A Wayne State University School of Medicine researcher has secured a National Institutes of Health grant to further research training methods that lessen the health impacts of stress on police officers, and will conduct that research with the Detroit Police Department.

Bengt Arnetz, M.D., Ph.D., M.P.H., a professor in the Department of Family Medicine and director of the Division of Occupational and Environmental Medicine, received $680,000 from the National Institute of Mental Health for his study, "Imagery-Based Trauma-Resiliency Training for Urban Police."

He called this research the first "scientific evaluation of a primary prevention program for trauma-related mental health and behavioral effects in high-risk professionals" in the United States. Only post-incident programs - those initiated after an incident and after trauma-related disorders have developed in police officers and other first-responders -- have been scientifically assessed.

"First-responders such as police, firefighters and soldiers play a vital role in protecting our nation and our civil society," Arnetz said. "They are potentially exposed to numerous critical incidents, for example, threat to their life, terror attacks, death and suffering. These events are well-researched and are established risk factors for mental and somatic health consequences, including post-traumatic stress disorders, depression and anxiety. However, during recent years there has been an increased interest as to possible effects from sustained/chronic low-level stress among first-responders and health and performance effects. This kind of stress, on the face not looking that dramatic, might exert a significant toll on first-responders."

With this grant, Arnetz hopes to replicate a study he conducted among police officers in Sweden. In that study, he found that organizational factors, productivity performance assessment systems, organizational change, lateral expansion of job duties - including jobs for which first-responders were not trained -- were stressful.

"Police officers thought administrative work took an increasing amount of time, as did a more formal reporting system," Arnetz said. "But, there were also significant tensions in the work-family intersection. For example, undercover police and customs officers might see drug sales going on as they visit a restaurant with their spouse. When they brought this up with their spouse, the spouse said the undercover person was ‘hallucinating' since they were not trained to see these things."
Other significant low-level stressors, Arnetz noted, included the demand and expectation to constantly be prepared and trained for the "Big Event," for example a major terrorist attack or other catastrophe. While such events are rare, changing mental and physical gears -- for example, responding to an alarm involving a report of an armed suspect - creates substantial stress.

The initial findings, published this year in the Journal of Police and Criminal Psychology, demonstrated that practicing lifelike scenarios coupled with incorporating mental relaxation cues resulted in "substantial" stress reduction in Swedish police officers, and decreased the risk of suffering cardiovascular events, mostly from increased risk from blood clots during exposure to challenging stress.

The pre-event training resulted in significantly less negative moods, a lesser rise in heart rate during a simulated emergencies and a larger increase in antithrombin (a chemical in the bloodstream that decreases the propensity for blood clots caused by stress).

Arnetz said the Swedish study's results suggest that imagery and skills training have the potential to reduce negative trauma exposure in police officers and other first-responders. Such training, coming before emergencies, could prove more beneficial than post-incident debriefing and counseling. It could also result in fewer lost work days and less human suffering, and may be more acceptable to officers than seeking psychological assistance.

"In a controlled intervention, we found that mental training, getting ready for various critical events by using a combination of technical skills training and stress management resulted in decreased stress (lower heart rate response) and decreased clotting reaction of the blood as compared to police officers trained as usual," Arnetz said.

The Detroit Police Department, Arnetz said, played an active role in the preparatory phase of the project planning, including a letter of support for the project and representation on a steering committee.

Sgt. DeShaune Sims, of the Detroit Police Department's Risk Management Bureau and Planning Department, said as many as 100 officers will be involved in the stress desensitization research. The department is in the process of developing the scenarios to be used in the project.

Such pre-event training, said Sims, a 12-year police veteran, is not offered to rookie officers at police academies. "That's one thing we hope, that depending on the outcome we can incorporate it into our academy training," she said.

The three-year study, which begins this month, will utilize experienced officers within the department as trainers. Arnetz and his colleagues will train them in the imagery training process.

"We will use very experienced officers," he explained. "Their knowledge about critical incidents experienced during the years, as well as proper police strategy to address these challenges, will be incorporated into the training sessions with junior police officers." None of the senior trainers will have line command relationships with the trainees.
"In this first phase of the study, we will check out the feasibility of the proposed imagery training program in a rough, inner-city environment," Arnetz said. "We will adapt the scenarios to the realities of Detroit. We will focus on self-reports, objective supervisor-assessed performance (based on administrative data that exists for all police officers, in order not to have to tell the supervisor to rate trainees specifically.) Once this feasibility study is done, we will be able to optimize the cost benefit of future controlled interventions."
Co-investigators with Arnetz include James Blessman, M.D., Ph.D., and Todd Lucas, Ph.D., of the WSU Department of Family Medicine's Division of Occupational and Environmental Health; Mark Lumley, Ph.D., professor of the WSU Department of Psychology; and Nnamdi Pole, Ph.D., associate professor of the Department of Psychology at Smith College.