Head Injuries and Mental Health in Law Enforcement and Corrections Officers: Results From a Statewide Survey.

OBJECTIVE

This study examined the prevalence, mechanisms, and treatment of lifetime and duty-related head injuries (HIs) among law enforcement and corrections officers (LEOs), and their associations with mental health outcomes.

SETTING

Online survey (September 2024-March 2025).

PARTICIPANTS

Two hundred ninety eight LEOs in Ohio (mean age = 43 ± 12 years; median 17 years of service; 18.2% military history).

DESIGN

Cross-sectional, anonymous survey.

MAIN MEASURES: HI history was assessed using the Ohio State University Traumatic Brain Injury (TBI) Identification Method. Mental health outcomes were assessed using the Patient Health Questionnaire-9 (PHQ-9), PTSD Checklist-Civilian version (PCL-C), and Difficulties in Emotion Regulation Scale (DERS-16).

RESULTS

A high prevalence of HIs were reported: 64.1% of LEOs endorsed at least 1 lifetime HI and 28.3% reported at least 1 duty-related HI. Critically, these injuries were largely unaddressed, with 64.4% of lifetime HIs and 72.8% of duty-related HIs remaining undiagnosed or untreated. Common duty-related mechanisms included physical training (24.3%), fights (21.4%), falls (20.4%), blast exposure (18.5%), and vehicle incidents (15.3%). Significant mental health symptoms were prevalent, with 25.8% reporting mild, 14.2% moderate, and 7.8% moderately severe-to-severe depressive symptoms (PHQ-9); 17.4% screened positive for PTSD (PCL-C), and 14.7% reported difficulties with emotion regulation (DERS-16).

CONCLUSIONS

Duty-related HIs were common, frequently untreated, and associated with adverse mental health outcomes. The absence of structured TBI recognition and return-to-duty protocols leaves LEOs vulnerable to reinjury, prolonged recovery, and reduced occupational readiness. These findings highlight the need for systematic TBI screening, occupational health supports, and implementation of tailored return-to-duty protocols to enhance recovery and improve workforce safety.