Global prevalence and risk factors for mental health problems in police personnel: a systematic review and meta-analysis

Police face an increased risk of developing mental health problems, yet reliable estimates of their psychological difficulties remain unknown. This systematic review and meta-analysis estimate the pooled prevalence and risk factors for mental health problems among police personnel worldwide. Three i...

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Published in:Occupational and environmental medicine (London, England) Vol. 77; no. 11; pp. 737 - 747
Main Authors: Syed, Shabeer, Ashwick, Rachel, Schlosser, Marco, Jones, Rebecca, Rowe, Sarah, Billings, Jo
Format: Journal Article
Language:English
Published: England BMJ Publishing Group Ltd 01.11.2020
BMJ Publishing Group LTD
Subjects:
Alcohol
Anxiety disorders
Bias
Correlation analysis
Drinking behavior
Drug dependence
Emergency response
Epidemiology
Estimates
First responders
Health problems
Longitudinal studies
Mental depression
Mental disorders
Mental health
Meta-analysis
Occupational health
Personnel
Police
Post traumatic stress disorder
psychiatry
Psychological stress
psychology
public health
Risk analysis
Risk factors
Sample size
Social interactions
Systematic review
Trauma
Working conditions
United Kingdom > UK
post traumatic stress disorder
epidemiology
psychiatry
psychology
public health
ISSN:1351-0711, 1470-7926, 1470-7926
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Abstract Police face an increased risk of developing mental health problems, yet reliable estimates of their psychological difficulties remain unknown. This systematic review and meta-analysis estimate the pooled prevalence and risk factors for mental health problems among police personnel worldwide. Three independent reviewers searched 16 databases and screened 11 506 articles published between January 1980 and October 2019. Eligible studies involved at least 100 active police professionals and used validated instruments to ascertain specific mental health problems. Estimates were pooled using random-effects meta-analyses. In total, 60 cross-sectional and seven longitudinal studies, involving 272 463 police personnel from 24 countries met criteria for inclusion. The overall pooled point prevalence was 14.6% for depression (95% CI 10.9% to 18.6%), 14.2% for post-traumatic stress disorder (PTSD; 95% CI 10.3% to 18.7%), 9.6% for a generalised anxiety disorder (95% CI 6.7% to 12.9%), 8.5% for suicidal ideation (95% CI 6.1% to 11.2%), 5.0% for alcohol dependence (95% CI 3.5% to 6.7%) and 25.7% for hazardous drinking (95% CI 19.6% to 32.4%). The strongest risk factor for depression and suicidal ideation was higher occupational stress, and the strongest risk factors for PTSD were higher occupational stress and avoidant coping strategies. Higher levels of peer-support were associated with significantly lower PTSD symptoms. Our findings suggest that the prevalence of mental health problems among police exceeds twice that previously reported in mixed samples of first responders, and is associated with poor social support, occupational stress and maladaptive coping strategies. Without effective intervention, psychological difficulties will remain a substantial health concern among police.
AbstractList Police face an increased risk of developing mental health problems, yet reliable estimates of their psychological difficulties remain unknown. This systematic review and meta-analysis estimate the pooled prevalence and risk factors for mental health problems among police personnel worldwide. Three independent reviewers searched 16 databases and screened 11 506 articles published between January 1980 and October 2019. Eligible studies involved at least 100 active police professionals and used validated instruments to ascertain specific mental health problems. Estimates were pooled using random-effects meta-analyses. In total, 60 cross-sectional and seven longitudinal studies, involving 272 463 police personnel from 24 countries met criteria for inclusion. The overall pooled point prevalence was 14.6% for depression (95% CI 10.9% to 18.6%), 14.2% for post-traumatic stress disorder (PTSD; 95% CI 10.3% to 18.7%), 9.6% for a generalised anxiety disorder (95% CI 6.7% to 12.9%), 8.5% for suicidal ideation (95% CI 6.1% to 11.2%), 5.0% for alcohol dependence (95% CI 3.5% to 6.7%) and 25.7% for hazardous drinking (95% CI 19.6% to 32.4%). The strongest risk factor for depression and suicidal ideation was higher occupational stress, and the strongest risk factors for PTSD were higher occupational stress and avoidant coping strategies. Higher levels of peer-support were associated with significantly lower PTSD symptoms. Our findings suggest that the prevalence of mental health problems among police exceeds twice that previously reported in mixed samples of first responders, and is associated with poor social support, occupational stress and maladaptive coping strategies. Without effective intervention, psychological difficulties will remain a substantial health concern among police.Police face an increased risk of developing mental health problems, yet reliable estimates of their psychological difficulties remain unknown. This systematic review and meta-analysis estimate the pooled prevalence and risk factors for mental health problems among police personnel worldwide. Three independent reviewers searched 16 databases and screened 11 506 articles published between January 1980 and October 2019. Eligible studies involved at least 100 active police professionals and used validated instruments to ascertain specific mental health problems. Estimates were pooled using random-effects meta-analyses. In total, 60 cross-sectional and seven longitudinal studies, involving 272 463 police personnel from 24 countries met criteria for inclusion. The overall pooled point prevalence was 14.6% for depression (95% CI 10.9% to 18.6%), 14.2% for post-traumatic stress disorder (PTSD; 95% CI 10.3% to 18.7%), 9.6% for a generalised anxiety disorder (95% CI 6.7% to 12.9%), 8.5% for suicidal ideation (95% CI 6.1% to 11.2%), 5.0% for alcohol dependence (95% CI 3.5% to 6.7%) and 25.7% for hazardous drinking (95% CI 19.6% to 32.4%). The strongest risk factor for depression and suicidal ideation was higher occupational stress, and the strongest risk factors for PTSD were higher occupational stress and avoidant coping strategies. Higher levels of peer-support were associated with significantly lower PTSD symptoms. Our findings suggest that the prevalence of mental health problems among police exceeds twice that previously reported in mixed samples of first responders, and is associated with poor social support, occupational stress and maladaptive coping strategies. Without effective intervention, psychological difficulties will remain a substantial health concern among police.
Police face an increased risk of developing mental health problems, yet reliable estimates of their psychological difficulties remain unknown. This systematic review and meta-analysis estimate the pooled prevalence and risk factors for mental health problems among police personnel worldwide. Three independent reviewers searched 16 databases and screened 11 506 articles published between January 1980 and October 2019. Eligible studies involved at least 100 active police professionals and used validated instruments to ascertain specific mental health problems. Estimates were pooled using random-effects meta-analyses. In total, 60 cross-sectional and seven longitudinal studies, involving 272 463 police personnel from 24 countries met criteria for inclusion. The overall pooled point prevalence was 14.6% for depression (95% CI 10.9% to 18.6%), 14.2% for post-traumatic stress disorder (PTSD; 95% CI 10.3% to 18.7%), 9.6% for a generalised anxiety disorder (95% CI 6.7% to 12.9%), 8.5% for suicidal ideation (95% CI 6.1% to 11.2%), 5.0% for alcohol dependence (95% CI 3.5% to 6.7%) and 25.7% for hazardous drinking (95% CI 19.6% to 32.4%). The strongest risk factor for depression and suicidal ideation was higher occupational stress, and the strongest risk factors for PTSD were higher occupational stress and avoidant coping strategies. Higher levels of peer-support were associated with significantly lower PTSD symptoms. Our findings suggest that the prevalence of mental health problems among police exceeds twice that previously reported in mixed samples of first responders, and is associated with poor social support, occupational stress and maladaptive coping strategies. Without effective intervention, psychological difficulties will remain a substantial health concern among police.
Author Rowe, Sarah
Billings, Jo
Schlosser, Marco
Syed, Shabeer
Ashwick, Rachel
Jones, Rebecca
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  orcidid: 0000-0002-4349-4181
  surname: Syed
  fullname: Syed, Shabeer
  email: shabeer.syed@hmc.ox.ac.uk
  organization: Division of Psychiatry, University College London, London, UK
– sequence: 2
  givenname: Rachel
  surname: Ashwick
  fullname: Ashwick, Rachel
  organization: Oxford Institute of Clinical Psychology Training and Research, University of Oxford & Oxford Health NHS Foundation Trust, Oxford, UK
– sequence: 3
  givenname: Marco
  surname: Schlosser
  fullname: Schlosser, Marco
  organization: Division of Psychiatry, University College London, London, UK
– sequence: 4
  givenname: Rebecca
  surname: Jones
  fullname: Jones, Rebecca
  organization: Division of Psychiatry, University College London, London, UK
– sequence: 5
  givenname: Sarah
  surname: Rowe
  fullname: Rowe, Sarah
  organization: Division of Psychiatry, University College London, London, UK
– sequence: 6
  givenname: Jo
  surname: Billings
  fullname: Billings, Jo
  organization: Division of Psychiatry, University College London, London, UK
BackLink https://www.ncbi.nlm.nih.gov/pubmed/32439827$$D View this record in MEDLINE/PubMed
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Copyright Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.
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Copyright_xml – notice: Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.
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DOI 10.1136/oemed-2020-106498
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Issue 11
Keywords post traumatic stress disorder
epidemiology
psychiatry
psychology
public health
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Galovski, Peterson, Beagley 2016; 29
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Surgenor, Snell, Dorahy 2015; 28
Neria, Nandi, Galea 2008; 38
Kutlu, Civi, Karaoğlu 2009; 29
Wisnivesky, Teitelbaum, Todd 2011; 378
Wickramasinghe, Wijesinghe, Dharmaratne 2016; 5
Pienaar, Rothmann, van de Vijver 2007; 34
Haugen, McCrillis, Smid 2017; 94
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Mithoefer, Mithoefer, Feduccia 2018; 5
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Andrew, McCanlies, Burchfiel 2008; 10
Meyer, Rothmann, Pienaar 2003; 6
Garbarino, Cuomo, Chiorri 2013; 3
Gershon, Barocas, Canton 2009; 36
Rajaratnam, Barger, Lockley 2011; 306
Carlier, Lamberts, Gersons 1997; 185
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Berg, Hem, Lau 2006; 48
Ballenger, Best, Metzler 2011; 20
Martin, Marchand, Boyer 2009; 10
Larsson, Berglund, Ohlsson 2016; 57
Varvarigou, Farioli, Korre 2014; 349
Carleton, Afifi, Turner 2018; 59
Pole, Best, Weiss 2001; 189
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Violanti, Burchfiel, Miller 2006; 16
DeVylder, Lalane, Fedina 2019; 10
van der Meer, Bakker, Smit 2017; 205
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Harman 2019; 34
Kerswell, Strodl, Johnson 2019; 25
Lee, Choi, Kim 2016; 28
Marmar 2006; 1071
van Wyk, Pillay-Van Wyk, Wyk 2010; 3
Berg, Hem, Lau 2003; 33
Stephens, Miller 1998; 21
Everding, Hallam, Kohut 2016; 58
Lawson, Rodwell, Noblet 2012; 110
Thoen, Dodson, Manzo 2020; 17
Riley, Jackson, Salanti 2017; 358
Regehr, LeBlanc, Barath 2013; 14
ERd, Schenker, Constantino 2013; 18
Trikalinos, Hoaglin, Schmid 2014; 33
Skogstad, Heir, Hauff 2016; 66
Stephens, Long 1999; 12
Burke, Mikkelsen 2007; 30
Ménard, Arter 2014; 17
Nemeroff, Bremner, Foa 2006; 40
West, Bernard, Mueller 2008; 50
Pietrzak, Schechter, Bromet 2012; 46
Gabriel, Ferrando, Cortón 2007; 22
Chopko, Palmieri, Facemire 2014; 29
Breslau, Peterson, Schultz 2008; 65
Habersaat, Geiger, Abdellaoui 2015; 143
Chopko 2010; 64
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Lee (2024110804401792000_77.11.737.83) 2014; 47
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Andrew (2024110804401792000_77.11.737.38) 2008; 10
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van Wyk (2024110804401792000_77.11.737.136) 2010; 3
Brewin (2024110804401792000_77.11.737.124) 2000; 68
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Kutlu (2024110804401792000_77.11.737.78) 2009; 29
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Yoshimasu (2024110804401792000_77.11.737.17) 2011; 2
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Hartley (2024110804401792000_77.11.737.71) 2012; 2012
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Snippet Police face an increased risk of developing mental health problems, yet reliable estimates of their psychological difficulties remain unknown. This systematic...
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SubjectTerms Alcohol
Anxiety disorders
Bias
Correlation analysis
Drinking behavior
Drug dependence
Emergency response
Epidemiology
Estimates
First responders
Health problems
Longitudinal studies
Mental depression
Mental disorders
Mental health
Meta-analysis
Occupational health
Personnel
Police
Post traumatic stress disorder
psychiatry
Psychological stress
psychology
public health
Risk analysis
Risk factors
Sample size
Social interactions
Systematic review
Trauma
Working conditions
Title Global prevalence and risk factors for mental health problems in police personnel: a systematic review and meta-analysis
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https://www.ncbi.nlm.nih.gov/pubmed/32439827
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