolating. 

Many family and friends were supportive, but a lot of people couldn’t deal with the trauma. They 

would break down crying on the phone. Or people were afraid to call because they didn’t want 

to intrude. And the last thing you want to do when something dramatic like this happens is 

dump it all on someone who can’t handle it. I relied on the people who called me to be my support system, because I didn’t dare reach out. I was 

isolated but, at the same time, saturated with the 

media. Newtown was on the news for three or four 

days straight. You couldn’t turn on the TV without 

seeing it.

Mike does not get upset. He is always cool, calm, 

and collected. He doesn’t bounce off the walls. A 

few weeks after the shooting, he came home and was pacing and absolutely agitated beyond 

agitated. He was concerned about his officers committing suicide. He expressed his concerns, 

and we came up with options for him to execute the next day. I was always the sounding board, 

bringing whatever common sense I could muster to the table.

Those were the days when I would wonder, whom do you call for answers? After all, isn’t there 

always someone to call for help in life? When you got a flat tire, you call your dad. If your cake 

won’t rise, you call your mom. I realized there is no one to call when 20 children get blown away 

in your town. You’re watching your partner struggle with all these questions and no answers. 

After 20 years as a hospice nurse, I understand grief and crisis. Without that experience, we 

probably wouldn’t still be married. Understanding the process of grief, I was able to identify a 

little anger this week, depression the next, bargaining, denial. Recognizing those stages allowed 

me to give Mike all the room he needed and understand the changes that were happening.

He was suddenly in control of everything. All of a sudden, he was telling me what to do and 

when. It was bizarre from a man who never gave orders at home. Then I realized he needed to 

be in control, to maintain order. He was spending his days making rapid-fire decisions continuously for weeks on end.

I went to the police department the day after the event. When I got off the highway, life changed. 

There was an officer and his town car on every corner for the entire length of the town—

hundreds of officers in a little quaint country one-horse town, where they usually had no more 

Recognizing those stages [of grief] 

allowed me to give Mike all the 

room he needed and understand the 

changes that were happening.
Preparing for the Unimaginable: How Chiefs Can Safeguard

Officer Mental Health Before and After Mass Casualty Events

8

than five officers on a shift. The police department was inundated with flowers, food, and gifts—

so much that they almost couldn’t do their jobs. Then I knew why he had everything covered: 

I suppose if you had 5,000 cops at your beck and call, you’d have it covered too. 

Finally in August (nine months after the shooting), Mike came home and said, “I got to something on my desk today that was on my desk before December 14.” I thought to myself, “It’s 

August, and the trauma is finally over.”

A year after the shooting, I was mentally and emotionally not functioning, almost to the point of 

not getting out of bed. And even though I’m a nurse, I didn’t know about trauma—I didn’t know 

what trauma could do to a person or that there was such a thing as PTSD by association. I was so 

angry. I was mad at everyone and everything. I was depressed beyond belief, alone, and isolated.

The first anniversary was a turning point. The media stayed away, and I realized it was going to 

start simmering down. I realized it was not my job to take care of Mike any longer. So I went 

online and googled “law enforcement spouses and trauma,” and I found a treatment center 

called the West Coast Post-Trauma Retreat in California. They had a week-long spouses’ treatment program a couple of times a year.

I called them expecting them to turn me down because Newtown was such a large incident—

I didn’t want my trauma to overshadow someone else’s. Instead, they interviewed me on the 

phone and said, “It sounds like you could use our help. Come on out.” They taught me that the 

trauma actually changes your brain—you can see it on an MRI. In addition to five full days of 

intervention and counseling, they did a physical treatment on me called eye movement desensitization and reprocessing (EMDR). It’s designed to reduce the emotion that goes with the 

thoughts about the traumatic experience. It was extremely effective.

The treatment was necessary, and it changed my life. I absolutely came back a new woman, and 

I got better and better after treatment. Today, we’re good.

I think education is so important. If an incident like this affects the officer, it affects the family. 

They may never talk about it, but it’s still happening. And in some ways, I was lucky—many 

people react to trauma with alcohol abuse and out of control behavior that creates chaos. That 

did not happen to my officer.

You need to know that when a trauma occurs, alcohol abuse, depression, and chaotic behaviors 

can be symptoms of PTSD. Whether it is the officer or the family member displaying symptoms, 

you need to know what it looks like and that it is a physical injury. There is treatment. You can 

and must do something about it. n
Part One. Why Mental Wellness Matters to You and Your Agency 

1. Understanding Trauma and Resiliency

9

In police work, the opportunity 

for mistakes is pretty high, and 

they haunt you.

Sergeant Andy O’Hara’s story: Managing cumulative 

PTSD and helping to prevent officer suicide

Andy O’Hara is a retired California Highway Patrol officer and the founder 

of The Badge of Life, an organization of active and retired law enforcement 

officers dedicated to preventing officer suicide.

Rather than coming from one incident, my PTSD was cumulative. I compare all the things that 

happen on a regular basis in police work to bee stings: One is tolerable, but as they build up, the 

pain becomes overwhelming.

In the course of my career with the California Highway Patrol, I accumulated 24 years of traumatic experiences—11 years as a sergeant and the rest as a traffic officer. I spent most of my 

career on the road, so I saw accidents on a daily basis. Some were gruesome: decapitations and 

dismemberments. I heard a lot of screams, and honestly you become tired of them. I responded 

to murders and suicides, backing up our local police departments. I saw injured and abused 

children. I was assaulted.

Probably the biggest incident that finally triggered a full blown case of PTSD was when an officer 

of mine was killed. He wanted to work overtime, and I knew he was tired. He pleaded with me 

to work, and I didn’t want him to, but I relented and 

let him. He fell asleep on his motorcycle. I responded 

to the scene and half of his head was missing.

Cumulative PTSD can be difficult to treat because 

you’ve got so much to deal with. You get into feelings 

like guilt and self-blame. You’ve got mistakes—dirty little secrets and mistakes in judgment. 

Everybody makes mistakes. In police work, the opportunity for mistakes is pretty high, and they 

haunt you. You take a lot of responsibility for things that happen on the road. Officers think 

about how they might have prevented it, how they might have gotten there sooner. All the “what 

ifs” will kill you.

It all begins to compile and becomes a big bundle of yuck that catches up to you in nightmares, 

depression, and flashbacks. 

After my officer died, I took the blame for it. I couldn’t forgive myself. I went through crying

spells. My temper flared at home and at work. It became explosive. I started having panic attacks 

and anxiety. I started withdrawing. I became almost agoraphobic. The flashbacks reached a point 

where I couldn’t sleep. I tried alcohol as a coping technique, and it worked: I could sleep.
Preparing for the Unimaginable: How Chiefs Can Safeguard

Officer Mental Health Before and After Mass Casualty Events

10

I was a closet drinker. At first, I always quit 8 to 10 hours before work, but eventually I became 

an alcoholic. I was starting to show up to work with the odor of alcohol on my breath. Ultimately, drinking just made it worse; I wasn’t able to suppress the feelings with the alcohol.

I started to get scared of losing my career. And there was pressure from my wife. I knew I had to 

quit drinking, and when I did I felt worse because I didn’t have the sedative effects of the alcohol 

to overcome the flashbacks and anxiety.

About a year later, I became suicidal and went into the hospital. I’ve been on meds and in therapy since then, and I eventually retired on disability.

I’ve been able to manage my problems. You don’t cure PTSD; you learn to manage it. I’ve been 

able to manage the depression, the flashbacks, and the problems sleeping. But I still get panic 

attacks and anxiety, especially in traffic and in crowds. I don’t handle stress very well. When I 

was on patrol, I was the figure of calm; nothing could bother me. Today, even driving is a challenge for me.

After I had gone through a lot of recovery, I reflected back on things that I could have done to 

avoid the predicament I got into. It never occurred to me to get into therapy during my career; 

I had never even heard of therapy. But it works pretty well. If I had gotten therapy back then, I 

might not have had to retire.

I got to thinking about why officers don’t try therapy or medication. There are officers suffering 

from anxiety and PTSD, and they are determined to suffer through it for the rest of their lives. 

I think in this day and age, when officers are being questioned on a lot of things (shootings, 

arrests, and brutality), a lot of that could be avoided through some good therapy. And I think 

people are scared of medication. Medication doesn’t necessarily affect your ability to work, but 

officers don’t know that. n

Sergeant Mark DiBona’s story: Using his personal 

struggles to help other cops 

Mark DiBona is a deputy sheriff with the Seminole County Sheriff’s 

Department in central Florida and is on the board of directors for 

The Badge of Life.

It was my lifelong dream to be a cop, and I started on the job at age 21. I’ve been in law enforcement for 30 years and a supervisor for 17.

About eight years ago, I was going through some tough times at work. I wasn’t getting along 

with my immediate supervisor. We were both alpha males, but we had completely different 

styles of working and supervision. He was hard headed and strict, and I tried to be approachable 
Part One. Why Mental Wellness Matters to You and Your Agency 

1. Understanding Trauma and Resiliency

11

to my guys. I felt he was very disrespectful. We became argumentative, insulting each other. He 

told me I wasn’t aggressive enough, that I had to be harder on my guys. I took things to heart. 

He gave me an evaluation of “below standards.” I felt worthless, like maybe he was right, maybe 

this job wasn’t for me anymore. I felt like I couldn’t do anything right.

This went on for a few months. It affected 

me physically. I gained 40 pounds. I refused 

to shave. I started coming in with my uniform wrinkled. I didn’t go to my wife for 

help. I thought, “If you aren’t a cop, you 

don’t understand.” The stigma is if you show 

a weakness, if you say something’s bothering 

you, they look at you like you are weak.

So all this is already happening, and one 

night I am at the fire station, and a woman pulls up in her car. She cried, “My baby isn’t breathing!” Just before she pulled up, the firemen had gone out on a call, so I did CPR on the baby. It 

seemed like I did CPR for an hour. 

The baby died. I went to the funeral and the wake. I started to get nightmares about him, like 

maybe I could have done better. I can still feel that baby in my arms.

I told my boss, and he said, “You were just doing your job,” like it wasn’t a big deal.

I started feeling more worthless. I had lots of nightmares, waking up in cold sweats. I started 

thinking about the baby that died, and all the other stuff came up too: the horrible crashes I’ve

seen, the victims of sexual abuse, the victims of robbery, the bad guys, the friends who died in 

the line of duty. I thought, “I don’t want to be a cop anymore because this line of work sucks.” 

One night, it hit me: This job is not for me; I’m failing really fast. I tried to fight the thoughts, 

but I felt like I was drowning. I attempted suicide twice that night. 

I got lucky. A car pulled up, and it was another cop. He talked me down. I went home because 

I couldn’t go back to work that night. I was afraid of losing my job. I thought they would take 

away my gun and put me in the hospital.

I called a close friend in Boston. He said he wanted me to come up there to get help. I went to 

Massachusetts and got some therapy, and then I went back to Florida a week and half later. I 

bounced back and forth between therapists. It wasn’t clicking because the therapist didn’t have 

any police background. I didn’t go to the employee assistance provider because they are countywide, not specialized to police. I just wasn’t in my comfort zone.

I was diagnosed with PTSD and 

depression. I’m on medication, and it’s 

helped me to focus. I was concerned 

about the meds; could I still be a cop? 

But I can; it’s not a problem whatsoever. 

I’m still an active deputy sheriff.
Preparing for the Unimaginable: How Chiefs Can Safeguard

Officer Mental Health Before and After Mass Casualty Events

12

It was a difficult time in my life. I saw a person in me that I’d never seen before. There’s that 

Michael Jackson song, “The Man in the Mirror.” When I looked in the mirror, I didn’t like the 

guy I saw. I didn’t like his looks; I didn’t like him. I felt weak. I knew in my heart that something 

was wrong, but it was hard to accept when I was diagnosed.

I stopped going to therapy, and I started looking on online. I found fascinating articles about 

police mental health, suicide, stigma, and an organization called The Badge of Life. I never 

realized that support was out there. I had a friend, a fellow officer, who committed suicide, but I 

thought it was just a family problem.

I started to go to a support group in central Florida, just cops talking to cops. I found a therapist 

who is a retired cop. During the course of all this, I got my marriage back on track. I felt guilty

about the way I treated my wife, and I apologized. She had felt helpless. She was trying to get me 

help, and I wouldn’t take the help.

I was diagnosed with PTSD and depression. I’m on medication, and it’s helped me to focus. I was 

concerned about the meds; could I still be a cop? But I can; it’s not a problem whatsoever. I’m 

still an active deputy sheriff.

I’ve never had a suicidal thought since. I still have the nightmares, just not as much as I used to. 

I just feel a lot better now. I lost the weight I gained. I don’t let it ruin my everyday life, ruin my 

job, ruin my marriage. On the days when I feel down, I’ve learned to control that—the anxiety, 

depression, and PTSD.

The biggest problem I have now is the stigma. When I’m open about it, the guys look at me 

funny. But there are others; when they hear my story, they come up to me and say, “Can I talk 

to you for a second?” There’s nothing better than helping another cop through the issues that I 

experienced. 

I really enjoy my life now, when for years I didn’t. I still love being a cop. n
Part One. Why Mental Wellness Matters to You and Your Agency 

1. Understanding Trauma and Resiliency

13

Police officers aren’t immune to trauma

For police officers, traumatic experiences are an occupational hazard: responding to car accidents, homicides, child abuse, domestic violence, and similarly negative events are part of the 

job. Law enforcement culture values self-reliance, stoicism, and strength. Officers, the thinking 

goes, can “suck it up” and continue working, so it is easy to assume that officers who are fit for 

duty are, by nature, resilient. 

However, resilience can be a matter of degree, and not all traumatic events are created equal. 

For example, most people are resilient enough to read about the death of someone they did 

not know without becoming overwhelmed by anxiety. But when they read about the death of 

a friend, they react more strongly. Similarly, most police officers may be able to tolerate a more 

vivid exposure to death or violence than the general public, but there are situations, such as 

mass casualty events, where the traumatic stress simply exceeds an officer’s ability to cope without support. 

Officers can also experience cumulative trauma. As they encounter death, injury, and dangerous 

situations with some regularity, the impact of these experiences can accumulate over time. These 

events do not make an officer tougher. Rather, research shows that the more traumatic incidents 

someone experiences over the course of a lifetime, the more likely another event may tip the 

balance. Even officers known to be resilient may find recovery harder after yet another incident 

or after a particularly stressful incident. 

DEFINING PSYCHOLOGICAL TRAUMA

Psychological trauma is what we call a person’s emotional response to an 

extremely negative experience, such as suffering life-threatening danger, injury, 

or abuse; witnessing the death of others; or losing a colleague in the line of 

duty. Experiencing a traumatic incident does not mean someone is damaged or 

doomed to develop post-traumatic stress disorder (PTSD). Such an experience 

simply means that the event occurred, is now part of a person’s sensory memory, 

and needs to be processed and integrated. 
Preparing for the Unimaginable: How Chiefs Can Safeguard

Officer Mental Health Before and After Mass Casualty Events

14

In an environment where frequent exposure to trauma is part of the job, recognizing the consequences of cumulative trauma can be particularly challenging. You may think an officer is 

resilient because he shows up at work every day but not know that he drinks every night to fall 

asleep. Similarly, an officer might be struggling with marital problems or suicidal thoughts and 

not recognize that the roots of those problems may lie at work and can be addressed with psychological support.

Another challenge to understanding the impact of trauma is that reactions can change over time. 

An officer who seems to be doing well may suddenly begin to struggle months or years later 

when confronted with an unwelcome reminder of the event. Or an officer may gradually become 

depressed and not recognize that the depression relates to the traumatic event. 

To understand what fosters resilience and what types of support officers need after a traumatic event, we need to first take a closer look at how our brains and bodies respond to 

traumatic events. 

“Rather than coming from one incident, my PTSD was cumulative. 

I compare all the things that happen on a regular basis in police 

work to bee stings: One is tolerable, but as they build up, the pain 

becomes overwhelming.”

— Sergeant Andy O’Hara (ret.), California Highway Patrol

The immediate impact of traumatic events

Most human beings have a similar biological response to a traumatic encounter. When we fear 

for our lives or experience another traumatic situation, adrenaline floods our bodies, making us 

more vigilant and helping us to survive. Everyone, no matter how experienced or disciplined, 

experiences this fight-or-flight response, during which all nonessential systems in the body shut 

down so energy can be directed toward the systems needed to either fight or flee. 

This response affects our bodies in several ways:

zzSha king, especially of the hands. 

zzStomach butterflies. The overall shutdown of all nonessential systems includes the digestive 

system. Throughout the day, the digestive tract constantly moves and contracts. When this 

stops, it creates the sensation of butterflies or knots.
Part One. Why Mental Wellness Matters to You and Your Agency 

1. Understanding Trauma and Resiliency

15

zzTunnel vision. The visual field narrows. Officers often express concern that they did not see 

certain aspects of a scene (e.g., a pedestrian walking by or a car driving by); however, they 

cannot control this physiological response. During a fight-or-flight experience, if you choose 

to fight, you generally need to focus only on the object that poses the biggest risk (a gun, a 

knife, etc.). If you choose flight, you need to see only the escape route. Tunnel vision focuses 

your attention on your maximum chance of survival.

zzTunnel hearing. As with tunnel vision, the brain focuses only on the sounds it perceives as 

essential for survival and filters out anything extraneous. For example, officers may not hear 

someone shouting at them, or some shouts may sound muffled to officers during a fight-orflight situation. 

zzAmnesia. Research suggests that high levels of stress can negatively impact memory, particularly short-term memory for simple facts. When faced with fight-or-flight decisions, the brain 

is concerned with survival, not detail. For example, law enforcement investigators might ask 

officers how many rounds they fired 

from their weapon during a critical incident, but some officers may not know 

because the brain was not concerned 

with bullet count; the brain was concerned with stopping the threat.

Once our safety and the safety of others 

are ensured, we try to regain a sense of 

normalcy over time. Our common biological reactions turn into more complex, individual coping mechanisms. Many people 

experience nightmares, anxiety, numbness, 

or anger—the range of normal reactions is 

wide. While these responses to a traumatic 

event can be upsetting or unexpected, 

that does not necessarily mean they are 

unusual or a sign of a persistent mental 

health problem. However, just because 

officers may be having a normal reaction 

to a traumatic event does not mean they shouldn’t have support to deal with their response; in 

fact, support from the agency, from family and friends, and from mental health professionals can 

help officers return to the baseline of normal functioning more quickly. 

“[After the shooting,] I went back to the 

police department, and they interviewed 

me right away. Later, we found out that 

my interview was completely wrong. I 

swore that the woman’s hair was white 

blonde, and it was actually black. I got 

tunnel vision and focused on the gun. 

I could probably still tell you the serial 

number on that gun, but I got all the 

other details wrong.” 

— John Edwards, Chief of Police, 

Oak Creek, Wisconsin
Preparing for the Unimaginable: How Chiefs Can Safeguard

Officer Mental Health Before and After Mass Casualty Events

16

It’s important to note that having a strong reaction to a traumatic event is not a sign of weakness. The slight differences in how officers can experience a particular event, such as how close 

they were to the victims or how long they spent at the scene, can influence the intensity of their 

individual responses. Even with identical exposures to a traumatic event, officers’ responses 

will differ based on factors like how they cope with stress, availability of social supports, prior 

trauma experience, and the overall stress in their lives.

The long-term impact of trauma

Everyone has their own timeline for healing from a traumatic incident. It is hard to predict who 

will improve and who will struggle. Most people recover after a traumatic incident, but some can 

develop more persistent or serious mental health conditions. This is not a sign of weakness or 

lack of willpower.

Serious problems can include depression, anxiety, PTSD, alcoholism, marital problems, or 

thoughts of suicide. If they arise, mental health conditions are generally not diagnosed until 

months and sometimes years after the traumatic experience. One reason for this delay in diagnosis is that many people react strongly to traumatic situations but recover on their own in a 

matter of weeks or months. For others, the symptoms and challenges may not be obvious, they 

may not understand that they are dealing with the effects of trauma, or they may not be willing 

to seek help. Sometimes people experience a delayed reaction: Someone who seemed fine may 

have a strong reaction at the anniversary of the event or when there’s an unavoidable reminder, 

like the trial of the perpetrator. 

Not all serious outcomes can be prevented, but many people can be helped and return to normal 

life even after a serious mental health problem; the sooner support is available, the better. Many 

long-term negative outcomes can be mitigated or prevented by building a resilient agency, promoting healthy coping strategies, and providing proactive support from a mental health professional. 
Part One. Why Mental Wellness Matters to You and Your Agency 

1. Understanding Trauma and Resiliency

17

Unresolved trauma is an officer safety issue

In addition to its personal impact on officers, unaddressed trauma can create an officer safety 

and work performance issue. 

A lot has been learned in recent years about how military service can traumatize soldiers. Soldiers with PTSD can become counterproductive on duty and even destructive once back in their 

normal lives, for example by becoming a threat to themselves and their families. Suicide and 

domestic violence rates are high among veterans of recent wars. 

While much less studied, police officers straddle a similar divide between life on and off duty. 

While doing their jobs, they may see the dark side of humanity in all its unimaginable forms and 

need their normal stress response to stay alive. Then they go off shift and are expected to switch 

off that reaction. Because that is not always possible, suicide, alcoholism and similar unhealthy 

coping mechanisms can be a problem for law enforcement officers.1

1. Robert Kroll, “Managing the Dark Side: Treating Officers with Addiction,” The Police Chief 81, no. 9 (September 

2014), http://www.policechiefmagazine.org/magazine/index.cfm?fuseaction=display_arch&article_id=3492&issue_

id=92014#2.

Unresolved trauma can negatively 

affect behavior both at work and 

at home. If an officer suffers from

undetected PTSD, for example, he 

might be hypervigilant on the job, 

just as Chief Edwards describes 

in his story from the field (quoted 

on page 3). Hypervigilance is 

an important part of the trauma 

response as it helps us focus on the 

most essential information in a life-threatening situation. But when a threat has passed, hypervigilance can lead to behavior that is at best inappropriate and at worst unsafe (such as when a 

hypervigilant officer perceives a threat where others do not and shoots too soon). 

Officers can also exhibit unsafe or unusual behavior when exposed to a trauma trigger. In a 

traumatic situation, our brain carefully registers all information coming in from the senses: What 

we smell, see, hear, taste, and touch when we are under maximum stress will be stored together 

with the biochemical equivalent of a massive warning sign. If an officer noticed a distinct smell 

“I was paranoid on calls. I was hypersensitive. 

It got so bad that once an elderly man asked 

me to unlock his car for him, and I made him 

stand 50 feet away.” 

— John Edwards, Chief of Police,

Oak Creek, Wisconsin
Preparing for the Unimaginable: How Chiefs Can Safeguard

Officer Mental Health Before and After Mass Casualty Events

18

during a traumatic incident, encountering the same smell months later can send him immediately back into survival mode. Officers need to understand and anticipate potential triggers to 

be confident and safe. 

Avoidance is another common coping mechanism in the aftermath of trauma that can backfire if 

it does not recede: Some officers, often to their own surprise, may not react to a threat as readily 

as they used to because they are instinctively avoiding additional stress. Some officers may avoid 

situations that remind them of a traumatic event—a survivor of a car accident may avoid highways, for example.

These and other aspects of unresolved trauma also carry into officers’ private lives and can make 

relationships complicated. In one recent study, for example, law enforcement officers with PTSD 

were four times more likely than those without PTSD to use physical violence in an intimate 

relationship; those with an alcohol dependency were eight times more likely than those who 

were not dependent on alcohol to physically attack a partner.2

Acknowledging that no one is immune to the impact of trauma allows chiefs to take a fresh 

look at some well-known challenges around officer mental health in law enforcement agencies. 

Providing adequate mental health services for officers can help them process a traumatic event 

and improve their performance. It’s not just the right thing to do—it is essential to maintaining 

a healthy and strong force. 

2. Karen Oehme et al., “Alcohol Abuse, PTSD, and Officer-Committed Domestic Violence,”Policing 6, no.4 (2012), 

418–430, http://policing.oxfordjournals.org/content/6/4/418.abstract.

 “There are officers suffering from anxiety and PTSD, and they are 

determined to suffer through it for the rest of their lives. I think in this 

day and age, when officers are being questioned on a lot of things 

(shootings, arrests, and brutality), a lot of that could be avoided 

through some good therapy.”

— Sergeant Andy O’Hara (ret.), California Highway Patrol
Part One. Why Mental Wellness Matters to You and Your Agency 

1. Understanding Trauma and Resiliency

19

“In order to deliver professional, compassionate, and respectful 

policing services to the community, it makes sense that we take 

care of our own mental health and well-being, too—before you can 

take care of others, you have to take care of yourself. So it is vital 

that officers have the support, tools, and education to ensure 

healthy interactions.”

— Inspector Karen Meyer, Wellness Unit Manager, 

Ontario Provincial Police

Psychological resilience

It’s important to know that after trauma, individuals cannot and probably should not go back to 

being the exact same people they were before. They grow and learn. They remember and think 

differently. They have moments when they are overcome by the stress but also moments of hope 

and optimism. This is psychological resilience, which simply means that a person who has had 

a traumatic experience is able to adapt and move past that experience over time. 

People used to think that we are all born with different degrees of resilience and there’s no way 

to change the baseline—people are either resilient or they are not. 

DEFINING PSYCHOLOGICAL RESILIENCE

Psychological resilience is an individual’s or a community’s ability 

to recover after a traumatic event. Resilience is not about being 

unaffected by negative emotions—almost everyone has negative 

feelings after a traumatic experience. Instead, resilience is the 

process that helps us balance negative emotions with positive ones 

and choose coping strategies that enable a gradual recovery. Someone who is resilient will react to a trauma in ways that reduce the 

risk of long-term problems. 
Preparing for the Unimaginable: How Chiefs Can Safeguard

Officer Mental Health Before and After Mass Casualty Events

20

Today, we know that resilience is more fluid than that. It is better to think of resilience as a 

process rather than just a trait. While some factors that can increase resiliency—such as having a 

sense of humor or having strong religious or spiritual beliefs—are not easily changed after someone has been traumatized, the right support systems can help most people recover successfully 

and prevent mental health problems in the future. 

Support can come from work or personal life. Research suggests that people are more resilient 

when they feel that they are part of a cohesive and supportive group, including in the workplace. 

In a resilient agency officers are able to support each other, and they know that agency leaders 

care about their well-being. Everyone from the top down in your agency needs to know one 

another, have one another’s backs, and support one another in difficult times. 

At home, resilience is strengthened by emotional literacy (identifying and understanding our 

emotional reactions). It is also strengthened by a supportive family and friends and use of 

healthy strategies for coping with stress, like healthy eating, exercise, and sleep habits and taking 

time off to wind down from work.

Sometimes work stress is compounded by other factors that reduce resilience. For example, 

going through a divorce or losing a loved one can make it harder to recover from a traumatic 

event at work. Other risk factors include a personal or family history of depression, unhealthy 

eating or sleep habits, or the lack of access to a supportive group of friends. 

“I don’t think we need to change the culture. The culture is what 

allows a cop to go toward the sound of gunfire and stop a threat. A 

cop’s got to walk with a little bit of a swagger. We need to understand 

the culture better. There are things that need to change a little bit—

like thinking we are Superman, that these things don’t hurt us. Those 

are weaknesses in the culture, and we need to deal with them.”

— Sergeant AJ DeAndrea, Patrol Officer, Arvada, Colorado
Part One. Why Mental Wellness Matters to You and Your Agency 

1. Understanding Trauma and Resiliency

21

Do we need to change law enforcement culture to promote resilience?

Given this information about trauma and resilience, chiefs may be unsure how to safeguard 

officer mental wellness especially after a mass casualty event. Looking back at their experiences, 

chiefs involved in mass casualty events realized that they had to do more than find the right 

mental health professionals and put in place the right supports: They also had to remove the 

taboo around talking about mental health and wellness. 

Law enforcement culture often discourages officers from discussing mental health problems

or from seeking help. Officers often feel their jobs or reputations are at stake if they admit 

to any vulnerability. Instead of reaching out for help, an officer who is struggling may turn 

to unhealthy coping mechanisms such as drinking, aggression, overwork, or even extreme 

exercising—and that’s the case under normal conditions, not in the extraordinary circumstance of a mass casualty event. 

Instead of these unhealthy coping mechanisms, officers need to feel free to make decisions to

care for themselves, such as taking a day off or talking to a mental health professional. Officers 

may also need support to manage stress in healthy ways—like connecting with friends and 

family, moderate exercise, getting enough sleep, and eating well. 

This is not about touchy-feely conversations; it’s about supporting officers’ mental health in the 

same way as you would their physical health and creating an agency culture that keeps officers 

resilient, adaptable, and fit for duty.

 “When I got back to work after two months of medical leave, the 

chief called me into his office. The chief was a World War II vet, 

and his whole office was a memorial to World War II. He said, 

‘I always like to talk to someone who has tasted a bit of the lead. 

You hear about these doctors, but you don’t need doctors. You 

just need to suck it up.’”

— John Edwards, Chief of Police, Oak Creek, Wisconsin
Preparing for the Unimaginable: How Chiefs Can Safeguard

Officer Mental Health Before and After Mass Casualty Events

22

EMOTIONAL LITERACY AT A GLANCE

Police officers are exposed to a significant amount of stress. Stress can be 

energizing or debilitating, and it affects both our physical and emotional 

well-being. Learning how to recognize and deal with stress takes education 

and practice, like any other skill. Preparation pays off, especially in a crisis.

Officers are trained to restrain their emotions. It’s what makes it possible to 

do this challenging work. So, why should you talk about emotions? Because 

this kind of education—being able to recognize, understand, and describe 

emotions—helps us better cope with stress. Fortunately, you can understand 

your emotions without getting lost in them. 

This is called emotional literacy: Learning about our emotional responses the 

same way we learn the alphabet and then beginning to read, understand, and 

act with better information at hand. For example, by knowing how the body 

responds to stress—adrenaline kicking in, leading to shaking hands, tunnel 

vision, and other symptoms—we can “read” our own responses during an incident and avoid confusion about why we react a certain way. 

Emotional literacy allows us to recognize when stress begins to negatively 

affect us. Instead of feeling lost in guilt or shame in the aftermath of a critical incident, for example, we can recognize these are normal reactions to 

trauma and ask for help in dealing with them. 

In short, emotional literacy can help police officers take charge of the mental challenges of police work and keep a clear mind to make safe decisions, 

maintain healthy relationships, and stay strong on the job. 
Part Two. 

Preparing for a 

Mass Casualty Event

Contents

2. Recommendations for Enhancing Resilience in Your Agency Today 25

Take a personal interest in officer wellness. 2

Form a work group to recommend officer wellness programs and education 27

Support the creation of an officer peer support program 28

Find the right mental health service providers to support your officers 32

Review your psychological services policies and procedures 33

Clear communication about new policy ..................................... ................. 34

Encourage family and peer support, not isolation 3

Review the research on early formal intervention after traumatic events ..................... 34

Summary and recommendations based on these research findings 36

Some options for assisting officers shortly after traumatic incidents 37

On day one, provide brief, flexible one-on-one check-ins .................................... 37

Group educational briefings ......................... 38

One-on-one wellness checks at least a few days after the incident 38

Other supports ..................................... 39

 

23
3. Planning the Incident Response for a Mass Casualty Event ................................ 41

Assign a mental health incident commander 4

Build close partnerships with first responder agencies and other leaders 

in your community ........................................... .......... ................ ....... 44

Make a regional or statewide plan .................................... ......................... 47

4. Building Your Media Team and Strategy for a Mass Casualty Event 49

Why you need a media strategy. 4

There will be massive media interest 5

There will be errors and inaccuracies in media coverage ..................................... 50

There will be intrusive behavior. 5

There will also be important reporting ...................................... ................. 52

Social media will play an important role .......................................... ........... 52

How to plan an effective media strategy: Be prepared. 

Be proactive. Own your narrative. .................... ............... ............................ 54

What to include in your media plan 55

Preparing for the Unimaginable. How chiefs can safegurad 

officer mental health and before and after mass casualty events

24
25

2 Recommendations for 

Enhancing Resilience in 

Your Agency Today

While it may seem daunting to plan for a mass casualty event—something unprecedented for 

most law enforcement agencies—there are steps you can take now to prepare for the possibility. And the good news is that these steps will benefit your agency even if you never experience 

a mass casualty event. Starting now is key. After an incident, it will be hard to put together a 

strong mental health plan in the face of many other competing responsibilities.

To get you started, we have outlined steps you can take to address officer mental health in your 

agency. These steps are suggestions based on the experience of a small group of chiefs who have 

lived through mass casualty events, as well as current research on mental health and trauma. 

There will not be a perfect formula that will work for every agency, and your needs and resources 

may vary. But we hope these steps provide useful, concrete ways for you to start building robust 

officer wellness programs and a more resilient agency. 

Take a personal interest in officer wellness

Officers take their cues from the command staff and supervisors, who take their cues from the 

chief. A great mental health support program means little if officers don’t see their leaders take 

a personal interest. Here are some suggestions for how to show that officer wellness is a priority 

for you:

zzAssign someone as your representative on mental health issues, and make is clear this 

individual has your full support. Later in this guide, we outline a role for a mental health 

incident commander to address these needs. You may not be able to be available personally 

to support all your officers, so make it clear that on mental health matters, the mental health 

incident commander is your representative. 

zzBe present and visible for officers after a critical incident. After a traumatic incident, 

officers will look at your reaction to decide whether the agency is taking their well-being 

seriously. Checking in personally with officers who were involved in a critical incident—and 

asking how they are and what you can do to help—will go a long way. 
Preparing for the Unimaginable: How Chiefs Can Safeguard

Officer Mental Health Before and After Mass Casualty Events

26

zzBe supportive and available every day. You can do this by showing up at roll call and having 

an open door policy. If your agency is too large for you to make personal contact with all your 

officers regularly, set the example with your command staff and supervisors and direct them to 

look out for their reports.

zzShow officers that you value their work. Employees who feel valued are less likely than 

those who do not to be stressed in their everyday work and more likely to report good mental 

health. Recognition of good work along with open and honest communication can help. 

zzProactively resolve conflict. A mass casualty event will not unify your agency. Quite the 

opposite: the stress of a mass casualty event often worsens existing tensions or leads to new 

conflict. It’s important to proactively address these conflicts and demonstrate to your officers 

that you take their concerns seriously. 

zzLook for ways to build agency unity. Officers’ best support comes from one another. Look 

for ways to promote socializing and support, such as family night, kids’ academies, an agency 

sports league, or other regular social events. 

zzShare some of your personal reactions. After a critical incident, it is okay for you to share 

some of your genuine emotional response with officers. If something affects you deeply, it’s 

likely your officers are experiencing the same thing. Your willingness to share will make it 

easier for them to talk about it. If you seek out mental health support after a critical incident, 

tell your officers you have done so. 

zzSet a healthy example. When you need a day off, take one—and grant that same flexibility 

to your staff. When your officers are in fitness or mental health training, make an appearance 

and tell them something you are doing to ensure you stay healthy and resilient. 

 “When it’s all said and done, no matter how big, bad, and tough we 

think we are, we need to pay attention to the issue of mental health. 

It comes down to relationships—understanding each other on an 

emotional level and taking care of each other. As a supervisor, I take 

seriously my responsibility for taking care of the guys.”

— Sergeant AJ DeAndrea, Patrol Officer, Arvada, Colorado
Part Two. Preparing for a Mass Casualty Event 

2. Recommendations for Enhancing Resilience in Your Agency Today

27

Form a work group to recommend officer wellness programs and education 

While it might seem more expedient to implement an array of officer wellness programs right 

away, a work group serves several purposes. First, it creates a forum for discussing wellness 

issues within the agency, which is an important step to helping officers feel comfortable with the 

change. Second, you will help ensure officer wellness programs are inviting for officers and take 

advantage of the mental health resources available in your community. Finally, by working with

your labor force, you will help ensure that if there is a mass casualty event, it doesn’t spark 

a conflict between labor and management over the availability of mental health services. 

The work group should include command staff, supervisors, union leadership, mental health 

providers affiliated with the agency, and mental health providers from the broader community. 

It should be tasked with

zznetworking with mental health providers;

zzassessing what sort of wellness education officers need;

zzmaking recommendations about ongoing officer wellness programs;

zzmaking recommendations about changes to policy related to psychological services after critical incidents (see “Review your psychological services policies and procedures” on page 33).

There is a lot of innovation in officer wellness programming. There are a variety of options, and 

your work group can help you narrow down which approaches match your agency’s needs and 

resources. The work group may suggest implementing programs such as the following: 

zzPresentations from officers who have experienced mental health challenges. Fellow 

officers who have experienced and gotten through mental health challenges can help officers 

understand that it’s okay to ask for help. Organizations like Badge of Life3

 may be able to help 

you identify an officer who is willing to share his or her story.

zzChaplain support program. For many officers, religious and spiritual support can boost resilience. The International Conference of Police Chaplains and the American Police Chaplains 

Association have resources to help you learn more.4

3. “Badge of Life,” http://www.badgeoflife.com/. 

4. “International Conference of Police Chaplains,” http://www.icpc4cops.org/; “American Police Chaplains 

Association,” http://www.americanpolicechaplain.org/.
Preparing for the Unimaginable: How Chiefs Can Safeguard

Officer Mental Health Before and After Mass Casualty Events

28

zzAnnual in-service training to all officers on mental wellness. Officers may need a regular 

reminder about what to expect during a critical incident and healthy ways to cope with stress. 

Supervisors in particular must also understand what their organizational responsibility is and 

what resources are available when dealing with a peer or subordinate who needs assistance. 

This education could be integrated with other required training on firearms and use of force.

zzAnnual officer wellness checks. Offering or even requiring an annual appointment with a 

mental health clinician can give officers who are struggling an opportunity to get assistance 

and provide others with a refresher on managing stress.

zzWellness resources and information. These can help officers learn how to build their own 

resilience and understand warning signs of a serious problem and how to connect with mental 

health support. Some officers will learn best by reading, and that information can be shared 

through agency bulletin boards, newsletters, websites, etc. Some handouts are available at the 

end of this guide. 

zzCrisis intervention team (CIT) programs.5 These programs provide training for officers on 

how to respond to a person experiencing a mental health crisis. More important for officer 

wellness, they provide an opportunity for officers to learn about mental health conditions 

without being in the spotlight. CIT programs also help create good working relationships 

with local mental health providers, which are vital in a mass casualty event. 

5. “Law Enforcement and Mental Health,” National Alliance on mental Illness, accessed April 6, 2016, 

http://www.nami.org/cit.

Support the creation of an officer peer support program

Many officers are more comfortable talking to fellow officers than with mental health professionals about stressful or traumatic situations. They feel that only another law enforcement officer 

can really understand their experiences and stresses. Officers are also often wary of using any 

mental health services that might appear on their employment or medical record. Well-trained 

peer support officers can offer confidential support and education, providing officers easy access 

to help they can trust. Some peer support programs also offer help lines to provide support for 

day-to-day stresses and teams that can be deployed to the scene of a critical incident. 

Peers, if they are trained to notice signs of stress, can also be helpful in proactively reaching out 

to fellow officers who are struggling. Even when they aren’t providing formal support, peers 

can help create a more supportive, cohesive agency where offers feel comfortable looking out for 

one another. 
Part Two. Preparing for a Mass Casualty Event 

2. Recommendations for Enhancing Resilience in Your Agency Today

29

But peers need to work hand-in-hand with licensed mental health clinicians to ensure that any 

officer needing more intensive support can be connected easily. Peers may be able to convince an 

officer to seek professional support if needed, or provide a testimonial about a particular mental 

health professional who really understands the concerns of law enforcement. 

Much of the appeal of a peer program is that it is driven by officers’ needs and concerns, so you 

cannot force the implementation of a successful peer support program. However, as chief, your 

endorsement and support is a sign that you care about officers’ well-being. 

The International Association of Chiefs of Police provides detailed guidelines for peer support programs.6

6. “Peer Support Guidelines,” International Association of Chiefs of Police, accessed April 6, 2016, 

http://www.theiacp.org/ViewResult?SearchID=148.

“I think everybody knows that there are bad things 

that happen to people, but they need to know there 

are people out there to help. We need to know early 

on in our career that we are not alone—other people 

have been here first, and they can help me through 

this trauma I have experienced.”

— Lieutenant Kit Cummings, 

Law Enforcement Peer Specialist, 

Virginia Law Enforcement Assistance Program
Preparing for the Unimaginable: How Chiefs Can Safeguard

Officer Mental Health Before and After Mass Casualty Events

30

CASE STUDY:

POLICE ORGANIZATION PROVIDING PEER ASSISTANCE (POPPA)

After the September 11, 2001 attack on the World Trade Center, police officers 

in New York City reached out for support from their fellow officers. The Police Organization Providing Peer Assistance (POPPA) organization, an officer peer support 

program established in 1996, offered a way for officers to connect with someone 

who understood the stresses of policing without alerting their supervisors or immediate colleagues.

Training for volunteers

POPPA volunteers are active police officers, not mental health professionals. 

Current volunteers and mental health professionals screen those who wish to join 

the peer support team. Each new member must undergo eight days of training that 

includes a focus on communication skills, some practice listening with empathy 

and without judgment, and information about mental health resources. Peer support volunteers are also trained on how to help a fellow officer access professional 

mental health services when appropriate and how to handle a crisis situation if one 

arises. Peers attend training two to four times per year to remain updated on peer 

support strategies, referral options, and current treatment.

Types of supports

POPPA has a 24/7 help line and is staffed to provide a response to callers within 

15 minutes. In addition to telephone contact, POPPA provides individual face-toface peer support and assistance with referrals to mental health professionals and 

peer-led support groups. When appropriate, volunteers work with mental health 

professionals to refer to them cases that require further evaluation and treatment. 

In addition, POPPA has developed Trauma Response Teams, which respond to 

certain traumatic events such as shootings, serious motor vehicle accidents, and 

officer line of duty deaths to provide peer support and psychoeducation regarding 
Part Two. Preparing for a Mass Casualty Event 

2. Recommendations for Enhancing Resilience in Your Agency Today

31

traumatic stress, self-care, and when to seek professional assistance. POPPA has 

also developed an Outreach and Resiliency Support Program, in which peers and

a mental health professional provide an overview of job-related and personal stress 

to a large group of officers. Then a small group meeting provides officers an opportunity to talk about work-related and personal stressors, strategies to cope with 

stress, and when and how to seek assistance.

Confidentiality

The size of the New York Police Department (NYPD) and the POPPA volunteer network allows the program to provide anonymous support from peer support officers who do not have a prior relationship with the officer seeking assistance. It is 

important to note that both the client and peer are protected, and any information 

obtained from their interaction will never become part of a departmental enquiry 

or investigation or enter an officer’s personnel file. This aspect of POPPA may be 

hard to replicate in smaller departments, and some peer support programs may use 

external volunteers (such as retired officers) to reassure officers that information 

that they share will be kept confidential.

Conclusion

The POPPA help line served more than 1,000 officers per year for a few years after 

9/11 and continues to serve about 450 officers per year. Another 3,000–5,000 

officers are assisted by other POPPA programs each year. It is estimated that 

POPPA services have prevented at least 80 suicides. Since POPPA’s inception in 

1996, the suicide rate in the NYPD has dropped approximately 40 percent—from 

about 22/100,000 to 12–14/100,000 per year. After Hurricane Katrina in New 

Orleans in 2005, the Boston Marathon bombing in 2013, and the riots in Baltimore 

in 2015, POPPA provided peer support to police departments in the affected cities 

and laid the groundwork for local peer support programs. For more information, 

visit http://poppanewyork.org/.

Reviewed by John Petrullo and Frank Dowling, MD
Preparing for the Unimaginable: How Chiefs Can Safeguard

Officer Mental Health Before and After Mass Casualty Events

32

Find the right mental health service providers to support your officers

If your agency experiences a mass casualty event, your mental health incident commander 

(described in chapter 3) will coordinate the overall mental health response, but you will need 

a deeper bench to support all your officers. You also need to ensure the providers you choose 

have credibility with your officers.

Many officers are uncomfortable asking for help from a mental health professional on the agency’s or city’s payroll. They worry that the information they share will not remain confidential 

and could jeopardize their job. On the other hand, officers can also have a hard time connecting 

with a mental health provider who is not familiar with law enforcement culture. During a critical 

incident, officers will be more likely to ask for assistance from a mental health provider if they 

already know and trust the provider. Finding mental health providers who can work successfully 

with officers can be a challenge, so it’s important to reach out to providers in the community 

now and identify the right individual(s). Look for mental health professionals who

zzare familiar with law enforcement culture or are willing to learn;

zzhave at a minimum a master’s degree in a mental health discipline, i.e., social work, psychology, or counseling; 

zzare properly licensed;

zzare trained in trauma care and understand the principles of psychological first aid;

zzunderstand privacy concerns and can guarantee that private information will not be shared;

zzare able to interact regularly with officers through training, ride-alongs, investigations, and 

other activities.

“I bounced back and forth between therapists. It wasn’t clicking 

because the therapist didn’t have any police background. I didn’t go 

to the employee assistance provider because they are countywide, not 

specialized to police. I just wasn’t in my comfort zone. . . . I stopped 

going to therapy, and I started looking online. . . . [Later,] I started to 

go to a support group in central Florida, just cops talking to cops. I 

found a therapist who is a retired cop.”

— Sergeant Mark DiBona, Deputy Sheriff, Seminole County, Florida
Part Two. Preparing for a Mass Casualty Event 

2. Recommendations for Enhancing Resilience in Your Agency Today

33

There are several options to pursue to find the right mental health providers. If your employee 

assistance provider (EAP) provides licensed mental health professionals, it can be a good choice. 

However, officers’ privacy concerns will have to be addressed proactively, and they will need a 

guarantee that no information goes back to the agency. Other places to look include the following:

zzPolice psychologists and other mental health professionals involved in officer training 

or investigations

zzMental health providers who work with other law enforcement and first responder agencies 

near you

zzMental health agencies and mental health organizations within your community

zzMental health workers who are former law enforcement or who have a family member in 

law enforcement

zzUniversity and hospital departments of psychology, psychiatry, counseling, and social work

Once you have identified your mental health provider(s), make sure to work with them frequently. The more visible and active these professionals are within the agency, the more comfortable officers will be with them. Involve them in your mental health work group and ask them to 

assist in reviewing policy and providing education and training. 

“We can’t continue to treat officers involved in a use of force incident 

like criminal suspects. Yes, there are parts of investigation that have 

to occur, but we need to encourage our peers to take time to process, 

to talk to their families, and to use the support systems they have.”

— Lieutenant Alexander L. Eastman, MD, MPH, FACS,

Deputy Medical Director, Dallas Police Department

Review your psychological services policies and procedures

If your agency does not have a policy on psychological support after critical incidents, we recommend you develop one. It can be as simple as stating that any officer involved in a critical 

incident should meet with the mental health manager (if there is one), a known and trusted 

mental health professional, or a member of the command staff for informal support. Refer to 
Preparing for the Unimaginable: How Chiefs Can Safeguard

Officer Mental Health Before and After Mass Casualty Events

34

“How to Assist a Fellow Officer after a Critical Incident” in the handouts and resources section 

at the back of the book for help determining what to say to an officer after a critical incident. 

Your policy should also describe support resources available to officers on an ongoing basis.

Clear communication about new policy 

One challenge for chiefs in changing policy is how to communicate about changes to officers. 

We recommend proactively educating officers about the kinds of flexibility and support you can 

offer, especially if you are making a change to your current policy. Officers who are used to a 

particular program of formal support might feel confused or let down if that support changes, 

even if the changes involve an increase in support options. Make it clear that any changes are 

designed to improve the support offered and to take advantage of the most effective psychological support available. 

Encourage family and peer support, not isolation

We know that support—from friends and family, fellow officers, supervisors, and mental health 

professionals—and access to personal coping mechanisms is important to resilience and recovery. Most people benefit from time to spend with family, get adequate sleep, and take care of 

themselves. Ensure that your policies allow officers enough flexibility to take care of themselves 

and that they do not unnecessarily isolate officers from their peers and families. 

Review the research on early formal intervention after traumatic events

You may also want to check in on your current practices regarding debriefings and other forms 

of formalized early psychological interventions. Currently, there is no formal psychological intervention that has been shown to be effective in preventing post-traumatic stress disorder (PTSD) 

or other mental injuries in the immediate aftermath of a traumatic event. 

Many chiefs are familiar with critical incident stress management (CISM) debriefings, which 

are a common way to support first responders in the immediate aftermath of a traumatic event. 

Mental health clinicians and peer support officers using this approach have driven the conversation about officer mental wellness and brought attention to the needs of officers after critical 

incidents. You may wonder why we aren’t wholeheartedly recommending this debriefing technique. It’s because debriefings, especially delivered in a single session with no follow-up, are not 

a panacea. We want to describe the components of interventions based on best practices, rather 

than focus on a term—debriefing—that has come to mean different things to different people.
Part Two. Preparing for a Mass Casualty Event 

2. Recommendations for Enhancing Resilience in Your Agency Today

35

Various forms of debriefing, with individuals or groups, have been used by law enforcement 

agencies since the 1980s. There has been confusion about the effectiveness of debriefings. Many 

people find them a positive experience, but officers who have experienced them do not fare better in the long run than those who have not. And most concerning, a small number of individuals actually do worse after a debriefing. People have different responses to debriefings, and it’s 

not clear why.

Developed in the 1980s by former firefighter Jeffrey Mitchell and George Everly of the Johns 

Hopkins School of Medicine, the original CISM debriefings followed a set structure that encouraged everyone to share their experiences and emotions while the impact of the trauma was still 

fresh. They also included a review of the traumatic experience and education about a range 

of possible reactions to psychological trauma. They were often mandatory. Studies, and then 

reviews summarizing the findings of more than a dozen studies, have shown that this specific 

approach and variations of it following similar rules were ineffective and in some cases were 

even harmful.7

One possible explanation of these findings is that when a debriefing is too rigid and scripted, 

it can compound the trauma some individuals experience. This may be true particularly if the 

debriefing is mandated for individuals who would rather not attend and requires individuals to 

retell (and listen to) the details of the incident. Another possible explanation is that learning 

about all the potential warning signs of a serious mental health problem immediately after a 

trauma can be self-fulfilling, increasing the chances an officer will develop PTSD down the line. 

Based on the evidence showing that people react differently to debriefings, many mental health 

providers have adapted their approach. In 2007, George Everly co-authored a paper with Jonathan Bisson of Cardiff University, a lead author of the research that raised concerns about 

debriefings. Both authors suggested an alternative to mandatory debriefings. They suggested 

that, shortly after the traumatic event, those affected should be provided with empathetic and 

practical psychological support and with information about possible reactions, about what they 

can do to help themselves, and about how they can access support from family and community.8

7. Suzanne C. Rose et al., “Psychological Debriefing for Preventing Post Traumatic Stress Disorder (PTSD),”

Cochrane Database of Systematic Reviews 2002, no. 2 (2010), http://onlinelibrary.wiley.com/doi/10.1002/14651858.

CD000560/epdf.

8. Jonathan I. Bisson et al., “Early Psychosocial Intervention Following Traumatic Events,” American Journal of Psychiatry 164, no. 7 (2007), 1016–1018, http://www.wpic.pitt.edu/Education/CPSP/2%20%20%20IE1%20-%20Bisson%20

et%20al.pdf.
Preparing for the Unimaginable: How Chiefs Can Safeguard

Officer Mental Health Before and After Mass Casualty Events

36

IMPLICATIONS FOR TACTICAL DEBRIEFINGS

Note that this research applies only to psychological debriefings that include a 

discussion of officers’ experiences—not to tactical debriefings that are focused on 

ensuring communication about facts and other information that is necessary for 

police work. Tactical debriefings can also trigger a traumatic response and should 

be delayed if possible.

During a tactical debriefing, it is important to remember that while some officers 

may freely express their feelings, many people who have been exposed to psychological trauma remain businesslike or even emotionally withdrawn in the immediate aftermath. Therefore, it may be especially difficult to gauge the impact of 

the discussion on some individuals. Comments and observations, even those that 

are intended to be reassuring, may spur unexpected reactions that develop into 

sources of long-term resentments, fears, despair, or anguish.

Whatever model of early support you use, be sure that psychological support 

is available during and after tactical debriefings to help identify and address 

negative reactions.

At the time, most of the available evidence was from research assessing the impact of individual 

debriefings—as opposed to group debriefings, which had not been studied as thoroughly. In the 

years since, further research has reinforced these earlier findings.9

 Research also shows neither early formal psychological nor pharmacological interventions (i.e., medication) have been 

shown to prevent PTSD or other mental injuries following traumatic events.10

Summary and recommendations based on these research findings 

Because the research doesn’t explain why debriefings have different levels of benefit for different 

individuals or predict which individuals will react to debriefings in which ways, it’s especially 

important to rely on a trusted and experienced mental health professional to help you navigate 

this challenge. Together, you can decide what approach is best for your agency. Specifically, we 

suggest asking your mental health professional to review the research carefully and make recommendations about any needed changes to your current policy and procedure.

9. Edna B. Foa et al. eds., Effective Treatment for PTSD: Practice Guidelines from the International Society for Traumatic 

Stress Studies (New York: Guilford, 2009).

10. Jonathan I. Bisson, “Editorials: Early Responding to Traumatic Events,” British Journal of Psychiatry 204, no. 5 

(May 2014), 329–330, http://bjp.rcpsych.org/content/204/5/329.
Part Two. Preparing for a Mass Casualty Event 

2. Recommendations for Enhancing Resilience in Your Agency Today

37

In the absence of formal interventions that are proven to work for all people, experts have developed a more flexible, individualized approach built on findings from related research on resilience. Several organizations recommend that early interventions follow these five principles: 

1. Promoting a sense of safety 

2. Calming 

3. A sense of self and community efficacy 

4. Connectedness 

5. Hope 

Psychological First Aid is the most commonly used early intervention based on these principles 

and has been promoted by the National Institute of Mental Health,11 the National Center for 

Post-Traumatic Stress Disorder,12 and the Cochrane Review.13 “How to Assist a Fellow Officer 

after a Critical Incident” in the handouts and resources section at the back of the book is based 

on the concepts of Psychological First Aid.

The good news is that while PTSD and other conditions may not be preventable immediately 

after a traumatic incident, there are effective treatments that can help individuals who are 

in distress.

11. “Post-Traumatic Stress Disorder,” National Institute of Mental Health, accessed November 30, 2015, 

https://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml#part_145372. 

12. “PTSD: National Center for PTSD,” U.S. Department of Veterans Affairs, accessed November 30, 2015, 

http://www.ptsd.va.gov/professional/treatment/early/index.asp. 

13. Rose et al., “Psychological Debriefing” (see note 3).

Some options for assisting officers shortly after traumatic incidents 

After critical incidents, there is no one-size-fits-all approach that works for every officer. Officers who need support should be able to access it through a variety of means—not necessarily required to participate in a specific intervention. In addition, wellness supports should be 

ongoing so that officers have access to support at any point, whether immediately after a critical 

incident or months later. 

Here are some options for providing psychological support shortly after a traumatic incident. 

On day one, provide brief, flexible one-on-one check-ins 

Brief, one-on-one check-ins with officers, ideally before they go off shift on the day of a critical 

incident, can help officers collect themselves. One model for individual check-ins is Psychological First Aid, which focuses on providing practical support (safety, food, transportation) and 
Preparing for the Unimaginable: How Chiefs Can Safeguard

Officer Mental Health Before and After Mass Casualty Events

38

offers empathy and suggestions for coping. Psychological First Aid can be delivered by a mental 

health provider or by anyone else who is ready to listen. The person providing Psychological 

First Aid offers to listen but allows the officer to decide how much to say about the specifics of 

the incident. He or she also makes sure that the officer has a number to call day or night to talk 

with someone who can provide ongoing psychological support.

For more information on how to have these conversations, see the handouts and resources 

section at the back of the book for “How to Assist a Fellow Officer after a Critical Incident.”

Group educational briefings

Some group meetings can be helpful as long as officers are not asked to retell the story of the 

event. After mass casualty events with many responders, some agencies have chosen to do educational briefings during which officers learn about mental health supports that will be available 

to them and where to call for help. Officers can also be reminded about healthy ways to cope 

with stress. Finally, officers can be given an opportunity to ask about their reactions—this can 

help them feel reassured about unexpected reactions they are experiencing. 

We suggest not listing the “normal” reactions to trauma, because there is such a wide range of 

reactions. If an officer does not hear his experience on the list, he may worry that something is 

wrong with him. If you do list possible reactions to trauma, make it clear that almost any reaction is normal at this point (though officers may need help coping with them). 

One-on-one wellness checks at least a few days after the incident

Several agencies have offered one-on-one wellness checks with a mental health professional a 

few days or weeks after a mass casualty event. These conversations can provide information 

about what services are available, explain how support and treatment are different from fitnessfor-duty evaluations, and, most important, stress that mental health treatment is entirely confidential (you as chief cannot know what is being discussed). The checks can be brief, and the 

mental health professional should take a flexible approach, never forcing the officer to discuss 

something that they aren’t ready for. 
Part Two. Preparing for a Mass Casualty Event 

2. Recommendations for Enhancing Resilience in Your Agency Today

39

Some chiefs have made these check-ins mandatory, with the hope of providing “cover” to officers 

who really need help—a mandatory check means no officer draws attention by seeking assistance. While mandatory mental health services are generally not recommended,14 this approach 

may be helpful if approached carefully. For example, wellness checks should be scheduled after 

the immediate crisis is over. Officers will not be able to focus on their mental health until safety 

and security are assured, and they may react defensively if the check is too soon.

It can be helpful to describe these checks as an opportunity for officers to ask about any health 

or wellness issues. For example, some officers may feel more comfortable asking about their 

children’s reaction to the incident or about how to lose weight than discussing their own psychological reactions—and that’s okay. Those conversations are an opportunity to build trust so that 

officers feel comfortable coming back for help if they need it.

Other supports 

In addition to the brief interventions already mentioned, officers should also have access to individual support from mental health professionals, employee assistance providers, peer support 

providers, chaplains, and other programs. With an array of options, each officer is more likely to 

find what works for his or her individual needs.

14. National Institutes of Mental Health, Mental Health and Mass Violence: Evidence-Based Early Pyschological 

Intervention for Victims/Survivors of Mass Violence (Washington, DC: Government Printing Office, 2002), 

http://www.nimh.nih.gov/health/publications/massviolence_34410.pdf.

41

3 Planning the Incident 

Response for a Mass 

Casualty Event

Once you are working on a foundation of greater resilience within your agency, there are some 

specific steps to take to plan for a mass casualty event. Again, even if you do not experience a 

mass casualty event in your jurisdiction, these steps will help you coordinate with other jurisdictions during any crisis. And if a mass casualty event occurs in a neighboring community, this 

planning will help you support your neighbors.

Assign a mental health incident commander

To implement your mental health work group’s recommendations and really get into shape to 

deal with a mass casualty event, you will need a highly respected point person on mental health 

issues. Communities like Aurora, Colorado, and Newtown, Connecticut, found that a trusted 

mental health professional who knows the agency and law enforcement culture can help build 

your agency’s resilience. He or she can build relationships and credibility now with your officers 

so that they are comfortable turning to him or her during a mass casualty event. 

Identify this individual today, and task him or her with the following: 

zzManaging all mental health-related tasks during a mass casualty event

zzCoordinating with the officer wellness workgroup 

zzDeveloping relationships between the agency and mental health service providers

zzReviewing policies and procedures on providing psychological services to officers 

after a critical incident

zzProviding training and consultation for supervisors

zzProviding education and support for officers’ family members
Preparing for the Unimaginable: How Chiefs Can Safeguard

Officer Mental Health Before and After Mass Casualty Events

42

During a mass casualty event, your mental health manager will serve as an incident commander 

working with you, your command staff, and mental health service providers to triage for immediate needs and make plans for longer-term mental health supports. He or she will also advise 

you on operational decisions that may have an impact on officer mental health to avoid unnecessary exposure to trauma and ensure that mental health services support operations rather 

than hamper them. 

Choose someone thoroughly qualified and suited to the role to serve as your mental health 

manager. To be most effective both today and in the event of a mass casualty incident in the 

future, your mental health manager should be 

zzfamiliar with the impact of trauma;

zzfamiliar with the principles of Psychological First Aid;

zzwilling to learn about your agency and get to know commanders, line staff, and 

union leadership along with operational and support staff; 

zzintegrated into the incident command structure;

zzfamiliar with state, regional, county, and local mental health services.

For many agencies, a licensed mental health provider affiliated with your employee assistance 

provider (EAP) or a police psychologist may be ideal for this role. Other agencies may use 

a community mental health provider who is willing to familiarize him- or herself with law 

enforcement culture or a command level officer with a background in mental health. You may 

not have the perfect individual, but now is the time to assign these responsibilities and provide 

training and support. 

For more on the mental health incident commander’s role during a during a mass casualty 

event, see the handout “The Mental Health Incident Commander’s Role during the Immediate 

Response to a Mass Casualty Event” in the handouts and resources section at the back of 

the book. 
Part Two. Preparing for a Mass Casualty Event 

3. Planning the Incident Response for a Mass Casualty Event

43

A RELATIONSHIP OF TRUST WITH 

YOUR MENTAL HEALTH INCIDENT COMMANDER

by Daniel Oates, Chief of Police, Miami Beach, Florida, 

and former Chief of Police, Aurora, Colorado

Dr. John Nicoletti and I already had that relationship of trust. So when the theater 

shooting occurred [in Aurora, Colorado], I made sure John was called, and he and 

his team were on site within two hours. They stayed with our cops and civilian members for weeks as we coped with the media crush, the memorials, the funerals, and 

the ongoing devastation we were enduring with the victim families and the community. His team did all kinds of ad hoc, spur-of-the-moment counseling, as well as 

formal debriefings for our first responders and our victim advocates. They were just 

‘there’ all the time, and by always being present, they very much helped us endure 

and begin to heal. 

Everyone who responded to the theater that night participated in a collective 

debriefing eight days later. I know there is debate within the professional community as to the value of such debriefings, but in our case this session was powerful 

and effective, almost certainly because we had Dr. Nicoletti, a true pro and a veteran of the Columbine tragedy, running the debriefing.
Preparing for the Unimaginable: How Chiefs Can Safeguard

Officer Mental Health Before and After Mass Casualty Events

44

Build close partnerships with first responder agencies 

and other leaders in your community

During and after a mass casualty event, your strongest allies can be the other first responders 

and community leaders in your community and neighboring communities. It’s important to 

strengthen those relationships now and plan together for responding to emergencies. You should 

also create a mechanism for resolving different approaches during the incident, to avoid agencies 

working at odds with one another during a crisis. Unfortunately, lack of coordination during a 

crisis can have a real impact at the scene and lead to long-term conflict between agencies. For 

example, the 9/11 Commission Report suggests that additional lives may have been lost during 

the September 11, 2001 attacks because police officers who passed firefighters in the stairwell of 

the World Trade Center did not inform the firefighters of instructions to evacuate and because 

other firefighters were not willing to take evacuation orders from police officers.15

Which agencies you need to coordinate with depends on your community’s size and location, 

but here are some stakeholders that are generally involved in an emergency response:

zzNeighboring police and sheriff’s departments

zzFire and emergency medical services

zzLocal and state offices of emergency management and victims services

zzMunicipal, county, and state government 

zzLocal emergency response organizations, such at the Red Cross and Volunteer Organizations 

Active in Disasters

zzFaith groups

zzYour local, regional, and state departments of health and mental health

zzHospitals and other healthcare providers 

zzSchool districts, colleges, and major employers

It is particularly important that you have agreements in place with other first responders about 

incident command. You may not need formal agreements with schools or employers, but having 

pre-existing relationships with these groups will make it easier to coordinate during a crisis. 

15. National Commission on Terrorist Attacks on the United States, 9/11 Commission Report (Washington, DC: 

Government Printing Office, 2004), 553, http://govinfo.library.unt.edu/911/report/index.htm.
Part Two. Preparing for a Mass Casualty Event 

3. Planning the Incident Response for a Mass Casualty Event

45

“ANGEL CHIEFS” AFTER SANDY HOOK

by Douglas Fuchs, Chief of Police, Redding, CT

Many years ago, the chiefs of police departments around Danbury, Connecticut, 

made a pact that if something tragic happened in any of our neighboring communities, we would all respond and do whatever was needed to assist one another 

and act in a supporting role to see the incident through. You might have a huge 

department with all kinds of support staff underneath you, but having a peer to be 

there for you is invaluable for a chief. As a fellow chief, once you show up, the chief 

knows he is not walking alone.

Six chiefs from neighboring towns responded after the Sandy Hook Elementary 

School shooting to support the Newtown Police Department. Within 24 hours, 

we had a schedule in place so that Chief Michael Kehoe was never left alone. He 

went from place to place with another chief by his side. Other elected officials and 

department heads started to ask, “Where’s my shadow?” 

After an incident like this, the chief is constantly in meetings, reacting and making 

decisions 24/7. Chief Kehoe could delegate responsibilities to us. He’d just look 

at us, and one of us would say, “I got this.” Whether it was assisting the Sandy 

Hook business owners who were financially impacted by road closures and traffic 

volume, negotiating with national media to relocate television satellite trucks, or 

(much later on) helping to train others on lessons learned—we were his representatives. Everyone knew if another chief was involved, it was as if Chief Kehoe was 

there. On the other hand, if we goofed, it was on us.
Preparing for the Unimaginable: How Chiefs Can Safeguard

Officer Mental Health Before and After Mass Casualty Events

46

“ANGEL CHIEFS” AFTER SANDY HOOK (cont’d)

We also helped listen and process everything that was going on. We all have our 

own insights, and we all are able to call on additional resources as needed. We 

provided additional sets of ears, taking some of the pressure off Chief Kehoe. Our 

only agenda was to focus on him and what he needed to support the community 

and his officers. 

We completely took over the function of coordinating the mutual aid response for 

Newtown. An independent administration was set up to handle all logistics. Day 

to day, we would assess the need for additional patrol officers. In addition to regular patrol functions and the need to provide security at all the schools, we looked 

at what events were taking place and what details needed to be filled. We knew 

exactly how many officers were required on each shift, and with the assistance of 

a multitude of other agencies we filled those slots. There was nothing random 

about officers self-deploying; we had it all scheduled out for 7–10 days in the 

immediate aftermath of the shooting. 

It is so important for agencies, for chiefs, to pre-think this. With the plethora of 

incidents that are happening each week, it’s going to happen in your backyard 

someday. I cannot overstate how overwhelming a position a chief is in after one 

of these incidents. Make a pact with your neighboring chiefs now that if a horrific 

event or mass casualty event happens in their community, you will show up—no call 

necessary. Your presence will be required.
Part Two. Preparing for a Mass Casualty Event 

3. Planning the Incident Response for a Mass Casualty Event

47

Make a regional or statewide plan

Unless your agency is very large, a mass casualty event will require coordination with other first 

responder and law enforcement agencies across your region or your state. Keep in mind that any 

incident of this magnitude that occurs in a neighboring jurisdiction is likely to have an impact 

on your agency—so it’s important to plan the assistance you can offer as well as what you can 

expect to receive. 

Specifically, as you plan to address officer mental health, consider reaching out to other agencies 

in your region and state to discuss the following questions:

zzWhat mental health resources are available, including peer support teams, police psychologists, and employee assistance providers? Can an agreement be made now about 

how to deploy these resources in the event of a mass casualty event? For example, after the 

Virginia Tech shooting in 2007, the South Carolina Law Enforcement Assistance Program and 

North Carolina Highway Patrol’s Members Assistance Team were able to deploy a team of 25 

peer support providers to support officers responding to the event in a matter of hours with 

a single phone call. This assistance proved vital because local peer support providers were 

involved in responding to the incident and were not available to assist officers within their 

own agencies.

zzWhat kind of mutual aid can your agency expect to provide or receive, and how will that 

be deployed in a crisis? For example, the Connecticut Police Chiefs Association is developing a plan to provide a detailed breakdown by severity of the event of how many officers 

neighboring agencies will provide and the procedure they should follow. The hope is that 

during an event, the deployment of mutual aid will be swift and seamless. For the sake of officer mental health, having adequate resources and a clear plan is key. 

zzHow can chiefs in your region support one another in the event of a mass casualty 

event? After the Sandy Hook Elementary School shooting, several neighboring chiefs provided round-the-clock support for Newtown’s Chief Michael Kehoe and his officers. Among 

those providing support, Chief Marc Montminy of Manchester, Connecticut, had managed a 

mass casualty event previously and was able to advise on the lessons he learned about protecting officer mental health. To learn more, see the sidebar “‘Angel chiefs’ after Sandy Hook” on 

page 45. 

49

4 Building Your 

Media Team and Strategy 

for a Mass Casualty Event 

Why you need a media strategy

One of the greatest stressors for chiefs who responded to mass casualty events was their role as 

gatekeepers of media access. While all chiefs are experienced in providing media briefings, a 

mass casualty event can draw an unprecedented level of national and international media attention and test the most media-savvy chief. 

Media reports inform the community about what happened and create transparency about an 

incident and its impact. Most reporters will be working to help the wider community understand 

and process the incident, but there may be exceptions. Regardless, the workload and the unprecedented scrutiny can be very stressful.

A great deal of time and energy is often required to manage the media and respond to inquiries. 

This may stress your officers and community in several ways, including the following:

zzThe volume of media requests and the presence of media representatives can create an overwhelming volume of work. 

zzOfficers, victims, and family members may be harassed by members of the media looking 

for interviews.

zzReporters may disrupt the crime scene.

zzOfficers may be distressed when their actions or the agency’s actions are criticized or reported 

out of context. 

zzOfficers may be frequently confronted with images and descriptions of the victims and crime 

scene, or they may be distressed when their loved ones see these images and ask questions.

zzOfficers may become upset and angry when news coverage of the police response is inaccurate 

or misleading.
Preparing for the Unimaginable: How Chiefs Can Safeguard

Officer Mental Health Before and After Mass Casualty Events

50

It is important to learn how to work effectively with the media and mitigate any challenges associated with the media’s involvement. 

News today is disseminated faster, more globally, and on more diverse platforms than ever 

before. The pitfalls of this new media reality come into sharp view when a major incident 

occurs. Here are five important insights about modern media and tragedies.

There will be massive media interest

Recent mass casualty events have often been accompanied by immediate and massive media 

frenzies.. Not just local and national media will swarm your city; you might also see Chinese TV 

and British newspapers and German bloggers—in short, you should expect media teams from all 

over the world to show up.

You are in charge of setting the boundaries regarding media engagement, access, and restriction. 

Develop a detailed media strategy now to prepare for an incident that will attract massive public 

interest. It will allow you to act swiftly and get a handle on the media chaos early on. For details 

on building a plan, see “How to plan an effective media strategy” on page 54 and “What to 

include in your media plan” on page 55. 

There will be errors and inaccuracies in media coverage

The first details that emerge in the public after an incident are usually not the most reliable ones. 

Rumors spread fast. These dynamics have always accompanied tragedies—but now they play out 

in new ways, with social media often replacing word of mouth, for example.

Don’t let initial inaccuracies distract you or your agency; they are an unwelcome but inevitable part 

of the chaos following a mass casualty event. You can correct errors with consistent messaging:

zzCorrect errors in every briefing and make sure reporters get the latest facts quickly. 

zzRemind journalists of their important role as fact checkers and curators of information on 

social media and the Internet. 

zzRemind everyone that speculations and premature conclusions backfire and that innocent 

people may be hurt in the process. 

zzIf major errors are not corrected in a reasonable amount of time, actively approach major news 

organizations that continue to broadcast inaccuracies and ask for a correction. Use the support 

of officials and your local news sources if needed. 

zzContact a news organization’s ombudsperson or a columnist who covers the media. These can 

serve as internal watchdogs.
Part Two. Preparing for a Mass Casualty Event 

4. Building Your Media Team and Strategy for a Mass Casualty Event

51

There will be intrusive behavior 

The police and the press are immediately pitched against each other in the aftermath of a mass 

casualty event. It is the role of the media to inform the public and to ask difficult questions. It 

is the role of the police to prioritize the community’s safety, the investigation’s integrity, and victims’ privacy over immediate transparency. 

This often results in heated debates about what is intrusive and distasteful in reporting about 

an atrocity. There are no simple answers to these questions because people’s feelings about them 

depend on factors such as an individual’s proximity to the tragedy or their prior experiences 

with trauma. As we have learned about trauma in chapter 1, a funeral story might be interesting 

until it becomes clear the person buried was a good friend, at which point the information or 

photographs may suddenly seem voyeuristic. Similarly, while some people may need concrete 

images to make the tragic event seem real, others are overwhelmed by graphic depictions. 

As chief, you will be among those closest to the tragedy, and you need to be prepared to work 

with your community leaders on controlling your message and enforcing the boundaries. What 

is appropriate and what goes too far should be decided by your community.

As always when dealing with media requests, trust your instincts and err in favor of protecting 

the people in your community from too much scrutiny. While you want to be as open as you 

possibly can be about details of the investigation and the response to the incident, you also need 

to be as protective as you can of victims, survivors, and everyone else in your community. 

While most journalists will be respectful of victims and their families, some simply will not. 

For example, in the past, media representatives have posed as family members to gain access 

to a holding area. Others have obtained personal photos from protected online accounts without permission.

You can take the following steps to deal with intrusion:

zzRestrict access to press briefings—just as a news organization can lose its accreditation to 

attend a trial, it can lose its right to participate in your press briefings. 

zzMake it clear early on that harassment of victims and violations of privacy laws will not 

be tolerated. 

zzBring a victim advocate or mental health professional to the briefings to describe how specific 

behaviors are negatively affecting victims and the community.

zzRemind media organizations of their own ethical standards by praising those who do the right 

thing and asking your mayor and other community leaders to do the same. 
Preparing for the Unimaginable: How Chiefs Can Safeguard

Officer Mental Health Before and After Mass Casualty Events

52

There will also be important reporting

Given your role in the response to a horrific event, you will likely experience the onslaught of 

media attention as extremely problematic. It is important to remember that no attention at all 

would not be beneficial—a respectful public conversation about the incident is important, and 

insightful media coverage of a tragedy does not have to be voyeuristic or intrusive.

Mass casualty events are of broad public interest for a reason: They are events that rattle a community, a nation, and sometimes the world to its core. If people are capable of shooting children 

in an elementary school or moviegoers at the cinema, then are we still safe? And what kind of 

society are we?

While your agency and your community will work hard to maintain some privacy and quiet to 

begin the painful process of grieving, those watching from the sidelines often need opportunities 

to talk, inquire, and try to understand what happened. They are looking for answers that help 

restore a sense of order and predictability or maybe even bring meaning or at least clarifications 

to a senseless act. 

Half of adults in the United States followed news of the Sandy Hook shootings closely, a study 

by the Pew Research Center found.16 While there clearly are exploitations of tragedy by both 

trained and citizen journalists, the majority of coverage is helping the public make sense of a 

horrific incident.

Social media will play an important role 

Today, an incident is often instantly reported. Details about shots being fired or police rushing 

to a crime scene are shared immediately with the world on social media. What’s more, as these 

are fairly new tools, the ethics and moral boundaries of such sharing are still developing. People 

who happen to be at the crime scene are the first to broadcast details with little or no context, 

unaware of the rumors and problems this can create. 

This presents several challenges for law enforcement:

zzPeople eager to catch a glimpse may rush to the scene of a crime while a shooter is still at 

large, not appreciating the danger.

zzSurvivors may share information about victims from the scene before police can ask them 

not to and before officers can reach out to families for proper death notifications.

16. Pew Research Center, Public Divided Over What Newtown Signifies: Parents Shield Young Children (Washington, 

DC: Pew Research Center, 2012), http://www.people-press.org/files/legacy-pdf/12-17-2012%20Newtown%20release

%20NII%20FINAL.pdf.
Part Two. Preparing for a Mass Casualty Event 

4. Building Your Media Team and Strategy for a Mass Casualty Event

53

zzFamily members may see images of their relatives that are disturbing and that police or experienced journalists would not share.

zzWorried family members may approach officers in holding areas asking about rumors and 

half-truths picked up on social media that cannot be confirmed or proven false at the time. 

But social media can also be productive:

zzTwitter and other social media sites may provide unique, detailed access to information from 

an active crime scene as the crime continues to unfold (as was the case in the Boston Marathon bombing).

zzIt is among the fastest ways to spread information about safety and what not to do (in case a 

shooter has fled the scene and is at large, for example).17

zzIt may be the most efficient tool to quickly inform the traditional media and ask them to share 

important public messages immediately.

zzBystanders’ and survivors’ posts and images may become important evidence, as they often 

provide images and details not otherwise available.

To use social media effectively and to your advantage, you need to have accounts on social media 

platforms like Facebook and Twitter before a crisis occurs. You also need to work on building 

a following so that people are paying attention to your message. The Police Executive Research 

Forum has developed guidance on building your social media strategy and using it effectively.18

17. Edward F. Davis III et al., Social Media and Police Leadership: Lessons From Boston, New Perspectives in Policing 

Bulletin (Washington, DC: National Institute of Justice, 2014), https://www.ncjrs.gov/pdffiles1/nij/244760.pdf.

18. Police Executive Research Forum, Social Media and Tactical Considerations for Law Enforcement (Washington DC: 

Office of Community Oriented Policing), http://ric-zai-inc.com/Publications/cops-p261-pub.pdf.

FIVE THINGS TO KNOW ABOUT MEDIA AND MASS CASUALTY EVENTS

1. There will be massive media interest, and you need to prepare for it.

2. There will be errors and inaccuracies in media coverage, and you can learn 

how to address them.

3. There will be intrusive behavior, and there are ways to regain some control.

4. There will also be important reporting.

5. Social media will play an important role; you should learn to harness it now.
Preparing for the Unimaginable: How Chiefs Can Safeguard

Officer Mental Health Before and After Mass Casualty Events

54

How to plan an effective media strategy: 

Be prepared. Be proactive. Own your narrative. 

These tips will help you plan an effective media strategy and use the insights discussed earlier to 

your advantage as you navigate media interest in a mass casualty event.

zzAssign a public information officer or director of media relations. Just as you need a mental health professional in charge of officer mental health, you need a police media relations 

professional in charge of handling the media. 

zzYour entire media team needs to be closely involved in planning your media strategy. 

Share your thinking now and ask for their ideas and suggestions. 

zzReach out to your local media. Invite your local news reporters to join you for a planning 

meeting. This will help raise awareness of what the challenges will be. It will educate you 

and your team about the realities of media needs in the age of social media and educate the 

journalists about their role and potential missteps in a tragedy. As part of your community, 

local media often end up taking a leadership role in asking their national and international 

colleagues to respect boundaries and keep up ethical standards. Building this relationship and 

awareness now will be crucial.

zzMap out the possibilities. Look at a map of your community and decide where large numbers of media teams can be held and where you would need to restrict access. Have a map 

indicating these options ready and easily accessible in case the need arises. Tip: Mass shooters 

often are copycats, so look at where your schools, movie theaters, city hall, and other important 

buildings are located. Where would you put 150 TV trucks close to each of these buildings? 

zzIdentify media relations professionals in your community. Ideally, each victim or affected 

family would have their own media relations consultant who would help them navigate the 

sudden public interest, potential misinformation, and advances by reporters. Thinking creatively, other chiefs have used the help of local businesses who have supplied such media professionals to support victims. Are there major employers in town you could ask for this type 

of support? Identify and approach them now so you have a plan in place—including a list of 

phone numbers of people to call and bring in—that you can quickly activate when necessary.

zzBrief your officers on your media strategy. From enforcing rules around access to victims 

to speaking with survivors about their choices for media exposure to being asked to give 

interviews themselves, your officers will constantly be dealing with aspects of the media’s 

overwhelming presence. To handle this well, your staff needs to be educated about what media 

might do, why, and what appropriate responses are. In addition, it is important to share your 

agency’s media strategy so officers don’t have to guess in the moment. 
Part Two. Preparing for a Mass Casualty Event 

4. Building Your Media Team and Strategy for a Mass Casualty Event

55

What to include in your media plan 

zzSchedule press conferences early and often. Frequent briefings from you, even if there’s 

nothing new to share, will discourage reporters from inappropriately approaching victims, 

families, and first responders for further information.

zzHave a blanket statement ready for all staff, such as: “I do not have details yet on 

what happened, but I know the agency has well-designed contingency plans that allow 

us to be as responsive as possible in any kind of situation. If you have more questions, 

please talk to our public relations team.” This will help your staff know what to say when 

approached by reporters in stressful moments. Make sure your plan includes distributing this 

statement immediately to all personnel during an incident.

zzStick to your message: There was a plan in place that allowed you to adapt quickly. 

Focus on how your contingency plan led to minimizing the harm. Some things always could 

have been done better during a crisis, and you can acknowledge that—but then return to your 

message. Keep key staff members in the public eye for at least a week delivering your message 

and owning the airwaves. Focus on what is known. Respond to speculative questions by identifying them as such and say that you will stick with what is known.

zzSet the rules of engagement. For example, every TV station will want its own equipment set 

up. Instead, make them collaborate. For a public appearance by the governor or an important 

speech by victims, ask one news organization to supply the cable, the next the camera, and so 

forth so they all own the footage together and you can avoid hundreds of cameras and microphones in the face of survivors.

zzFeed the media useful information. Since you cannot stop the media machinery from 

reporting 24/7, work with others in the community to get out the messages that will help your 

community heal. Your team can set up briefings with experts who can talk about the needs of 

victims and the community, for example. 

zzAdapt your message for national and international media. National and international 

media representatives do not have the same relationships with your community as the local 

press. Ask them to report this incident as if it happened in their own town. Ask them if they 

would sneak into a funeral to snatch photos if their child’s best friend were being buried. 

zzChallenge the media to acknowledge the consequences of harmful reporting.19 Keep victim advocates and mental health professionals front and center to provide specifics about how 

harmful reporting affects survivors and families.

19. On the Media, “The Breaking News Consumers Handbook,” New York Public Radio, last modified 

September 20, 2013, http://www.onthemedia.org/story/breaking-news-consumers-handbook-pdf/.

Part One. Why Mental Wellness Matters to You and Your Agency 

Recommendations for Enhancing Resilience in Your Agency Today

57

Part Three. 

Managing a Mass Casualty 

Event and Its Aftermath

Incident and Aftermath 

Management Action Items

at a Glance

Managing challenges for your 

agency and community

Managing challenges and 

stressors for officers

Managing leadership 

challenges

Immediate 

incident 

response

(Detailed 

checklists 

begin on 

p. 68)

z Set up a central command 

with other first responder 

agencies (p. 61).

z Anticipate a high level of 

media interest and use a 

proactive, rather than reactive, media strategy 

(p. 61).

z Proactively manage 

well-wishers and self-deployed helpers (p. 61).

z Prioritize support for 

victims and their families, 

but be aware of the toll that 

working with these families 

takes on officers (p. 62).

z Assign a mental health 

incident commander to 

oversee officer mental 

health (p. 63).

z Make sure someone checks 

in with every officer on duty 

before they go off shift 

(p. 64).

z Be transparent about evolving plans for mental health 

services (p. 65). 

z Be aware that most officers 

are in survival mode, trying 

to ensure their safety and 

the safety of others (p. 65). 

z Be aware that reactions to 

the event will vary widely 

and that normal reactions 

can still be upsetting and 

unexpected for officers 

(p. 65).

z Seek out assistance from 

other chiefs, community 

leaders, and larger law enforcement agencies in your 

state or region (p. 66).

z Stay visible and explain 

what you are doing to keep 

everyone safe (p. 67).

z Recognize that this event is 

unprecedented (p. 67).

57
Managing challenges for your 

agency and community

Managing challenges and 

stressors for officers

Managing leadership 

challenges

The first 

weeks

z Manage well-wishers with 

mutual aid and careful 

media messaging (p. 73).

z Stem the flow of donations, 

and assign a project manager to manage those that 

arrive (p. 74).

z Avoid mistrust and tension 

by continuing to coordinate 

and communicate with other first responder agencies 

(p. 75).

z Develop a proactive, longterm media plan (p. 75).

z Expect debate and speculation about the cause of the 

tragedy (p. 77).

z In responding to Freedom 

of Information Act (FOIA) 

requests, be sensitive to 

officers’ needs (p. 77).

z Anticipate that funerals will 

be challenging on many 

fronts (p. 78).

- Take time and care to 

ensure memorials and 

other events are culturally appropriate (p. 78).

- Bring in extra hands to 

get the logistics right 

(p. 78).

- Anticipate the presence 

of hate groups and 

protesters, and work to 

avoid further violence 

(p. 79).

- Have an agency presence at each memorial 

service (p. 79).

- Do not require officers 

to attend funerals, but 

communicate clearly 

about expectations if 

they do (p. 79).

z Add a mental health professional to your team if 

you don’t have one already 

(p. 81).

z Make support available to 

all staff members (p. 82).

z Ensure that informal mental health support is available at all times (p. 82).

z Offer one-on-one checkins with a mental health 

professional (p. 82).

z Avoid collective retelling of 

the events (p. 83).

z Expect officers to react 

differently depending on 

where they were when the 

event occurred (p. 83).

z Support officers through a 

roller coaster of responses 

to the event (p. 84).

z Be aware that officers may 

experience stress and frustration from dealing with 

the aftermath (p. 85).

z Address conflicts within the 

agency and with other first 

responder agencies before 

they fester (p. 86).

z Realize that officers may 

displace anger onto their 

colleagues and leaders 

(p. 87).

z Take your time deciding 

how to recognize officers 

with formal awards and 

honors (p. 87).

z Encourage supervisors to 

look out for their officers 

(p. 89).

z Find allies in your community (p. 90).

z Recognize that your leadership is vital even when 

another agency is in charge 

of the investigation (p. 91).

z Stay alert to conflict within 

the agency (p. 91).

z Put your oxygen mask on 

first (p. 92).

z Model help-seeking behavior for officers (p. 92).

Incident and Aftermath Management Action Items at a Glance (cont’d)

Preparing for the Unimaginable. How chiefs can safegurad 

officer mental health and before and after mass casualty events

58
Managing challenges for your 

agency and community

Managing challenges and 

stressors for officers

Managing leadership 

challenges

The first 

weeks

(cont’d)

z Be aware that visiting 

dignitaries and other VIPs 

may add to your workload 

(p. 79).

z Anticipate bomb threats, 

death threats, “truthers,” 

and conspiracy theorists 

(p. 80).

z Expect increased calls for 

service from a community 

on edge (p. 81).

z Be flexible and look for 

ways to alleviate the pressure on officers (p. 89).

z Reach out to officers’ families (p. 89).

z Keep officers as informed 

as possible (p. 90). 

The first 

months

z Work with survivors and 

families to respectfully 

clean up temporary memorials (p. 93).

z Call on volunteers to sort 

donations (p. 93).

z Be aware that investigations and reports can 

reopen the wounds (p. 94).

z Work with other community 

leaders to accommodate 

expanded policing responsibilities (p. 94).

z Be aware of emotional 

exhaustion (p. 94).

z Be aware that serious mental health problems can 

emerge now, just as things 

are getting back to normal 

(p. 95).

z Keep working closely with 

your mental health team 

(p. 95).

z Anticipate trauma triggers, 

and prepare officers to deal 

with them (p. 95).

z Create a long-term officer 

wellness plan (p. 96).

z Ensure officers have access 

to evidence-based services 

and supports (p. 97).

z Consider setting up a formal peer support network 

(p. 98).

z Continue education and 

outreach to officers’ families (p. 98). 

z Adjust your expectations, 

and get help if the intensity 

does not let up (p. 98).

z Help officers move forward 

by acknowledging the toll 

the event has taken on you 

(p. 99).

Part Three. Managing a Mass Casualty Event and Its Aftermath 

Incident and Aftermath Management Action Items at a Glance

59
Managing challenges for your 

agency and community

Managing challenges and 

stressors for officers

Managing leadership 

challenges

The long haul z Try to make anniversaries a 

healing event rather than a 

painful reminder (p. 101).

z Look for opportunities to 

help the community heal 

(p. 102).

z Be aware that time doesn’t 

heal for everyone (p. 104).

z Anticipate triggering 

events, and provide support 

(p. 105).

- Help officers cope with 

the trial (p. 105).

- Anticipate the impact 

of other mass casualty 

events (p. 106).

z Support officers in finding 

their own ways to remember and cope (p. 106).

z Create a long-term infrastructure to support officer 

mental health (p. 107).

z Attend to your own mental 

wellness (p. 108).

z Be wary of defining yourself 

by your crisis leadership 

(p. 108).

z Reassess you role in light 

of how this experience has 

changed you (p. 108).

Incident and Aftermath Management Action Items at a Glance (cont’d)

Preparing for the Unimaginable. How chiefs can safegurad 

officer mental health and before and after mass casualty events

60
61

5 Immediate 

Incident Response 

Managing challenges for your agency and your community

Set up a central command with other first responder agencies.

One significant challenge for you and your officers during the incident will be coordination 

with other law enforcement agencies and first responders. Officers from other agencies may 

self-deploy when their command staff are not present. Conflicting information or conflicting 

plans of action may be stressful or even dangerous. 

If at all possible, set up a central command with other agencies that are responding and make 

sure your efforts are coordinated. Speak to first responders, victims, family members, and 

the media with one voice as much as you can. In the midst of a chaotic situation this level 

of coordination may seem impossible, but there are significant benefits when you can coordinate effectively.

X Anticipate a high level of media interest and use a proactive, 

rather than reactive, media strategy.

The media response to this event is likely to be bigger and more intrusive than you have ever 

experienced before. Create a media briefing area right away and provide frequent updates. For 

more on how to handle the media, see chapter 4. 

X Proactively manage well-wishers and self-deployed helpers.

Some communities experience an overwhelming onslaught of well-wishers. Individuals and 

agencies such as aid groups, clergy, community mental health providers, and well-intentioned 

members of the public may self-deploy. In most cases, it is best to work with first responder 

agencies and emergency management organizations rather than individuals. It will be very 

difficult to vet and coordinate self-deployed responders if they are not affiliated with an existing organization. 
Preparing for the Unimaginable: How Chiefs Can Safeguard

Officer Mental Health Before and After Mass Casualty Events

62

Identify an area where they can gather—away from victims and their families—such as a school 

gymnasium, library, or community center and assign an officer or a volunteer to take their information and assess whether they can be helpful. It is okay to tell them they have to wait or to tell 

them to go home. 

X Prioritize support for victims and their families, but be aware of the toll that working with 

these families takes on officers.

Supporting the families of victims is a huge challenge for you and your officers. Distraught family members will be desperate for and may demand information that you do not have or endanger themselves trying to access the crime scene. Officers assigned to assist the families may face 

questions they cannot answer. When families are gathered together, information—sometimes 

inaccurate—may spread about the police response or the welfare of an individual. Families may 

get very upset if officers can’t answer their questions. For example, an officer may know whether 

an individual was injured or killed but not be able to share that information with family members because the person hasn’t been officially identified. At the same time, media, clergy and 

well-wishers may want access to families that prefer privacy. Officers are in the middle, trying to 

ensure that families needing privacy can have it and that families that want access to clergy and 

well-wishers also get their needs met.

Sorting out the facts and informing the appropriate family members in a timely way can be a big 

stressor for officers. Recommendations for managing this challenge include the following:

zzProvide clear communication. Officers need to know what information they can share and 

with whom. They also need to know who should have access to the families. Families should 

receive frequent updates, and these should be given to all the families as a group if possible.

zzOfficers who were first on the scene or who worked the crime scene should not be reassigned 

to support families or to conduct death notifications. This can create potential conflicts, where 

officers have information about the scene that they can’t share, and can intensify feelings of 

guilt about not being able to save a life.

zzWhile it’s not always possible, in an ideal world each family would have a private room to 

gather in and a victim advocate to assist them. 

zzClergy, counselors, and other supporters can be in a separate area, available at the families’ 

request. Do not permit a free-for-all, because families may become more distressed if unwelcome help is pushed on them. 
Part Three. Managing a Mass Casualty Event and Its Aftermath 

5. Immediate Incident Response

63

Managing challenges and stressors for officers 

X Assign a mental health incident commander to oversee officer mental health.

No one would suggest stopping in the middle of a crisis to have a heart-to-heart, but you still 

need to make sure officer wellness is addressed. You will need help with this task. If you have 

assigned a mental health incident commander as described on page 41, rely on that individual to 

advise you on matters related to officer mental health. 

If you don’t have an existing mental health incident commander, assign someone to be responsible for officer mental health. This individual may only serve in this role for a few days while 

you set up something more permanent, but assigning someone as soon as possible will help with 

important tasks in the early days. This person could be any of the following:

zzA trusted police psychologist 

zzA licensed mental health professional 

zzA licensed employee assistance provider 

zzA member of your command staff 

zzA chief from a neighboring community 

The mental health incident commander’s responsibilities today include the following:

zzMonitoring the officers’ behavior and verbalizations on scene to see if anyone needs immediate assistance.

zzEnsuring that a mental health provider or supervisor checks in with all officers and civilian 

staff before the end of shift. This is not a formal intervention, but anyone conducting these 

check-ins should receive a copy of “How to Assist a Fellow Officer after a Critical Incident” 

in the handouts and resources section at the back of the book, which provides on Psychological First Aid guidance on what to do and say.

zzBeing available to consult with the chief and command staff.

zzSharing information about available mental health services with officers and ensuring that 

officers’ questions are answered. 

zzConnecting with officers’ family members if needed. 
Preparing for the Unimaginable: How Chiefs Can Safeguard

Officer Mental Health Before and After Mass Casualty Events

64

zzCoordinating with employee assistance providers and other mental health service providers.

zzManaging self-deployed mental health professionals. Unfortunately, it will be very difficult 

to screen and credential mental health professionals on the spot, so it’s unlikely that selfdeployed providers will be able to assist on the first day. Keep them from disrupting victims 

and families, take their information for the future, and tell them to go home. 

Make sure someone checks in with every officer on duty before they go off shift.

Before going home on the first day, every officer should have a quick conversation with a colleague or mental health professional to check in about how they are doing. If mental health 

professionals or trained peer support officers familiar to your officers are not available, supervisors can talk with their staff one-on-one at the end of shift. These conversations do not need 

to be lengthy or complicated, but they should cover a few basics: safety and immediate needs, 

helping the officer to connect with family or friends, and letting them know whom to call if they 

need to talk. Even if mental health professionals are able to connect with an officer, most officers 

will appreciate this kind of support from some combination of fellow officers, supervisors, and 

command staff. 

For a handout with step-by-step instructions on how to approach these conversations, see 

“How to Assist a Fellow Officer after a Critical Incident” in the handouts and resources section 

at the back of the book. Your mental health incident commander should ensure that all supervisors have a copy of this handout and know they are responsible for their officers. For more 

information on the research behind this approach, see “Review the research on early formal 

intervention after traumatic events” on page 34. 

“Psychological First Aid represents the future of the modern 

response to the critical incident. It allows officers to help each 

other in a safe, structured way. It’s something we can 

all grasp and use effectively.” 

— Lieutenant Alexander L. Eastman, MD, MPH, FACS, 

Deputy Medical Director, Dallas Police Department
Part Three. Managing a Mass Casualty Event and Its Aftermath 

5. Immediate Incident Response

65

Be transparent about evolving plans for mental health services.

Even if you do not yet have a plan for providing officers with mental health services going 

forward, share whatever information you can. Officers appreciate transparency, even if all you 

can say is, “We are still working on setting up counseling with the employee assistance provider. 

We will let you know as soon as possible how to get assistance.” It tells them you are concerned 

about their well-being and working on it. 

Be aware that most officers are in survival mode, trying to ensure their 

safety and the safety of others.

During the incident, your officers are just trying to do their jobs and ensure basic needs are 

addressed—including their own safety, the safety of others, and the availability of medical assistance. Some officers may not even be aware of having any emotional reaction to their experience 

until much later. This is called “survival mode.” 

Depending on the circumstances, survival mode may extend days or weeks— for example, if 

some victims remain unaccounted for or are still medically unstable or when perpetrators remain 

at large. In other words, the danger or constant reminders of it have not yet passed. 

You can still ask how an officer is doing and provide support—just realize that physical health 

and safety rather than mental well-being are the top priority now. 

Be aware that reactions to the event will vary widely and that normal reactions 

can be still be upsetting and unexpected for officers.

At the end of the first day—or whenever survival mode ends—many officers will want to go 

down to the bar and get a few beers. The camaraderie of a night at the bar with other cops may 

be a healthy way to cope in the immediate aftermath of a crisis—it is when a few drinks become 

too many or when drinking becomes a habit that problems start. 

Other normal reactions to trauma in the first 24–48 hours include replaying and re-imagining 

the event over and over. Some officers will have insomnia or nightmares or feel like they are on 

an emotional roller coaster. Some may worry about what to tell their kids and spouses and then 
Preparing for the Unimaginable: How Chiefs Can Safeguard

Officer Mental Health Before and After Mass Casualty Events

66

say nothing. Spouses often notice right away that the officer has withdrawn, not wanting to burden their family. Others become short-tempered. All of these natural reactions can be short-lived 

and do not necessarily mean that the person will have any long-term mental health problems. 

Some officers will feel fine, and they may even think something’s wrong with them because they 

feel fine. But feeling fine is also a normal reaction right after a traumatic event. 

Managing leadership challenges 

X Seek out assistance from other chiefs, community leaders, and larger law enforcement 

agencies in your state or region. 

Today and going forward, you will face increased demands on you personally and on your 

agency. You will play a role in everything from responding to the media to communicating with 

victims’ families to reassuring the community. Your leadership is vital in setting the tone for your 

officers, but you also need help to manage the increased responsibilities and ensure that officer 

wellness is addressed.

You will receive offers of assistance from a wide variety of sources. You will not have time to sift 

through all of these offers and respond immediately. Assuming the immediate danger has passed, 

pause for a moment and decide what sort of assistance you need and seek it out. 

Some chiefs said their best ally was a chief from a neighboring agency who shadowed them to 

meetings, kept track of the moving pieces, spoke with authority, and provided personal support. 

For example, another chief can help you manage witnesses who are uninjured but still need to 

be interviewed, establish an outer perimeter, and respond to routine calls for service with his or 

her own personnel. After the Sandy Hook Elementary School shooting, several chiefs responded 

to support Chief Michael Kehoe, including Chief Marc Montminy from Manchester, Connecticut, who had experience with a previous mass casualty event. Do not hesitate to identify a 

trusted colleague and ask him or her to serve in that role. 

Other chiefs suggested reaching out to larger agencies in your region or your state to identify 

mental health resources. Many large agencies have a police psychologist on staff, a peer support 

team, or access to mental health professionals through an employee assistance provider. Do not 

hesitate to ask for their help in identifying mental health professionals to assist your agency. 
Part Three. Managing a Mass Casualty Event and Its Aftermath 

5. Immediate Incident Response

67

X Stay visible and explain what you are doing to keep everyone safe.

The victims, their families, and the community will be looking to you for reassurance that they 

are safe and the situation is under control. Your officers will also be looking to you for the same 

reassurance. It’s important that you address these concerns proactively, and even if there’s little 

news to report—for example, when the perpetrator is still at large—it’s important to keep everyone informed.

Officers, especially those who responded to the scene, will appreciate if you take time to speak 

with them individually or as a group. You may wish to call an all-staff meeting or address each 

shift at roll call. Acknowledging that it’s a difficult time and thanking them for hard work will 

also go a long way to boosting their confidence and easing their concerns. 

X Recognize that this event is unprecedented.

Just like your officers, you as the chief may be experiencing a wide range of reactions to the 

event. All the chiefs who contributed to this guide experienced guilt and grief and felt they 

made mistakes. Recognize that this is an unprecedented event in your career and for your 

agency and that no one can prepare for every possible scenario. It is normal to take your responsibilities very seriously, but some things are truly outside of your control, and a mass casualty event is one of them. 

Containing strong feelings can be important to getting through the crisis, but when the immediate danger has passed, do not be afraid to show your officers that you, too, are affected by the 

tragedy. You can model professionalism by showing that you can experience emotion without 

losing your ability to function and lead. 

Some leaders in this situation will beat themselves up, thinking they lost control of their emotions when they shouldn’t have, but the truth is that everyone has to process their reaction. As a 

preventive measure, seek out someone to talk with so that you can process in private and avoid 

a loss of control at the wrong time. If there’s not a mental health professional on hand, a fellow 

chief, your spouse, or a trusted friend can assist you. 

Immediate incident response checklists

The following checklists (on pages 68–72) are deliberately placed on individual pages so that 

you can easily photocopy them for individual use.
Preparing for the Unimaginable: How Chiefs Can Safeguard

Officer Mental Health Before and After Mass Casualty Events

68

Immediate incident response checklist: Operations

TASK COMPLETED

1. Activate your mental health incident commander immediately 

(see page 41). 

2. If you don’t have a mental health incident commander, assign someone 

to be responsible for officer mental health. 

Tip: This person can be a member of your command staff, a licensed 

behavioral health professional affiliated with your employee assistance 

provider, a police psychologist, or a chief from a neighboring agency. 

If needed, ask a neighboring agency to “lend” you their police psychologist or a mental health professional affiliated with their employee assistance program.



3. Assign the mental health incident commander to meet with self-deployed 

mental health responders, take their contact information, and then send 

them home. 



4. Set up a central command with other agencies that are responding and 

make sure your efforts are coordinated as much as possible. 

5. Together with other the leaders of other responding agencies, speak to 

first responders, victims, family members, and the media with one voice. 

6. Once the threat is neutralized, give the first responders the option of 

some time off. 
Part Three. Managing a Mass Casualty Event and Its Aftermath 

5. Immediate Incident Response

69

Immediate incident response checklist: 

Getting the help you need and managing self-deployed responders 

TASK COMPLETED

1. Ask a chief from a neighboring agency to shadow you, take notes, and 

help sort and delegate tasks. 

2. Request mutual aid from other agencies. Neighboring chiefs can take on 

the following assignments:

a. Establishing a perimeter 

b. Creating designated areas for media and well-wishers

c. Assisting and interviewing uninjured witnesses

d. Administering the mutual aid response for at least the next week



3. If needed, contact a larger police department in your state that has an 

employee assistance provider or police psychologist who can offer guidance 

about how to support your officers. 

Tip: A community-based mental health provider may be helpful, but you really 

want to identify someone familiar with law enforcement culture.


Preparing for the Unimaginable: How Chiefs Can Safeguard

Officer Mental Health Before and After Mass Casualty Events

70

Immediate incident response checklist: Support for victims’ families 

TASK COMPLETED

1. Work with victim assistance specialists in your community 

as much as possible. 

2. Work closely with the coroner or medical examiner to identify victims 

quickly so that the families can be informed. 

3. Assign a private space, if possible, for each family to gather. 

4. Create separate holding areas for victims’ families, the media, and 

self-deployed helpers (clergy, mental health providers, and other groups). 

5. Tell family members that clergy and counselors are available at 

their request. 

6. Ask victim advocates to educate families about their rights in 

interacting with the media. 

7. Make sure that officers assigned to assist victims’ families have 

clear instructions about what they can and cannot say to distraught 

family members. 

Tip: If possible, officers should receive guidance from someone trained 

in victim assistance.



8. Do not assign officers who were part of the initial response or 

who worked the crime scene to support victims’ families or conduct 

death notifications.


Part Three. Managing a Mass Casualty Event and Its Aftermath 

5. Immediate Incident Response

71

Immediate incident response checklist: Managing the media 

TASK COMPLETED

1. Print out your media plan. If you do not have a media plan, see page 55 

for what to include in your plan. 

2. Be proactive rather than reactive in managing your response to 

the media. 

3. Update the media regularly even if there is nothing new to report. 

4. Create an area reserved for media away from the crime scene 

and victims’ families. 

5. Assign a media liaison and direct all contacts to him or her. Instruct 

officers to direct all media inquiries to the media liaison. 

6. Remind the media to be respectful and maintain boundaries when it 

comes to victims and their family and friends. 

7. Consider whether there’s anything the media can do for you. If there’s 

something you need the community to do, such as a particular need that 

can be fulfilled, get the word out through the media.


Preparing for the Unimaginable: How Chiefs Can Safeguard

Officer Mental Health Before and After Mass Casualty Events

72

Immediate incident response checklist: Supporting officer wellness 

TASK COMPLETED

1. Instruct supervisors to make sure each officer and civilian staff member 

has a brief personal contact and check-in before they go off shift today. 

2. Give every employee the name and phone number of your mental 

health incident commander or a licensed mental health professional in 

case they need to talk.



3. Do not require the first-on-scene officers to file their reports on the 

day of the incident. 

Tip: After a traumatic incident, an officer’s memory will be clearer after 

a night of sleep, and filing the report on the day of the event may cause 

unnecessary stress.



4. If your plan for providing officers with mental health services is still 

evolving, tell officers that their well-being is important to you and that you 

are working on making mental health support available to them. Share 

whatever information you have at each point.



5. Do not assume that you know who will need assistance. Anyone in 

your department, from officers to dispatchers to administrative staff, could 

need mental health support.


73

6 The First Weeks: 

From Chaos to a 

New Normal 

Managing challenges for your agency and your community

It may seem that the challenges in the aftermath of a mass casualty event are primarily logistical 

and operational rather than mental health-related. The fact is that managing the overwhelming 

demands on your agency effectively is incredibly important to your officers’ well-being. They 

will need time, space, and consistency to recover, and you can help provide that with your leadership. This can be an overwhelming time and there is no perfect or one-size-fits-all approach 

that works for every agency; following are some challenges other chiefs faced and how they 

managed them. 

X Manage well-wishers with mutual aid and careful media messaging.

Many high profile events gain national and international attention, which means you may have 

hundreds or thousands of well-wishers in your city offering to help or creating impromptu 

memorials. Your agency is in charge of handling the logistics of such a massive emotional 

outpour. Initially this may be reassuring to your community, but self-deployed responders and 

well-wishers quickly become a huge burden. All the help you receive can lead to such a depletion of time and resources that it has been called a “secondary disaster.”

How do you keep all the well-meaning people away from survivors and families, who need 

privacy? How do you keep well-meaning visitors safe? How do you manage when your visitors 

block traffic, making it nearly impossible for residents to get around their own community? 

How do you ask the well-wishers to go home so that the community can have some privacy to 

begin healing? 
Preparing for the Unimaginable: How Chiefs Can Safeguard

Officer Mental Health Before and After Mass Casualty Events

74

Some tips for managing these logistics include the following:

zzContinue to accept mutual aid to manage security, traffic control, and other needs. 

zzAsk for respect for the grieving families and the community.

zzWork with other community leaders to strategize about outside visitors. Is there a message you can get out through media—for example, ways that people can help while staying 

at home? 

X Stem the flow of donations, and assign a project manager to those that arrive.

People who feel compelled to help will also send donations, monetary and otherwise. In Newtown, Connecticut, the volume of donations was overwhelming. The community received more 

than 63,000 stuffed animals and between 150,000 and 200,000 pieces of mail, along with pallets 

of books, school supplies, and backpacks. In Oak Creek, Wisconsin, after the Sikh Temple 

shooting, the police department began receiving financial donations from Sikh communities in 

India designated for the officer who was injured during the incident. The department had to 

open new bank accounts to hold that money on the officer’s behalf while he was recovering from 

his injuries.

Your department will likely be the recipient of many donations, including food, flowers, money, 

and letters of appreciation. Tips for managing donations include the following:

zzCommunicate early and often through the media which specific types of assistance are needed 

and that other efforts, though well meant, are complicating things for your community. 

zzAsk well-wishers to donate to a cause in their local community or to a well-established 

relief organization.

zzIdentify someone to serve as a project manager for sorting donations. Reach out to local 

businesses and emergency management agencies to find the right person or use a competent volunteer.

“The donations came in tractor-trailer trucks.” 

— Michael Kehoe, Chief of Police (ret.), 

Newtown, Connecticut
Part Three. Managing a Mass Casualty Event and Its Aftermath 

6. The First Weeks: From Chaos to a New Normal

75

X Avoid mistrust and tension by continuing to coordinate and communicate with other first 

responder agencies.

There is often a “honeymoon” period in the immediate aftermath of large-scale tragedies—the 

community comes together and first responders of all sorts are lauded as heroes. Everyone works 

together for the good of the community. Over time, however, it is common for some of these 

agencies to become distrustful and even hostile towards one another, especially when insufficient communication and coordination lead to conflicting plans or duplication of effort. 

Because everyone is under incredible stress, some tension is inevitable. But effective coordination, communication, and teamwork are essential not just to the success of the overall response 

but also to the resilience of all involved. 

X Develop a proactive, long-term media plan.

After the first 48 hours, it will be clear how much media attention your incident is attracting. 

You will have created your media holding area and be controlling your message about your 

response (for details, see chapter 4.) The question is how long the media will stay. This cannot 

be predicted: In Newtown, Connecticut, reporters were on site constantly for six to eight weeks 

after the Sandy Hook Elementary School shooting. After the Manchester, Connecticut, workplace shooting at Hartford Distributors in 2012, the initially strong media response tapered off 

after a few days. As these events become more frequent, the focus of media attention may shift 

more quickly to the next event or threat. 

A continued strong media presence can be frustrating for residents and officers alike. There is a 

variety of approaches to interacting with the media. The most important thing is to have a proactive strategy. If you are simply reactive, your agency will become overwhelmed with requests. 

Review “What to include in your media plan” on page 55 for strategies to promote a good working relationship with the media and mitigate any negative impact on victims, survivors, yourself, 

and your officers. 
Preparing for the Unimaginable: How Chiefs Can Safeguard

Officer Mental Health Before and After Mass Casualty Events

76

“In responding to the media, my highest priority was achieving justice 

for the victims. I didn’t want to misstep and provide reporters with 

any information that would make it harder to have a successful 

criminal prosecution. We also adopted the mindset that the media 

was a tool for us to get the community the information they needed 

to know about the event, and to be reassured that it was handled 

well. Provided we stuck to that agenda, we didn’t feel compelled to 

answer their endless questions.”

— Daniel Oates, Chief of Police, Miami Beach, Florida, 

and former Chief of Police, Aurora, Colorado 

RESPONDING TO MEDIA REQUESTS AFTER THE 

HARTFORD DISTRIBUTORS SHOOTING 

In the aftermath of the Hartford Distributors shooting, Chief Marc Montminy and 

other community leaders took a novel approach to addressing media requests. 

Because the perpetrator was deceased and there was no reason to withhold information, they decided to release all the documentation about the shooting to the 

media with the exception of graphic images of the victims and the crime scene. 

They called a press conference and gave each reporter a DVD with all the information. This proactive approach effectively ended the rush to uncover information and 

the story quickly faded from the spotlight. 
Part Three. Managing a Mass Casualty Event and Its Aftermath 

6. The First Weeks: From Chaos to a New Normal

77

X Expect debate and speculation about the cause of the tragedy.

Elected leaders, pundits, or the media will consider this an important time to address the political debate about the causes of the tragedy: Was it lax gun control laws, or should people have 

easier access to weapons to defend themselves? Was the cause inadequate mental health services? Could better policing or different laws have prevented the incident? Your community may 

still be burying the dead and resent the spotlight and pressure to engage in these discussions. 

If your investigation is ongoing, your inability to share information about the perpetrator will 

frustrate representatives of the media and may lead to further digging for details. Some things 

you can do include the following:

zzWith other community leaders, ask for respect and time to mourn. 

zzClearly explain the reasons why some information cannot be shared. 

zzStick to you media plan and don’t speculate when the facts aren’t clear.

zzContinue to reassure your community about the things you are doing to keep everyone safe. 

X In responding to Freedom of Information Act (FOIA) requests, be sensitive to officers’ needs.

It is typical for law enforcement agencies to receive many FOIA requests after a mass casualty 

event, starting on day one and picking up in the first weeks. They can come from media representatives and from citizens determined to uncover the “real” story. 

When information pertaining to particular officers, such as videos or documents, is released, the 

officers may be subject to intense scrutiny. This is immensely stressful for the officers. To alleviate this stress and protect officers’ privacy, you should do the following: 

zzIf at all possible, give the officers an opportunity to see videos or read documents before they 

are released.

zzRemind officers to secure their social media accounts and the accounts of their family members prior to the release of information to protect their privacy.

zzInstruct your mental health team to reach out to the officers to provide support.
Preparing for the Unimaginable: How Chiefs Can Safeguard

Officer Mental Health Before and After Mass Casualty Events

78

X Anticipate that funerals will be challenging on many fronts.

X Take time and care to ensure memorials and other events are culturally appropriate. 

In the rush to accommodate visiting dignitaries and show the community that they are taking 

action, some community leaders are hasty in planning memorials and other events. It’s important to ensure that you are being sensitive and culturally appropriate for the victims and their 

families. This is particularly true when the incident occurs in a cultural community center, such 

as a place of worship or a school. You may find yourself caught in the middle trying to mediate 

these decisions.

The best way to ensure that your agency is sensitive to any issues is to talk with leaders of the affected 

community and to take sufficient time to understand everyone’s needs and preferences.

RESPECTING THE SIKH COMMUNITY’S CUSTOMS IN OAK CREEK

After the Sikh Temple of Wisconsin shooting, the Sikh community wanted small, 

private memorials; their custom is not to have expressions of grief in public. 

Unfortunately, there was pressure for large public funerals with VIPs in attendance. 

Although the large funerals went forward, the police chief advocated on behalf of 

the Sikh community and built a lasting relationship based on understanding and 

support of their customs.

Bring in extra hands to get the logistics right.

Your agency will need to manage logistics around the funerals—clearing roads, providing police 

escorts, getting people safely in and out of the buildings, keeping media at bay, and providing 

security for high-profile visitors. In extreme cases when there are multiple funerals in one day, 

your attention to these logistical concerns can have a real impact on the families. For example, 

if the memorial services are delayed because there’s not sufficient security for a visiting dignitary, it can be very upsetting to families. Again, mutual aid can help fulfill staffing needs for 

these events.
Part Three. Managing a Mass Casualty Event and Its Aftermath 

6. The First Weeks: From Chaos to a New Normal

79

Anticipate the presence of hate groups and protesters, and work to avoid further violence.

Funerals can also draw the attention of hate groups and other extremists who are looking for a 

platform to showcase their ideologies. While nothing could be more infuriating than disrespecting grieving families, it is important to make sure that protesters, community members, and 

officers remain calm to prevent further violence. 

X Have an agency presence at each memorial service

As a community leader, you or your command staff should be visible at the funerals. Your 

presence can be comforting for the families and your community. As these events may be very 

painful, consider dividing up the ceremonies with your command staff so that no one has to go 

to every memorial. 

X Do not require officers to attend funerals, but communicate clearly about expectations

if they do.

For officers not involved in managing logistics at a specific funeral, we recommend not making 

attendance mandatory. Some officers will want to go and may find it comforting. For others, 

it may be torturous to interact with the family of someone whose life they couldn’t save. It’s 

important to inform officers of the schedule of services, that they have a choice whether or not 

to attend, and whether there is any protocol they should follow if they attend. 

“The impact of interacting with families of victims cannot be 

overstated. There were police officers who would have preferred to 

be involved in the active shooter situation [rather] than going to the 

funeral. They were more concerned about facing the families of people 

they could not save than going into a dangerous situation.” 

— Marc Montminy, Chief of Police, Manchester, Connecticut

Be aware that visiting dignitaries and other VIPs may add to your workload.

When a high-profile event occurs, state and national leaders may visit to console families, show 

their support, and draw attention to a political issue that they believe is the cause of the tragedy. 

These visits add intensive security requirements and other tasks to your agency’s workload. For 

example, after the Aurora, Colorado, movie theater shooting, President Obama visited with the 
Preparing for the Unimaginable: How Chiefs Can Safeguard

Officer Mental Health Before and After Mass Casualty Events

80

injured and the families of the dead. Afterward, his office asked local officials to provide a list of 

the names, addresses, and relationship of key family members of all the victims so that he and 

the First Lady could write personal letters of condolence. It was a difficult and time-consuming 

task for the police department, but it was a vitally important service to the victims. A letter from 

the President of the United States is a powerful statement of the nation and a part of the longterm healing process for the victims and their families.

“Whenever you have sustained media attention on a community, it 

will draw the attention of a certain element of society that is very 

suspicious of the government.” 

— Michael Kehoe, Chief of Police (ret.), Newtown, Connecticut

X Anticipate bomb threats, death threats, “truthers,” and conspiracy theorists

Just as the spotlight on your community may draw the attention of hate groups, trouble-makers 

may also take advantage of the perception of chaos to make your job more challenging. Schools, 

churches, police stations, and other public buildings may be the targets of bomb threats. Public 

officials, survivors, and victims’ families may receive death threats. 

People from outside the community, driven by distrust of the government or extreme ideology, 

may claim that the incident never occurred or that there was a vast government cover-up of the 

real incident. They may claim to know the “truth” and broadcast bizarre misinformation. For 

them this may be idle speculation covered by the anonymity of the Internet. For your community it is salt on the wounds. 

The “flavor” of this unwanted attention is different depending on the incident. For example, 

after the Hartford Distributors shooting, White supremacists protested and sent hate mail 

because the shooter was Black. You may get threats that someone is going to “finish the job” or 

accusations that police officers killed the victims and there was a cover-up. Some agencies investigate hundreds of such threats in the weeks, months, and years after the event. For particularly 

high profile incidents there doesn’t seem to be any end—some students injured in the Columbine High School shooting in 1999 continue to receive unwanted communication more than 16 

years later. 

You cannot ignore these threats, or you run the risk of normalizing this behavior. Some harassers 

have been successfully apprehended. Reach out to federal law enforcement agencies, including 

the Federal Bureau of Investigation (FBI) and U.S. Marshals Service, for help identifying where 

threats are coming from, and access to technical experts and behavioral scientists.
Part Three. Managing a Mass Casualty Event and Its Aftermath 

6. The First Weeks: From Chaos to a New Normal

81

Expect increased calls for service from a community on edge.

After a mass casualty event, everyone in the community is on edge and may be hypervigilant about potential threats. Expect increased calls for service. For example, after a workplace 

shooting, you may receive calls for assistance when a local company has plans to fire or lay off 

employees in the worry that such employees may return to take revenge. Following a school 

shooting, school staff may be more likely to call 911 when they see a stranger or unattended 

package near the school. 

To allay the community’s concerns, it’s important that your leadership is visible and that you 

communicate all the things you are doing to keep the community safe. 

Managing challenges and stressors for officers

Add a mental health professional to your team if you don’t have one already.

As chief, you likely do not have the training to evaluate mental health services and service providers. You also may not know who could benefit from professional support or how to encourage 

them to seek it out. And you do not have the time. 

If you haven’t already, now is the time to bring in a mental health professional who can coordinate services for you and set up an appropriate support structure that makes it most likely that 

officers will take advantage of the services that are available. This individual will be your mental 

health incident commander. In the first 24–48 hours, you can assign anyone you trust these 

responsibilities, but going forward, expertise matters. For more information about what to look 

for in a mental health incident commander, see “Assign a mental health incident commander” 

on page 41.

“You need a licensed mental health provider who knows the law 

enforcement culture and knows trauma, including the principles of 

Psychological First Aid. Lots of mental health providers think they are 

good at everything, but if you think that, you’re probably not doing 

anything very well.”

— Jim Rascati, LCSW
Preparing for the Unimaginable: How Chiefs Can Safeguard

Officer Mental Health Before and After Mass Casualty Events

82

X Make support available to all staff members.

Because there is such a variety of reactions to traumatic experiences, anyone in your department, 

whether they were on-scene during the incident or not, may be affected. Some staff may react 

more strongly than you expect because of difficulties outside of work or previous experience 

with traumatic events. This is why frequent casual check-ins with all staff members in the first 

weeks are essential. 

If time and resources are limited, staff members who were closest to the event should receive 

support first. For example, you may want to check in with staff in this order: 

zzFirst responders to the scene

zzOfficers who were on-scene and arrived after the violence was over, including those assigned 

to work with victims, their families, or the media 

zzDetectives assigned to process the scene

zzDispatchers, other civilian staff, and anyone who was off duty

X Ensure that informal mental health support is available at all times.

Conversations about traumatic experiences don’t have an on and off switch. Ideally, an officer 

or staff member should be able to reach a supportive listening ear—a trained professional or a 

peer—whenever they are ready. This means that officers have a phone number to call and also 

that mental health staff are integrated into your day-to-day operations so officers have many 

opportunities to become familiar with them. Having mental health professionals at roll-call, 

during trainings, and during briefings builds the credibility of your mental health team and provides officers with easy access to them.

At the same time, there need to be frequent, casual check-ins with all staff members. In addition 

to mental health professionals, instruct supervisors to continue to check in with front-line staff, 

and alert the mental health incident commander if there is a serious concern. 

X Offer one-on-one check-ins with a mental health professional.

Offer one-on-one coffee or other informal meetings with a trained mental health professional. 

Make sure it is clear that this is not a physical and not an official fitness-for-duty test—just a 

conversation with someone trained to help officers cope with their response to the situation. 
Part Three. Managing a Mass Casualty Event and Its Aftermath 

6. The First Weeks: From Chaos to a New Normal

83

X

X

Every officer should have at least one such conversation within the first days or weeks following 

a mass casualty event. Some chiefs choose to make this mandatory so that officers who are hesitant to ask for help can have some cover with their peers.

“The people who really need support don’t take advantage of it. At 

Aurora, we had a list of every person who responded in the theater. 

I divided them up among my staff, and every officer had to talk to 

someone at least once. We didn’t wait for them to come to us.”

— John Nicoletti, PhD

Avoid collective retelling of the events.

If you have mandatory group meetings early on, focus on the psychological impact and educate 

your officers about how acute stress affects the body, ways to stay resilient, and where to seek 

support. It may not be possible to stop officers from sharing their experiences, but if they start 

down that track, suggest they meet separately to continue their discussion. Keep in mind that 

some officers will be upset to hear details, but they may not feel free to speak up. Make sure officers know that someone is always available if they want to talk about the experience one-on-one. 

If possible, consider delaying tactical debriefings. Because of the emotional impact, any officers 

will not have enough perspective to engage in a “lessons learned” discussion productively. Such 

a debriefing done too soon may intensify feelings of helplessness and guilt. When a tactical 

debriefing is scheduled, strongly encourage officers to attend, but do not make it mandatory. A 

mental health professional or mental health incident commander should be available during any 

tactical debriefings. 

Expect officers to react differently depending on where they were when the event occurred.

Officers may experience a wide variety of reactions related to their assignments on the day of the 

event. Some officers would rather have worked the crime scene than have been responsible for 

assisting victims’ families, especially while the families were waiting for news of their loved ones’ 

well-being. Officers who were doing crowd control or responding to ordinary calls for service 

may feel like their contributions were not important. Officers who were off duty or on vacation 

may feel out of place because they did not share in the experience and did not contribute. 
Preparing for the Unimaginable: How Chiefs Can Safeguard

Officer Mental Health Before and After Mass Casualty Events

84

First responders may be worried about the people who were injured. Civilian employees tasked 

with holding down the fort and fielding hundreds of calls may be overwhelmed or feel their 

contributions went unrecognized.

When you are assigning responsibilities, account for the officers’ roles on the day of the incident. 

For example, first responders should not be assigned to assist victims’ families or required to 

attend funerals. Officers who were off duty may actually appreciate the opportunity to take on 

those roles as it helps them contribute meaningfully. Dispatchers and other civilian employees 

may need more support and flexibility than you expect. 

X

“Imagine the most important event in your career, and you were on 

vacation. Part of an organization is shared experience. If you were the 

odd guy who happened to be in Disneyland, then you come back and 

you can’t relate to what happened.”

— Marc Montminy, Chief of Police, Manchester, Connecticut

Support officers through a roller coaster of responses to the event.

For many officers, the emotional roller coaster that started immediately after the event will continue in these weeks. Individual reactions to traumatic events and acute stress vary greatly and 

can change quickly. The important thing for everyone to remember is that our brains and our 

bodies are processing the experience, and a whole range of normal responses are expressed: Numbness, grief, guilt, anger, sadness, and many other confusing emotions are all normal reactions. 

Some officers may feel fine but worry that something’s wrong with them because they feel fine.

Some officers may start asking “why” questions. “Why did the perpetrator kill innocent people?” 

“Why did I live when others did not?” “Why did God allow this to happen?” These questions 

generally do not have simple answers, and officers may frustrate themselves trying to make 

sense of an event that has no easy explanations.

Officers’ reactions to the event may affect how they work. For example, some officers will want 

to work around the clock. Others will not leave an injured colleague’s hospital bed. Some will 

take a day off and then find it hard to return. Those who were off duty when the event happened 

may overwork themselves trying to make up for the guilt they feel about being unable to help 

during the incident. 

Everyone will try to suck it up and do their jobs, but for some that will be difficult. To the degree 

possible, offer flexibility and encourage all officers to take care of themselves. 
Part Three. Managing a Mass Casualty Event and Its Aftermath 

6. The First Weeks: From Chaos to a New Normal

85

X Be aware that officers may experience stress and frustration from dealing 

with the aftermath.

As if it wasn’t enough to cope with the aftereffects of witnessing violence, officers are probably 

also experiencing stress that has less to do with the event and more to do with the aftermath. 

Your officers will want to work hard, to contribute, and to support the community, but dealing 

with the logistical challenges can be incredibly frustrating. Rather than moving the community 

forward, it can feel like the community has been overrun by an occupying force and their job 

is just to stem the tide. Officers may resent assignments that feel frivolous, such as escorting a 

visiting VIP or handling crowd control. 

The overwhelming media presence—rehashing of every detail of the event, digging into the 

back story of the perpetrator, scrutinizing the details of the police response—is often torturous 

for officers and community members. The same is true for the constant crowd of well-meaning 

community members bringing food and gifts. Taken together, these constant reminders can 

actually trigger a trauma response for some officers and members of the community. This influx 

can make healthy coping mechanisms—such as going for a walk outside and staying away 

from images of the incident—unavailable. Without a break, there is no opportunity to heal and 

move forward. 

Misreporting and inappropriate behavior by media representatives can also contribute to officers’ 

nagging sense that the world is not as trustworthy as it used to be or that things are not as controllable as they used to be. They can add to the struggle to maintain a sense of hope and control 

in the aftermath of a great atrocity—all of which can wear down resilience. 

“An officer walked up to me in the weeks after the shooting and asked, 

‘Chief, when does it stop?’ I said, ‘It doesn’t stop. But there are 

professionals out there that can help you. To help make a plan for you 

to move forward.’” 

— John Edwards, Chief of Police, Oak Creek, Wisconsin
Preparing for the Unimaginable: How Chiefs Can Safeguard

Officer Mental Health Before and After Mass Casualty Events

86

X Address conflicts within the agency and with other first responder agencies 

before they fester.

Within your agency there may be conflicts around overtime, time off, and worker’s compensation. Officers may be upset if someone takes time off and perceive that as weakness or slacking 

off. One first responder agency, or staff members within a particular agency, may feel that other 

first responders are not pulling their weight and are instead taking advantage of the situation to 

get maximum time off or to set the stage for a disability claim down the line. While there may be 

an occasional abuse of the system, for officers who truly need time off or psychological support 

there may be unnecessary pressure to show up as usual or even work extra. 

Officers may also bond with those who shared a similar experience that day—with those who 

responded first feeling more entitled than those who were off duty or responded later. This can 

cause great conflict within an organization. 

Resentment can also arise around awards and honors. Officers in one agency may feel that other 

first responders are inflating how important their role was in responding to the incident or that 

particular responders are being singled out for heroic actions when others are not. For guidance 

on how to award honors sensitively, see “Take your time deciding how to recognize officers with 

formal awards and honors” on page 87. 

Conflicts can also arise around gifts and donations that come to the agency. Well-meaning 

community members will send tickets to a ball game or trays of food, and officers can get upset 

if someone seems to take (or be given) more than their fair share. They might ask why, if there 

were only a limited number, did the gifts go to officers who weren’t even on scene that day? 

Some tips for managing these conflicts include the following:

zzSet a professional example when interacting with other agencies. If there is a persistent conflict, sit down with other agency heads to hash it out, and then tell your staff how the conflict 

has been resolved.

zzRemind officers that anyone could have been a first responder, and that while we should support those that were, there are no “Ground Zero Heroes.”

zzEven when conflicts seem petty, take officers and their concerns seriously. For example, think 

carefully about how to distribute gifts fairly and explain your reasoning. 
PPart Three. Managing a Mass Casualty Event and Its Aftermath 

6. The First Weeks: From Chaos to a New Normal

87

X Realize that officers may displace anger onto their colleagues and leaders.

Sometimes when people are upset about something they cannot change—like the fact that 

someone killed people in their community—they will take out their anger and frustration on 

things that can change. It’s a lot easier to get angry with a living person or with a frustrating 

situation than with a deceased perpetrator. This is called displaced anger, and it is a very common response when people feel that a situation is chaotic or out of control. Displaced anger can 

be directed at you as the chief, your command staff, other community leaders, or colleagues and 

other first responders. 

Take your time deciding how to recognize officers with formal awards and honors.

In the aftermath of a mass casualty event, it is entirely appropriate to thank your staff for their 

hard work and dedication, to take extra time listening to their concerns, and to provide time off 

if possible. Officers expect and deserve recognition for their contributions and sacrifices. But 

take your time before giving out awards or honors. 

These incidents will garner an unusual amount of political pressure and attention from the 

media, pushing you to honor officers more quickly and with more pomp than usual. Under that 

kind of pressure, it can be hard to find the right way to recognize officers and there are good 

reasons to be cautious.

X Challenges and concerns related to officer wellness and award

In some circumstances, award ceremonies can actually make officers feel worse about their 

involvement in the incident. Some challenges that have arisen after mass casualty events include 

the following:

zzSome officers are uncomfortable with the attention of an award ceremony and with being 

called a hero. When others died, officers may feel like their heroism was not adequate 

or important. 

zzSome officers may not want to hear about the details of the incident again, even in the context 

of an award ceremony. 

zzWith so many responders playing important roles, it is hard to draw the line between who 

should be recognized and who should not. Officers or civilian staff who were involved in the 

incident response but who were not injured and did not save lives may feel resentful if their 

role is not recognized.
Preparing for the Unimaginable: How Chiefs Can Safeguard

Officer Mental Health Before and After Mass Casualty Events

88

z If the award ceremony includes other first responder agencies it will be very hard to recognize 

all the individuals that contributed to the incident response, and there’s a good chance of inadvertently leaving someone out. 

X There’s no perfect approach, but there are some lessons learne

There is no perfect formula for crafting an award ceremony that works for everyone. These recommendations and examples can help you think through your options: 

zzDon’t assume you know what the officers would appreciate. Ask them for input so they 

will be more comfortable with the final decision.

zzDo not cave to political pressure to honor officers if you don’t think it will be appropriate or respectful. Well-meaning community leaders may want you to throw a huge award 

ceremony very soon after the event. Sometimes these events can be comforting for the victims 

and the community, but that needs to be carefully balanced with the potential negative impact 

on officers being honored. Instead of making a quick decision, give yourself time to think 

through your options and consult with the officers involved.

zzThink of the award ceremony as an opportunity for healing. Even during an award ceremony, you can acknowledge the pain and grief officers may have experienced and make a 

public statement of support. You may also consider whether there is a beloved local celebrity 

who could present, making the award ceremony special to the officers. Alternatively, a representative of the affected families who could speak, making the honors more personal. 

zzConsult with your mental health incident commander before any award program. He or 

she may be able to identify individual officers who will be negatively affected by an award 

ceremony and help you navigate appropriate awards. Include him or her in the room during 

the ceremony. 

zzInform officers of any award ceremonies so they are not surprised.

zzDo not make attendance at award ceremonies mandatory. Make the agenda clear and tell 

officers they can opt out of attending. 

zzIncorporate awards for the incident in an annual ceremony. The honors for the incident 

response can be included in the overall ceremony but should not be the centerpiece. In 

Newtown, Connecticut, Chief Kehoe made attendance at the annual award ceremony voluntary and gave officers the option to leave prior to the awards for response to the Sandy Hook 

Elementary School shooting. 
Part Three. Managing a Mass Casualty Event and Its Aftermath 

6. The First Weeks: From Chaos to a New Normal

89

zzGive a certificate of appreciation to every officer and civilian staff member involved in 

the incident response. By recognizing everyone, you acknowledge the vital roles played by 

all members of your agency and remind everyone how they pulled together to provide a service to their community. This may also be helpful when there’s internal conflict among officers 

about who is a “hero” and who is not.

zzGive appreciations in private. If an officer is not comfortable with a public ceremony, you 

can express the agency’s thanks personally and in private. 

zzConsider offering a variety of awards beyond those for lifesaving or for injury in the line 

of duty. For example, dispatchers may be recognized for calm and professionalism, or officers 

who conducted death notifications may be recognized for compassion and support to families.

Encourage supervisors to look out for their officers.

Supervisors are in a good position to notice if an officer is struggling. Instruct supervisors to 

watch for signs that an officer needs help and to discuss their concern with the officer. There is 

a lot of work to do, but supervisors should have as much flexibility as possible to give officers 

time off or change assignments if an officer requests it. 

X Be flexible and look for ways to alleviate the pressure on officers.

When possible, provide officers with some opportunity to control their time—find ways to pay 

for vacation time or overtime if working more or less is helping some staff cope. You may need 

to continue to cover shifts with mutual aid from other agencies. Consider also giving the entire 

agency a day off or extending holiday vacation time. 

Reach out to officers’ families.

Officers’ spouses and children often need education and support when an officer has experienced a trauma. They are also a good source of information. Some agencies have conducted a 

brief anonymous online survey of family members asking for their observations. This can help 

identify whether officers or families need additional support.

Also, encourage officers to connect with family and to talk about their experiences. Include 

spouses and other family members in significant agency events. 
Preparing for the Unimaginable: How Chiefs Can Safeguard

Officer Mental Health Before and After Mass Casualty Events

90

Keep officers as informed as possible.

Officers will appreciate regular updates on a variety of topics. In the absence of information 

rumors may start, or officers may worry unnecessarily. You may want to brief officers on the 

following topics: 

zzThe status of the investigation, especially if another entity, such as a federal law enforcement 

agency, is in control of the investigation. Officers may be frustrated or angry if there are developments they learn about on the evening news. Push respectfully for regular updates and pass 

that information on to officers. 

zzInformation leaked to the media, especially if it includes information about specific officers. 

For example, if video footage of an officer being injured is released, give the officer an opportunity to warn friends and family to not watch the news if the footage might be disturbing. 

zzThe status of victims who were injured. First responders who assisted the injured may find it 

helpful to meet with them in person to be reassured that everyone is okay.

Managing leadership challenges 

X Find allies in your community.

As chief, you should know all the players in your community so you can bring your leadership 

to the overall community response. 

If you haven’t already, start lining up allies in addition to your command staff. Your team should 

include people you trust and can rely on, such as a mental health professional who is serving 

as your mental health incident commander or a fellow chief from a neighboring community. 

Another chief may be particularly suited to shadowing you during the day-to-day and helping 

you prioritize, delegate, and execute in the face of too many competing demands. 

Other chiefs have also found it helpful to get support from city government and elected officials. Pay them a visit—from the mayor to the health department to city engineers—during the 

first weeks following the incident to answer questions and identify ways to share the workload. 

When city officials understand what you are dealing with, they can provide more assistance. In 

smaller communities, such support often comes intuitively. In larger cities, you have to make 

these connections and make yourself available. 
Part Three. Managing a Mass Casualty Event and Its Aftermath 

6. The First Weeks: From Chaos to a New Normal

91

X Recognize that your leadership is vital even when another agency is in charge 

of the investigation.

Your leadership role can become particularly challenging when another agency, such as the FBI, 

takes over the investigation of the incident. If that happens, keep in mind that the investigation 

is just one part of the community response and that you remain in charge of everything else. 

Federal agents will leave when the dust has settled. But this is your community, you will stay, 

and you have the community’s long-term welfare in mind. It is important to your own resilience 

and that of your officers to push for respectful collaboration and an understanding that your 

continued leadership is crucial. 

Tell the agency in charge of the investigation that it’s important for you to be informed of any 

developments in a timely way. Keep your officers informed as the investigation unfolds, and try 

to ensure that they get updates before the information is released to the media. It’s also important to articulate to your officers the important roles that you all will continue to play in supporting your community. 

X Stay alert to conflict within the agency

Some level of tension and conflict is inevitable within agencies that are managing the aftermath 

of a mass casualty event. You and your command staff should be alert to this and work proactively to address it. When there is conflict, even if it appears to be over trivial issues, it’s important to not let it fester. Ignoring conflicts can be risky because these situations can lead to toxic 

group dynamics that quickly snowball out of control. Don’t try to guess the root of a particular 

conflict; ask the officers what’s going on and how to resolve the issue. You can’t keep everyone 

happy all the time, but taking a collaborative approach will help you maintain positive working 

relationships in the long term.

FINDING ALLIES IN THE BUSINESS COMMUNIT Y 

The business community can be a resource to you. After the Sandy Hook Elementary School shooting, a local company, GE Capital, offered a significant donation to 

the town of Newtown. Ultimately, instead of a financial donation, community leaders asked the company to provide an executive management team to assist in coordination between agencies, interfacing with media, and dealing with donations. 

While this agreement came several months after the incident, an arrangement like 

this could be very beneficial much earlier in your community.
Preparing for the Unimaginable: How Chiefs Can Safeguard

Officer Mental Health Before and After Mass Casualty Events

92

X Put your oxygen mask on first.

After a mass casualty event, the chief is just as prone to mental health issues as officers. In addition, the pressure keeps piling on in these first few weeks: Your community is relying on you, 

your officers are relying on you, and the families of the victims are relying on you. Everyone 

needs you to hold it together and be the leader. 

You can only carry on at this intensity for so long before you need some kind of safety valve to 

relieve the pressure. You need to have someone to talk to—it may be a friend, your spouse, a colleague, your mental health incident commander, or another mental health professional. Even if 

you’re handling things fine, think of it as a proactive measure to prevent you from losing control 

at the wrong time. There are critical times (such as when you are interacting with the media) 

when you need to maintain composure, so it’s important to find a private way to vent. 

Model help-seeking behavior for officers.

Consider whether it would be beneficial to disclose to your officers that you sought mental 

health support, even if it was just a check-in. You can keep the details to yourself, but letting 

your officers know that you took proactive steps to maintain your mental wellness will reassure 

those that really need it that it’s okay to get help. 

“Nearly all the officers [who responded to the theater] chose to have 

separate private counseling with John or a member of his team. A 

very small number of officers declined to do the one-on-one sessions. 

I did not make them. They were all well aware that the psychological 

services were available. I tried to model my behavior by letting them 

know that I had gone for counseling, but I did not give an order that 

every officer go. Given all that they had been through, it didn’t feel 

right to place this added pressure on them.” 

— Daniel Oates, Chief of Police, Miami Beach, Florida, 

and former Chief of Police, Aurora, Colorado
93

7 The First Months 

Managing challenges for your agency and your community

One thing that chiefs who experienced mass casualty events told us they did not expect was the 

intensity and duration of the aftermath. Several weeks after the event, you may expect the workload to become manageable again, but it may not do so. On top of managing the normal calls for 

service, your agency will likely continue dealing with an array of issues related to the incident 

for weeks or months.

Work with survivors and families to respectfully clean up temporary memorials.

The good news is that many of the well-wishers may have gone home by now. There will still be 

events that you need to plan for such as candlelight vigils and fundraising runs, but there may be 

less chaos in the streets.

The bad news is that they may leave a lot of things behind. You will have to thoughtfully manage issues like how to remove thousands of stuffed animals from a makeshift memorial in a 

respectful, meaningful way and where to store all the keepsakes that families don’t want. Involve 

survivors in the process of handling makeshift memorials once they become a hazard. You can 

arrange for the survivors to visit the memorial (away from the media) so they can take home 

whatever they want to keep before you remove the rest. 

X Call on volunteers to sort donations.

Where do you send excess donations? When victims and their families receive an overwhelming 

volume of mail, how do you screen out death threats or painful reminders of their loss while 

ensuring they do receive the good wishes and support? Consider assembling a team of volunteers to screen mail and sort donations. Reach out to established aid organizations to identify 

places to send excess donations. 
Preparing for the Unimaginable: How Chiefs Can Safeguard

Officer Mental Health Before and After Mass Casualty Events

94

Be aware that investigations and reports can reopen the wounds.

In addition to the criminal investigation, there will likely be any number of other investigations 

and reports stemming from the incident. An extreme example is the Sandy Hook Elementary 

School shooting, which resulted in half a dozen reports from state and federal agencies. Each 

new report can reignite the media storm. Investigations may bring to light new details about the 

perpetrator, the emergency response, or the victims. Reliving these events, especially when new 

information causes officers to question their actions, can reopen wounds that may just be starting to heal and can pile on the guilt. 

Work with other community leaders to accommodate expanded policing responsibilities.

A mass casualty event can shake up a community’s sense of safety and spark new conversations 

about how to improve safety going forward. This may result in the community requesting or 

demanding more police presence in some settings. For example, after the Sandy Hook Elementary School shooting, the community was particularly concerned about school safety, and the 

Newtown Police Department committed to assigning officers or security guards full time to 

every school in the community. 

Your agency cannot take on new responsibilities without new resources. Work with other community leaders to ensure you have the resources to meet these needs in the long term. 

Managing challenges and stressors for officers

X Be aware of emotional exhaustion.

When an officer smiles at a pedestrian just after being berated by a driver during a traffic stop, 

the effort to experience and deflect another person’s emotions is called emotional labor. Professionalism and courtesy often demand that you perform within a set of rules about how you 

express yourself regardless of what happened earlier or how you may be feeling inside. Your 

officers perform this way constantly—expressing sympathy when families need comfort, providing stability when others are falling apart, or expressing hope when the community wants to feel 

that something good can come out of this tragedy. 

This is an important part of the role police play in the community, but over time it becomes 

exhausting. Without breaks it can become more difficult for officers to deal with their own reactions in a healthy way. Make sure officers have time and space to meet their own needs.
Part Three. Managing a Mass Casualty Event and Its Aftermath 

7. The First Months

95

Be aware that serious mental health problems can emerge now, just as things are getting 

back to normal.

Sometimes when the initial response to an event ends, the acute stress that officers feel subsides. 

As the workload dies down, officers finally have some time to notice and deal with their own 

reactions to the event. Some people start to bounce back, and others have more difficulty coping. 

However, there’s not a strict timeline; it’s not uncommon for serious mental health problems to 

emerge months or even years after a traumatic event. 

Many officers will not recognize signs of a lasting mental health problem, and they might not 

always be evident at work. Instead, they might have problems with their spouse or start drinking heavily. 

Keep working closely with your mental health team.

When the media is gone, the funerals are over, and the investigation is complete—in other 

words, when the immediate stressors slow down—your mental health team starts shifting gears. 

This is the time to check in again and catch officers who are not finding effective coping mechanisms and to start looking for colleagues who are starting to develop more serious problems. It is 

important to collaborate closely with your mental health team to recognize potential challenges 

early on and resolve them sensibly. 

X Anticipate trauma triggers, and prepare officers to deal with them.

Trauma triggers—experiences that remind an individual of the event and can trigger a return to 

the memories and feelings associated with the event—are everywhere. It’s impossible to avoid all 

trauma triggers, but it is possible to anticipate some of them and educate officers about how to 

deal with them.

“Everything changed after the incident. There was no more idle chatter 

in the hallways, and employees—both officers and dispatchers—were 

keeping to themselves more. Daily briefings, which were once vibrant 

interactions between shifts, had become solemn events.”

— Marc Montminy, Chief of Police, Manchester, Connecticut
Preparing for the Unimaginable: How Chiefs Can Safeguard

Officer Mental Health Before and After Mass Casualty Events

96

Create a long-term officer wellness plan.

In chapter 2, we described strategies for creating an officer wellness committee and engaging your officers and mental health staff in a making a long-term wellness plan. Make it clear 

that officer wellness is still a priority, and convene your committee to develop a plan for the 

years ahead. 

If you haven’t done so already, make basic education about mental wellness a part of officer 

training. Officers need to know the basics of trauma and trauma triggers, healthy and unhealthy 

coping mechanisms, and where to get support. 

MANAGING TRAUMA TRIGGERS IN NEWTOWN

About five months after the tragedy at Sandy Hook Elementary School, Newtown’s 

Chief Michael Kehoe scheduled a full departmental meeting and invited his behavioral health team to participate and talk about what triggers traumatic memory and 

what to do when it happens. An officer then approached the therapists about the 

upcoming recertifications at the shooting range. Couldn’t that be a trigger?

The mental health team knew that one of the first senses activated for the responders at Sandy Hook was olfactory. The smell of gunpowder at the scene was overpowering. For all the Newtown officers engaged at Sandy Hook, recertification at 

the range would be the first time on duty that they would smell gunpowder again. 

A plan was drawn up quickly:

zzOfficers were informed that requalifying on the range as well as the smell of 

gunpowder may act as a trigger. This was done during roll calls where a mental 

health team member briefly talked about possible triggers. 

zzAny interested officer could go to the range and practice prior to recertification. 

This was voluntary and could be done one-on-one. 

zzShould there be a negative experience from recertifying, officers were encouraged to either contact a therapist they had previously worked with or get in touch 

with a mental health provider on the team.
Part Three. Managing a Mass Casualty Event and Its Aftermath 

7. The First Months

97

Ensure officers have access to evidence-based services and supports.

If an officer needs mental health care for a serious mental health condition, they should work 

with a mental health professional who is experienced at diagnosing addiction and trauma-related 

disorders. This is important even if it seems clear that the officer has a specific diagnosis, because 

trauma-related disorders can closely resemble one another. It is also very common for individuals who experience such traumatic events to have more than one diagnosis. 

While your agency may not be directly responsible for providing mental health services, your 

mental health incident commander should know which services are effective in treating common 

mental health conditions resulting from trauma so he or she can help connect officers to appropriate services. 

Officers should have access to an array of providers who have experience with evidence-based 

treatments, including

zzmedication management; 

zzexposure therapy;

zzcognitive-behavioral therapy;

zzeye-movement desensitization and reprocessing (EMDR);

zzaccelerated resolution therapy (ART);

zzinterpersonal therapy; 

zzmedication management for addictions; 

zzintegrated, concurrent treatment of addiction and other mental health conditions.

Any inpatient psychiatric or addiction treatment should be provided by institutions or individual providers with experience and sensitivity working with traumatized individuals. 

Unfortunately, not all mental health professionals are trained in effective practices, and 

many are not familiar with the effects of trauma. The U.S. Department of Veterans Affairs 

National Center for PTSD offers sound guidance on finding a trauma-informed therapist at 

http://www.ptsd.va.gov/. The Substance Abuse and Mental Health Services Administration 

(SAMHSA) can also help officers find treatment providers at https://findtreatment.samhsa.gov/

or 800-662-HELP (4357). 
Preparing for the Unimaginable: How Chiefs Can Safeguard

Officer Mental Health Before and After Mass Casualty Events

98

Consider setting up a formal peer support network.

Most officers have an easier time talking to a fellow officer than reaching out to a professional; 

it makes sense for those peers to be trained to help fellow officers access professional mental 

health supports if needed. And a peer support program can help officers learn how to look out 

for their colleagues. For an example of how a peer support program works, see the case study of 

New York City’s Police Organization Providing Peer Assistance (POPPA) program on page 30. 

Your agency may not be able to replicate the scale of POPPA, but the principles may be helpful, 

and you may have greater capacity by joining together with law enforcement agencies around 

your region or state. 

X Continue education and outreach to officers’ families.

Spouses and families often recognize a serious mental health problem before the officer does. 

They need guidance on how to help their loved one get needed support. Your mental health 

manager should continue to reach out proactively to communicate with officers’ families. 

Managing leadership challenges

X Adjust your expectations, and get help if the intensity does not let up.

Police officers do not become chiefs without ambition, and no one with ambition has plenty of 

free time to take on a whole new job. Yet the direct demands from mass casualty events, together 

with the barrage of offers to help and requests for information, can easily become a second fulltime job. 

Some chiefs may be able to juggle some of these demands by developing greater efficiency, temporarily working more hours, or delegating effectively to people with the requisite skills. Ultimately, the increased demands may dictate that you change the structure of your agency or bring 

in new personnel to deal with new responsibilities. 

The increased workload comes at the same time as you are dealing with a high level of scrutiny—from the media, your community, and your officers. It is a challenge knowing that any 

missteps you make will be noticed immediately and judged harshly.
Part Three. Managing a Mass Casualty Event and Its Aftermath 

7. The First Months

99

Several weeks out, you may feel exhausted. Most chiefs will have times when they feel overwhelmed and ineffective. You will be more likely to manage your frustration or disappointment 

if you remember that there is no such thing as a perfect response to large-scale trauma and 

accept, even expect, that there will be missteps. You will be able to cope better if you adjust your 

expectations about things returning to “normal” and accept that you will instead reach a new 

normal someday. 

For better or for worse, group 

dynamics often cause leaders 

to become focal points for the 

fear, anger, aspirations, and 

grief of their followers. 

“My aim every day was to come to work and move the agency forward. 

For a whole year, I could not do that.”

— Michael Kehoe, Chief of Police (ret.), Newtown, Connecticut 

Help officers move forward by acknowledging the toll the event has taken on you.

“Emotional labor,” described on page 94, is a good description for the job of a police chief in 

the first months after a mass casualty event. Aside from your own emotional reaction to the 

event itself and the frenzy of work demands that follow, you must also process the emotional 

tugs of others who are having an intense reaction to the event. 

In normal circumstances, chiefs may be spared some emotional labor by the law enforcement 

culture that values stoicism, self-reliance, and compartmentalization of emotional reactions. 

But mass casualty events are not normal circumstances, and these coping strategies may not 

work when agencies are challenged with the intense 

emotions that follow such events. For better or for worse, 

group dynamics often cause leaders to become focal points 

for the fear, anger, aspirations, and grief of their followers. 

As chief, you can expect to become the target of hostility or unfair criticism for matters that were beyond your 

control. Alternatively, you may be lauded individually as a 

hero because of the collective efforts of all first responders. 

Try not to take it personally. 

This intensity of emotion is why police chiefs may find it useful to acknowledge some of their 

own reactions in the first weeks after the event. Most officers will appreciate an acknowledgment 

that this is a difficult time for everyone and that you, like everyone else, have strong feelings. 
Preparing for the Unimaginable: How Chiefs Can Safeguard

Officer Mental Health Before and After Mass Casualty Events

100

Although encouraging officers to be more emotionally aware may seem like opening a can of 

worms that will only make things worse, the opposite is probably true. Officers will appreciate 

your acknowledgment, but most officers will prefer to discuss such personal experiences outside 

of the work setting. By being open with officers about the feelings that stem from the event, you 

can decrease the risk that their emotions will leak out in other ways—such as in anger toward 

fellow officers or agency leadership.

Tips for helping officers to heal 

Be flexible. Running a tight agency is important, but after a mass casualty event, it is temporarily more important to bend the rules on a case-by-case basis and give your officers the time and 

space they may need. For example, after the Sandy Hook Elementary School shooting (which 

occurred in December 2012), Chief Kehoe rolled vacation time that would have expired at the 

end of the year to the new year, because most officers had not been able to take planned vacation. 

Be supportive. You cannot be there for everyone all the time, but you can make sure someone 

is. Encourage officers to take care of themselves and take time off if needed. Make it clear to 

your officers that their well-being is a priority.

Be transparent. If you have struggled with the emotional impact of an incident you responded 

to or if you had to seek help, mention it. You don’t have to go into the details, but acknowledging that you have sought mental health support can validate your officers’ decision to do 

so themselves. 

Connect survivors and cops. This can be a powerful way to help officers process the events 

and find support. Chiefs recommend bringing together survivors, cops, other first responders, 

and even hospital personnel for a breakfast or lunch. Spending time with others who have been 

through the same traumatic event builds community and resilience. 

Allow officers time with families at the memorial site. Being able to mourn alongside families 

can also be a useful way for officers to process their experience. 

Limit officers’ exposure to triggering events. It will be hard to avoid reminders of the incident, but you can help by not mandating that officers participate in events where they will hear 

the stories and see the images again. That means thinking carefully about how many officers 

need to read the latest report and who needs to review news articles or attend an award ceremony. Delay tactical debriefings as long as possible, and do not use the event as an example in 

officer training.
101

8 The Long Haul 

Managing challenges for your agency and your community

A mass casualty event will continue to shape your community and your agency for years to 

come. Some high-profile events become so embedded in our nation’s culture that strangers, 

hearing where you are from, will think first of the event. When you say “Columbine” or “Sandy 

Hook,” everyone has some image or memory of those events. It may be hard for your community to move forward on its own terms. 

In the years after the event, your community will relive what happened in a variety of ways. 

These reminders can be therapeutic and healing, or they can be upsetting reminders of the darkest days. As chief of police, you can bring together other community leaders and help lead the 

community in healing. 

X Try to make anniversaries a healing event rather than a painful reminder.

Anniversaries are key days in the process of individual and collective healing after trauma. They 

are always both painful reminders of the tragedy and moments when the community can come 

together and create meaningful, helpful ways to commemorate the unforgettable. The first anniversary is often the hardest.

In recent years, communities affected by mass shootings have learned not to let their community be overrun by media and well-wishers on this important day but instead to take control 

of what they want the day to be like. In addition to controlling the media presence, communities have planned events like wellness fairs, conferences, and commemorations for the anniversary. The key to these events is that they are driven by the community’s needs, not from pressure 

by outsiders. 
Preparing for the Unimaginable: How Chiefs Can Safeguard

Officer Mental Health Before and After Mass Casualty Events

102

X Look for opportunities to help the community heal.

Just as a traumatic event affects the whole community, healing is a long-term process that often 

involves the whole community. Communities, law enforcement agencies, and individual officers 

approach the healing process differently. For many, it helps to create some positive change, such 

as working to prevent further violence, supporting a charity favored by survivors or victims’ 

family members, or simply coming together as a community. You and your officers can benefit 

from leading or joining in something positive.

Is there a cause that the community can get behind or a service you can do for the survivors? 

Are there ways you can help everyone feel safe? 

HOW NEWTOWN MANAGED THE FIRST ANNIVERSARY OF SANDY HOOK

In preparation for the first anniversary of the Sandy Hook Elementary School shooting, the town of Newtown decided to ask all media representatives and well-wishers to stay away from the town on the day of the first anniversary. The strategy was 

designed to meet the needs of the community and the families who had suffered 

the most; they did not want to expose their sorrow and healing to onlookers.

Instead, the community tried to involve people touched by the tragedy in the way 

families wanted their loved ones to be remembered: by conducting an act of kindness. People who wanted to honor the victims could share an act of kindness with 

a person they know, a stranger on the street, or their community. A week before the 

anniversary, key people in the community explained the concept to media in press 

briefings staged by the media relations staff of GE Capital. It worked; the TV trucks 

and visitors stayed away, and the community was able to commemorate the victims 

away from cameras and public scrutiny. 
Part Three. Managing a Mass Casualty Event and Its Aftermath 

8. The Long Haul

103

OAK CREEK: COMING TOGETHER TO ADDRESS HATE

The Sikh Temple shooting in Oak Creek, Wisconsin, targeted a religious minority. 

While the event obviously deeply affected the Sikh community, it also galvanized 

the broader community to support them as documented in the film Waking in Oak 

Creek.

* Among other activities, the police chief and the Sikh community successfully advocated with Congress to have Sikhs added to federal hate crime forms so 

that crimes against that community would be tallied in their own category rather 

than “other.” The community also joined Not In Our Town, a national movement to 

stop hate, address bullying, and build safe, inclusive communities.

* Not in Our Town, Waking in Oak Creek (Washington, DC: Office of Community Oriented Policing Services, 

2014), DVD, http://ric-zai-inc.com/ric.php?page=detail&id=COPS-CD044.

MOVING THE COMMUNIT Y FORWARD AFTER THE PLATTE CANYON 

HIGH SCHOOL SHOOTING

While not a mass casualty event, the Platte Canyon High School shooting offers 

an example of how the community (including law enforcement) can move forward 

in a positive direction after tragedy. During the incident, a gunman entered a high 

school in Bailey, Colorado, and took several female students hostage. After sexually assaulting several girls, he ultimately killed one, Emily Keyes. A few days later, 

on the same day as the memorial service for Keyes, 5,000 motorcyclists rode from 

Columbine to Platte Canyon in honor of the victims of both school shootings. The 

ride evolved into an annual parade, a 5K run, and the creation of the I Love U Guys 

Foundation, which advances collaboration between schools, first responders, and 

experts to improve school safety. 
Preparing for the Unimaginable: How Chiefs Can Safeguard

Officer Mental Health Before and After Mass Casualty Events

104

Managing challenges and stressors for officers 

X Be aware that time doesn’t heal for everyone.

There is a wide range of normal reactions to grief and trauma, and most people are resilient. The 

majority of officers who experience a traumatic event will not develop a serious mental health 

condition. But it can be hard to predict who will have difficulty months or years later. It is not 

uncommon for the reverberations of a mass shooting to continue past the first anniversary of the 

event. Even years later, major life changes such as divorces and career changes can stem from 

the incident. One challenge with such a delayed reaction may be that officers themselves don’t 

necessarily recognize the connection between the incident and the difficulty they are having.

If an officer is struggling, it may seem to come out of the blue, or it may be hard to tie new 

behavior to the long-ago traumatic event. Many officers who experience problems like excessive 

drinking or changes in mood will be able to conceal that from colleagues for a long time. 

“A couple years later, when an officer quits and says ‘I’m not 

getting paid enough for this,’ what they really mean is that they 

are no longer willing to absorb additional psychological trauma.”

— Marc Montminy, Chief of Police, Manchester, Connecticut

SERIOUS WARNING SIGNS OF A MENTAL HEALTH PROBLEM

Some serious warning signs indicate that an officer may need professional mental 

health evaluation, including the following:

zzExpressing that life is not worth living or that it would be better if they were dead

zzIntoxication at work or while driving

zzSeeing or hearing things that other people cannot see or hear

zzSevere fatigue, drowsiness, irritability, or anger that interfere with the ability to 

work or drive
Part Three. Managing a Mass Casualty Event and Its Aftermath 

8. The Long Haul

105

X Anticipate triggering events, and provide support.

Trials, anniversaries, and other events can bring an officer back to the fight-or-flight reaction 

they experienced during the incident. Officers may be particularly frustrated because they 

already dealt with the event and feel like they are back to square one. Some officers who seemed 

to handle the initial incident without problems may have a strong reaction to triggering events. 

The good news is that most officers who dealt with the incident before have the skills to deal 

with triggering events as well, especially if they have easy access to mental health support. With 

predictable triggering events, it may be possible for officers to avoid the worst exposure—to 

decide not to follow the news reports of the trial, for example, or not to read a new investigative 

report. Officers should also have the flexibility to prepare for triggering events—to take vacation 

days, schedule extra time with family or friends, get mental health support, or spend time with 

fellow officers. 

With these events, it can be helpful to anticipate that some officers will struggle and to reach out 

to them proactively. Work with your mental health team on a strategy for addressing predictable 

triggering events. 

X Help officers cope with the trial

Trials can be especially difficult for officers. They may need to testify to the events they witnessed, reliving the incident in great detail. The media attention on the police response may 

return. After the trial, a flood of information that could not be released previously may be made 

available to the media, reigniting the media’s interest in the perpetrator, the police response, the 

victims, or other issues. 

The verdict and sentencing portion of a trial can be stressful and sometimes disappointing. Many 

people hope that a guilty verdict or the harshest possible sentence will help bring them closure, 

but this is not always the case. Officers may be frustrated when the sentence does not bring the 

relief they hoped for.
Preparing for the Unimaginable: How Chiefs Can Safeguard

Officer Mental Health Before and After Mass Casualty Events

106

X Anticipate the impact of other mass casualty events

Mass casualty events, especially mass shootings, can quickly take over the news cycle. When 

another incident occurs, officers may be triggered by news stories or images of the event. This is 

especially true if the incident is similar to their experience in some way—e.g., the same type of 

victims or the same type of location.

X Support officers in finding their own ways to remember and cope.

Officers will come up with their own plans for commemorating the anniversary or other significant markers of the event. For example, the officers who were first on scene may want to get 

together to honor the victims. Try to support them, or at a minimum don’t do anything to stop 

them. Unlike awards, which may unnecessarily or artificially single out groups of responders, 

these informal gatherings can serve an important function for those who feel they share a common experience. The key is that they come from officers and are entirely voluntary.

If you find out that a group of officers is planning an event on an anniversary, consider whether 

to plan a separate, optional commemoration for the entire agency. Many staff will certainly want 

some acknowledgment of the day.

HOW MENTAL HEALTH SUPPORT HELPED AURORA OFFICERS 

COPE WITH THE TRIAL

The trial of the perpetrator in the Aurora Century 16 theater shooting came almost 

three years after the event. The Aurora police chief and police psychologists working with his department anticipated that the trial would be difficult for officers, 

especially those who would testify. They compiled a list of all the officers who were 

testifying, and police psychologists reached out to each officer. Each officer was 

required to have a check-in with a mental health professional so that no one was 

singled out for seeking assistance.
Part Three. Managing a Mass Casualty Event and Its Aftermath 

8. The Long Haul

107

X Create a long-term infrastructure to support officer mental health.

In order for officer mental wellness to stay a priority within your agency, you will need to institutionalize new policies around psychological services and programs to support officer wellness. 

We suggest making the following a permanent part of your agency’s structure:

zzThe mental health manager role

zzAn officer wellness workgroup

zzOfficer wellness education and training

zzRegular interaction with mental health professionals

For more information about how to do this, return to chapter 2. 

“On the first anniversary of Columbine, I was sitting on my deck, alone 

with a glass of whiskey. . . . After the Platte Canyon shooting, I didn’t 

want any of my guys to go through a dark night, sitting alone, drinking 

alone, when they don’t have to. So we organized a 38-mile run from 

[the Jefferson County Sheriff’s Office] to Platte Canyon High School—

the first 35 miles were just for the guys who were in the school during 

the incident. The guys needed to be together, grieve together, and have 

some time. It was hugely cathartic—we can laugh and cry together, 

acknowledging that we are human, acknowledging that we are a year 

out, and it is still an important thing. We still do a 5k every year with 

some of the guys who were on the entry team.” 

— Sergeant AJ DeAndrea, Patrol Officer, Arvada, Colorado, and an entry 

team leader at the Columbine and Platte Canyon High School shootings
Preparing for the Unimaginable: How Chiefs Can Safeguard

Officer Mental Health Before and After Mass Casualty Events

108

Managing leadership challenges

X Attend to your own mental wellness.

To maintain ongoing support for your officers and your community, it is important that you 

as the chief continue to attend to your own mental wellness. Are you constantly stressed or 

have you started to feel disconnected from your work or home life? Do you have the allies 

and supports you need to move forward and be successful in your role as chief? These aren’t 

easy questions, so take time to get support from friends, family, fellow chiefs, and mental 

health professionals. 

X Be wary of defining yourself by your crisis leadership.

You may have been in your element during the crisis or you may have felt you made too many 

mistakes. Either way, be wary of going through life defining yourself by how you performed 

during this crisis. If you become too attached to this identity, you might find the rest of your 

day-to-day life just doesn’t feel important or that you are out of step with a wider community 

that has moved on.

If this happens, try to reconnect to the people and activities that were most important to you 

before the crisis. Or seek out mental health support to define your next steps.

X Reassess your role in light of how this experience has changed you.

Like your officers and your community, you have been through a traumatic experience. After 

traumatic experiences most people re-evaluate their lives and reconsider their priorities. Think 

of the experience like a heart attack—after a heart attack, you have an opportunity to reassess 

how you want to go forward. You may make a new commitment to exercise or diet or end a bad 

marriage or finally get your master’s degree. Reassessment is a helpful process after an incident. 

You may find yourself with changing priorities and ambitions, and this is entirely normal.
Part Three. Managing a Mass Casualty Event and Its Aftermath 

8. The Long Haul

109

You might find yourself with renewed energy for your position as chief and be excited to take on 

new initiatives to advance public safety in your community. You might decide to switch careers 

and pursue a long-held ambition. Or the incident may have opened your eyes to an important 

issue, and you may begin dedicating yourself to charity or advocacy work. You might decide to 

move to get away from constant reminders of the tragedy. This process is not about reinventing 

yourself so much as it is about making meaning out of your experience and making the best 

of the new things you learned about yourself. How can you best use your talents? What would 

ensure your long-term happiness? Do you want something good to come out of what you’ve 

endured, and how can you contribute to that?

One way to work through these questions is to contact mentors or colleagues, especially chiefs 

who have been through a similar crisis. Look for advice from someone you consider wise and 

thoughtful rather than someone who is still struggling.

If you decide to transition out of your current role, give sufficient notice for others to adjust and 

work with your command staff and community leaders on a plan that helps everyone through 

the process. 

However you move forward, know that there is a growing community of chiefs who have been 

through these mass casualty events. They may be able to support you and provide perspective on 

how to plan your future.

Handouts and

Other Resources

To help your officers understand the importance of mental wellness and the impact that trauma 

can have on them, you may wish to share some personal accounts or information. The resources 

in this section are designed to be copied and handed out for educational purposes. You may find 

that they are slightly repetitive; this is deliberate. People learn in different ways, and where one 

person might get a lot out of personal accounts, others will appreciate a more systematic description of how acute trauma affects the body.

Contents

Handouts

zzChief Edwards’ Story: Overcoming PTSD

zzLori Kehoe’s Story: The Impact of Trauma on Law Enforcement Spouses

zzSgt. O’Hara’s Story: Managing Cumulative PTSD and Helping to Prevent Officer Suicide

zzSgt. DiBona’s Story: Using His Personal Struggles to Help Other Cops

zzToo Much, Too Ugly: Understanding the Trauma Contamination for Law Enforcement Officers

zz“This Shouldn’t Be Bothering Me:” Common Myths about Police Officers’ Responses 

to Traumatic Events

zzThe Mental Health Incident Commander’s Role during the Immediate Response to a Mass 

Casualty Event

zzHow to Assist a Fellow Officer after a Critical Incident

Other Resources

zzResources

zzOrganizations

 

111
Preparing for the Unimaginable: How Chiefs Can Safeguard

Officer Mental Health Before and After Mass Casualty Events

112
1 of 3

Chief Edwards’ Story: 

Overcoming PTSD

John Edwards is the chief of police in Oak Creek, Wisconsin. He oversaw the police response to the 

2012 shooting at the Sikh Temple of Wisconsin, where a white supremacist killed six worshippers 

and injured four others, including a police officer.

In 1989, I had been on the job for four years. One night, I was working the 

third shift when I came across an individual at a truck stop off the interstate. 

There was a car in a back area, where I would normally run into prostitutes, 

and I saw two people in the backseat. 

When I saw the car, I felt something was wrong. They train us to trust the 

hairs on the back of our necks. I started to walk around the car, and I saw an Indiana plate. 

I knew immediately who it was. The FBI was looking for an escaped prisoner who had tried 

to shoot a sheriff’s deputy in Indiana and taken a hostage before fleeing north with a prison 

employee who helped him escape.

As I was walking around the car, the driver got out of the backseat and came around the other 

side with two guns. He shouted, “Put your hands up! Get on the ground! Get on the ground!” 

Later on, when interviewed, he admitted that his plan 

was to get me on the ground, handcuff me, and then 

execute me. 

I decided not to lie down on the ground. I had my hands 

raised, and I knew the gun would not penetrate my vest. 

I was young and agile, so I turned, put my head down, and ran. I knew I would get shot in the 

back. A bullet went through my jacket and my badge. Another hit me in the hand, which threw 

me off balance. I got behind a car, and I took my gun out to engage him. But he was already in 

the car, leaning out the open window and pointing his guns back in my direction. I was going to 

shoot him, but I saw two people just behind him at the gas station in the line of fire, so I ran to 

my car and chased him on the expressway, into the next county south. 

He and his accomplice stopped at a farm and holed up in a barn. His accomplice was a psychiatrist, and she had medication on her. They both took medication and overdosed. When they 

were found, they were unconscious but alive. 

They said if he’d been trying 

to kill me, he would have hit 

me more than twice.
Chief Edwards’ Story: Overcoming PTSD

2 of 3

When he went to trial, the jury found him guilty of reckless use of a weapon but not guilty 

of attempted murder. They said if he’d been trying to kill me, he would have hit me more 

than twice. 

When these things happen, you either get angry, or you go into a shell. A doctor asked me later 

what I would have done if I had been able to stop them. I would have shot them both. That’s not 

what you are supposed to do, but I was just so angry that they had tried to kill me.

Right afterward, I was at the hospital. There was nothing life-threatening about my injuries, but 

it hit me that I almost died. I went back to the police department, and they interviewed me right 

away. Later, we found out that my interview was completely wrong. I swore that the woman’s 

hair was white blonde, and it was actually black. I got tunnel vision and focused on the gun. I 

could probably still tell you the serial number on that gun, but I got all the other details wrong. 

Now I know that there’s an adrenaline dump during these incidents, and a rest period is needed 

to remember correctly. 

Afterward, I was treated like a hero. I got a letter of commendation and an award ceremony. That 

was really hard because I knew I screwed up. I approached the car wrong. I didn’t see his hands. 

The whole time I was thinking, “Shit, this is wrong. This is wrong.” But I still did it. The hero 

label is a pretty heavy burden to put on somebody who knows they made a mistake. 

When I got back to work after two months of medical leave, the chief called me into his office. 

The chief was a World War II vet, and his whole office was a memorial to World War II. He said, 

“I always like to talk to someone who has tasted a bit of the lead. You hear about these doctors, 

but you don’t need doctors. You just need to suck it up.”

So I did. I sucked it up for about two years. I was paranoid on calls. I was hypersensitive. It got 

so bad that once an elderly man asked me to unlock his car for him, and I made him stand 50 

feet away. 

I couldn’t sleep. Once, my wife moved in her sleep, and I jumped up on top of her and grabbed 

her by the throat. 

I couldn’t sleep. Once, my wife moved in her sleep, and I 

jumped up on top of her and grabbed her by the throat. 
 

Chief Edwards’ Story: Overcoming PTSD

3 of 3

When a new chief came in, I decided I couldn’t take it anymore. I told him I needed help, that 

I had to go see someone. He took my gun and badge away for seven months. He said he wasn’t 

letting anyone get a disability on his watch. I had just gotten married, and my wife was pregnant. 

I went to several doctors, and they all said, “This guy isn’t lying. He does have PTSD,” but that 

wasn’t enough for the chief. PTSD wasn’t as well known back then. The mayor got wind of what 

the chief had done and intervened. I was finally able to get my job back and get reimbursed for 

all that time. 

More than 20 years later, the Sikh Temple shooting brought back my PTSD. It was about two 

or three days after the shooting, and I went to the hospital to see Lieutenant Brian Murphy, the 

officer who was shot during the incident. His wife was sitting next to him in the hospital room. 

He couldn’t communicate, so I took her out into the hallway and tried to explain the disability 

benefits to her. A few nights later, I woke up at 3 a.m., and my bed was soaked. I was sweating 

profusely, crying uncontrollably, shaking, and trembling, just like after my shooting. The scene 

of Brian in the hospital bed is what brought it all back. It was a snapshot of many years before 

when I was in the hospital after my shooting, my wife was in the chair next to me, and my sergeant came in to talk to me and my wife. 

When I came into work, I called my captains into my office, and I broke down. I told them, “You 

cannot tell the officers; the supervisors can’t know.” But I wanted the captains to know so they 

could watch out for me. 

The Milwaukee area has police officer support teams to assist officers after a critical incident. 

I called in a lieutenant from Milwaukee to come to one of my staff meetings and talk with the 

supervisors about what they were feeling. The room was very quiet. At that point, I felt that I 

had to tell them what had happened to me. I told them that I didn’t want them to have to deal 

with that. It was important for them to know it’s okay if it happens, and don’t suck it up. 

I went to see a psychologist who works with us at the police department. I spent about three 

hours talking, getting a tune-up. It reassured me and got me back on track.

One of the things I’m doing now is trying to create a branch of the city employee assistance 

provider (EAP) to provide six visits to a psychologist or psychiatrist for police- and fire-related 

PTSD. The city pays for it, but they don’t look at the medical records. This is not part of the disability determination process, and we control the network of doctors, so we know that officers 

can’t use it to game the system. The goal is that early intervention can make it not as severe as it 

was for me and can prevent worker’s comp claims down the line.

 

1 of 3

Lori Kehoe’s Story: 

The Impact of Trauma on 

Law Enforcement Spouses 

Lori Kehoe, RN, is a former hospice nurse and advocate for her adult son with special needs. Lori is 

also the wife of Chief Michael Kehoe, ret., who oversaw the police response to the 2012 Sandy Hook 

school shooting in Newtown, Connecticut.

December 14, 2012, the day of the Sandy Hook school shooting, was very 

long. I did not expect Mike to come home that night. After all, they had 

cots at the police department; they had uniforms and showers. When he 

did arrive home at midnight, he talked and talked until he passed out in the 

middle of a sentence. At 6:00 a.m., he was out the door. I offered to answer 

phones or e-mail. His answer was “no, I got it covered.” I offered to make 

him breakfast, and the answer—which became a common 

phrase in our home—was “no, I got it covered.” It was rare 

that he needed me for anything.

This became the schedule: 6:00 a.m. to midnight. Mike was 

not available to talk on the phone, so our time was from 

midnight to two in the morning, when he would talk and tell 

me every little detail of the day. Each night it was necessary 

for Mike to decompress, and I saw it as my job to be available and to listen and do whatever he needed. He would continue to literally fall asleep talking. 

When Mike started yelling in his sleep, I could tell he was reliving the incident. This schedule 

lasted for about four months, and it became extremely isolating. 

Many family and friends were supportive, but a lot of people couldn’t deal with the trauma. 

They would break down crying on the phone. Or people were afraid to call because they didn’t 

want to intrude. And the last thing you want to do when something dramatic like this happens 

is dump it all on someone who can’t handle it. I relied on the people who called me to be my 

support system, because I didn’t dare reach out. I was isolated but, at the same time, saturated 

with the media. Newtown was on the news for three or four days straight. You couldn’t turn on 

the TV without seeing it.

Each night it was necessary 

for Mike to decompress, 

and I saw it as my job to be 

available and to listen 

and do whatever he needed. 
Lori Kehoe’s Story: The Impact of Trauma on Law Enforcement Spouses

2 of 3

Mike does not get upset. He is always cool, calm, and collected. He doesn’t bounce off the walls. 

A few weeks after the shooting, he came home and was pacing and absolutely agitated beyond 

agitated. He was concerned about his officers committing suicide. He expressed his concerns, 

and we came up with options for him to execute the next day. I was always the sounding board, 

bringing whatever common sense I could muster to the table.

Those were the days when I would wonder, whom do you call for answers? After all, isn’t there 

always someone to call for help in life? When you got a flat tire, you call your dad. If your cake 

won’t rise, you call your mom. I realized there is no one to call when 20 children get blown away 

in your town. You’re watching your partner struggle with all these questions and no answers. 

After 20 years as a hospice nurse, I understand grief and crisis. Without that experience, we 

probably wouldn’t still be married. Understanding the process of grief, I was able to identify a 

little anger this week, depression the next, bargaining, denial. Recognizing those stages allowed 

me to give Mike all the room he needed and understand the changes that were happening.

He was suddenly in control of everything. All of a sudden, he was telling me what to do and 

when. It was bizarre from a man who never gave orders at home. Then I realized he needed to 

be in control, to maintain order. He was spending his days making rapid-fire decisions continuously for weeks on end.

I went to the police department the day after the event. When I got off the highway, life changed. 

There was an officer and his town car on every corner for the entire length of the town—

hundreds of officers in a little quaint country one-horse town, where they usually had no more 

than five officers on a shift. The police department was inundated with flowers, food, and gifts—

so much that they almost couldn’t do their jobs. Then I knew why he had everything covered: 

I suppose if you had 5,000 cops at your beck and call, you’d have it covered too. 

Finally in August (nine months after the shooting), Mike came home and said, “I got to something on my desk today that was on my desk before December 14.” I thought to myself, “It’s 

August, and the trauma is finally over.”

Recognizing those stages [of grief] allowed me to 

give Mike all the room he needed and understand 

the changes that were happening.
 

Lori Kehoe’s Story: The Impact of Trauma on Law Enforcement Spouses

3 of 3

A year after the shooting, I was mentally and emotionally not functioning, almost to the point of 

not getting out of bed. And even though I’m a nurse, I didn’t know about trauma—I didn’t know 

what trauma could do to a person or that there was such a thing as PTSD by association. I was so 

angry. I was mad at everyone and everything. I was depressed beyond belief, alone, and isolated.

The first anniversary was a turning point. The media stayed away, and I realized it was going to 

start simmering down. I realized it was not my job to take care of Mike any longer. So I went 

online and googled “law enforcement spouses and trauma,” and I found a treatment center called 

the West Coast Post-Trauma Retreat in California. They had a week-long spouses’ treatment 

program a couple of times a year.

I called them expecting them to turn me down because Newtown was such a large incident—I 

didn’t want my trauma to overshadow someone else’s. Instead, they interviewed me on the phone 

and said, “It sounds like you could use our help. Come on out.” They taught me that the trauma 

actually changes your brain—you can see it on an MRI. In addition to five full days of intervention and counseling, they did a physical treatment on me called eye movement desensitization 

and reprocessing (EMDR). It’s designed to reduce the emotion that goes with the thoughts about 

the traumatic experience. It was extremely effective.

The treatment was necessary, and it changed my life. I absolutely came back a new woman, and I 

got better and better after treatment. Today, we’re good.

I think education is so important. If an incident like this affects the officer, it affects the family. 

They may never talk about it, but it’s still happening. And in some ways, I was lucky—many 

people react to trauma with alcohol abuse and out of control behavior that creates chaos. That 

did not happen to my officer.

You need to know that when a trauma occurs, alcohol abuse, depression, and chaotic behaviors 

can be symptoms of PTSD. Whether it is the officer or the family member displaying symptoms, 

you need to know what it looks like and that it is a physical injury. There is treatment. You can 

and must do something about it.

 

1 of 2

Sgt. O’Hara’s Story: 

Managing Cumulative 

PTSD and Helping to 

Prevent Officer Suicide

Andy O’Hara is a former California Highway Patrol officer and the founder of The Badge of Life, 

an organization of active and retired law enforcement officers dedicated to preventing law enforcement suicide.

Rather than coming from one incident, my PTSD was cumulative. I compare 

all the things that happen on a regular basis in police work to bee stings: One 

is tolerable, but as they build up, the pain becomes overwhelming.

In the course of my career with the California Highway Patrol, I accumulated 

24 years of traumatic experiences—11 years as a sergeant and the rest as a 

traffic officer. I spent most of my career on the road, so I saw accidents on a daily basis. Some 

were gruesome: decapitations and dismemberments. I heard 

a lot of screams, and honestly you become tired of them. 

I responded to murders and suicides, backing up our local 

police departments. I saw injured and abused children. I 

was assaulted.

Probably the biggest incident that finally triggered a full 

blown case of PTSD was when an officer of mine was killed. 

He wanted to work overtime, and I knew he was tired. He pleaded with me to work, and I didn’t 

want him to, but I relented and let him. He fell asleep on his motorcycle. I responded to the 

scene and half of his head was missing.

Cumulative PTSD can be difficult to treat because you’ve got so much to deal with. You get into 

feelings like guilt and self-blame. You’ve got mistakes—dirty little secrets and mistakes in judgment. Everybody makes mistakes. In police work, the opportunity for mistakes is pretty high, 

and they haunt you. You take a lot of responsibility for things that happen on the road. Officers 

think about how they might have prevented it, how they might have gotten there sooner. All the 

“what ifs” will kill you.

In police work, the 

opportunity for mistakes 

is pretty high, and they 

haunt you.
Sgt. O’Hara’s Story: Managing Cumulative PTSD and Helping to Prevent Officer Suicide

2 of 2

It all begins to compile and becomes a big bundle of yuck that catches up to you in nightmares, 

depression, and flashbacks. 

After my officer died, I took the blame for it. I couldn’t forgive myself. I went through crying 

spells. My temper flared at home and at work. It became explosive. I started having panic attacks 

and anxiety. I started withdrawing. I became almost agoraphobic. The flashbacks reached a point 

where I couldn’t sleep. I tried alcohol as a coping technique, and it worked: I could sleep.

I was a closet drinker. At first, I always quit 8 to 10 hours before work, but eventually I became 

an alcoholic. I was starting to show up to work with the odor of alcohol on my breath. Ultimately, drinking just made it worse; I wasn’t able to suppress the feelings with the alcohol.

I started to get scared of losing my career. And there was pressure from my wife. I knew I had to 

quit drinking, and when I did I felt worse because I didn’t have the sedative effects of the alcohol 

to overcome the flashbacks and anxiety.

About a year later, I became suicidal and went into the hospital. I’ve been on meds and in therapy since then, and I eventually retired on disability.

I’ve been able to manage my problems. You don’t cure PTSD; you learn to manage it. I’ve been 

able to manage the depression, the flashbacks, and the problems sleeping. But I still get panic 

attacks and anxiety, especially in traffic and in crowds. I don’t handle stress very well. When I 

was on patrol, I was the figure of calm; nothing could bother me. Today, even driving is a challenge for me.

After I had gone through a lot of recovery, I reflected back on things that I could have done to 

avoid the predicament I got into. It never occurred to me to get into therapy during my career; 

I had never even heard of therapy. But it works pretty well. If I had gotten therapy back then, I 

might not have had to retire.

I got to thinking about why officers don’t try therapy or medication. There are officers suffering 

from anxiety and PTSD, and they are determined to suffer through it for the rest of their lives. 

I think in this day and age, when officers are being questioned on a lot of things (shootings, 

arrests, and brutality), a lot of that could be avoided through some good therapy. And I think 

people are scared of medication. Medication doesn’t necessarily affect your ability to work, but 

officers don’t know that.

It never occurred to me to get into therapy during 

my career. . . . If I had gotten therapy back then, 

I might not have had to retire.
 

1 of 3

Sgt. DiBona’s Story: 

Using His Personal Struggles 

to Help Other Cops 

Mark DiBona is a deputy sheriff in Central Florida and is on the board of directors of The Badge 

of Life, an organization of active and retired law enforcement officers dedicated to preventing law 

enforcement suicide.

It was my lifelong dream to be a cop, and I started on the job at age 21. I’ve 

been in law enforcement for 30 years and a supervisor for 17.

About eight years ago, I was going through some tough times at work. I 

wasn’t getting along with my immediate supervisor. We were both alpha 

males, but we had completely different styles of working and supervision. He 

was hard headed and strict, and I tried to be approachable to my guys. I felt he was very disrespectful. We became argumentative, insulting each other. He told me I wasn’t aggressive enough, 

that I had to be harder on my guys. I took things to heart. He gave me an evaluation of “below 

standards.” I felt worthless, like maybe he was right, maybe this job wasn’t for me anymore. I felt 

like I couldn’t do anything right.

This went on for a few months. It affected me physically. I gained 40 pounds. I refused to shave. 

I started coming in with my uniform wrinkled. I didn’t go to my wife for help. I thought, “If you

aren’t a cop, you don’t understand.” The stigma is if you show a weakness, if you say something’s 

bothering you, they look at you like you are weak.

So all this is already happening, and one night I am at the fire station, and a woman pulls up in 

her car. She cried, “My baby isn’t breathing!” Just before she pulled up, the firemen had gone out 

on a call, so I did CPR on the baby. It seemed like I did CPR for an hour. 

The baby died. I went to the funeral and the wake. I started to get nightmares about him, like 

maybe I could have done better. I can still feel that baby in my arms.

I told my boss, and he said, “You were just doing your job,” like it wasn’t a big deal.
Sgt. DiBona’s Story: Using His Personal Struggles to Help Other Cops

2 of 3

I started feeling more worthless. I had lots of nightmares, waking up in cold sweats. I started 

thinking about the baby that died, and all the other stuff came up too: the horrible crashes I’ve 

seen, the victims of sexual abuse, the victims of robbery, the bad guys, the friends who died in 

the line of duty. I thought, “I don’t want to be a cop anymore because this line of work sucks.” 

One night, it hit me: This job is not for me; I’m failing really fast. I tried to fight the thoughts, 

but I felt like I was drowning. I attempted suicide twice that night. 

I got lucky. A car pulled up, and it was another cop. He talked me down. I went home because 

I couldn’t go back to work that night. I was afraid of losing my job. I thought they would take

away my gun and put me in the hospital.

I called a close friend in Boston. He said he wanted me to come up there to get help. I went to 

Massachusetts and got some therapy, and then I went back to Florida a week and half later. I 

bounced back and forth between therapists. It wasn’t clicking because the therapist didn’t have 

any police background. I didn’t go to the employee assistance provider because they are countywide, not specialized to police. I just wasn’t in my comfort zone.

It was a difficult time in my life. I saw a person in me that I’d never seen before. There’s that 

Michael Jackson song, “The Man in the Mirror.” When I looked in the mirror, I didn’t like the 

guy I saw. I didn’t like his looks; I didn’t like him. I felt weak. I knew in my heart that something 

was wrong, but it was hard to accept when I was diagnosed.

I stopped going to therapy, and I started looking on online. I found fascinating articles about 

police mental health, suicide, stigma, and an organization called The Badge of Life. I never 

realized that support was out there. I had a friend, a fellow officer, who committed suicide, 

but I thought it was just a family problem.

I started to go to a support group in central Florida, just cops talking to cops. I found a therapist 

who is a retired cop. During the course of all this, I got my marriage back on track. I felt guilty 

about the way I treated my wife, and I apologized. She had felt helpless. She was trying to get me 

help, and I wouldn’t take the help.

I’m on medication, and it’s helped me to focus. 

I was concerned about the meds; could I still be a cop? 

But I can; it’s not a problem whatsoever. 

I’m still an active deputy sheriff.
 

Sgt. DiBona’s Story: Using His Personal Struggles to Help Other Cops

3 of 3

I was diagnosed with PTSD and depression. I’m on medication, and it’s helped me to focus. 

I was concerned about the meds; could I still be a cop? But I can; it’s not a problem whatsoever. 

I’m still an active deputy sheriff.

I’ve never had a suicidal thought since. I still have the nightmares, just not as much as I used to. 

I just feel a lot better now. I lost the weight I gained. I don’t let it ruin my everyday life, ruin my 

job, ruin my marriage. On the days when I feel down, I’ve learned to control that—the anxiety, 

depression, and PTSD.

The biggest problem I have now is the stigma. When I’m open about it, the guys look at me 

funny. But there are others; when they hear my story, they come up to me and say, “Can I talk 

to you for a second?” There’s nothing better than helping another cop through the issues that 

I experienced. 

I really enjoy my life now, when for years I didn’t. I still love being a cop.

 

1 of 2

Too Much, Too Ugly: 

Understanding the Trauma 

Contamination for 

Law Enforcement Officers

by John Nicoletti, PhD, ABPP 

What is trauma? How do we get it? 

Trauma is exposure to an event that involves injury or death. This exposure can be direct (you 

are the victim) or vicarious (you are the responder or witness). 

What are the types of trauma that affect law enforcement officers? 

Too much, too ugly, too soon. 

The defining aspect of this type of trauma is the rapid onset of events with little time for psychological preparation. An example is the Aurora Century 16 theater shooting, which left 12 dead 

and 70 injured in a matter of minutes. 

Too much, too ugly, too long. 

This happens when the law enforcement officer is experiencing prolonged exposure to trauma 

either as a victim or through staying too long in assignments such as child sexual abuse, crime 

scene investigation, or homicide investigations. Prolonged exposure depletes the mind and 

body’s energy reserves, making it increasingly difficult to cope with and process stressors. 

Too much, too ugly, too similar. 

This happens when the law enforcement officer is a victim of or a responder to a traumatic event 

that is similar to a previous incident. It can also happen when the brain makes a connection 

between an event (the death of an infant, for example) and something similar in the officer’s life 

(their own baby). 
Too Much, Too Ugly: Understanding the Trauma Contamination 

for Law Enforcement Officers

2 of 3

Too much, too ugly, too different. 

This happens when the law enforcement officer is a victim of or a responder to an event that is 

unpredictable and outside their normal life experiences, such as a mass casualty event. It can 

also happen when a responder encounters an unfamiliar type of incident.

What does trauma do to us? 

zzTrauma causes intrusion based on either our sensory modalities or our thoughts. Sights, 

sounds, tastes, smells, and touches that remind you of the traumatic event can cause the event 

to come to life in your thoughts or senses. 

zzTrauma causes flashbacks.

zzTrauma destroys our comfort zones and shatters our assumptions about how the world works. 

For example, children are not supposed to be killed at school, and massacres should not happen at movie theaters. 

zzTrauma deteriorates our physical well-being. 

What can we do about a trauma reaction? 

Get rid of it, or you will have to live with it!

zzView psychological trauma symptoms the same as physical symptoms. If you cut your leg 

open with a chainsaw, you would never say, “This shouldn’t be bothering me.” If you are having a trauma reaction, don’t think to yourself, “This shouldn’t be bothering me.” If you did not 

treat the cut from the chainsaw, you would eventually bleed out. If you don’t treat the trauma 

reaction, you will eventually “bleed out” mentally. Get psychological treatment.

zzTalk about it or write about it. Keep talking and writing until you feel that it has become a 

memory as opposed to a thought. A thought is always at the front of our awareness, whereas 

a memory sleeps until we wake it up. For example, what did you have for dinner last Friday 

night? It takes a moment to recall that, because it is saved in your brain as a memory.

zzManage your “Book of the Dead.” Work through your reactions to these deaths so that you 

can keep them as memories but they don’t have the power to “wake up” and wander around in 

your thoughts. 
 

1 of 4

“This Shouldn’t Be 

Bothering Me:” Common 

Myths about Police Officers’ 

Responses to Traumatic Events 

“I shouldn’t be feeling this way. This shouldn’t be bothering me.”

Law enforcement officers are exposed to an extreme share of human violence, tragedy, and suffering. In the face of so much violence, law enforcement culture has developed its own stoicism: 

Don’t be bothered; suck it up, or you can’t do your job. Stay cool. Stay strong.

Emotional restraint is vital during a crisis, and to maintain it an individual often learns to desensitize to violence. It can be difficult to remain detached, however, when faced with an incident 

that is too similar to everyday experience, for example when an officer takes a child’s death to 

heart because the victim is the same age as their own child. On the other hand, an incident that 

is very unusual can be unsettling, such as when an officer responds to a mass casualty event for 

the first time. Suddenly, officers who are accustomed to being restrained may find it difficult to 

hold in their response to the stressful encounter.

Not surprisingly, many officers feel something is wrong with them when they experience strong 

emotions after a traumatic incident. Yet those reactions are quite normal and involuntary. 

Resilience is not the absence of emotional reactions—it is the ability to process such natural 

responses and overcome the impact of a tragedy over time.

Expecting not to feel anything after witnessing and responding to an atrocity is like expecting 

not to bleed after an injury—it’s not how human bodies work. If you accidentally cut yourself 

working with a saw, would you say, “I should not be bleeding?” No, you would get medical 

help. Psychologically speaking, if you are having a trauma symptom and say to yourself, “This 

should not be bothering me,” you will allow yourself to bleed out emotionally. A more resilient 

way to handle the situation would be to say: “This is bothering me, and I need to do something 

to fix it.” 

Whether we like it or not, our bodies react to a traumatic event and it can trigger unexpected 

and often unwanted feelings. But just as we can attend to physical injuries, we can attend to our 

psychological reactions and recognize that immediate care prevents future complications.
“This Shouldn’t Be Bothering Me:” Common Myths about 

Police Officers’ Responses to Traumatic Events

2 of 4

“I should be able to handle this on my own.”

When officers realize they are reacting in unexpected ways to an incident, most of them think 

they should be able to handle the issue on their own. They’re police officers. They are trained in 

self-control and problem solving. Asking for help is seen as a sign of weakness. 

Most people deal with traumatic events by talking to friends and family or commiserating with 

co-workers. But that can be hard for police officers; friends and family may not be able to relate 

to the officer’s experiences, and talking about it can make them uneasy. 

If you find yourself in this situation, you can think of meeting with a mental health professional 

the same way you think about any other expert consultation. The expert can help you assess 

whether your experiences are normal (they probably are) or might be a sign of a lasting problem. They can suggest strategies for processing these reactions so you can move on. And they 

can help identify when an immediate coping mechanism—such as burying yourself in work or 

drinking every night to fall asleep—could result in long-term problems.

Here is one way to think about it: When we break a bone, we don’t think we should be able to 

handle it ourselves; we trust professionals who are trained in healing that kind of injury. Similarly, our psychological injuries heal faster and better when they benefit from professional care.

“I’m shaking. I have a knot in my stomach. 

This means I’m scared and weak.”

It does not fit the common image of a competent, composed officer to be shaking after a stressful encounter or to have knots in the stomach—yet these are very common, normal physical 

reactions to a traumatic event. That’s because mortal fear or other traumatic situations cause the 

body to flood with adrenaline. The response is called “fight or flight”—all nonessential systems 

in the body shut down so energy can be directed toward the systems needed to either fight or 

flee. This affects the body in several ways:

zzShaking, especially of the hands. Not enough blood and oxygen is going to the small muscles in the body, impairing their ability to function normally.

zzStomach butterflies. The overall shutdown of all nonessential systems includes the digestive 

system. Throughout the day, the digestive tract constantly moves and contracts. When this 

stops, it creates a sensation of butterflies or knots.

zzTunnel vision. The visual field narrows. Officers often express concern that they did not see 

certain aspects of a scene (e.g., a pedestrian walking by or a car driving by); however, they 

cannot control this physiological response. During a fight or flight experience, if you choose 
“This Shouldn’t Be Bothering Me:” Common Myths about 

Police Officers’ Responses to Traumatic Events

3 of 4

to fight, you generally only need to focus on the object that poses the biggest risk (a gun, a 

knife, etc.). If you choose flight, you only need to see the escape route. Tunnel vision focuses 

our attention on the maximum chance of survival.

zzTunnel hearing. As with tunnel vision, the brain focuses only on the sounds that it perceives as essential for survival and filters out anything extraneous. For example, officers 

may not hear someone shouting at them, or some shouts may sound muffled during a 

fight-or-flight situation.

zzAmnesia. Research suggests that high levels of stress can negatively impact memory, particularly short-term memory for simple facts. When faced with fight-or-flight decisions, the brain 

is concerned with survival, not detail. For example, law enforcement investigators might ask 

officers how many rounds they fired during a critical incident, but some officers may not 

know because the brain was not concerned with bullet count; the brain was concerned with 

stopping the threat.

“I shouldn’t be freaking out over something that happened 

weeks or months ago.”

People often think that symptoms will show up right away after a traumatic event. That is true 

only for some people; others won’t experience any symptoms for days or even weeks. They 

might think they are fine and then all of a sudden have nightmares or become moody, for example. There’s nothing wrong with having a delayed response to an incident. Just be sure you seek 

assistance or use your healthy coping strategies whenever you do become aware that you are 

experiencing a reaction.

In addition to such sudden or delayed responses to a traumatic event, the impact can also be 

cumulative: Think of the slowly boiled frog that doesn’t even know that it’s being cooked until 

it’s too late. When you are constantly exposed to trauma, it can start to feel “normal” and you 

may not be aware of the impact it is having on you. Friends and family members may notice 

small changes in you first. Try not to become defensive if they bring this to your attention. Let 

their perspective serve as an early warning sign to you that it might be time for a mental wellness check.

“Going to the shrink will jam me up.”

Many officers think that seeking help from a mental health professional will negatively impact 

their career. They fear the chief will find out about a drinking problem or they will be found 

unfit for their jobs. They worry that their fellow officers will think they are too weak to deal 

with stress. 
“This Shouldn’t Be Bothering Me:” Common Myths about 

Police Officers’ Responses to Traumatic Events

4 of 4

What most officers don’t know is that there is a very strict line between fit-for-duty evaluations 

(which the agency will see) and mental health treatment details (which the agency will not have 

access to or even be aware of). In fact, when you see a licensed mental health professional for 

treatment either in private practice or through an employee assistance provider, they must keep 

all interactions confidential, or they risk losing their license. The only exceptions to this confidentiality rule are cases where reporting is required by law: when the patient poses a danger to 

him or herself or others or when there is a case of child or elder abuse.

So in reality, it is often the other way around: Not seeking treatment can slow down officers 

in their law enforcement career as post-traumatic stress disorder or alcoholism or other negative responses become harder to control. Getting timely, professional help, on the other hand, 

ensures you stay ready to engage and resilient in the long run. 
 

1 of 4

The Mental Health Incident 

Commander’s Role during 

the Immediate Response to 

a Mass Casualty Event

Who should be assigned to this role?

If your agency does not have a mental health incident commander, the chief should assign a trusted 

individual to this role as soon as possible. This can be a temporary assignment while you determine who would be best to serve in this role for the long-term. The most important characteristics are credibility, openness to learning, and empathy. Ideally, this is an individual who has

zzfamiliarity with your agency and law enforcement culture;

zzcredibility with your officers;

zzmental health training;

zzconnections with your local mental health community; 

zzan understanding of the impact of trauma and familiarity with Psychological First Aid.

The temporary incident commander can be a police psychologist, a licensed mental health professional, a certified employee assistance professional who is also a mental health professional, a 

member of your command staff, or a chief from a neighboring community. 

Depending on the scope of the incident and the size of your agency, your mental health incident 

commander may need an assistant.

If your agency does not have a mental health incident 

commander, the chief should assign a trusted individual 

to this role as soon as possible.
The Mental Health Incident Commander’s Role during 

othe Immediate Response to a Mass Casualty Event

2 of 4

Responsibilities: Immediate incident response

SUPPORTING 

OFFICERS

SUPPORTING THE CHIEF 

AND COMMAND STAFF

z Monitoring officers’ behavior and verbalizations 

on scene to see if any officer needs immediate 

assistance 

z Connecting officers in distress with peer support 

or mental health professionals

z Sharing information about available mental 

health services with officers and ensuring 

that every employee has the name and phone 

number of a licensed mental health professional 

or supervisor to call in case they need to talk

z Updating officers about the status of mental 

health services—even if it is just reassurance 

that services will be made available

z Ensuring that a mental health provider or supervisor checks in with all officers and civilian staff 

before the end of shift; anyone conducting these 

check-ins should receive a copy of the handout 

“How to Assist a Fellow Officer after a Critical 

Incident” on page 137

z Contacting an officer’s family members 

if needed

z Briefing the chief and other command staff

z Advising the chief and command staff on 

operational decisions that impact officer 

mental health: e.g., an assignment to work 

with victims’ families (see “Prioritize support 

for victims and their families . . .” on page 62) 

or when to file reports (see “Immediate incident 

response checklist: Supporting officer wellness” 

on page 72)

z Vetting and managing self-deployed mental 

health service providers—unfortunately, it’s 

unlikely that self-deployed providers will be able 

to assist on the first day, but you can take their 

information for the future and ensure they don’t 

disturb victims, their families, or officers
The Mental Health Incident Commander’s Role during 

othe Immediate Response to a Mass Casualty Event

3 of 4

Responsibilities: The first weeks

SUPPORTING 

OFFICERS

SUPPORTING THE CHIEF 

AND COMMAND STAFF

z Triaging to decide which personnel need mental 

health follow-up (see “Managing challenges and 

stressors for officers” beginning on page 81 in 

chapter 6)

z Proactively sharing information about mental 

health supports with all agency personnel, including civilian personnel and officers who were 

off duty during the incident

z Maintaining an active presence at police stations 

and the investigation scene and continuously 

monitoring officers’ behavior for signs of distress

z Regularly updating officers on the status of mental health services that will be made available to 

them in the future

z Reviewing potential stressors on the community and officers (see “Managing challenges for 

your agency and your community” beginning on 

page 73 in chapter 6)

z Reaching out proactively to officers’ families to 

share information about mental health supports

z Educating officers about healthy strategies for 

coping with stress and trauma (e.g. sleep, exercise, time with family and friends)

z Attending full departmental meetings to be 

available for questions on wellness and resiliency; this is also an opportunity for the chief to 

emphasize his or her commitment to wellness

z Working with command staff to identify appropriate mental health service providers, including 

continuing to vet self-deployed responders; for 

qualifications to look for in a mental health professional, see “Assign a mental health incident 

commander” on page 41

z Continuing to advise the chief and command 

staff on operational decisions that affect officer 

mental health

z Providing personal support to the chief and 

command staff to ensure they are able to 

manage their stress 
The Mental Health Incident Commander’s Role during 

othe Immediate Response to a Mass Casualty Event

4 of 4

Long-term planning

After the early weeks of an incident, officer mental wellness should remain a top priority. The 

mental health incident commander should review pages 73–109 (“The First Weeks” through 

“The Long Haul”) to begin the process of understanding stressors and challenges the agency 

will continue to face. In particular, he or she should anticipate trauma triggers that might 

affect officers (such as requalifying for firearms use or testifying at a trial) and take appropriate 

countermeasures. He or she should continue support and education for officers, their families, 

and the chief. And finally, the mental health incident commander leads the process of developing 

a long-term officer wellness plan.
 

1 of 1

How to Assist a Fellow 

Officer after a Critical Incident

A mental health professional, supervisor, or fellow officer should check in as soon as possible 

with any officer who has been involved in a traumatic incident. This conversation can be brief 

and doesn’t require any specialized training—just common sense and genuine concern. Here 

are some steps you can take:

1. Ensure safety. Make sure that the officer is safe and uninjured. If the immediate threat has 

passed, ask if he or she needs medical care and provide reassurance of safety.

2. Provide practical assistance. Ask if there’s any way you can help—food, water, a ride 

home, or a call to a family member.

3. Offer to talk. Let him or her know you are available to listen. For example, say, “That was an 

awful situation. I’m sorry you had to go through it. Do you want to talk?” If he or she does 

not want to talk, don’t be surprised and don’t push it.

4. Listen attentively. Some people will want to talk through what they experienced, and others 

will not. Don’t worry about fixing the problem, and don’t feel like you need to ask detailed 

follow-up questions. 

5. Reassure. If the officer seems upset, reassure him or her that whatever reaction they are having is normal. You can also offer a hug. If they feel fine, that’s also okay. Say, “There’s nothing 

wrong with you. You are having a normal reaction to an abnormal situation.” 

6. Make sure the officer gets home safely, and leave a number to call. Before you leave, 

give the officer your phone number or the number of a 24-hour helpline—somewhere they 

can call day or night. 

Dos and don’ts for supporting a fellow officer

DO

zzListen carefully.

zzBe patient and sit with him or her for a few 

minutes.

zzEncourage him or her to go home, get some 

sleep, eat, or call a friend.

zzLeave if asked to, but make sure to leave behind 

a phone number in case they want to talk later.

DON’T

zzTell him or her to suck it up and get back 

to work.

zzAsk for details of the incident to satisfy 

your curiosity.

zzGet side-tracked telling a story about your 

own experience.

 

139

Resources

Medical literature

Brymer, Melissa, Anne Jacobs, Christopher Layne, et al. 2006. Psychological First Aid: 

Field Operations Manual. 2nd ed. Los Angeles: National Child Traumatic Stress Network. 

http://www.nctsn.org/sites/default/files/pfa/english/1-psyfirstaid_final_complete_manual.pdf.

Mind Tools. 2016. “Holmes and Rahe Stress Scale.” Mind Tools Ltd. Accessed April 4, 2016. 

http://www.mindtools.com/pages/article/newTCS_82.htm.

Rose, Susanna C., Johnathan Bisson, Rachel Churchill, et al. 2002. “Psychological Debriefing 

for Preventing Post-Traumatic Stress Disorder (PTSD).” Cochrane Database of Systematic 

Reviews 2. doi:10.1002/14651858.CD000560.

Violanti, John. 2014. Dying for the Job: Police Work Exposure and Health. Springfield, IL: 

Charles C. Thomas. 

Media resources

On the Media. “The Breaking News Consumer’s Handbook.” New York Public Radio. Last 

modified September 20, 2013. http://www.onthemedia.org/story/breaking-news-consumershandbook-pdf/.

Police Executive Research Forum. 2013. Social Media and Tactical Considerations for 

Law Enforcement. Washington, DC: Office of Community Oriented Policing Services. 

http://ric-zai-inc.com/ric.php?page=detail&id=COPS-P261.

Mental wellness education and support 

Blue LLC. 2014. BLUE. Vimeo video. Accessed April 4, 2016. https://vimeo.com/105565084.

DeHart, Ralph. 2014. “The Blue App.” iTunes. https://itunes.apple.com/us/app/the-blue-app/

id931490733?mt=8&ign-mpt=uo%3D4.

Ferreras, Jesse. 2015. “‘You Are Not Alone’: RCMP PTSD Video Aims to Raise Awareness.” 

The Huffington Post Canada, August 11. http://m.huffpost.com/ca/entry/7973626?ir=

Impact&ncid=fcbklnkushpmg00000054.

Gilmartin, Kevin. 2002. Emotional Survival for Law Enforcement. Tucson, AZ: E-S Press. 

http://emotionalsurvival.com/author.htm.

Cactus. 2015. “Man Therapy.” Accessed April 4, 2016. http://mantherapy.org/.

141

Organizations

American Police Chaplains Association

http://www.americanpolicechaplain.org/

Badge of Life

http://www.badgeoflife.com/

Boston Police Peer Support Unit 

Self-Check Quiz

https://www.bostonpeersupportquiz.org/

welcome.cfm

Center for Officer Safety and Wellness, 

International Association of Chiefs 

of Police

http://www.theiacp.org/CenterforOfficer

SafetyandWellness

Concerns of Police Survivors

http://www.nationalcops.org/

First Responder Support Network

http://www.frsn.org/

HEART (Healing Emergency 

and Response Team) 9/11

http://www.heart911.org/

International Conference 

of Police Chaplains

http://www.icpc4cops.org/

International Critical Incident 

Stress Foundation

http://www.icisf.org/

International Society for 

Traumatic Stress Studies

https://www.istss.org/

National Center for PTSD, 

U.S. Department of Veteran Affairs

http://www.ptsd.va.gov/

National Institute of Mental Health, 

National Institutes of Health

https://www.nimh.nih.gov

Police Executive Research Forum

http://www.policeforum.org/

Police Officers Providing Peer 

Assistance (POPPA)

http://www.poppanewyork.org/

Virginia Law Enforcement 

Assistance Program

http://valeap.org/

 

143

Key Word Index

cumulative trauma, pp. 13–14

debriefing, pp. 34–36, 43, 83, 100

donations, pp. 74, 86, 91, 93 

media, pp. 7, 8, 43, 45, 49–55, 61, 

62, 66, 68–71, 73–78, 82, 85, 87, 

90–95, 98, 101, 102, 105, 117, 119

memorial, pp. 5, 43, 73, 78, 79, 93, 

100, 103, 114

peer support, pp. 28–31, 34, 39, 47, 

64, 66, 98, 134

post-traumatic stress disorder (PTSD), 

pp. 3, 5, 6, 8–10, 12, 13, 16–18, 

34–37, 97, 113, 115, 119, 121, 122, 

125, 132, 141 

Psychological First Aid, pp. 32, 37, 38, 

42, 63, 133 

resilience, pp. 13, 14, 19–21, 25, 27, 28, 

34, 37, 41, 75, 85, 91, 100, 129

suicide, pp. 7, 9, 11, 12, 16, 17, 31, 118, 

121, 124

trauma, pp. 3, 6–8, 13–22, 25, 30, 32, 

35, 36, 38, 42, 51, 65, 85, 89, 95–97, 

99, 101, 104, 111, 117–119, 127–129, 

131, 133, 135–137

145

About the Authors

Laura Usher is the manager, criminal justice, and advocacy with National Alliance on Mental 

Illness (NAMI). Usher served for eight years as NAMI’s program manager for crisis intervention teams (CIT) and has assisted law enforcement agencies nationwide in improving responses 

to people in the community experiencing mental health crises. Usher is also the coauthor of 

numerous reports, including Responding to Youth with Mental Health Needs: A CIT for Youth Implementation Manual, Grading the States 2009: A Report on America’s Health Care System for Adults 

with Serious Mental Illness, and State Mental Health Cuts: The Continuing Crisis. She has served 

on numerous advisory panels on policing and mental illness for the Police Executive Research 

Forum, the International Association of Chiefs of Police, the Substance Abuse and Mental Health 

Services Administration, and The Arc. 

Stefanie Friedhoff is a German-American journalist. Her work has appeared in the Boston 

Globe, Time Magazine, Frankfurter Allgemeine Zeitung, and many other publications. From 2006 

to 2014, Friedhoff ran a variety of programs at the Nieman Foundation for Journalism at Harvard University, including Nieman’s Trauma Journalism Program. At Nieman, Friedhoff created major conferences20 convening trauma experts, victims, law enforcement, journalists, and 

others involved in the lives of survivors to explore each other’s roles—and the role of storytelling—in the aftermath of crime and disaster. Friedhoff teaches media literacy for victim advocates 

at the Massachusetts Victim Assistance Academy and is a media consultant to the Resiliency 

Center for Victims of the Boston Marathon bombings. Friedhoff was retained as an expert consultant to NAMI to coauthor this publication.

Sam Cochran retired as major with the Memphis (Tennessee) Police Department after developing the nation’s first CIT program and serving as its coordinator for 20 years. Today, he assists 

law enforcement agencies across the United States, England, Australia, and Israel in building 

partnerships with the mental health system and in starting their own CIT programs. He is a 

national spokesperson on mental illness and policing issues and received the 2000 News Person 

of the Year Award from City University of New York John Jay College of Criminal Justice. NAMI 

has named an annual law enforcement advocacy award after Cochran. He was retained as an 

expert consultant to NAMI to coauthor this publication.

20. See Melissa Ludtke, “The Conference: Covering Violence and Tragedy,” NiemanReports, accessed April 6, 2016, 

http://niemanreports.org/articles/the-conference-covering-violence-and-tragedy/.
Preparing for the Unimaginable: How Chiefs Can Safeguard

Officer Mental Health Before and After Mass Casualty Events

146

Anand Pandya, MD, is the cofounder of Disaster Psychiatry Outreach in Brooklyn, New York, 

and a National Institute of Mental Health-funded researcher on the predictors of depression in 

survivors of disasters. He has won numerous awards for his work in the field. He is a coeditor 

of two award-winning books on disaster psychiatry and author of numerous articles and book 

chapters on disaster psychiatry and mental health advocacy. He previously served on the board 

of directors of the Menninger Clinic in Houston, Texas, and he has served two terms as president 

of NAMI. Pandya was retained as an expert consultant to NAMI to coauthor this publication. 
 

147

About NAMI

NAMI, the National Alliance on Mental Illness, is the nation’s largest grassroots mental 

health organization dedicated to building better lives for the millions of Americans affected by 

mental illness. 

What started as a small group of families gathered around a kitchen table in 1979 has blossomed 

into the nation’s leading voice on mental health. Today, we are an association of hundreds of 

local affiliates, state organizations, and volunteers who work in your community to raise awareness and provide support and education that was not previously available to those in need. 

What We Do 

We educate. Offered in thousands of communities across America through our NAMI State 

Organizations and NAMI Affiliates, our education programs ensure hundreds of thousands of 

families, individuals, and educators get the support and information they need. 

We advocate. NAMI shapes the national public policy landscape for people with mental illness 

and their families and provides grassroots volunteer leaders with the tools, resources, and skills 

necessary to save mental health in all states.

We listen. Our toll-free NAMI HelpLine allows us to respond personally to hundreds of thousands of requests each year, providing free referral, information, and support—a much-needed 

lifeline for many. 

We lead. Public awareness events and activities including Mental Illness Awareness Week 

(MIAW), NAMIWalks, and other efforts successfully combat stigma and encourage understanding. NAMI works with reporters on a daily basis to make sure our country understands how 

important mental health is. 
148

About the COPS Office

The Office of Community Oriented Policing Services (COPS Office) is the component of the 

U.S. Department of Justice responsible for advancing the practice of community policing by 

the nation’s state, local, territorial, and tribal law enforcement agencies through information 

and grant resources.

Community policing begins with a commitment to building trust and mutual respect between 

police and communities. It supports public safety by encouraging all stakeholders to work 

together to address our nation’s crime challenges. When police and communities collaborate, 

they more effectively address underlying issues, change negative behavioral patterns, and 

allocate resources. 

Rather than simply responding to crime, community policing focuses on preventing it through 

strategic problem solving approaches based on collaboration. The COPS Office awards grants to 

hire community police and support the development and testing of innovative policing strategies. 

COPS Office funding also provides training and technical assistance to community members and 

local government leaders, as well as all levels of law enforcement. The Collaborative Reform 

Initiative for Technical Assistance (CRI-TA), a program that promotes organizational transformation through analysis of policies, practices, and training related to issues of concern, is also 

available to law enforcement agencies

Since 1994, the COPS Office has invested more than $14 billion to provide training and technical assistance, enhance crime fighting technology, and add more than 125,000 officers to our 

nation’s streets. We also offer a wide variety of information resources to help law enforcement 

and community leaders address specific crime issues at www.cops.usdoj.gov.

Though most agencies have trained and equipped their officers for immediate response 

to mass casualties, few have prepared their personnel for the psychological fallout. Tragic 

events can have a profound effect on first responders, who may suffer emotional distress 

that lingers long afterward. To help the Newtown (Connecticut) Police Department cope with 

the murder of 26 people, including 20 children, at Sandy Hook Elementary School, the COPS 

Office reached out to the National Alliance on Mental Illness (NAMI) to provide guidance. 

This unique guide, which is the result of NAMI’s work with Newtown’s police chief, Michael 

Kehoe, offers expert advice and practical tips for helping officers to heal emotionally, 

managing the public, dealing with the media, building relationships with other firstresponder agencies, and much more. Making this guide especially helpful are the personal 

contributions of four police chiefs and numerous officers who have lived through incidents 

such as these and have shared their experiences. 

U.S. Department of Justice

Office of Community Oriented Policing Services

145 N Street NE

Washington, DC 20530

To obtain details about COPS Office programs, call 

the COPS Office Response Center at 800-421-6770.

Visit the COPS Office online at www.cops.usdoj.gov.

National Alliance on Mental Illness

3803 N. Fairfax Drive

Suite 100

Arlington, VA 22203

Visit NAMI online at www.nami.org.

ISBN: 978-1-935676-90-4

e121529737

Published 2016