title: How common is hazardous and harmful drinking in the UK Police Service, and what is the relationship with mental health and job strain?
Creators: name: Irizar, Patricia
Publisher: name: University of Liverpool Repository
Year: 2024

description: Policing can be a stressful occupation, characterised by operational stressors and organisational stressors, both of which have known associations with poor mental health. There is strong evidence indicating a relationship between poor mental health and alcohol problems, with emerging evidence also showing a link with abstinence from drinking. Due to the nature of their work, UK police employees may be using alcohol to cope with stress or trauma. This thesis aimed to understand the level of alcohol problems in the UK Police Service and examine the relationship with poor mental health and job strain. This thesis took a multi-method approach. First, a systematic review and meta-analysis was conducted, to collate the evidence on the prevalence of hazardous and harmful alcohol use in trauma-exposed occupations. Next, representative data from 40,000 UK serving police employees was analysed, to determine the prevalence of hazardous and harmful alcohol use (and abstinence), and their co-occurrence with poor mental health and job strain. Then, the level of harmful alcohol use and poor mental health was compared in police employees and military personnel, analysing men and women in separate studies. Given that harmful drinking often co-occurs with other harmful behaviours, this thesis examined the classes of health (risk) behaviours, and their associations with mental health and job strain. Finally, qualitative interviews were used to gain a deeper understanding of police employees experiences of hazardous/harmful drinking or abstinence. The quantitative and qualitative findings were integrated through triangulation. The meta-analysis identified gaps in the literature, with only two UK studies and no UK studies of police employees. Of the 40,000 UK police employees, 33% met criteria for hazardous drinking and 3% for harmful drinking. Those with poor mental health were more likely to drink harmfully and abstain (versus low-risk). High strain (versus low) was associated with reduced odds of hazardous drinking (though this was moderated by mental health). There were comparable levels of probable PTSD but higher levels of harmful drinking in military personnel compared to police employees (for both men and women). Police employees with poor mental health had double the odds of engaging in multiple health risk behaviours. The interviews developed an understanding of the motivations for drinking and abstaining, and the organisational culture of drinking. The evidence indicated a J-shaped relationship, whereby poor mental health was linked with both abstinence and harmful drinking, in the UK Police Service. Critically, those with poor mental health were also more likely to engage in multiple health risk behaviours and may be at risk of harm. The triangulated findings have important theoretical implications, contributing to the self-medication hypothesis and sick quitter hypothesis, and practical implications, highlighting the need for accessible support for alcohol problems within the Police Service.