Blue Flower

Psychological Trauma Risk Management in the UK Police Service 

This paper was written by Heather Prince. She is in charge of the research briefs program for the American Society of Evidence Based Policing. If you're unfamiliar with ASEBP, they are an organization that translates police relevant research into short briefs for their members - police agencies and officers around the country, to read and learn from. Their goal is to disseminate research to police officers and agencies across the country (USA) to form a better connection between research and policy, and academia and practice.



Hesketh, I., & Tehrani, N. (2018). Psychological Trauma Risk Management in the UK Police Service. Policing: A Journal of Policy and Practice. doi: 10.1093/police/pay083


  • Proactive mental health treatment can have positive mental health effects for officers 
  • Resilience training for staff and officers shows improvements in communication, working relationships, and increased feelings of control 
  • Regular identifying of trauma and monitoring of officers’ psychological health is still crucial to maintaining mentally healthy officers

The UK police services have recently been undergoing many changes and reduced budgets alongside many new challenges of the time they have to face. Some of the accompanying changes in officer behavior include reduced numbers in the force, increased sickness absences, and changes to terms and conditions. As police officers face difficulties in an already very demanding job, management should ensure that their health, including mental health, is taken care of to promote better service and wellbeing. A recent paper discusses the efforts to deal with the current efforts in psychological trauma risk management and emphasizes the approaches it feels should be improved to increase the quality of care. 

The paper suggests splitting officers into three categories to better tailor psychological trauma services: responders, specialists, and those who work during major disasters. All three categories deal with primary and secondary trauma, though in different ways. The first category of officers deals with incidents everyday, with unpredictable traumatic exposure to very serious events, as well as chronic psychological stress from working in contact centers and having to deal with complaints which can lead to compassion fatigue and burnout. The specialists, on the other hand, deal with specific expected trauma, such as handling child abuse cases, dealing with victims of rape, conducting hostage negotiations, etc. 

For both of these groups, regular identifying of trauma and monitoring of officers’ psychological state is crucial to dealing with their mental health. The monitoring and assessment should have established cut off levels that lead to support services being set up for the officer, in order to catch the problem even when the stress and trauma levels are gradually changing rather than all at once. 

Both pre-screening as well as post-screening are useful, as shown in two police forces. Pre- screening showed that while the majority of incoming officers had normal psychological test scores, 15% had concerning scores, and 5% had symptoms of clinically significant PTSD. While they were still cleared to work, the scores triggered an occupational health assessment, with the potential assignment of trauma therapy and wellbeing focused session with mental health professionals. The officers in these sessions reported satisfaction with the process and services, showing that proactive treatment can be positive, particularly in retaining those who have some exposure to trauma. 

For the last category, those who help deal with major disasters, they may face vast personal and human trauma during their service, and also may not be accustomed to the work the same way officers who regularly work in policing are. To handle this, the police services need to create systems and processes which can quickly be made available to large numbers of people. These depend on the availability of early post-trauma interventions, including psychological first aid and debriefing. 

Many of these tactics are starting to become more commonplace in police forces across the UK. Resilience training for officers and staff in general has also been shown to be useful, with participants in a pilot study reporting improvements in communication, working relationships, and increased feelings of control. 

Policing overall is a tough occupation, with many hazards, not least of which include threats to psychological health. While there are several forces moving in the direction of looking out for their officers, many departments still are environments where there is hesitation around acknowledging trauma and asking for help. With management and staff, along with health professionals working to provide systems and processes to help, hopefully the culture will change and the quality of identification and treatment of trauma will improve as time goes on. 

This is a great talk, from the heart, from William Pullen... Dynamic Running Therapy (Mindful Running/Walking), Empathy Runs/Walks




Dr Karen Amendola of the American Police Foundation presents the findings of a study on shift work, shift hours and fatigue.

Dr Noreen Tehrani speaks to Dave Thomas about the policing brain, trauma exposire and how we maintain resilience.

Key observations from the presentation delivered by Dr. Ceri Jones at the Police PTSD conference 2017

DEFINITION: Healthcare team members involved in an unanticipated patient event, a medical error and/or a patient related injury and become traumatised by the event. Frequently, these individuals feel personally responsible for the patient outcome. Many feel as though they have failed the patient, second guessing their clinical skills and knowledge base.

Recent studies in the sector suggest that almost 50% of healthcare professionals have a second victim experience during their career, and that it leads to experiences similar to PTSD.

Like policing, the NHS operates in a life-changing environment that sees trauma of varying degrees on a daily basis for the majority of its staff. This daily exposure to trauma, and the association with specific incidents, has serious psychological effects on the worker including compassion fatigue, intrusive thoughts and images, difficulties separating work from personal life, decreased feeling of work competence, and burnout.

A pilot project is underway in the NHS. The creation of an Emotional Resilience Support Unit is underway at University Hospital London and Nottingham University Hospital. This sees a 3-tier approach involving training local leaders on supportive leadership of human factors, implementing peer support programmes, and access to an expedited referral network with external provision.

The second tier, peer support, focuses on providing 1:1 crisis intervention, support, mentoring, and debriefing initiatives. Acting as an ‘emotional first aid’ programme, it is available immediately or soon after a difficult work-related event and provides a confidential and safe place to talk.

The programme has been built around evidenced-based guidelines developed by the National Institute for Health and Care Excellence (NICE) on treating PTSD, and is designed to be delivered by staff with no pre-existing expert knowledge. Most importantly, there is no implication of legal liability beyond the normal NHS workplace duty of care.

The peer support programme provides a useful way to address the issues for an individual within an environment that is comfortable without the stigma.

It is not about implementing a clinical process. It allows the individual to reflect out loud to a colleague who understands the environment they operate in, and encourages their brain to process the information it has built up.

The Injury on Duty report produced by the Police Dependants’ Trust highlighted that there was a need for “…Not a counselling service but like an off-loading service. You know, we suck up so much trauma but there is no release for that…”. That is what the ERSU is designed to do, but it also has the next tier of support built in as well for when the peer support programmes are not enough.



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