Silent Struggles: Traumatic Brain Injuries and Mental Health in Law Enforcement.

OBJECTIVE

To determine the prevalence of head injuries (HIs), posttraumatic stress disorder (PTSD), and depressive symptoms in law enforcement officers (LEOs) and (2) the association between HIs and psychological health conditions.

SETTING

County-level survey administered via Research Electronic Data Capture.

PARTICIPANTS

A total of 381 LEOs completed the survey (age = 43 ± 11 years; 40 [11%] females; time as LEO = 1-50 years, median = 15 years).

DESIGN

Cross-sectional study.

MAIN MEASURES: We examined the prevalence of HIs (the Ohio State University Traumatic Brain Injury Identification Method), PTSD (PTSD Checklist-Civilian [PCL-C]), and depressive symptoms (Patient Health Questionnaire-9 [PHQ-9]). We used Mann-Whitney U and chi-square analyses to compare PTSD and depressive symptoms between those with and without a HI history.

RESULTS

There were 282 (74%) participants who reported a lifetime history of 1 or more HIs; 116 (30%) sustained 1 or more HIs on the job. PCL-C scores ranged 17 to 85 (median = 27); 33 (10%) participants met or exceeded the clinical cutoff score of 50 to indicate a positive PTSD screening. Participants with a HI history (median = 29) had higher PCL-C scores than those with no HI history (median = 24; P < .001), but the proportion of participants who met the clinical cutoff for PTSD was not different between those with ( n = 28, 11%) and without ( n = 5, 5%) a HI history (X 2  = 2.52, P = .112, odds ratio = 2.18; 95% confidence interval, 0.82-5.83). PHQ-9 scores ranged 0 to 20 (median = 3); 124 (36%) participants reported mild or greater depressive symptoms. Participants with a HI history (median = 3) had higher depressive symptoms than those with no HI history (median = 2; P = .012). The proportion of participants with mild or greater depressive symptoms was higher among those with a HI history ( n = 99, 39%) than without ( n = 25, 27%; X 2  = 4.34, odds ratio = 1.74; 95% confidence interval, 1.03-2.93).

CONCLUSION

HIs are prevalent in LEOs, which may have consequences for their performance, well-being, and career longevity. PTSD and depressive symptoms are higher in those with a HI history, suggesting LEOs need better traumatic brain injuries and mental health resources.