Officer Safety and Wellness (OSW) Group Meeting Summary

Psychological Health

February 4, 2013
This project was supported by cooperative agreement number 2011-CK-WX-K023 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, Bureau of Justice Assistance, 

and Major City Chiefs Association can vouch for their current validity. 

Recommended citation:

Stephens, Darrel W., and Lisa Mantel. 2014. OSW Group Meeting Summary: Psychological Health, 

February 4, 2013. Washington, DC: Office of Community Oriented Policing Services.

Published 2014

e02146626
Contents

Overview of the Officer Safety and Wellness Group.............................................................. 2

Introduction ........................................................................................................ 3

Initial remarks ..................................................................................................... 4

Research on the Impact of Police Officer Stress .................................................................. 4

Police Stress and Health: The Mind-Body Nexus............................................................ 4

Assessment of Health Risks in Law Enforcement Cohorts................................................ 10

Resilience and Fatigue: Research-Based Traction for Action ............................................. 12

Impact of Shift Length: An Experimental Study .......................................................... 15

Police Agency Psychological Health Initiatives ................................................................. 17

Austin (Texas) Police Department.......................................................................... 17

Columbus (Ohio) Division of Police ....................................................................... 18

Fresno (California) Police Department .................................................................... 20

Discussion and Action Agenda .................................................................................. 22

Leadership .................................................................................................. 22

Research ..................................................................................................... 23

Policy ........................................................................................................ 23

Training ..................................................................................................... 24

Practice/Programs .......................................................................................... 24

Conclusion........................................................................................................ 24

Appendix A: OSW Group meeting agenda ..................................................................... 25

Appendix B: OSW Group meeting attendees ................................................................... 27

Appendix C: OSW Group Presenters’ Profiles.................................................................. 30

References ........................................................................................................ 32

About BJA ........................................................................................................ 36

About the COPS Office .......................................................................................... 37
Overview of the Officer Safety and Wellness Group

The U.S. Department of Justice’s Office of Community Oriented Policing 

Services (COPS Office) and Bureau of Justice Assistance (BJA) established 

the Officer Safety and Wellness (OSW) Group to provide a national forum 

for conversations about how to reduce deaths and injuries. 

Comprised of representatives from law enforcement agencies and associations, federal agencies, and the 

research community, the purpose of the OSW Group is to bring law enforcement thought leaders, criminal 

justice practitioners, and other colleagues together to share their broad perspectives on improving officer 

safety and wellness. Participants contribute information and ideas with the goal of enhancing subject-related 

products, tools, resources, and services available to the field. In addition, the group encourages the nation’s 

law enforcement agencies to adopt cultures of safety and wellness.

During the initial kick-off meeting held in July 2011, the OSW Group identified the 16 focus areas that 

would guide future meetings as well as the overall mission of the group (see sidebar). The following 16 areas 

were further defined and prioritized in the subsequent September 2011 meeting, also considered the first 

official meeting, after which the COPS Office produced a summary report (see Fiedler 2011): 

1. Injuries and death due to gunfire 

2. Premeditated and unprovoked ambush situations 

3. Rifle/long-gun threats/assault weapons 

4. Education and training 

5. Leadership and safety practices 

6. Emergency vehicle operation and safety 

7. Physical health (e.g., fatigue, alcohol, weight, 

and nutrition) 

8. Psychological health 

9. Foot pursuit safety 

10. Task force operations (federal and local) 

11. Offenders (behavior during incident and history) 

12. Court security 

13. Deployment strategies and communications 

technologies 

14. Maintaining good health 

15. Equipment 

16. Former military in law enforcement 

All meeting summary reports as well as information 

about future meeting topics are available on the COPS 

Office OSW Group web page: www.cops.usdoj.gov/

Default.asp?Item=2603.

The OSW Group Mission

The OSW Group will contribute to the improvement of officer safety and wellness in the United 

States by convening a forum for thoughtful, 

proactive discussion and debate around relevant 

programs and policies within the law enforcement field. Information and insight gained and 

shared will help enhance programs, policies, and 

initiatives related to officer safety and wellness.

The OSW Group Goals

 To create an opportunity and environment 

for law enforcement organizations and 

researchers to collaborate on improving officer 

safety and wellness 

 To bring law enforcement organizations 

and researchers together quarterly to share 

knowledge and information about officer 

safety and wellness initiatives 

 To disseminate information and best practices 

to the field through the government and law 

enforcement organizational communications 

mechanisms 
3

Introduction

On February 4, 2013, the OSW Group convened its sixth meeting to discuss the psychological health of 

officers in terms of helping law enforcement to improve officer safety and wellness. Subject-matter experts 

provided research findings and focused specifically on the impact of police officer stress, resilience, 

and fatigue. Participants also heard presentations on specific psychological health initiatives at police 

departments in Austin, Texas; Columbus, Ohio; and Fresno, California. 

In keeping with the OSW Group’s mission, the group dedicated the latter half of the day to obtaining 

participants’ recommendations based upon their skills, knowledge, and expertise by asking them to answer 

the following questions in terms of organizational leadership, research, policy, training, and best practices 

and programs (see “Discussion and Action Agenda” on page 22): 

 Leadership: What is the role of the chief executive and the management team in dealing with 

psychological health challenges in policing? What is the role of employee organizations in dealing with 

psychological health challenges in policing? What is the role of individual employees in dealing with 

psychological health challenges in policing?

 Research: What are the law enforcement psychological health research gaps?

 Policy: What policies should police agencies have in place to address psychological health issues? 

 Training: What type of training should departments provide employees to help them cope with the 

psychological challenges in policing? 

 Practice/Programs: What specific practices or programs should departments have to help reduce stress 

and improve psychological health of officers?

During the meeting, the OSW Group addressed eight of the OSW Group’s top priorities: 

1. Injuries and death due to gunfire 

2. Premeditated and unprovoked ambush situations 

3. Rifle/long-gun threats/assault weapons 

4. Education and training 

5. Leadership and safety practices 

6. Emergency vehicle operation and safety 

7. Physical health (e.g., fatigue, alcohol, weight, and nutrition) 

8. Psychological health

The following sections of this report provide a summary of the February 2013 meeting, including the 

subject-matter experts’ presentations and participants’ recommendations that law enforcement agencies can 

use to help improve officer safety and wellness regarding psychological health.
4

Initial remarks 

The meeting opened with introductory comments from Bernard K. Melekian, then director of the 

COPS Office, and Denise O’Donnell, director of BJA. Both recognized the joint work of BJA and the 

COPS Office and stressed the importance of finding ways to address the psychological issues that 

affect law enforcement officers. 

Darrel Stephens, executive director of the Major Cities Chiefs Association, also addressed the group, 

acknowledging the important work the OSW Group has accomplished while also recognizing there 

is still much work to be completed. 

Research on the Impact of Police Officer Stress

Police Stress and Health: The Mind-Body Nexus

John M. Violanti, Ph.D., Research Professor, Department of Social 

and Preventive Medicine, University of Buffalo

Dr. John Violanti presented on the nexus of police stress and health and how psychological health affects 

physiological health of police officers. 

What is stress? 

While there are more than 3,000 definitions of “stress,” it is essentially a psychological strain when one 

is overwhelmed and unable to deal with issues (Goldberger and Breznitz 1993). 

A key type of stress is post-traumatic stress disorder (PTSD). Approximately 10–17% of police officers 

in the United States have PTSD symptomology (Carlier et al. 1997; Maia et al. 2007; McCaslin et al. 

2006). PTSD may result from threatened death, serious injury, threat to one’s physical integrity, or such 

events occurring to other persons. According to the American Psychiatric Association (2000), an essential 

feature of PTSD is the development of characteristic symptomology, which includes the following: 

 Re-experiencing the traumatic event

 Avoidance of stimuli associated with the trauma 

 Numbing of general responsiveness

 Symptoms of increased physiological arousal

During the physiological stress response, the sympathetic nervous system (SNS) activates, and the 

human body releases epinephrine (i.e., adrenaline) and norepinephrine within seconds. The hypothalamic 

pituitary-adrenal axis (HPA) releases stored energy (e.g., glucose/fatty acids) to deal with emergencies 

via glucocorticoids (e.g., cortisol). This is a slower onset that occurs within minutes of a stressor 

(Chrousos 1998). 

Naturally, the human body tries to adapt to stressors by producing adrenaline, cortisol, and other chemical 

messengers (McEwen 2005). For example, an overheated body will naturally start to sweat to cool down 

through the autonomic system. If these chemical messengers continue for a long period of time, the body 

will experience allostatic overload (i.e., being stressed out), which results in wear and tear on the body 

and brain (ibid.).
5

In a healthy stress pattern (see figure 1), one recovers quickly from a stressor. In an unhealthy stress pattern 

(see figure 2), one is unable to recover quickly and ends up functioning at a lower level because of allostatic 

overload (McEwen and Wingfield 2003).

Figure 1. A healthy stress pattern

Relaxed

Excited

Uh Oh!

Ah!

Uh Oh!

Normal

MANAGEMENT

Resiliency

Sleep

Circadian

Phase

Domestic 

Life

Relaxed

Excited

Uh Oh!

Uh Oh!

Breakdown

Source: McEwen and Wingfield 2003

Figure 2. An unhealthy stress pattern

Relaxed

Excited

Ah!

Uh Oh!

Nutrition Domestic 

MANAGEMENT

Resiliency

Sleep

Circadian

Phase

Domestic 

Life

Relaxed

Excited

Uh Oh!

Uh Oh!

Breakdown

Source: Adapted from McEwen and Wingfield 2003

Buffalo Cardio-Metabolic Occupational Police Stress study

Violanti was one of the researchers in the Buffalo Cardio-Metabolic Occupational Police Stress (BCOPS) 

study, funded by the Centers for Disease Control and Prevention’s National Institute of Occupational Safety 

and Health (NIOSH), that looked at 464 police officers from Buffalo, New York, for over five years (Violanti, 

Burchfiel, et al. 2006). In this study, Violanti and his colleagues collected demographic and employment 

information and conducted health and stress screens measuring the following variables:

 Cortisol (stress hormone)

 Ultrasound brachial and carotid artery plaque thickness

 Body composition (body fat and bone density)
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 Blood pressure changes when moving from lying down to standing

 Body measures (e.g., height, weight, waist circumference, and BMI)

 Physical activity

 Alcohol consumption (current and lifetime)

 Dietary intake

 Smoking (current and lifetime)

 Psychosocial factors (e.g., stress, depression, PTSD, and life events)

 Sleep quality and quantity

 Screening for sleep apnea 

 Shift work: 5-year, day-to-day compilation 

BCOPS researchers found significant health disparities among police officers compared to the U.S. general 

population: police had not only higher levels of traditional cardiovascular disease risk factors, including 

BMI, metabolic syndrome, and total cholesterol, but also higher levels of nontraditional cardiovascular 

disease risk factors, including higher percentages for those who work nonday shifts, depression, and shorter 

sleep time (Hartley, Burchfiel, Fekedulegn, Andrew, and Violanti 2012).

Metabolic syndrome

Having three or more of the following key components indicate the presence of metabolic syndrome 

(Grundy et al. 2005):

 Abdominal obesity

 High triglycerides

 Low high-density lipoprotein (good) cholesterol

 High blood pressure

 High fasting glucose

In terms of officers, those with severe PTSD had a three-fold higher prevalence of the metabolic syndrome 

than those reporting the fewest PTSD symptoms (Hartley, Burchfiel, Fekedulegn, Andrew, Knox, and 

Violanti 2012). Police stress, particularly organizational pressure and lack of support, was significantly and 

positively associated with the metabolic syndrome (ibid.). Last, officers who worked nights and either had 

less than six hours of sleep or worked more overtime had a four-fold greater number of metabolic syndrome 

components than officers working the day shift (Violanti, Burchfiel, Hartley, et al. 2009).

Cortisol

This stress hormone is normally released in a pulsatile fashion with the frequency and amplitude of these 

episodes declining over the course of the day, resulting in a well-characterized diurnal pattern (i.e., high 

in the morning, low in the evening). However, in chronic stress, this pattern may change so that levels of 

cortisol are not elevated upon awakening and/or fail to return to baseline within a period of several hours 

(McEwen and Wingfield 2003).
7

Violanti and colleagues found that officers with more severe PTSD symptoms had slightly higher mean 

awakening cortisol levels than those with less severe symptoms, indicating a dysregulation of the stress 

hormone cortisol (Violanti, Burchfiel, Fekedulgen, et al. 2009). Furthermore, based on work during the 

previous two weeks, night and afternoon shift workers had a significantly diminished awakening salivary 

cortisol response pattern compared with day shift workers, indicating a dysregulation of cortisol, which may 

lead to diseases of the cardiovascular system (ibid.).

Artery health

Artery reactivity refers to how the artery reacts after it is experimentally cuffed and then released. Violanti 

and his colleagues used the brachial artery (in the arm) to obtain this measurement. The wider the artery 

expands, the healthier the artery. Arteries that do not expand well may be indicators of future heart disease. 

In looking at brachial artery health and PTSD, Violanti and his colleagues found that officers with high 

levels of PTSD symptoms had two-fold less artery flexibility and expansion than those with lower symptoms 

(Violanti, Burchfiel, Fekedulgen, et al. 2009). 

The same study also measured the thickness of the carotid arteries. The thicker the carotid artery, the more 

likely plaque has built up in the walls of the artery, indicating the possibility of future heart disease. Police 

officers had increased artery thickness compared with a similarly aged civilian population sample from the 

same geographical region (see Joseph, et al. 2009).

Shift work

Sleep deprivation and shift work disrupt the 24-hour sleep-wake circadian cycle. This can produce a 

“double-barreled effect” when experienced together with stress (Violanti, Burchfiel, Hartley, et al. 2009).

Violanti and colleagues discovered that age-adjusted incidence of injury was significantly elevated in 

officers working night shift (by 72%) and afternoon shift (by 66%) compared to those working the day shift 

(Violanti, Fekedulegn, et al. 2013).

Compared to officers with the lowest perceived stress, female officers with the highest levels of perceived 

stress were nearly four times more likely to have poor sleep quality; male officers were nearly six times more 

likely to have poor sleep quality (Charles et al. 2007). 

Cancer

Officers were at a higher risk of developing cancer as well. Researchers compared records for officers 

who worked between 1950 and 2005 against cancer registry records and discovered that 18.2% developed 

cancer; officers also had an elevated risk of Hodgkin’s lymphoma (Gu et al. 2012). The risk of brain cancer 

was slightly elevated among officers and was significantly increased for officers with 30 or more years of 

service (ibid.). 

Suicide

Policing inherently involves exposure to upsetting events in the workplace, including human misery, 

negative public image, abused children, and death. Such exposure can take a toll on the mental of officers 

and may ultimately result in suicide (Violanti, O’Hara, and Tate 2012).
8

Although O’Hara and colleagues have yet to publish their latest research, an estimated 126 officers died 

as a result of suicide, according to 2012 estimates (O’Hara et al. 2013). This number is down from the 

previous years of 2008 and 2009. Although suicide estimates have decreased, intervention still remains 

an important issue.

Violanti and colleagues disproved the notion that retired officers are more likely than working officers to 

commit suicide. They looked at employment, retirement, and mortality records for a large group of police 

officers and found that suicide rates were 8.4 times higher in working officers as compared to officers who 

had retired or left the department for other reasons (e.g., resigned) (Violanti, Gu, et al. 2012).

Violanti and colleagues also discovered that smaller police departments had a significantly higher suicide 

rate than large departments. Possible reasons include lack of availability for mental health assistance, 

increased workload and danger, and community visibility (Violanti, Fekedulegn, et al. 2013).

PTSD and effects on the brain

PTSD is thought to be a behavioral manifestation of stress-induced changes in brain structure and function. 

Alterations in neurotransmitters and neuroreceptors result in changes in neuronal function in specific brain 

areas involved in the stress response. 

According to Shucard and colleagues (2012), police officers with higher re-experiencing PTSD scores 

tended to have higher arousal ratings of pictures of traumatic police incidents and reduced amygdala, 

thalamus, and globus pallidus volumes. There was also a trend toward higher re-experiencing and reduced 

hippocampal volume. The amygdala, thalamus, and globus pallidus volumes are the centers of the brain 

that deal with fear and memory. Reduced volume of these centers can result in the officer being unable to 

extinguish the fear associated with the trauma experienced.

In a related brain imaging study, researchers found that police officers with increased PTSD symptoms had 

difficulty distinguishing between what is important and what is not when faced with dangerous situations 

(Violanti, Shucard, and Shucard 2011). 

Suggested interventions

Taking all of these studies and health risks into consideration, Violanti shared with the OSW Group a 

summation of suggested interventions from Violanti’s and other researchers’ work. 

First, police officers should have annual medical exams, although police organizations may face resistance 

from unions that fear their members would face disciplinary action if, for example, they are overweight or 

have a health problem. To help circumvent this, unions and police organizations should work together to 

better understand the problems. There is also significant variation in departments; some have significant 

labor-management conflicts while other departments have a more supportive environment. 
9

Second, the suicide rate among police officers is higher than the general population (Violanti, Hartley, et 

al. 2012). Violanti, Hartley, and colleagues (2012) found that the suicide rate among police officers was 

15.3/100,000 compared to 11/100,000 in the U.S. general population. Thus, suicide awareness is essential not 

only among line personnel but also among supervision to help recognize the signs and symptoms of suicide 

and mental health problems (Clark et al. 2012).

Third, departments should develop a peer support program. Officers generally prefer to talk with other 

officers before talking with a mental health professional. If needed, peer support personnel can develop 

mental health networks of professionals who understand police problems (Police Chief Magazine 2007).

Fourth, a recent suggestion made by the Badge of Life (2013) group involves a yearly “mental health check,” 

where an officer may go to a counselor or peer support officer once a year to discuss any concerns or life 

problems. This can help to alleviate small problems before they become big ones (www.BadgeofLife.com).

Fifth, it is important to introduce behavioral intervention at the academy before stress occurs. Called an 

“inoculation effect” (Meichenbaum 1996), this involves preparing the recruit for future stress and providing 

an understanding of the effects of stress when not managed properly. 

Sixth, obesity stands out as one of the biggest precursors to developing cardiovascular disease in police 

officers (Violanti, Fekedulegn, et al. 2012). Lifestyle factors such as diet, no smoking, exercise, and proper 

sleep can decrease obesity and should be part of police training for both recruit and in-service programs. 

While current police budgets likely do not have sufficient funds to provide time and/or facilities for exercise, 

many health insurance programs now offer funds for subscribers to participate in health clubs at either 

reduced or no cost. 

Seventh, recent findings suggest that lack of support can increase stress in officers (Hartley, Burchfiel, 

Fekedulegn, Andrew, Knox, and Violanti 2012). Supportive organizations can also increase resiliency among 

officers when faced with stress (Paton et al. 2010). 

In these times of budgetary concerns, it is difficult to convince governments to provide funds for police 

health and stress interventions. Despite this, providing such funds is fiscally sound because fit officers have 

less absenteeism (Rivera 2001). Departments that have initiated wellness programs for their personnel have 

improved cardiovascular risk factors and reduced the rate of complications in their officers (Anshel and 

Kang 2008). However, departments can play only a partial role in maintaining healthy officers. Good health 

is ultimately the responsibility of the individual officer.

Future BCOPS work

Violanti and his research group at NIOSH are presently conducting a five-year follow-up study for which 

they will reexamine the same stress and health factors of the officers involved in the first study. This will 

enable the researchers to measure changes in health factors over time and suggest more definitive causal 

connections between stress, PTSD, and police health. 
10

Assessment of Health Risks in Law Enforcement Cohorts

Sandra L. Ramey, Ph.D., R.N., Assistant Professor, College of Public Health, 

University of Iowa 

Dr. Ramey reviewed a multitude of studies on the variety and prevalence of risk factors and cardiovascular 

disease (CVD) among police officers. These studies spanned approximately 14 years and included data from 

16 different police departments ranging in size from less than 30 officers to more than 2,000. The purpose of 

these studies was to find ways to address these risk factors and improve the health of police officers. Ramey 

provided the OSW Group with a summary of the studies and their findings.

Cardiovascular disease studies

CVD Risk and Morbidity in Nine Midwestern States (2001). This study included 2,800 participants 

from highway patrol departments from nine Midwestern states. Researchers looked at stress and other risk 

factors for CVD. Key findings included a higher prevalence of hypertension, hypercholesterolemia (high 

cholesterol), tobacco use, and elevated body mass compared to the general population. The best predictors 

of CVD among law enforcement were time in the profession and stress. Researchers found a significant 

direct association of stress with CVD and an indirect association of stress with CVD by potentiation of 

three risk factors: physical inactivity, cholesterol, and hypertension. While most of the officers perceived 

their health to be good or excellent, there was a disconnect between the perception of health and CVD risk. 

Although officers had greater CVD risk factors, CVD morbidity rates were similar to the general population.

Kidney Stones and CVD (2003). This study looked at officers from the Oklahoma Department of Public 

Safety. Researchers found that those who had kidney stones were also overweight, had high cholesterol, and 

had high blood pressure. Researchers also found that Native American officers had a disproportionately 

higher prevalence of kidney stones. 

Milwaukee Police Department (2004). This study surveyed 672 officers to establish a baseline. Then 

researchers conducted 40 one-on-one interviews as well as focus groups in each of Milwaukee’s seven police 

districts. Researchers found that officers

 had higher rates of hypertension (27.4%) than the general Wisconsin population (17.6%);

 were more likely to be overweight (71.6%) than the general Wisconsin population (60.8%);

 used tobacco and were inactive less than the general Wisconsin population (32.1% to 49.4%, and 11.2% 

and 17.5%, respectively);

 were the same as the general Wisconsin population in terms of actual risk for CVD.

Retirees of Milwaukee Police Department (2006–2007). This study looked at the health of 305 retirees. 

This was an important study because of a phenomenon called the healthy worker effect. Because the rates 

of actual morbidity from CVD in working officers are frequently similar to those in the general population 

this study looked at what happens when officers retire. This is important because when researchers look at 

cohorts of working officers, quite likely the people with severe CVD have self-elected out of the working 

group through disability or retirement. Researchers found a greater prevalence of high blood pressure, high 

cholesterol, and obesity. The results suggest an association between law enforcement and an increase in CVD.
11

Stress Mediators in Law Enforcement (2008–2009). This study looked at 71 officers from the Milwaukee 

Police Department and examined sources of both personal and organizational stress. Researchers found that 

an increase in job demands was associated with certain biomarkers, for example, IL-6 and perceived stress. 

Des Moines Police (2009–2010). This study looked at 336 officers from the Des Moines Police Department 

and surveyed sleep, vital exhaustion, and stress while focusing on gender differences within the department. 

Researchers found that high cholesterol in males was twice that of females, and vital exhaustion scores were 

higher in females than males. Vital exhaustion is defined as extreme fatigue that manifests with feelings of 

irritability and demoralization. Also, the bivariate relationships with CVD and vital exhaustion, age, and 

stress were statistically significant.

Body Mass Index Misclassification, C-Reactive Protein, and Sleep (2008–2009). This study looked at 95 

subjects and determined that the actual prevalence of obesity was underestimated using BMI, resulting in a 

missed opportunity for early intervention. The C-reactive protein (an inflammatory marker) was positively 

associated with total stress. Also, sometimes people are wrongly classified as overweight when in fact they 

have a lot of lean muscle mass. In terms of sleep quantity and quality, officers on nonday shifts (more often 

younger officers) are 14 times more likely to sleep less and 2.5 times more likely to experience poor sleep. 

Physical Activity Study (2010). This study looked at 119 officers from six departments. Officers wore an 

armband that objectively measured physical activity using the SenseWear Pro3 armband pattern recognition 

monitor. The SP3 integrates data from a dual-axis accelerometer along with that from sensors assessing 

heat flux, skin temperature, and galvanic skin response. Worn on the posterior aspect of the upper arm, 

the SP3 records total energy expenditure, step counts, and metabolic equivalents over a 24-hour period. 

Officers wore the monitor on three work days and three days off. Officers were surveyed about sleep, vital 

exhaustion, depression, and stress. Researchers found that the profession is primarily sedentary with bursts 

of activity. Officers expended more energy per hour, took more steps, and had higher metabolic equivalents 

on their days off. Researchers also found that 31% of officers were mild to moderately depressed, with one 

in three saying that the symptoms of depression they experienced makes the job difficult. 

Conclusions and recommendations

Preliminary conclusions reveal that stress contributes to CVD directly and through a relationship with 

several risk factors, specifically hypertension, high cholesterol, and physical inactivity. These risk factors are 

greater in police, including those risk factors innate to the profession (e.g., shift work and physical activity). 

Ramey added that while many studies associate CVD with sitting time, a new study that Ramey will soon 

publish indicates that even if people exercise only on the weekends, they can still cut their CVD rate. 

In addition to these studies, thirty years of research supports that cardiovascular disease is an issue among 

police officers. Stress is a major player and contributes to 90% of chronic disease. Knowing what researchers 

and the field know now, Ramey argues that not taking action to address CVD among officers becomes an 

ethical issue if no one intervenes. 

Taking all of this information into consideration, Ramey recommends that police departments begin 

teaching officers stress management skills at the academy and continue providing officers with awareness 

of health risks at in-service training. By teaching stress resilience intervention, officers learn how to modify 
12

their physiological response to stress. This method improves heart rate variability, blood pressure, sleep, 

and other risk factors. Officers can practice the techniques with a small bio-monitoring device and realize 

benefits in 12 weeks. This type of intervention has the potential to save departments thousands of dollars 

per year by reducing chronic disease and reducing the number of officers on disability. 

Ramey also recommends surveying officers to see how they would like to receive intervention on addressing 

stress and other health risks, as well as partnering with academia to share costs, thereby benefiting both the 

departments and researchers. Increasing public awareness of efforts to improve police health is also beneficial. 

Ultimately, all of this research demonstrates that the burden of stress management falls on both the 

individual and the organization. However, when the primary stressor is the organization itself rather than 

the job, it is important to train police leadership to be better leaders and recognize the relationship between 

the job and health. While the stress resilience intervention program targets officers, there also needs to be 

buy in and demonstration from leadership. Organizational leaders must be aware of the stress factors. At the 

academy, officers must be trained properly and need to be aware that this job will show them things they 

have not seen before. By encouraging the health of their own officers, police departments will save money. 

Resilience and Fatigue: Research-Based Traction for Action

Bryan Vila, Ph.D., Professor of Criminal Justice and Criminology, Director, Simulated 

Hazardous Operational Tasks Laboratory, Washington State University 

Dr. Vila talked to the OSW Group about reducing fatigue and improving resiliency among police officers. 

To start, fatigue and resilience must be thought about systematically, and change must be anchored in hard 

science. This approach provides an impartial basis for finding a common ground between management and 

labor, as well as a risk basis for fiscal decisions (Vila 2010). 

The work of police officers involves critical job tasks such as interacting with people, deadly force judgment 

and decision making, and driving (often while distracted). Job performance is highly influenced by 

neuropsychological factors such as cognitive functioning, risk propensity, and how well officers manage 

their implicit biases (see Violanti, Fekedulegn, et al. 2013; James et al. 2013; Waggoner et al. 2012). Workrelated fatigue often contributes to performance impairment, accidents, injuries, and increased operating 

costs. Over the long term, chronic fatigue increases mortality and morbidity (see Vila 2006; Violanti, 

Burchfiel, Hartley, et al. 2009). 

Police officers sleep less and drive drowsy more often than the general population. In fact, 53% of police 

officers get less than 6.5 hours of sleep daily versus 30% of the general public, and 40% of police officers 

screen positive for (mostly undiagnosed) sleep disorders (see Vila 2000; Rajaratnam et al. 2011; National 

Sleep Foundation 2009). In a study involving 2,566 U.S. and Canadian officers, researchers found (AAA 

Foundation for Traffic Safety 2004):

 91% routinely fatigued

 14% usually tired at the beginning of work 

 85% drive while drowsy

 39% fell asleep at the wheel 
13

Fatigue reduces resiliency. When combined with sleep loss, hours of work, and other circadian factors, it 

also reduces our ability to form sound judgments, deal with complex stressful situations, and assess fatiguerelated impairment. Fatigue narrows perception, increases anxiety and fearfulness, and reduces perspective 

and understanding. It also degrades cognitive abilities and increases irritability, hostility, and the tendency 

to shift blame. As shown in figure 3, organizational issues such as understaffing lead to overwork and job 

stress, which in turn lead to difficulty getting adequate sleep. Taken together, this combination of factors 

tends to negatively affect officers’ domestic life, health, wellness, and nutrition—which are key components 

of resiliency, health, and wellness. As they decline, so too does officers’ work capacity, which exacerbates 

understaffing (Vila and Samuels 2011).

Fatigue management requires cooperation between employees and management. On the management 

side, sleep disruption and overwork from shift work, schedule changes, overtime, and moonlighting causes 

employee fatigue (83% of all agencies have policies restricting off-duty employment)(Reaves 2010). On 

the employee side, recreational, family, and personal activities cause employee fatigue. Employees are also 

responsible for how much they choose to moonlight. 

At the OSW Group meeting, Vila argued that organizational leadership should focus on the work capacity 

of the officer, rather than just staffing numbers. If officers are exhausted, they are more likely to get injured, 

make serious errors, and miss important information. They also are more likely to anger people whom they 

come in contact with instead of calming them down. Officers are more capable and safe when they are well 

rested and can manage stressful situations. 

To change organizational culture, employees and management must recognize their common stake in 

fatigue management. Managers cannot afford to ignore fatigue-related risk management and human 

capital management issues, and labor cannot afford to ignore fatigue-related safety and health issues. This 

means that representatives of management and labor need to work together as a team to develop fatigue 

management policies.

Unfortunately, strained relationships between police management and labor can make it difficult to work 

together on issues such as fatigue management that involve conditions of work. One way to overcome this 

obstacle is for both sides to agree to rely on hard scientific evidence from an impartial expert researcher to 

help them develop fatigue management policies that balance the needs of their organization and community 

with the needs of officers. 

Once the team develops an initial fatigue management policy, Vila recommended refining it over time 

by learning from experience. For example, the management-labor fatigue team should meet regularly 

and review evidence from fatigue monitoring activities using scientifically validated technologies, such 

as wrist actigraphs and fatigue risk-assessment modeling. They also should review the responses of line 

personnel and conduct after-action debriefings about incidents in which fatigue is a suspected factor. As 

the team identifies problems or opportunities for improvement, they should fine-tune the policy, improve 

counterstrategies, and integrate fatigue management into procedures, policies, rules, and the organizational culture. 
14

Managing fatigue is critical to police operations involving decision making, information collecting and 

reporting, resilience and adaptability in high-threat confrontations, and operational safety and health. 

However, the magnitude of fatigue effects in police operations is unknown. 

In a study conducted by Vila’s lab and funded by the Office of Naval Research (ONR) and California 

Commission on Peace Officers Standards and Training (California POST),1 researchers assessed fatigue 

associated with work and rest schedules in real-world environments and its impact on patrol officers’ deadly 

force judgment and decision making, driving, cognitive abilities, and tactical social interaction skills. The 

study involved randomized, controlled laboratory experiments with 80 patrol officers, who were each 

measured twice in rested and fatigued conditions. The researchers used high-fidelity training simulators, 

interval-level metrics,2 wrist actigraphy, and novel brain imaging devices to measure fatigue in both the 

laboratory and in the field. 

Preliminary results revealed that fatigued night shift workers had significantly more lapses in attention, 

a key mechanism through which fatigue adversely affects operational performance. To be more specific, 

the analysis showed that officers driving in a fatigued condition is considerably worse than in the rested 

condition—especially for officers working night shifts, who were more than twice as likely to have collisions 

during the experiments. This effect was even more pronounced when a simple distraction task was added 

to the driving simulation.3

Vila also provided several recommendations in the areas of training, health screening, smart napping, and 

shift work. First among them is recognition that fatigue is a safety issue, being well-rested gives officers an 

important “alertness edge.” It is also important to understand that diet, exercise, and personal habits affect 

sleep, as does caffeine intake. The circadian phase also affects alertness. Effective fatigue management can 

reduce risks. Thus, Vila recommends that officers learn how to manage their own fatigue and monitor one 

another for fatigue symptoms. 

For police departments, Vila recommends they advise officers to get screened by a sleep physician if they 

are not getting enough sleep or feel tired even after sleeping long enough to be rested. The most common 

sleep disorder is obstructive sleep apnea (OSA), which affects one-third of American police officers. OSA 

symptoms include snoring, drowsiness while awake, depression, irritability, and memory loss. Long-term 

consequences of OSA include high blood pressure, heart attack, stroke, depression, and car crashes. Risk 

factors for sleep apnea include being overweight, more than 40 years old, large neck size (greater than 

17 inches for men), alcohol or tobacco use, and family history. 

To address fatigue, Vila recommends smart napping in a quiet, dark, and cool environment with the use of 

foam earplugs and a sleep mask to block noise and light. The ideal time for napping is between 1 AM and 

6 AM, or between noon and 2 PM. If an officer is going to be awake for a long time, Vila suggests napping 

1. ONR grant no. N000141110185, CalPOST contract no. 00112338.

2. Developed with funding from National Institute of Justice grant no. 2008IJCX0015.

3. These results will be published in late-2014 in three articles in a special edition of Policing: An International Journal of Police 

Strategies and Management, which is devoted to research results of the California POST Situation-Appropriate, Focused, and 

Educated (SAFE) Driving Campaign.
15

early or napping before going on duty if the officer did not get enough sleep earlier in the day. It is easier 

to prevent fatigue than to restore alertness. Moreover, while longer naps improve alertness, naps longer than 

40 minutes require additional time to wake up to dispel sleep inertia. 

In addressing shift work, Vila recommends leaving time for 8 hours of sleep between shifts and providing 

at least 11 hours off between shifts. He also recommends officers receive at least two days off after a series 

of night shifts and normally not work more than 12 hours on duty, though a 9-hour maximum is better, 

especially for officers whose shifts force them to sleep during the day. When working at night, reduce 

monotony, increase light levels, monitor fatigue, and take safe opportunities to nap. 

Going forward, research is underway to address the multitude of distractions that officers are exposed to in 

their patrol car, including the radio, mobile data terminal, cell phone, and license plate reader. Vila cautions 

that the human brain cannot truly multitask. Instead, people shift rapidly from one focus of attention to 

another. This means that when an officer driving a patrol car pays attention to a mobile data terminal, GPS, 

cell phone, etc., he or she can’t also focus on the road.

Impact of Shift Length: An Experimental Study 

Karen L. Amendola, Ph.D., Chief Operating Off icer, Police Foundation 

Dr. Amendola presented research she conducted with her colleagues at the Police Foundation on the impact 

of shift length in work performance, health, safety, quality of life, and other outcomes. In their survey, 

Amendola and colleagues found that agencies had been moving away from 8-hour shifts over the last several 

years, despite of the lack of research on the effects of longer shifts (Amendola, Slipka, et al. 2011). She noted 

that many California agencies changed shift lengths in response to labor unions’ concerns about the officers’ 

commute times. As that began to happen, 12-hour shifts became necessary to recruit the best candidates. 

Based on data from 2009, small agencies (50–100 officers) favor both 8- and 12-hour shifts; mid-sized 

agencies (101–200 officers) almost equally distribute 8-, 10-, and 12-hour shifts; and large agencies (more 

than 200 officers) generally use 10-hour shifts. 

In her multi-site randomized experiment, Amendola looked at whether shift length in law enforcement 

affects any important outcomes, testing 8-, 10-, and 12-hour shifts. The study involved a total of 270 officers 

from Detroit, Michigan, and Arlington, Texas, who were assigned to one of three conditions: 8-, 10-, or 

12- hour shifts within the specific shift schedule (i.e., day, evening, or midnight). Researchers measured 

performance data using laboratory simulations (e.g., driving, shooting, and reaction time) and departmental data (e.g., accidents, injuries, and sick leave). The research also involved self-reported data, 

including validated measures of stress, quality of life and work, work-family conflict, sleep diaries, and 

alertness logs. Knowing that fatigue builds over time, the lab measures were taken during the last 3 hours 

of the officers’ shifts. 

Researchers found no significant differences for any of the laboratory measures (driving and shooting 

simu-lators, interpersonal reactions, or reaction time) or departmental data on stops, reports, and 

summonses/tickets across 8-, 10-, and 12-hour shifts. Researchers also found no significant differences 

across the shift lengths in health and stress or personal quality of life. However, researchers found that 
16

working 10-hour shifts improved officers’ quality of work life (i.e., job satisfaction, schedule satisfaction, and 

organization commitment). 

Although there were no significant differences among the shifts for sleep quality or sleep disorders, officers 

working 10-hour shifts slept .59 hours more per night, or 4 hours more per week. This suggests that 10-hour 

shifts could lead to reductions in fatigue for already overtired police officers. There was also no significant 

difference among the shifts for objectively measured fatigue. However, officers reported being sleepier on the 

12-hour shifts, despite the fact that officers often underestimate their subjective levels of fatigue. In addition, 

officers on 12-hour shifts reported lowered levels of alertness across their shifts. 

Researchers also found that officers assigned 10-hour shifts work significantly less overtime than those on 

8- or 12-hour shifts, although those working 12-hour shifts also worked substantially less overtime than those 

on 8-hour shifts. 

Considering agencies are concerned with liability and risk to the community, 10-hour shifts may be viable 

in larger agencies. Officers have improved quality of work life; sleep increases by half an hour over a 24-

hour period; and officers work significantly less overtime. However, Amendola acknowledged the difficulty 

in developing 10-hour schedules that capitalize on the busy times of the day without having unnecessary 

overlapping of officers. Job satisfaction can also subside over time. Twelve-hour shifts should be implemented 

with caution due to the increased subjective fatigue and decreased alertness. In addition, rotating shifts have 

long been established as having negative health effects, such as cancer, stroke, and CVD. Longer shifts across 

industries have also shown increased risk in long-term health problems.

In addition to developing workable schedules, Amendola cautioned that there is still a large gap in studying 

the effect of overtime and off-duty employment. Many agencies have policies about off-duty employment, but 

agencies do not monitor it well because many feel it falls outside the purview of the employment relationship.

All of Amendola’s studies can be found at http://www.policefoundation.org/content/shift-length-experiment. 
17

Police Agency Psychological Health Initiatives

One of the most effective ways of gaining insight into managing the psychological health of officers is to 

review the various programs that agencies have implemented. The OSW Group heard from representatives 

from three law enforcement agencies in Austin, Texas; Columbus, Ohio; and Fresno, California.

Austin (Texas) Police Department

Lt. Greg Moss, Professional Standards Division, Risk Management Section

The Austin Police Department (APD) serves a population of 825,000 people with 2,300 employees in one of 

the fastest growing cities in America. The APD takes an all-encompassing approach to employee wellness 

efforts by providing the following: 

 Psychological Services

 PEER Support Program

 Chaplains Program

 Returning Officer Program

 Other wellness benefits

Regarding the first, Dr. Carol Logan, who has been with the department since 2003, heads Psychological 

Services. As the clinical director of PEER Support Program, she provides services for 2,200 employees. 

Logan is also a practitioner of eye movement desensitization and reprocessing (EMDR), which some 

research has shown to be effective in treating PTSD, especially with law enforcement officers because it 

effectively gets through the strong defenses that many officers have. 

Second, Sergeant Dan Armstrong, a recovering alcoholic who was close to losing his job, leads the PEER 

Support Program, which began in 2008 and facilitates recovery by providing pre-crisis intervention from 

co-workers trained to give specialized social support specific to the law enforcement profession. It is 

designed to augment, but not replace, other outreach programs such as the employee assistance program 

(EAP), the chaplain program, psychological services, and wellness services. 

PEER Support personnel include six teams made up of a total of 48 volunteers, both sworn and non-sworn, 

25 of whom are trained in critical incident stress management (CISM) debriefing. The teams serve as a 

referral source for services, and their conversations are confidential. A peer support volunteer will break 

that confidentiality only if there is an admission of a criminal act or abuse, or an indication of intent to 

harm one’s self or others. Since 2008, peer support contacts have increased from 200 to more than 1,000. 

Historically, police culture has failed to acknowledge the impact of stress and trauma on officers. While 

some officers dealt with the stress of the job relatively well, others leave the profession, and still others turn 

to negative coping behaviors such as alcohol. The two key components to stimulating cultural change are 

policy and administrative support. In addition, police departments need to afford supervisors the ability to 

use alternative discipline as a means of training and education. 
18

Art Acevedo, APD’s chief of police, made it clear that he wants his officers to get help before an issue 

becomes a crisis. To provide this help, peer support volunteers reach out to an officer who, for example, 

had a negative interaction with internal affairs during an interview where the officer was the subject of 

an investigation. 

Third, the Chaplains Program, which began in 2008, is a collaborative effort between Psychological Services, 

PEER Support, and the training academy. It comprises 22 volunteer chaplains and offers spiritual support, 

personal and family counseling, and ministerial services for APD officers and employees, as well as their 

immediate family members. 

The chaplains are available to assist in times of injury, illness, the death of a loved one, and other traumatic 

situations. They are available upon request and in other circumstances when needed. Chaplains participate 

in a Duty Chaplain On-Call Program for critical incidents and visit area commands. In addition, each 

volunteer chaplain is required to participate in the APD ride-along program once a quarter. As a vital link 

with the Austin faith community, chaplains also provide the APD with input on community problems, 

needs, concerns, and interests as expressed by the faith community. 

Fourth, the Returning Officer Program includes two components. The first component maintains 

contact with the officers’ family members while the officers begin their military deployment. The second 

component is for returning officers, who must go through a physical and psychological assessment and 

retraining. They are not cleared to return to patrol until the checklist is complete. 

Last, other wellness benefits provided by the APD include confidential counseling for alcohol and drug 

issues, voluntary health screenings, fitness evaluations, and physical exams. Officers seeking civil service 

promotion must have a physical exam prior to being promoted. Officers that work in units that have 

physical fitness requirements are allowed to work out while on duty or use flexible schedules that provide 

time for exercise. 

The APD is a drug- and alcohol-free workplace that requires random and critical incident drug testing, 

and personnel have a duty to report both employees and supervisors. Supervisors also have a duty to get 

assistance for the employee. 

Columbus (Ohio) Division of Police 

Deputy Chief Tim Becker

The Columbus Division of Police (CPD) currently employees approximately 1,900 sworn officers and 250 

civilian personnel and services a residential population of more than 760,000 people. Chief Becker discussed 

with the OSW Group the psychological wellness programs offered by the department: 

 Professional, mandatory counseling for traumatic incidents with a licensed psychologist prior to 

returning to work

 Employee Assistance Program, a confidential service provided at no cost to members that may be 

voluntary or mandated by the department
19

 Peer Assistance Team, comprising sworn personnel who receive special training on common issues, serve 

as the confidant, and make appropriate referrals

 Officer Support Team, a volunteer program comprised of personnel who have gone through traumatic 

events and are trained to respond immediately to the scene of an incident to offer guidance to the 

employee without discussing the current incident (no confidentiality agreement for this team)

In addition to these programs, the CPD has established internal controls to monitor employee wellness. For 

example, any employee that calls in sick because of stress, depression, illness, or injury that may indicate a 

safety concern must receive clearance by a mental health or medical professional. There is also a mandatory 

review at the commander level for any personnel who are out sick four or more times per year. The CPD 

also offers a return to work program that evaluates and counsels employees with long-term absences or 

restrictions to determine if and when they can return to full duty. 

The Employee Action Review System (EARS) Committee is a semi-annual review of personnel using force 

or receiving complaints at a higher rate than their peers (top 15%) to evaluate whether or not patterns of 

conduct exist that warrant additional follow through by the chain of command. This does not generate 

disciplinary action but rather retraining. 

The department also conducts random drug and alcohol testing on a monthly basis in accordance with 

the respective collective bargaining agreements. Positive tests result in mandatory actions. Since enacting 

this policy 15 years ago, the CPD has found only been two positive tests for drugs (marijuana). On the other 

hand, the CPD not only had more positive tests for alcohol but also found that alcohol caused 78% 

of serious discipline cases. 

CPD’s Training Bureau proactively creates training topics to address wellness issues such as nutrition and 

stress. Furthermore, each academy class hosts a “Family Night” to advise family members of available 

assistance and common issues faced by new officers. 

The CPD also partners with the Columbus Public Health department, which offers a program called 

“Healthy Columbus” to all CPD employees. As part of this program, employees can take advantage of fitness 

classes, dietary programs, medical screenings, flu shots, and informational health fairs. 

Sworn personnel hired after January 1, 2008 are required to participate in annual physical fitness testing. 

Those hired before that date may participate on a voluntary basis. The annual fitness test includes a medical 

questionnaire about the state of the employees’ health, which is reviewed by medical professionals, who 

evaluate whether the employees can safely wear a gas mask. If issues arise, the medical personnel consult 

with CPD human resources professionals to determine if the employee is fit for duty. Approximately 70% of 

agency-sworn personnel participate in the annual fitness test. Although officers do not face discipline if they 

fail to meet standards, they can face disciplinary action if they fail to participate. 

Participants must also complete an annual physical examination, either by the police department’s designated doctor or by the participants’ own physicians. A health risk appraisal is also included. Participants are 

eligible for vacation leave and financial incentives, based on the member’s achievement and the overall level 
20

of participation by all sworn personnel, respectively. There is also mandatory lead testing for all personnel 

assigned to CPD ordnance functions; hearing testing for ordnance, heliport, and crime lab personnel; and 

physical fitness testing for personnel assigned to the SWAT, helicopter, and recruit training sections. 

The CPD hired an industrial hygienist at the end of 2012 to coordinate internal safety programs and 

conduct risk analyses of data within the CPD to identify problems “lying in wait.” 

Fresno (California) Police Department

Off icer Al Hernandez

The Fresno Police Department (FPD) serves a population of 495,000 people with a workforce of 800 sworn 

and 200 nonsworn personnel. Officer Hernandez, FPD’s Employee Services Bureau (ESB) coordinator, 

presented to the OSW Group the department’s wellness programs. 

Through the ESB, the department sought to encourage connection, credibility, and confidentiality with its 

employees, and its mission is to proactively address challenges unique to members of the FPD. The core 

components of this program include member education regarding stress and resource development to help 

members effectively manage stress in a confidential manner. The ESB wanted to create an environment 

where members could seek services that allow them to be content, healthy, and well-balanced, making them 

better suited to deliver police services to the public. 

The ESB coordinates training, serves as the point of contact for members to access services following 

a critical incident, promotes awareness, and fosters member awareness in recognizing warning signs of 

improperly managed job stress. Specific components of the ESB include the following seven services:

1. Companion Officer Program

2. Chaplains Program

3. Wellness Program

4. Psychological Services

5. Military Reentry

6. Structured Assistance for Valued Employees

7. Early Alert System 

Regarding the first, the Companion Officer Program has 26 trained volunteer peer support officers, who 

are selected through an oral interview process by the program co-chairs. The peer support officers are 

divided into three teams of eight. Each team is on call every third month. They can show up at the scene 

of an incident to support officers who may need to speak with someone, respond to critical incident stress 

management (CISM) debriefings, and participate in biannual training. This program also includes a “First 

Responder Meeting,” which is similar to a 12-step program where officers talk about life challenges (alcohol, 

relationships, etc.) at off-site locations. 

Second, the Chaplains Program provides spiritual support to FPD personnel and their families through 

counseling, encouragement, and resources. It is led by a retired FPD officer and includes 15 additional 

on-call chaplains.
21

Third, the Wellness Program provides fitness programs, nutrition plans, risk factor reduction techniques, 

and consultations throughout the year for officers who have fitness and health concerns. Officers are 

rewarded monetarily for meeting participation requirements. The average payout is $750. 

Fourth, the Psychological Services department, through Avante Health Counseling Services, provides 

mental health, chemical dependency, and employee assistance program services for depression, stress, grief 

and loss, and financial issues. Employees receive up to six visits per year at no cost. This program provides 

immediate access to high-quality resources with specialized training in police psychology. 

Fifth, officers returning from military duty are provided mentors to assist in reentering the department. They are also provided training on new policies, procedures, laws, and changes in equipment 

and technology. 

Sixth, Structured Assistance for Valued Employees (SAVE) relies on supervisors to identify potential 

problems before they become discipline issues. It includes a mandatory intervention for employees that 

demonstrate observable difficulties in dealing with traumatic events, professional challenges, or personal 

problems. It is not a substitute for discipline but rather is meant to help address issues before they become 

disciplinary problems. 

Seventh, the Early Alert System (EAS) focuses on detecting and correcting officers’ deficiencies before 

they become significant performance issues. The program provides positive, confidential, nondisciplinary 

intervention with training and counseling to assist members with performance problems. 

In the future, the ESB plans to hold biannual retirement seminars, targeting officers retiring within that 

period. The goal is to prepare officers for the psychological and financial issues they may experience in 

retirement. The program will focus on health benefits, workman’s compensation, Social Security, longterm care, reserve unit, association support, and life after law enforcement wellness. 

Hernandez recommends that departments considering the development of an Employee Services Bureau 

focus on making sure the right person is selected for the position, someone who can maintain trust and 

confidentiality. Hernandez believes the individual should be an officer, not an administrator, and should 

maintain access and contact with officers through briefings and riding with patrol officers in the field. It 

is also important for this individual to continue to seek additional funding sources for the program.

Hernandez ended his presentation by sharing a personal story with the OSW Group. Five years ago, he was 

out drinking on his day off. As he drove home intoxicated, he hit a pole and damaged his vehicle. His first 

thought was to ditch the car, but he realized that he had a drinking problem. He had been a police officer 

for 25 years at that point and had been stopped before and let go without further action. Knowing what 

would happen, he ended up calling his sergeant and was arrested. The following day, he went to see the chief 

of police and was ultimately suspended. Although it was humiliating, every person he spoke with told him 

that he did the right thing by addressing his problem. Two years after this incident, the chief offered him the 

position of coordinator for the ESB, a position he maintains today. Hernandez has been sober for five years. 
22

Discussion and Action Agenda

Based on the research, case studies, background reading, individual expertise, and discussions throughout 

the day, the OSW Group broke into smaller groups to discuss and identify recommendations and 

observations for police agencies to consider that might help contribute to improved safety and wellness for 

officers. The smaller groups discussed improving psychological wellness in the five areas highlighted in the 

introduction (see page 3)—leadership, research, policy, training, and practice/programs. The OSW Group 

meeting facilitator, Bascom “Dit” Talley, asked each group to respond to the questions outlined below: 

Leadership 

Q: What is the role of the chief executive and the management team in dealing with psychological health 

challenges in policing?

 See past differences (both the chief and union leader), and work together for the benefit of the officers. 

Create and exhibit a partnership with the bargaining unit and work collectively.

 Show they care, and gain political support to get funding for programs that help. Conduct a cost 

benefit analysis.

 Create a culture where officers are comfortable seeking out help. 

 Highlight success stories.

 Lead by example, and demonstrate commitment with actions.

 Communicate to officers why the department is making a particular change. Explain the long-term 

benefits and cost benefits.

 Recognize that sometimes the chief needs to set ground rules and ensure that officers follow them. 

Officers will work too many overtime or secondary employment hours for short-term gains that may 

not be in their long-term interests.

 Recognize the threat of officer suicide. More officers kill themselves than are killed in the line of duty.

Q: What is the role of employee organizations in dealing with psychological health challenges in policing?

 Educate and inform. Also provide encouragement to fellow officers.

 Partner with a nonprofit to provide 24/7 confidential peer counseling and referral services, such as 

Safe Call Now at www.safecallnow.org.

 Train leaders on understanding and managing organizational stress.

 Provide confidential counseling for officers. One department provides funding to allow officers four 

free visits, which could be extended to six.

 Establish a non-line-of-duty death wall to bring attention to officers who died because of traffic 

incidents, suicide, or domestic violence.

 Institute a peer counseling program.

 Watch for early warning signs (unions, coworkers, and first line supervisors).
23

Q: What is the role of individual employees in dealing with psychological health challenges in policing?

 Recognize leaders can come from any rank, including officers and unions. (In other words, everyone 

should reach out to an officer who may be experiencing a psychological health challenge, and every 

officer and union leader should ensure psychological health is an agency priority.)

 Educate officers on the “see something, say something” campaign as applied to fellow officers. 

 Eliminate the peer pressure faced by recruits at the academy. 

 Share stories, even on an informal basis.

 Provide tools for officers to manage stress. One department provides all recruits with Emotional 

Survival for Law Enforcement: A Guide for Officers and Their Families. 

Research 

Q: What are the law enforcement psychological health research gaps?

 Look for patterns between officers’ work hours, health, and safety. For example, 10% of officers work 

70–80% of the overtime for the entire organization.

 Research the impact of street police work on aging officers. 

 Increase the impact of limited funding through partnerships with federal agencies like the U.S. 

Department of Defense and U.S. Department of Justice. 

 Research the impacts of intervention strategies. Nearly all of the research is focused on describing 

the problem. 

 Determine what works in both the short and long term. 

 Examine the impact of police disciplinary practices on the psychological health of officers. 

Policy 

Q: What policies should police agencies have in place to address psychological health issues?

 Provide training to supervisors to assist them with recognizing and responding appropriately 

to problems. 

 Provide routine critical incident stress debriefings and post-incident counseling in response to 

critical incidents. 

 Develop a policy for officer-involved shootings that recognizes the psychological aspects of these 

incidents on officers. 

 Provide anonymous high-quality counseling. 

 Establish a policy to educate family members on what options are available when an officer develops 

certain behaviors (e.g., domestic violence). Help family members get help for officers.
24

Training 

Q: What type of training should departments provide employees to help them cope with the psychological 

challenges in policing?

 In-service training programs should annually reaffirm what services are available for officers 

and communicate this on a regular basis. 

 Departments should encourage mentorships with more experienced officers.

 Training should include stress management techniques. 

 Investigators should receive special training in officer-involved shootings. 

 All employees should receive training on recognizing the signs and symptoms of stress. 

 Training representatives should be dispatched to critical incidents to assess training needs. 

 Departments should provide prosecutors training on use of force.

Practice/Programs 

Q: What specific practices or programs should departments have to help reduce stress and improve 

psychological health of officers?

 Screen officers for sleep disorders, and refer them for help when problems are identified. 

 Discuss, publish, and share the lessons departments learned from their experiences in dealing with 

psychological health issues. 

 Encourage officers visiting websites similar to Gordon Graham’s Fire Fighter Close Calls, www.

firefighterclosecalls.com, where officers can learn from mistakes. Although departments may be 

concerned with liability.

 Encourage peer support and counseling. The U.S. Marshal’s office has one of the best policies, which 

could provide a model for other agencies to follow.

Conclusion

Improving psychological health is a challenging and long-term endeavor for law enforcement agencies. 

It requires understanding the full range of issues involved with officer health, stress response and 

management, and organizational management. The OSW Group discussion at this meeting focused on 

advancing research, improving the response to officer stress, and reducing the risks of related disease. 

Based on a thoughtful, full-day deliberation, the group identified points for consideration regarding 

gaps in research, areas to improve training, reviews of policies and procedures, and practices to improve 

psychological wellness among officers. There is more work to do in this area, but this meeting and 

resulting report begins the national discussion and helps to identify the best practices for training, policies, 

procedures, and programs. 
25

Appendix A: OSW Group Meeting Agenda

U.S. Department of Justice

Office of Justice Programs

810 Seventh Street NW

Washington, DC 

Monday, February 4, 2013

8:15 – 8:30 AM Participant Arrival

8:30 – 9:00 AM Welcome

by Bernard K. Melekian, then Director, Office of Community Oriented Policing Services

by Denise O’Donnell, J.D., Director, Bureau of Justice Assistance

Meeting Purpose

Presenter: Darrel Stephens, Executive Director, Major Cities Chiefs Association

9:00 – 9:15 AM Introduction of Participants

Facilitator: Bascom “Dit” Talley, Faculty Coordinator, Johns Hopkins University 

9:15 – 10:30 AM The Impact of Police Officer Stress

Presenter: John M. Violanti, Ph.D. Research Professor, Department of Social and 

Preventive Medicine, University of Buffalo

Presenter: Sandra L. Ramey, Ph.D., R.N., Assistant Professor, College of Public Health, 

University of Iowa 

10:30 - 10:45 AM Break

10:45 – 12:00 PM Resilience and Fatigue

Presenter: Bryan Vila, Ph.D., Professor of Criminal Justice and Criminology, Director 

of Simulated Hazardous Operational Tasks Laboratory, Washington State University 

Presenter: Karen Amendola, Ph.D., Chief Operating Officer Police Foundation

12:00 – 12:45 PM Lunch 

12:45 – 2:15 PM Police Agency Psychological Health Initiatives

Presenter: Lt. Greg Moss, Austin (TX) Police Department

Presenter: Deputy Chief Tim Becker, Columbus (OH) Police Department

Presenter: Officer Al Hernandez, Fresno (CA) Police Department

2:15 – 2:30 PM Break 

Continued on next page
26

2:30 – 4:00 PM Improving Psychological Health: Group Discussion and Action Agenda 

Participants will address the following issues in the context of psychological health:

 Leadership: What is the role of the chief executive and the management team in 

dealing with psychological health challenges in policing? What is the role of employee 

organizations in dealing with psychological health challenges in policing? What is the 

role of individual employees in dealing with psychological health challenges in policing?

 Research: What are the law enforcement psychological health research gaps?

 Policy: What policies should police agencies have in place to address psychological 

health issues? 

 Practice/programs: What specific practices or programs should departments have to 

address these issues? 

 Training: What type of training should departments provide employees to help them 

cope with the psychological challenges in policing? (Examples of department and other 

training that is available or needed) 

 Practice/Programs: What specific practices or programs should departments have to help 

reduce stress and improve psychological health of officers?

Facilitator: Bascom “Dit” Talley, Faculty Coordinator, Johns Hopkins University

4:00 – 4:10 PM Closing Comments 

by Darrel Stephens, Executive Director, Major City Chiefs Association

4:10 PM Adjourn
27

Appendix B: OSW Group Meeting Attendees

Joseph Akers

Interim Executive Director

National Association of Black Law Enforcement 

Officers

Karen L. Amendola, Ph.D.

Chief Operating Officer

Police Foundation

Tim Becker

Deputy Chief

Columbus Division of Police

Christie L. Bogle

AFOSI Liaison to the IACP

International Association 

of Chiefs of Police

Jim Bueermann

President

Police Foundation

Patrick A. Burke

Assistant Chief

Metropolitan (DC) Police Department

Pamela J. Cammarata

Associate Deputy Director

Bureau of Justice Assistance

Brett Chapman, Ph.D.

Social Science Analyst

National Institute of Justice

Nancy C. Demme

Captain

Training and Education Division

Montgomery County (MD) Police Department

Alexander L. Eastman, M.D.

Lieutenant and Deputy Medical Director

Dallas (TX) Police Department

Joshua A. Ederheimer

Principal Deputy Director

Office of Community Oriented 

Policing Services

Craig W. Floyd

Chairman and Chief Executive Officer

National Law Enforcement Officers 

Memorial Fund

Stephanie A. Garbarczuk 

Law Enforcement Coordination Manager

United States Attorney’s Office – DC

Alan M. Goldberg

Chief

Takoma Park (MD) Police Department

Elliott E. Grollman

Commander

Federal Protective Service

David L. Harlow

Assistant Director of Investigative Operations

U.S. Marshalls Service

William Haskell

Public Safety Sector Coordinator

National Institute for Occupational Safety 

and Health

Al Hernandez 

Officer

Fresno (CA) Police Department

Dennis Hyater

Program Manager

Commission on Accreditation for Law 

Enforcement Agencies

Hope D. Janke 

Director, Public Safety Officers’ Benefits

William Johnson

Executive Director

National Association of Police Organizations

Matthew Klein

Commander

Metropolitan (DC) Police Department

David Klinger, Ph.D. 

Associate Professor

University of Missouri – St. Louis
28

Ron Malega, Ph.D.

Statistician

Prosecution and Adjudication 

Statistics Unit

Bureau of Justice Statistics

Leonard Matarese

Director

Research and Project Development

International City/County 

Management Association

Bernard K. Melekian

Then Director

Office of Community Oriented 

Policing Services

Michael Miller

Detective 

Metropolitan (DC) Police Department

Roger Miller

Federal Bureau of Investigation

Brian Montgomery

Physical Scientist 

National Institute of Justice

Greg Moss

Lieutenant

Austin (TX) Police Department

Denise O’Donnell, J.D.

Director 

Bureau of Justice Assistance

William H. Petty, Ph.D.

Visiting Fellow

U.S. Department of Justice

Office for Victims of Crime

Sandra Ramey, Ph.D., RN

Assistant Professor

College of Public Heath

University of Iowa

Timothy M. Richardson

Senior Legislative Liaison

National Fraternal Order of Police 

Daniel Rodriguez

Lieutenant

Commander, Special Operations Section

Anne Arundel County (MD) 

Police Department

William Sarvis

Director, Medical Services Branch

Metropolitan Police (DC) Department

Ted Stanich 

Acting Deputy for the Criminal 

Investigation Division

Environmental Protection Agency

Darrel Stephens

Executive Director

Major Cities Chiefs Association

Bascom “Dit” Talley

Faculty Coordinator

Johns Hopkins University

Captain Barry M. Thomas

Chief Deputy

Story County (IA) Sheriff ’s Office

Bryan Vila, Ph.D.

Professor of Criminal Justice 

and Criminology

Washington State University 

John Violanti, Ph.D.

Research Professor

University of Buffalo

Department of Social and Preventive Medicine

Sandra Webb, Ph.D.

Deputy Director of Community 

Policing Advancement

Office of Community Oriented Policing 

Services

David Williams

Lieutenant

Jefferson City (MO) Police Department

Fred G. Wilson

Director

Operations

National Sheriffs’ Association
29

COPS/BJA Staff

Steven M. Edwards, Ph.D.

Senior Policy Advisor

Bureau of Justice Assistance

Mora L. Fiedler

Senior Social Science Analyst

Office of Community Oriented Policing Services

Deborah Meader

Policy Advisor 

Bureau of Justice Assistance

Deborah Spence

Supervisor of R&D Division

Office of Community Oriented Policing Services
30

Appendix C: OSW Group Presenters’ Profiles

Karen L. Amendola, Chief Operating Officer, Police Foundation

At the Police Foundation in Washington, D.C., Karen L. Amendola, Ph.D., manages state, local, and federal 

grants and contracts; directs research; and supervises police and research fellows. Amendola has conducted 

training and made numerous presentations to police and criminal justice audiences from the United States 

and abroad in such areas as democratic policing, early warning systems, recruitment, selection, ethics, and 

community policing. Her current research includes assessing evidentiary strength in eyewitness ID cases, 

evaluating technology, and examining police shift practices. Amendola serves as chairman of the board for 

the National Partnership for Careers in Law, Public Safety, Corrections, and Security and as a member of the 

Research Advisory Board of the Innocence Project (New York). Previously, Amendola served over five years 

on the Scientific Review Committee of the U.S. Department of Defense’s Polygraph Institute (now National 

Center for Credibility Assessment). She earned her Ph.D. in industrial and organizational psychology from 

George Mason University in Virginia.

Timothy Becker, Deputy Chief, Columbus Division of Police

Deputy Chief Timothy Becker joined the Columbus Division of Police (CPD) in December 1988. The CDP 

currently employees approximately 1,900 sworn officers and 250 civilian personnel and services a residential 

population of more than 760,000. There are six subdivisions within CPD, each headed by a deputy chief, 

under Chief of Police Kim Jacobs. Becker is currently assigned as the administrative deputy chief, overseeing 

fiscal, HR, and training operations, as well as policy creation and accreditation. Becker has held assignments 

in all six subdivisions throughout the course of his career.

Becker obtained a bachelor of arts in journalism from The Ohio State University and expects to earn a 

master of science in public safety leadership from Capella University in March 2013. Becker is a graduate of 

the FBI National Academy and the Northwestern University School of Police Staff and Command.

Becker is married to a Columbus police officer and is the proud father of three sons, ages 17, 15, and five.

Albert Hernandez, Officer, Fresno Police Department

Albert Hernandez was born and raised in Fresno, California. He was hired in 1983 with the Fresno Police 

Department and has worked in various units, including Patrol, Tactical Teams, Police Activities League, 

Mounted Patrol, and Employee Services. He received Officer of the Year Awards in 1992 and 2000 and 

the Life Saving Award in 1996 for saving a five-year-old girl from drowning. His training includes First 

Responder Support Network, Group Crisis Intervention, International Critical Incident Stress Foundation, 

Traumas of Law Enforcement Training, Peer Support Counseling, and Individual Crisis Intervention and 

Peer Support. He has developed a reputation for supporting fellow officers when needed. Many officers 

benefit from his compassion and desire to help others in his profession. He is married to his wife, Wendy, 

and they have five children. In his free time, he goes to one of the many sporting events that his children 

participate in all over the state. 

Greg Moss, Lieutenant, Austin Police Department

Lt. Moss has served the citizens of Austin and its police department for 20 years. He is a 1991 graduate from 

the University of Texas-Austin, with a bachelor’s degree in psychology. He has been recognized by the Texas 

Commission on Law Enforcement Officer Standards and Education (TCLEOSE) as a “Master Peace Officer” 

since 2002. He is a graduate of Austin Police Department’s Leadership Command College and is a member 

of the Texas Police Association.

During his career, he has worked various assignments, including patrol, the Fugitive Apprehension unit, 

and the Executive Protection unit. As a supervisor and manager, he has directed patrol officers, the Sex 

Offender Apprehension and Registration (SOAR) unit, and the Missing Persons unit. He has also served 
31

as the operations lieutenant for the South Bureau Command. His current assignment in Risk Management 

encompasses several units, including Psychological Services, Peer Support, Policy Development, the 

Guidance Advisory Program, and the Random Drug Testing program.

Sandra Ramey, Assistant Professor, College of Public Health, University of Iowa

Sandra Ramey, Ph.D., RN, received her Ph.D. from Iowa State University, her MSN from the University of 

Iowa, and her BS from St. Francis.

Ramey joined the Adult and Gerontology faculty in 2006 after serving as an assistant professor at Marquette 

University for three years. Ramey’s research program investigates the relationships among cardiovascular 

disease (CVD) risk factors and CVD morbidity in large law enforcements cohorts. Her work has extended 

to nine Midwestern states and currently is located within the Milwaukee Police Department where she 

studies inflammatory markers of stress as well. While health promotion has primarily been the focus of 

Ramey’s work, other interests include extending her work to the Cherokee Nation in Tahlequah, Oklahoma, 

exploring contributing factors to the prevalence of CVD and risk in the Native American population. Ramey 

was selected by the American Nurses Association to represent nursing at the Center for Disease Control and 

Prevention-American Medical Association Readiness Conference held in Washington, D.C., in July 2004.

Most recently she served as a reviewer for the National Nurse Emergency Preparedness Initiative, 

supported by Homeland Security and American Association of Colleges of Nursing. Ramey has a secondary 

appointment in the College of Public Health at the University of Iowa and works with multidisciplinary 

graduate students in the Occupational Health Nursing Program. 

Bryan Vila, Professor of Criminal Justice and Criminology, Washington State University

At WSU Spokane, Bryan Vila, Ph.D., serves as the director of the Simulated Hazardous Operational Tasks 

Laboratory. Prior to joining WSU in July 2005, he directed the Division of Crime Control and Prevention 

Research at the U.S. Department of Justice’s National Institute of Justice. Vila has served as principal 

investigator or co-principal investigator on $7.6 million in externally funded research projects. He has 

brought eight grants/contracts totaling $5.5 million to WSU in the past six years. Vila received his Ph.D. in 

ecology from the University of California, Davis in 1990.

He has held tenured faculty positions at the University of California, Irvine and the University of Wyoming. 

He was honored with the College of Liberal Arts Outstanding Career Achievement in Scholarship award for 

2012 for his research on the impact of fatigue and stress on police performance, his publication record, and 

his successful grantsmanship.

Before he became an academic, Vila served as a law enforcement officer for 17 years—including nine years 

as a street cop and supervisor with the Los Angeles County Sheriff ’s Department, six years as a police chief 

helping the emerging nations of Micronesia develop innovative law enforcement strategies, and two years in 

Washington, D.C., as a federal law enforcement officer.

John Violanti, Research Professor, University of Buffalo

John M. Violanti, Ph.D.,.is a research professor in the Department of Social and Preventive Medicine (SPM), 

School of Public Health and Health Professions at the University of Buffalo, State University of New York 

and has been associated with SPM for 22 years. Violanti is also a member of the University at Buffalo School 

of Medicine and Biomedical Sciences graduate faculty. 

He is a police veteran, serving with the New York State Police for 23 years as a trooper, member of the 

Bureau of Criminal Investigation, and later as a coordinator of the Psychological Assistance Program (EAP) 

for the state police. 

Violanti has authored more than 50 peer-reviewed articles on police stress and post-traumatic stress 

disorder, police mortality, and suicide. He has also written and edited fourteen books on topics of police 

psychological and physical health issues. Violanti has lectured internationally and at the FBI academy on 

matters of police stress, trauma, and suicide.
32

References

AAA Foundation for Traffic Safety. 2004. “Fact Sheet for the AAA Foundation for Traffic Safety’s Survey 

of U.S. and Canadian Police Officers about the Public’s Drowsy Driving Behavior.” Washington, DC: 

AAA Foundation.

Alasagheirin, Mohammad, Kathleen Clark, and Sandra Ramey. 2012. “BMI Misclassification of Obesity in 

Community Police Officers.” Workplace Health and Safety: Promoting Environments Conducive to WellBeing and Productivity 59 (11): 469–475.

Amendola, Karen. 2013. Presentation to Officer Safety and Wellness Group in Washington, D.C., 

February 4, 2013. 

Amendola, Karen L., Meghan G. Slipka, Edwin E. Hamilton, Michael Soelberg, and Kristin Koval. 2011. 

Trends in Shift Length: Results of a Random National Survey of Police Agencies. Police Foundation Reports. 

Washington, DC: Police Foundation. 

Amendola, Karen L., David Weisburd, Edwin E. Hamilton, Greg Jones, Meghan Slipka, Anneke Heitmann, 

et al. 2011. The Shift Length Experiment: What We Know About 8-, 10-, and 12-Hour Shifts in Policing. 

Washington, DC: Police Foundation.

American Psychiatric Association. 2000. Diagnostic and Statistical Manual of Mental Disorders (DSM-IVTR). Washington, DC: American Psychiatric Association.

Anshel, Mark H., and Minsoo Kang. 2008. “Effectiveness of Motivational Interviewing on Changes in 

Fitness, Blood Lipids, and Exercise Adherence of Police Officers: An Outcome-Based Action Study.” 

Journal of Correctional Health Care 14:48–62.

Badge of Life. 2013. “The Annual Mental Health Check.” http://www.badgeoflife.com/prescription.php. 

Becker, Timothy. 2013. Presentation to Officer Safety and Wellness Group in Washington, D.C., 

February 4, 2013.

Carlier, Ingrid V.E., Regina D. Lamberts, and Berthold P.R. Gersons. 1997. “Risk Factors for Posttraumatic 

Stress Symptomatology in Police Officers: A Prospective Analysis.” Journal of Nervous and Mental 

Disorders 185:498–506.

Charles, Luenda E., Cecil M. Burchfiel, Desta Fekedulegn, Bryan Vila, Tara A. Hartley, James Slaven, et al. 

2007. “Shift Work and Sleep: The Buffalo Police Health Study.” Policing: An International Journal of Police 

Strategies and Management 30:215–227.

Chrousos, George P. 1998. “Stress as a Medical and Scientific Idea and Its Implications.” Advanced 

Pharmacology 42:552–556.

Clark, Daniel W., Elizabeth K. White, and John M. Violanti. 2012. “Law Enforcement Suicide: Current 

Knowledge and Future Directions.” Police Chief 79 (May): 48–51.

Franke, Warren D., Marian L. Kohut, Daniel Russell, Hye L. Yoo, Panteleimon Ekkekakis, and 

Sandra Ramey. 2010. “Is Job-Related Stress the Link Between Cardiovascular Disease and the Law 

Enforcement?” Journal of Occupational & Environmental Medicine 52 (5): 561–565.

Franke, Warren D., Sandra L. Ramey, and Mack C. Shelley. 2002. “Relationship Between Cardiovascular 

Disease Morbidity, Risk Factors and Stress in a Law Enforcement Cohort.” Journal of Occupational & 

Environmental Medicine 44 (12): 1182–1189.

Goldberger, Leo, and Shlomo Breznitz, eds. 1993. “Stress research at a crossroads.” In The Handbook 

of Stress: Theoretical and Clinical Aspects, 2 ed., 3–6. New York: The Free Press.
33

Grundy, Scott M., James I. Cleeman, Stephen R. Daniels, Karen A. Donato, Robert H. Eckel, Barry A. 

Franklin, et al. 2005. “Diagnosis and Management of the Metabolic Syndrome: An American Heart 

Association/National Heart, Lung, and Blood Institute Scientific Statement.” Circulation 112:2735–2752.

Gu, Ja Kook, Luenda E. Charles, Cecil M. Burchfiel, Michael E. Andrew, and John M. Violanti. 2012. 

“Cancer Incidence Among Police Officers in a US Northeast Region: 1976–2006.” International Journal 

of Emergency Mental Health 13:279–289.

Hartley, Tara A., Cecil M. Burchfiel, Desta Fekedulegn, Michael E. Andrew, Sara S. Knox, and John M. 

Violanti. 2012. “Association Between Police Officer Stress and the Metabolic Syndrome in the BCOPS 

Study Cohort.” International Journal of Emergency Mental Health 13:243–256.

Hartley, Tara A., Cecil M. Burchfiel, Desta Fekedulegn, Michael E. Andrew, and John M. Violanti. 2012. 

“Health Disparities in Police Officers: Comparisons to the U.S. General Population.” International Journal 

of Emergency Mental Health 13:211–220.

Hernandez, Albert. 2013. Presentation to Officer Safety and Wellness Group in Washington, D.C., 

February 4, 2013.

James, Lois, Bryan Vila, and Kenn Daratha. 2013. “Results from Experimental Trials Testing Participant 

Responses to White, Hispanic and Black Suspects in High-Fidelity Deadly Force Judgment and DecisionMaking Simulations.” Journal of Experimental Criminology 9 (2): 189–212. 

Joseph, Parveen N., John M. Violanti, Richard Donahue, Michael E. Andrew, Maurizio Trevisan, Cecil 

M. Burchfiel, et al. 2009. “Police Work and Subclinical Atherosclerosis.” Journal of Occupational and 

Environmental Health 51:700–707.

Maia, Deborah B., Charles R. Marmar, Thomas Metzler, Augusta Nobrega, William Berger, Mauro V. 

Mendlowicz, et al. 2007. “Post-Traumatic Stress Symptoms in an Elite Unit of Brazilian Police Officers: 

Prevalence and Impact on Psychosocial Functioning and on Physical and Mental Health.” Journal of 

Affective Disorders 97:241–245.

McCaslin, Shannon E., Cynthia E. Rogers, Thomas J. Metzler, Suzanne R. Best, Daniel S. Weiss, Jeffrey A. 

Fagan, et al. 2006. “The Impact of Personal Threat on Police Officers’ Responses to Critical Incident 

Stressors.” Journal of Nervous Mental Disorders 194:591–597.

McEwen, Bruce S. 2005. “Stressed or Stressed Out: What is the Difference?” Journal of Psychiatry and 

Neuroscience 30 (5): 315–318. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1197275/.

McEwen, Bruce S., and John C. Wingfield. 2003. “The Concept of Allostasis in Biology and Biomedicine.” 

Hormonal Behavior 43:2–15.

Meichenbaum, Donald. 1996. “Stress Inoculation Training for Coping with Stressors.” The Clinical 

Psychologist 49:4–7.

Moss, Greg. 2013. Presentation to Officer Safety and Wellness Group in Washington, D.C., February 4, 2013.

National Sleep Foundation. 2009. “2009 Health and Safety.” Sleep in America Poll: Summary of Findings. 

http://www.sleepfoundation.org/article/sleep-america-polls/2009-health-and-safety.

O’Hara, Andrew F., John M. Violanti, Richard L. Levenson, and Ron Clark. 2013. “National Police Suicide 

Estimates: Web Surveillance Study III.” International Journal of Emergency Mental Health 15 (1): 31–38.

Paton, Douglas, John M. Violanti, and Jane Lunt. 2010. “Developing Resilience in High Risk Professions: 

Integrating Person, Team, and Organizational Factors.” In Storming the Global Business: The Rise of 

the Tigers. Edited by B. Pattanayak, P. Niranjana, K. Ray, and S. Mishra, 303–316. New Delhi, India: 

Excel Books.
34

Police Chief Magazine. 2007. “Peer Support Guidelines.” Police Chief 74 (8).

Rajaratnam, Shantha M.W., Laura K. Barger, Steven W. Lockley, et al. 2011. “Sleep Disorders, Health and 

Safety in Police Officers.” Journal of the American Medical Association 306 (23): 2567–78.

Ramey, Sandra L. 2013. Presentation to Officer Safety and Wellness Group in Washington, D.C., 

February 4, 2013.

Ramey, Sandra L., Kenneth Culp, Nancy R. Downing, and Yelena Perkhounkova. 2011. “Evaluation of Stress 

and Vital Exhaustion in a Midwestern, Urban Police Department.” American Association Occupational 

Health Nurses Journal 59 (5): 221–227.

Ramey, Sandra L., Nancy R. Downing, Warren D. Franke, Yelena Perkounkova, and Mohammad E. 

Alasagherin. 2012. “Relationships among Stress Measures, Risk Factors, and Inflammatory Biomarkers 

in Law Enforcement Officers.” Biological Nursing Research 14 (1): 16–26.

Ramey, Sandra L., Nancy R. Downing, and Angela Knoblauch. 2008. “Developing Strategic Interventions to 

Reduce CVD Risk in Law Enforcement Officers: The Art and Science of Data Triangulation.” American 

Association of Occupational Health Nurses Journal 56 (2): 54–62.

Ramey, Sandra L., Warren D. Franke, and Nancy R. Downing. 2009. “Milwaukee Police Department 

retirees: Cardiovascular Disease Risk and Morbidity Among Aging Law Enforcement Officers.” American 

Association of Occupational Health Nurses Journal 57 (11): 448–453.

Ramey, Sandra L., Warren D. Franke, and Mack C. Shelley. 2004. “Relationship Among Risk Factors 

for Nephrolithiasis, Cardiovascular Disease, and Ethnicity in a Law Enforcement Cohort.” American 

Association of Occupational Health Nurses Journal 52 (3): 1–6.

Ramey, Sandra L., Yelena Perkhounkova, Mikyung Moon, Laura Budde, Hui-Chen Tseng, and Kathleen 

Clark. 2012. “The Effect of Work Shift and Sleep Duration on Various Aspects of Police Officers’ Health.” 

Workplace Health and Safety: Promoting Environments Conducive to Well-Being and Productivity 60 (5): 

1–6.

Ramey, Sandra L., Gregory J. Welk, Warren D. Franke, and Mack C. Shelley. 2003. “Cardiovascular Disease 

Risk Reduction Efforts among Law Enforcement Officers: An Application of the Precede-Proceed 

Planning Model.” Evidence-Based Preventive Medicine 1 (1): 1–10.

Reaves, Brian A. 2010. “Table 8. Workplace Policies of Local Police Departments, by Size of Population 

Served, 2007.” Local Police Departments, 2007. Washington, DC: Bureau of Justice Statistics. NCJ 231174.

Rivera, Carrie. 2001. “Physical Fitness for Officers at All Levels.” Law and Order 49:80–84.

Shucard, Janet L., Jennifer Cox, David W. Shucard, Holly Fetter, Charles Chung, Deepa Ramasamy, et al. 

2012. “Symptoms of Posttraumatic Stress Disorder and Exposure to Traumatic Stressors are Related to 

Brain Structural Volumes and Behavioral Measures of Affective Stimulus Processing in Police Officers.” 

Psychiatry Research: Neuroimaging 204:25–31. 

Vila, Bryan. 2000. “Tired Cops: The Importance of Managing Police Fatigue.” Washington, DC: Police 

Executive Research Forum.

———. 2006. “Impact of Long Work Hours on Police Officers and the Communities They Serve.” American 

Journal of Industrial Medicine 49 (11): 972–980.

———. 2008. “Managing Police Fatigue: A High-Wire Act.” Gazette 70 (3). 

———. 2009. “Sleep Deprivation: What Does It Mean to Public Safety Officers?” NIJ Journal 262. 
35

———. 2010. “The Effects of Officer Fatigue on Accountability and the Exercise of Police Discretion.” 

In Holding Police Accountable. Edited by Candace McCoy. Washington, DC: Urban Institute Press.

———. 2013. Presentation to Officer Safety and Wellness Group in Washington, D.C., February 4.

Vila, Bryan, and Charles Samuels. 2011. “Sleep Loss in First Responders and the Military.” In Principles and 

Practice of Sleep Medicine, 5th ed. (PPSM 5e). Edited by Meir H. Kryger, Thomas Roth, and William C. 

Dement. Philadelphia: Elsevier Saunders. 

Violanti, John. 2012. “The Stress-Disease Connection.” Gazette 74 (4).

———. 2013. Presentation to Officer Safety and Wellness Group in Washington, D.C., February 4, 2013.

Violanti, John M., Cecil M. Burchfiel, Desta Fekedulgen, Michael E. Andrew, Joan Dorn, Tara A. Hartley, 

et al. 2009. “Cortisol Patterns and Brachial Artery Reactivity in a High Stress Environment.” Psychiatry 

Research 169:75–81. 

Violanti, John M., Cecil M. Burchfiel, Tara A. Hartley, Anna Mnatsakanova, Desta Fekedulegn, Michael E. 

Andrew, et al. 2009. “Atypical Work Hours and Metabolic Syndrome among Police Officers.” Archives 

of Environmental and Occupational Health 64 (3): 194–201.

Violanti, John M., Cecil M. Burchfiel, Diane B. Miller, Michael E. Andrew, Joan Dorn, Jean WactawskiWende, et al. 2006. “The Buffalo Cardio-Metabolic Occupational Police Stress (BCOPS) Pilot Study: 

Methods and Participant Characteristics.” Annals of Epidemiology 16:148–156.

Violanti John M., Desta Fekedulegn, Michael E. Andrew, Luenda E. Charles, Tara A. Hartley, and Cecil M. 

Burchfiel. 2012. “Obesity in Policing: Mental Health Consequences.” International Journal of Emergency 

Mental Health 13:257–266.

Violanti, John M., Desta Fekedulegn, Michael E. Andrew, Luenda E. Charles, Tara A. Hartley, Bryan Vila, et 

al. 2013. “Shift Work and Long Term Injury among Police Officers.” Scandinavian Journal of Work and 

Environmental Health 39 (4): 361–8.

Violanti John M., Ja Kook Gu, Luenda E. Charles, Desta Fekedulegn, Michael E. Andrew, and Cecil M. 

Burchfiel. 2012. “Is Suicide Higher Among Separated/Retired Police Officers? An Epidemiological 

Investigation.” International Journal of Emergency Mental Health 13:221–228.

Violanti, John M., Tara A. Hartley, Anna Mnatsakanova, Michael E. Andrew, and Cecil M. Burchfiel. 2012. 

“Police Suicide in Small Departments: A Comparative Analysis.” International Journal of Emergency 

Mental Health 14:37–42.

Violanti, John M., Andrew F. O’Hara, and Teresa T. Tate. 2012. On the Edge: Recent Perspectives in Police 

Suicide. Springfield, IL: Charles C. Thomas Publisher LTD. 

Violanti, John M., Janet L. Shucard, and David W. Shucard. 2011. “Heightened Attention During a Go-NoGo Task in Police Officers with High PTSD Symptomatology: A Dense Electrode Event Related Potential 

(ERP) Brain Study.” Presented at the International Society for Traumatic Stress Studies annual conference, 

Baltimore, Maryland, November 3–6, 2011.

Waggoner, Lauren, Devon Grant, Hans Van Dongen, Gregory Belenky, and Bryan Vila. 2012. “A Combined 

Field and Laboratory Design for Assessing the Impact of Night-Shift Work on Police Officer Operational 

Performance.” Sleep 35 (11): 1575–77.

Zimmerman, Franklin H. 2012. “Cardiovascular Disease and Risk Factors in Law Enforcement Personnel: 

A Comprehensive Review.” Cardiology in Review 20 (4).
36

About BJA

The Bureau of Justice Assistance’s (BJA) mission is to provide leadership and services in grant 

administration and criminal justice policy development to support local, state, and tribal justice strategies 

to achieve safer communities. 

BJA has four primary components: the Policy Office, Programs Office, Planning Office, and Public Safety 

Officers’ Benefits Program Office. The Policy Office provides national leadership in criminal justice 

policy, training, and technical assistance to further the administration of justice. It also acts as a liaison to 

national organizations that partner with BJA to drive policy and help disseminate information on promising 

practices. The Programs Office coordinates and administers state and local grant programs and acts as 

BJA’s direct line of communication to state, local, territorial, and tribal governments by providing assistance 

and coordinating resources. The Planning Office coordinates the planning, communications, and budget 

formulation and execution; provides overall BJA-wide coordination; and supports streamlining efforts. 

The Public Safety Officers’ Benefits Program Office provides death and education benefits to survivors of 

fallen law enforcement officers, firefighters, and other first responders and disability benefits to officers 

catastrophically injured in the line of duty.

BJA’s overall goals are to (1) reduce and prevent crime, violence, and drug abuse and (2) improve the 

functioning of the criminal justice system. To achieve these goals, BJA programs emphasize enhanced 

coordination and cooperation of federal, state, and local efforts. BJA’s objectives in support of these goals 

are to:

 Encourage the development and implementation of comprehensive strategies to reduce and prevent 

crime and violence 

 Encourage the active participation of community organizations and citizens in efforts to prevent crime, 

drug abuse, and violence 

 Provide training and technical assistance in support of efforts to prevent crime, drug abuse, and violence 

at the national, state, and local levels 

 Reduce the availability of illegal weapons and develop strategies to address violence in our communities 

 Enhance the capacity of law enforcement agencies to reduce crime 

 Improve the effectiveness and efficiency of all aspects of the adjudication process, including indigent 

defense services 

 Assist states in freeing prison space for serious and violent offenders through the design and 

implementation of effective correctional options for nonviolent offenders 

 Enhance the ability of criminal justice agencies to access and use new information technologies 

 Encourage and support evaluation of the effectiveness of funded programs and dissemination 

of program results
37

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, territory, and tribal law enforcement agencies through information and grant resources. 

Community policing is a philosophy that promotes organizational strategies that support the systematic use 

of partnerships and problem-solving techniques, to proactively address the immediate conditions that give 

rise to public safety issues such as crime, social disorder, and fear of crime. 

Rather than simply responding to crimes once they have been committed, community policing concentrates 

on preventing crime and eliminating the atmosphere of fear it creates. Earning the trust of the community 

and making those individuals stakeholders in their own safety enables law enforcement to better understand 

and address both the needs of the community and the factors that contribute to crime.

The COPS Office awards grants to state, local, territory, and tribal law enforcement agencies to hire and 

train community policing professionals, acquire and deploy cutting-edge crime fighting technologies, and 

develop and test innovative policing strategies. COPS Office funding also provides training and technical 

assistance to community members and local government leaders and all levels of law enforcement. 

The COPS Office has produced and compiled a broad range of information resources that can help law 

enforcement better address specific crime and operational issues, and help community leaders better 

understand how to work cooperatively with their law enforcement agency to reduce crime.

 Since 1994, the COPS Office has invested more than $14 billion to add community policing officers to 

the nation’s streets, enhance crime fighting technology, support crime prevention initiatives, and provide 

training and technical assistance to help advance community policing. 

 To date, the COPS Office has funded approximately 125,000 additional officers to more than 13,000 of 

the nation’s 18,000 law enforcement agencies across the country in small and large jurisdictions alike.

 Nearly 700,000 law enforcement personnel, community members, and government leaders have been 

trained through COPS Office-funded training organizations.

 To date, the COPS Office has distributed more than 8.57 million topic-specific publications, training 

curricula, white papers, and resource CDs. 

COPS Office resources, covering a wide breadth of community policing topics—from school and 

campus safety to gang violence—are available, at no cost, through its online Resource Center at 

www.cops.usdoj.gov. This easy-to-navigate website is also the grant application portal, providing 

access to online application forms.