Introduction

Mental and psychological health problems have gained prominence as a major public health concern.¹ A mental disorder can be described as a clinically significant disturbance in an individual’s thinking, emotional control, or behavior.² The mental health problems among police officers were indeed alarming. Police officers are generally considered to be a high-risk group for the development of psychological illnesses due to the numerous significant and potentially traumatic events they experience during their careers.^3,4 The duties and responsibilities in police officers place them in difficult and stressful circumstances, which can have a major consequence on their mental health and probably even performance.⁵

Previous research has linked law enforcement work to higher levels of physical, psychosocial, and anticipatory stress.⁶ Despite the fact that mental disorders are common and may be influenced by work-related experiences, police officers appear to be hesitant to seek mental health treatment. Furthermore, police officers are more likely to develop mental health problems, but little research into their psychological issues, mental health promotion and intervention programs, has been conducted.^7,8 Therefore, conducting research to learn more about mental disorders and mental health promotion, as well as to assist distressed police officers, is critical.

Methods

For reviewing relevant studies, the author conducted thorough searches in the Scopus, Web of Science, PubMed, Science Direct, Google Scholar, and Semantic Scholar databases. Boolean terms and truncation procedures were applied to broaden and then narrow the search for related articles. Keywords were merged using the Boolean operators “OR” and “AND” within each domain. The keywords and terms were used to search the literature consisting of “mental disorders”, “mental health promotion” and “police officers”, or “police personnel” or “law enforcement officers”. Some keywords that refer to mental disorders are also included, such as mental illness, and mental health problems. The PICO was also applied to an extensive search of the literature. The PICO first consists of “P” or “Participant/Population” which in this case is the police officers, “I” or “Intervention” which in this case is mental health promotion, “C” or “Comparison” which is based on non-specific comparison, and “O” or “Outcome” which in this study is mental disorders.

The criteria for including literature in this review are as follows: (a) clinical trials, controlled trials, randomized controlled trials, quasi-experimental research, longitudinal studies, descriptive, and cross-sectional research that related to mental disorders and mental health promotion in police officers; (b) full-text articles in details; and (c) published articles in English. Exclusion criteria included letters to editors, book reviews, news reports, commentaries, and comments.

Mental disorders in police officers

Prevalence

Public safety personnel were found to have a higher rate of psychological health problems.⁹ One in every seven police officers worldwide suffered from post-traumatic stress disorder (PTSD) or depression, and one in every ten struggled from other mental illnesses.⁸ When compared to the general population, police personnel have approximately twice the prevalence of PTSD and depression (20% vs 7% to 9%), and are associated with a lower quality of life.¹⁰ The study in Canada revealed that 50.2% of federal police officers and 36.7% of municipal/provincial police officers positively identified for one or more psychological illnesses.⁹ Approximately 44% of respondents throughout all groups of public safety personnel screened positive for at least one psychological disorder.¹¹ The rate of mental health problems in Ethiopian police officers was 28.9%.¹² Malaysian police personnel were revealed to be stressed, with 5.9% experiencing severe stress and 14.9% suffering moderate stress.¹³ According to a South Korean study, more than 40% of Korean police officers had a high risk of PTSD.¹⁴ Moreover, police personnel in Indonesia discovered that 2.14% had mental disorders.¹⁵

Risk factors

A growing number of law enforcement officers are being treated at work for stress-related mental health difficulties. It is possible that the work roles related to this professional field potentially lead police officers to mental health difficulties.¹⁶ One of the variables that has best explained mental health problems in police officers is a lack of social support within the organization. For these professionals, the perception of support from peers and superiors is essential.¹⁷ Public safety personnel are at a high risk of developing mental health problems if they perceive a lack of control or decision-making control, high demands or pressure to complete tasks, and insufficient support and coping strategies.^18,19 Police personnel are especially vulnerable to poor psychological health if they lack support networks (family, friends, and trust from coworkers and supervisors), or if they lack the personal qualities needed to deal with problems.²⁰ Prior studies demonstrated that police officers who perceived low organizational and peer support, as well as low rewards, had a higher prevalence of symptoms related to mental disorders such as depression.^21,22 Additionally, prolonged hours of work and an excessive workload, police culture, and organizational restructuring were the sources of job stress affecting police officers’ psychological state.²³

Furthermore, previous research found that socioeconomic (funding cuts and social pressure), organizational (police culture, leadership, managerial instability, and peer support), and personal factors (self-employment, emotional abilities, and disillusionment) influenced law enforcement officers’ psychological health.¹⁶ A higher risk of developing psychological disorders has been related to repeated trauma events in law enforcement. Occupational stress, alcohol consumption, poor level of peer support were the risk factors for lower mental health.⁸ Experiences childhood trauma, being female, being younger, and emotional copings are all generally indicated risk factors for mental illnesses.²⁴ Marital status and having chronic diseases were also found to be significantly associated with mental health difficulties.¹² Moreover, substance abuse or misuse (i.e., alcohol and drugs) is widespread and is directly related to suicide and psychological illnesses.²⁵

Negative consequences

Poor mental health has been associated with job loss, marital problems, and difficulty sleeping.^26,27 Prolonged exposure to critical situations and traumatic events while performing law enforcement tasks has negative consequences that can affect both physical and psychological well-being among police officers.²⁸ Long-term traumatic stress symptoms can appear unexpectedly, leaving an officer befuddled and unprepared to cope. The symptoms may emerge as an enhancement in physical problems, such as an increase in occupational injuries and a boost in diagnoses related to stress, such as high blood pressure or gastrointestinal ulcers. It could also emerge as a significant change in personality or habits, such as an officer being more likely to engage in a violent confrontation with a citizen, an increment in domestic altercations, or an increase in drug or alcohol abuse, suicidal ideation, and self-harm.²⁹ Job-related stress may have physiological consequences as well. Officers may have digestive problems as a consequence of the body suppressing the process of digestion during the “fight or flight” reaction. Police stressors and their mental and physical implications harm the police organization in the long term by reducing performance, raising absenteeism, and rising officers’ aggressiveness.³⁰

Mental health promotion in police officers

It is critical for police officers to look after their own well-being. Several studies, however, found that stigma within the police officers discouraged them from seeking support for mental health problems.³¹ The stigma related to mental health in the workplace continues to prevent officers from being willing to talk about the problems they are facing. It has been demonstrated that engaging and reducing stigma in police officers improves behavioral responses such as improved communication and desire to work.³² Good emotional and mental health is just as important as physical health for police officers to be effective in keeping the nation and communities safe from violence and crime. Therefore, it is essential to create and implement appropriate mental management skills and health promotion interventions among police officers.³³

Encourage officers to seek confidential counseling, improvements in training and recruiting practices, the availability of peer counselors, organizational modifications, the addition of diversity programs, and critical incident training can all help to reduce the risk of work stress and improve police officers’ mental health.³⁴ Furthermore, the place of work is one of the most significant environments for promoting mental health and behavioral changes. Workplace interventions for psychological health protection are primarily implemented at the organizational level, with a concentrate on working policies and conditions or at the individual level, with stress management and skills enhancement programs that enable employees with the skills and resources to deal with the implications of job difficulties.⁵ In addition, mental health checking is frequently promoted as a means of promoting a healthy psychological organization among police officers. Screening for mental disorders in high-risk occupational groups aims to achieve accurate assessment of those experiencing symptoms to provide evidence-based interventions on time.^35,36

Prevention or intervention program

Previous research on stress management and health promotion interventions for police officers in Athens, Greece, was successful. The study’s objective was to improve mental and cognitive health. The program’s uniqueness lies in the inclusion of a self-awareness technique into a psychoeducational program, which results in more effective implementation of the instructional guidelines and suggestions. The program not only outlines stress management, but it also addresses cognitive rehabilitation. The program has been associated with improvements in mental health, memory, a healthy lifestyle, and well-being. Furthermore, the program improved sleep quality, cognitive function, decision-making, empathy, relaxation, and stress coping. It also enhances cognitive function, which may account for the cognitive benefits. The program as an approach that has beneficial effects on police stress and negative emotions and anger management.³³

In Canada, a peer-support program for police officers’ mental health is highlighted. Mental health literacy, stigma reduction, police culture, and internal policy training are all part of the program. Peer support is social and emotional support provided by a person of equal level, mutually respectful, responsibility shared, and mutual consent on what is helpful. Peer support fosters confidence and hope for the resolving of mental health problems. Peer support was used to improve mental health literacy and mutual support among police officers. This method can help police officers improve their mental health.³⁷

Mindfulness approach can help police officers improve their problem-solving abilities and emotion regulation while also reducing organizational stress. Mindfulness training methods include decision-making under pressure, such as during counterinsurgency processes, and retaining self-awareness and emotion control during tough challenges with local populations.³⁸ The exercises are designed to improve emotional resilience, attention control, and tolerance for difficult experiences. There is numerous advantages of mindfulness program, varying from reducing stress to effective decision-making that is evidence-based. Furthermore, it has the potential to reduce the number of officers suffering from mental illnesses and committing suicide, as well as to decrease burnout and improve well-being.³⁹

In the United States, mindfulness training for police officers is aimed to promote coping skills to the acute and chronic stressors in police enforcement, as well as to support officers’ well-being. Mindfulness, emotions, stress, and scientific research on mindfulness are all covered in the program, as well as embodied practices such as meditation practice, mindful movement (including adapted yoga or qigong), meditation of thoughts and emotions, mindful listening and speaking, mindful eating, and sympathy practice. The findings revealed that after the intervention, police officers given rise to self-reported improvements in emotional turmoil, cognitive functioning, and sleep.⁴⁰

Conclusion and recommendations

Police officers are popularly viewed as a high-risk group for developing mental health disorders. The challenging and stressful nature of police duties has negative outcomes on mental health. However, the mental health promotion in police officers has not received the same level of attention. Regardless of that mental illnesses are frequently discovered; police officers appear to be hesitant to seek mental health care. Interventions that address the stigmas associated with poor mental health and help police officers understand the importance of seeking help could enable improve mental health.

Preventing officer mental problems necessitates a proactive and comprehensive method on mental and physical health. Mental health promotion requires the encouragement of mental health screening and long-term monitoring or intervention programs to promote the mental health and well-being of police officers. Mindfulness practices and stress management effectiveness are needed for police officers. Counseling services for officers who are depressed have also been recommended. It is critical to develop a regional mental health policy or guidance documents for peer mentoring in police organizations. Moreover, overall, the reviews indicated that any further intervention program should recognize the significance of police cultures. Understanding the organization and its structures is critical to ensuring that the program and prevention approaches engage obstacles to seeking assistance and involvement in opportunities to improve mental health and quality of life within the police officers.

Funding source

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Conflict of interest statement

The author declares that there is no conflict of interest.