police stress research paper

Advertisement

Police Stress and Deleterious Outcomes: Efforts Towards Improving Police Mental Health

• Published: 09 November 2021
• Volume 37 , pages 173–182, ( 2022 )

Cite this article

• Tina B. Craddock   ORCID: orcid.org/0000-0003-4446-9241 1 &
• Grace Telesco 2  

12k Accesses

16 Citations

17 Altmetric

Explore all metrics

Police officers are subjected, daily, to critical incidents and work-related stressors that negatively impact nearly every aspect of their personal and professional lives. They have resisted openly acknowledging this for fear of being labeled. This research examined the deleterious outcomes on the mental health of police officers, specifically on the correlation between years of service and change in worldviews, perception of others, and the correlation between repeated exposure to critical events and experiencing Post-Traumatic Symptoms. The Cumulative Career Traumatic Stress Questionnaire- Revised (Marshall in J Police Crim Psychol 21(1):62−71, 2006 ) was administered to 408 current and prior law enforcement officers across the United States. Significant correlations were found between years of service and traumatic events; traumatic events and post-traumatic stress symptoms; and traumatic events and worldview/perception of others. The findings from this study support the literature that perpetual long-term exposure to critical incidents and traumatic events, within the scope of the duties of a law enforcement officer, have negative implications that can impact both their physical and mental wellbeing. These symptoms become exacerbated when the officer perceives that receiving any type of service to address these issues would not be supported by law enforcement hierarchy and could, in fact, lead to the officer being declared unfit for duty. Finally, this research discusses early findings associated with the 2017 Law Enforcement Mental Health and Wellness Act and other proactive measures being implemented within law enforcement agencies who are actively working to remove the stigma associated with mental health in law enforcement.

Similar content being viewed by others

The Impact of Everyday Stressors on the Immune System and Health

Compassion Fatigue, Secondary Traumatic Stress, and Vicarious Traumatization: a Qualitative Review and Research Agenda

The Impact of Social Media on College Mental Health During the COVID-19 Pandemic: a Multinational Review of the Existing Literature

Avoid common mistakes on your manuscript.

Introduction

On December 9, 2015, Nicole Rikard, a crime scene investigator for the Asheville Police Department in North Carolina received word that her 38-year-old husband, Sergeant John Rikard, also of the Ashville Police Department, had been found dead in their home of an apparent self-inflicted gunshot wound (Balaban and Doubek  2019 ). In October 2017, Sergeant Michael Borland, a 44-year-old sergeant who spent 21 years with the Pinellas County Sheriff’s Office, was found deceased in the parking lot of the St. Petersburg College-Veterinary Technology Center, also from a self-inflicted gunshot wound (Pinellas Co. Sheriff’s Office press release  2017 ). Shortly after 6 pm on August 14, 2019, veteran NYPD officer, Robert Echeverria, died at his home from a self-inflicted gunshot wound. Officer Echeverria was only 56 years old and the ninth NYPD officer to commit suicide in 2019 following a fellow NYPD officer who killed himself the previous day (Moore and Celona  2019 ).

Law enforcement officers have historically been required to perform many functions within the scope of their jobs. They protect and serve the public, which at times requires them to assume the role of social worker, guidance counselor, and impartial peacekeeper. These roles, however, come with an emotional price tag. They are front-row witnesses to horrific atrocities including catastrophic natural disasters, acts of terrorism that results in mass casualties, suicides, motor vehicle accidents that result in trauma and/or death, child abuse or neglect, and acts of domestic violence.

These cumulative traumatic events have the potential to impact the individual and result in post-traumatic stress disorder (PTSD), as defined by the American Psychiatric Association. A study by Stephens and Long ( 1999 ) noted that between 12 and 35% of police officers suffered from PTSD. Another, examining the impact of suicide exposure on law enforcement found that nearly all their study participants (95%) indicated they had been exposed to an average of 30 career suicide scenes with two occurring over the 12 months prior to the study (Cerel et al.  2019 ). Additionally, it was noted that over 20% of those who responded indicated they experienced difficulties after the exposure including nightmares. After years of research, planning, and debate, the most recent version of the Diagnostic and Statistical Manual of Mental Disorders, the DSM-5, revised how PTSD was defined. It was removed from the anxiety disorder category, in part, because of the multiple emotions associated with PTSD (i.e., guilt, shame, and anger). It was subsequently placed in a new category, appropriately named “Trauma and Stressor-related Disorders”. This diagnostic category is distinctive among psychiatric disorders in the requirement of exposure to a stressful event as a “precondition” (Pai et al.  2017 p. 2.). This is significant and relevant to law enforcement because it encapsulates the symptoms they experience, often daily, over the course of their career.

It was decades after American troops returned from Vietnam that the mental health community openly acknowledged that soldiers deployed into war zones were emotionally traumatized by what they had witnessed and been exposed to. Regrettably, Vietnam veterans with PTSD symptomology did not receive proper mental health services upon their return. It was not until 1980 that the diagnosis of PTSD made its first appearance in the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-lll) published by the American Psychiatric Association. Similarly, in the quasi-military world of policing, officers too often find themselves exposed to traumatic events, but fear of being labeled as “not tough enough for the job”, “weak”, or even declared to be “unfit for duty” makes it difficult for them to display emotion and admit to experiencing stress in order to safeguard their career (Bonifacio  1991 ; Brown et al.  1994 ).

Research indicates that police officers suffer from higher-than-average instances of substance abuse and suicide when compared to the general population (Barron  2010 ; Cross and Ashley  2004 ; O’Hara et al.  2013 ). While the overall suicide rate in the USA is 13 per 100,000, the number for law enforcement is closer to 17 for every 100,000 (Hillard  2019 ). Between January 2016 and December 2019, there were over 700 reported current or former law enforcement officer deaths by suicide ( www.bluehelp.org ). In fact, it was noted that a law enforcement officer was more likely to die by suicide than to be killed in the line of duty ( www.bluehelp.org ). This work presents a summary of the literature on the most prevalent police stressors, the impact these stressors have on an officer’s physical and emotional well-being, and strategies for assistance. It further provides the findings of a descriptive, cross-sectional, and quantitative study, conducted by the authors, that examined how the variables of tenure (years of service), exposure to traumatic events, and gender and race of officer are associated with post-traumatic stress symptoms and change in officer’s worldview and perception of others.

Literature Review

Impact of long-term exposure.

There are copious amounts of research supporting the deleterious effects of police stress (Cerel et al.  2019 ; Chopko et al. 2018 ; Morash et al.  2006 ; Soomro and Yanos  2018 ; Stinchcomb  2004 ). Many of these studies focus on stress arising from one of two areas related to policing: operational stressors that would include stress from the demands and duties of the occupation and organizational stressors that include things such as a perceived lack of support, pressure from administration or a lack of opportunities to move up the hierarchy (Shane  2010 ; Stinchcomb  2004 ; Violanti  2011 ). Symptoms of long-term traumatic stress exposure, according to Marshall ( 2006 ), may appear without warning, leaving an officer confused and unprepared to cope. There is additional research, however, that focuses on the impact of law enforcement officers who have experienced mass casualty situations, did not feel comfortable seeking out any type of meaningful long-term mental health services, due to potential stigmas, and then returned to police work (Substance Abuse and Mental Health Services Administration  2018 ). The image that comes to mind is of a juggler attempting to maintain multiple fire sticks and having a double-edge sword thrown in when they were unprepared.

Witt ( 2005 ), speaking of decorated Oklahoma police officer turned convicted drug felon Jim Ramsey, summed it up best by saying:

There’s a dark underside to the heroics performed by rescue workers that is little noticed by citizens they protect: Long after the smoke clears and the last bodies are retrieved, massive disasters and terrorist attacks routinely claim additional casualties among the first responders who rush in to help, only to succumb to alcoholism, broken families and post-traumatic stress disorder (PTSD). (n.p.)

Following the September 11, 2001, attacks on the World Trade Center, Lowell et al. ( 2017 ) examined longitudinal studies of PTSD among those most exposed populations between October 2001 and May 2016. The findings suggested a significant burden of 9/11-related PTSD among those most exposed, and while most studies they examined indicated a decline in rates of the prevalence of PTSD, those of rescue/recovery workers showed an increase over time. Many of those serving in the capacity of rescue/recovery at both the Alfred P. Murrah Federal Building and the twin towers of the World Trade Center were police officers and other first responders. Telesco ( 2019 ) noted that the WTC Health Registry, who followed up on individuals directly impacted by the events of 9/11 including police officers, found an “elevated prevalence of post-traumatic stress disorder (PTSD) and physical and mental health burdens among 9/11-exposed individual’s years after exposure” (p. 10). Many of the police officers, who were physically able, went back out on the streets and to the daily stressors of being a police officer that were compounded by what they had been exposed to at ground zero.

There has been a steady stream of research conducted, over the past several decades, pertaining to the psychological impact of critical incidents on law enforcement officers. Spielberger et al. ( 1981a , b ) were early pioneers in this area focused their research specifically on areas including salary, shift work, administrative hierarchy, and job-related conflicts, as well as crises that occurred within the scope of their job were all examined.

Sheehan and Van Hasselt ( 2003 ) noted that “among law enforcement officers, job-related stress frequently contributes to the ultimate maladaptive response to stress: suicide” (p.16). Police organizations are beginning to acknowledge that they are now facing a mental health crisis of epic proportion and to combat this crisis a fundamental change in the police culture must occur. This change involves implementing proactive and ongoing mental healthcare practices with a focus on addressing the psychological equilibrium of law enforcement officers.

Similar findings were noted by Mumford et al. ( 2021 ), whose study focused on the physical and mental health of law enforcement officers as well as Price ( 2017 ), who acknowledged there had been an increase in wellness programs whose goal is to mitigate the effects of job-related stress. Finally, Price ( 2017 ) also reiterates previous findings that job-related stressors and/or exposure to critical incidents have a greater likelihood to manifest into symptoms including PTSD-like symptoms, increased alcohol abuse, increased suicide risk, relationship problems, depression, and aggressive conduct.

Law enforcement officers are subjected to not only critical incidents that occur within the day-to-day function of the job, but are also subject to other, more subtle, factors including organizational stressors (i.e., inadequate training, poor supervision, perceived inequality); additional job stressors (i.e., long hours in addition to “on call” status); public scrutiny; and specialized duties (i.e., undercover assignments, hostage rescue, or crisis negotiation). This is compounded by the normal personal problems that can occur including the physical changes that occur in our bodies as we begin to get older; increased likelihood of injury or illness; or psychological factors (Sheehan and Van Hasselt  2003 ; Wagner et al.  2020 ). These researchers noted that it was not a situation where either critical incidents or cumulative stressors alone would cause law enforcement officers undue stress, but rather the convergence of these factors.

Several studies have confirmed a relationship between the frequency by which law enforcement officers were exposed to critical incidents and PTSD symptom variables (Weiss et al.  2010 ; Chopko et al.  2015 ; Geronazzo-Alman et al.  2017 ). The instrument used for this study is the Cumulative Career Traumatic Stress Survey or CCTS. Marshall ( 2006 ) developed the CCTS based on both her experience as a law enforcement officer and as a trauma therapist. Like assertions made by Weiss et al. ( 2010 ) and Van Hasselt et al. ( 2008 ), Marshall ( 2006 ) noted that symptoms of CCTS were like PTSD with the exception that PTSD typically resulted from a single or sudden traumatic event. The impact of the event can result in the slow and subtle deterioration of the officer’s emotional and psychological stability that is more trauma than stress based. This slow deterioration can manifest in the form of intrusive thoughts, flashbacks or nightmares, anxiety, hyperarousal, sleeping and/or eating problems, disconnection from family and/or friends, emotional numbing, and moodiness. They can negatively impact the officer both personally and professionally in the form of impaired job performance, diminished physical health, or marital/family problems (Geronazzo-Alman et al.  2017 ; Marshall  2006 ; Van Hasselt et al.  2008 ). These align with the findings of previous research that focused on symptomology. An additional finding of interest made by Marshall ( 2006 ) was the change in worldview experienced since becoming a law enforcement officer. This included a change in the perception of others, a lack of trust of others, being prejudice towards others, and experiencing a change in faith/beliefs.

Tucker ( 2015 ) noted there appeared to be a gap in the literature that explores the value of organizational support, specifically in stress intervention services. She examined the likelihood of law enforcement officers voluntarily utilizing stress intervention services and found that if officers perceived their organization to be in support of these services, they would be more likely to utilize them. Conversely, if there was the perception of an officer being stigmatized using these services, there was a significant decline in their willingness to do so.

Changing an Ingrained Culture

The federal government has taken steps to ensure the mental health crisis within law enforcement organizations is addressed via the Law Enforcement Mental Health and Wellness Act of 2017 ( 2017 ). The philosophy underlying the policy is to assess whether law enforcement agencies have implemented mental health and wellness programming and determine what impact the implementation of those services has had on their officers and organizations. It incorporates a holistic approach to police officers, staff, and their family’s mental health and wellness after research indicated a direct correlation between the occupation and higher rates of chronic physical illnesses, domestic incidents, substance abuse, and mental health disorders including depression, anxiety, and PTSD. The final report was presented to Congress in early 2019 by Spence et al. ( 2019 ) and included information related to services and resources available to military veterans and law enforcement officers.

That same year, Copple et al. ( 2019 ) submitted a report to the DOJ that provided an overview of several successful and promising law enforcement mental health and wellness strategies that had been implemented in a diverse group of police agencies across the country including agencies creating a sense of ownership and support for the programs from the top police administrative officials down. In addition, the report included a summary of the peer crisis response hotline (Cop2Cop) including the design elements of a hotline and the necessary follow-up care and support provided by well-trained officers communicating with other officers. The report acknowledged that many police agencies have, in place, employee assistance programs (EAP) that are sponsored by the local government where they are located.

Based on the literature, there is a critical need to develop more comprehensive services for police officers exposed to traumatic events and police stress and implement early prevention assessment along with mental health and wellness strategies that are proactive rather than reactive. The current study examines the relationship between years of service, traumatic events, and deleterious outcomes of post-traumatic symptoms and change in perception of world and others. The authors also explored whether these outcomes are different among demographic factors.

Research Questions and Hypotheses

Research questions related to the independent variable = tenure/years of service.

RQ # 1: Is officer tenure (years of service) associated with reported traumatic events?

HR # 1: Officer tenure (years of service) is associated with reported traumatic events.

RQ # 2: Is officer tenure (years of service) associated with reported post-traumatic symptom (PTS) outcomes?

HR # 2: Officer tenure (years of service) is associated with reported post-traumatic symptom (PTS) outcomes.

RQ # 3: Is officer tenure (years of service) associated with reported changes in perception of world and others?

HR # 3: Officer tenure (years of service) is associated with reported changes in perception of world and others.

Research Questions Related to the Independent Variable = Traumatic Events

RQ # 4: Are traumatic events associated with reported post-traumatic symptoms (PTS) outcomes?

HR # 4: Traumatic events are associated with reported post-traumatic symptoms (PTS) outcomes.

RQ # 5 Are traumatic events associated with reported changes in perception of world and others?

HR # 5: Traumatic events are associated with reported changes in perception of world and others.

Research Questions Related to Independent Variable = Race/Gender

RQ # 6: Is there a difference in reported traumatic events or psychological/behavioral outcomes on demographic characteristics of gender and race?

HR # 6: There is a difference in reported traumatic events or psychological/behavioral outcomes on demographic characteristics of gender and race?

An IRB approved, cross-sectional, descriptive study was conducted utilizing a convenience sample of law enforcement officers yielding a total of 408 respondents ( n  = 408). To address the research questions, the Cumulative Career Traumatic Stress Questionnaire-CCTS-R (Marshall  2006 ) was administered (Fig.  1 ). The CCTS-R is a 60-item instrument and includes items measuring their opinion of others; their trust of others; their prejudice towards others; and whether they had experienced a change in faith or religious beliefs, job-related traumatic events, PTSD-like symptoms or experiencing personal/behavioral changes, and whether there was a history of anxiety/depression prior to becoming a sworn law enforcement officer. The instrument is broken down into 4 sections; part I asks respondents to self-report on demographic information (race, gender, rank, years of service, etc.); part II represents 20 items related to traumatic events as respondents to self-report with Yes/No whether they have experienced any of the items since being on the job. Some of the items include Have you confronted a person with a gun? Have you been involved in a shooting? Has a co-worker been shot or killed while on-duty? Have you responded to an incident involving the death of a child? Respondent’s scores can range from 20 to 40 (40 representing the highest reporting of traumatic events).

Study conceptual model

Part III represents 15 items related to post-traumatic stress symptoms, and part IV represents 11 items specific to change in perception of the world and others and contains Likert type responses. Examples of the items include Since being on the job …. I have experienced nightmares as a result of an incident, I have experienced flashbacks of an incident, I experience recurring memories of an event after being reminded by another event, I re-experience physical reactions of an event after being reminded by another event. The lowest possible self-reported post-traumatic stress symptom being a score of 15 and the highest score being 60.

Lastly, the world view and perception of others section represents 11 items that asks respondents to self-report on whether their perception of the world or others has changed since being on the job. Some examples include My opinion of other people has changed, I no longer trust others. Stress from the job has affected my relationship with family members. These scores range from 11 to 44 with 44 indicating the highest change in perception of the world and others.

Descriptive Statistics

The sample population of 408 respondents represented 83% male and 17% female. Over 81% ( n  = 332) identified as being Caucasian; about 5% ( n  = 23) identified as being African American; and 6% ( n  = 26) identified as being Hispanic American. There were significantly lower numbers of those who identified as Asian American (2%) and Native American less than 1%. Close to 3% reported “Other”.

In terms of education and rank, 53% of the sample indicated they held either an associate or baccalaureate degree, and nearly 30% indicated having some college. About 7% of the sample reported “no college” at all. For the variable “Rank”, 35% identified their rank as “Police Officer or Police officer /Trooper 1st Class”, while the rank of “Sergeant and Corporal” accounted for about 29% of the sample. Over 26% reported their rank as lieutenant or above and 10% identified their rank as “other”. While the average number of years reported was 4 years, close to 28% reported having 26 + years.

For the items representing traumatic events , the findings indicated that most officers in the sample had experienced a major traumatic event in their career with close to 92% of the sample reporting that they had confronted a person possessing a gun. Ninety eight percent of the sample indicated that they had confronted a person possessing a weapon other than a firearm and having to use force other than deadly force. The most disturbing call that officers identified was a child abuse/neglect or death of a child complaint. Eighty six percent reported a child abuse/neglect complaint and 73% involving the death of a child. One of the items that is most interesting and consistent with the literature is that 35% of the sample reported that they had a co-worker who committed suicide and 7% of the sample reported that they “sometimes think of suicide” (Hackett and Violante  2003 ; O'Hara et al.  2013 ).

One finding that is inconsistent with the literature is that 42% of the sample reported never using alcohol to relax and less than 10% report never using alcohol. According to the Substance Abuse & Mental Health Data Archive (Substance Abuse and Mental Health Services Administration  2019 ), among the 139.7 million current alcohol users aged 12 or older in 2019 in the USA, 65.8 million people (47.1%) were past month binge drinkers. The literature on police alcohol use indicates a much higher prevalence than reported in this sample (Ménard and Arter  2013 ; Chopko et al.  2013 ).

Among the Change in WorldView and Perception of Others items, the findings showed that close to 40% of the sample no longer trusts others and feels that the world is an unsafe place. Consistent with the literature on police and their family relationships, 36% of the sample reported that the stress from the job has affected their relationship with family members (Karaffa et al.  2015 ). Interestingly 43% of the sample report never having lost faith in religious beliefs. This finding indicates that future research on faith as a coping strategy is worth investigating.

The post-traumatic stress items show that close to 40% of the sample have experienced nightmares as a result of an incident or incidents, had flashbacks of an incident, or experienced recurring memories. A small minority of the sample (14%) reported having no trouble sleeping. Close to 44% of the sample reported that they have difficulty concentrating and experience jumpiness or restlessness. All of these descriptive findings are consistent with the literature on stress symptoms in police (Marshall  2006 ).

Scales Internal Consistency

A reliability analysis was run on the three subscales of the cumulative career traumatic stress measurement. Part II of the instrument represented “Traumatic Events” items, part II I represented “Post Traumatic Symptoms” items, and part IIV represented “Perception of World/Others” items. For part II traumatic events, the findings indicate a Cronbach’s alpha coefficient of α = 0.71 (Table 1 ). The Cronbach’s alpha coefficient for post-traumatic symptoms was reported as α = 0.91 (Table 2 ) and worldview/perception of others α = 0.85 (Table 3 ).

Inferential Statistics

Tenure/years of service and traumatic event, pts, and world view/perception of others.

To test hypotheses HR # 1, a Spearman’s correlation was run to assess whether there was a relationship between years of service in law enforcement and traumatic events, post-traumatic stress symptoms, and worldview and perception of others. Table 1 illustrates that years of service was significantly correlated with traumatic events (0.471) supporting hypothesis # 1. HR # 2 and HR # 3 were not supported by the analysis (Table 4 ).

Traumatic Events and PTS Symptoms/WorldView Perception of Others

To test hypotheses HR #4 and 5, a Spearman’s correlation was run to assess whether there was a relationship between Traumatic Events and PTS symptoms. Table 5 indicates a significant association at 0.383. Traumatic events and worldview/perception of others were significantly correlated at 0.272 (Table 6 ). HR # 6 was not supported.

Traumatic Event, PTS, WorldView, and Race/Gender

HR # 6: There is a difference for traumatic events, PTS symptoms, and worldview on the demographic variables of gender and race.

An independent t -test and ANOVA were run to determine whether there were differences among gender and race on the independent variables. These hypotheses were not supported showing no significant differences.

The findings from this study support the literature that perpetual long-term exposure to critical incidents and traumatic events, within the scope of the duties of a law enforcement officer, has negative implication that can impact both their physical and mental well-being. These symptoms become exacerbated when the officer perceives that receiving any type of service to address these issues would not be supported by law enforcement hierarchy and could, in fact, lead to the officer being declared unfit for duty. The symptoms may be in the form of increased physical ailments, including increased instances of injuries sustained on the job and increased stress-related diagnoses including gastrointestinal ulcers or hypertension. It could also manifest in the form of a significant personality or behavioral change including an officer being quicker to get into a physical altercation with a citizen, increased instances of domestic altercations, increased instances of alcohol and/or prescription drug abuse, noted depression, or suicide. Of interest was that this study did not indicate a correlation between years of service and increased alcohol abuse or between years of service, and a loss of faith and/or religious beliefs yet did indicate an overall loss of faith in the goodness and trustworthiness of people. These specific variables warrant further research to determine if the lack of reported alcohol abuse was simply underreported by this sample or if it indicates something altogether different, for example, the beginning of a change in police culture that no longer stigmatizes officers who seek help after experiencing a traumatic event. Additionally, what role does an individual’s faith or religious beliefs play in their ability to cope with the stressors of the job of being a law enforcement officer? Did they have faith to begin with? If so, was that faith the catalyst that allowed them to persevere during their darkest times on the job? Cox et al. ( 2019 ) indicated that law enforcement officers may, as a survival mechanism, become more cynical, yet the results from this study indicated no significant correlation existed. Additionally, this research did not include an exploration of size and location of the department or type of traumatic event. These variables are worthy of examination for future research as they may either modify or confound the outcome variable.

Implications

Dawson ( 2019 ) notes, “The ‘bulletproof cop’ does not exist. The officers who protect us must also be protected against incapacitating physical, mental and emotional health problems, as well as against the hazards of their jobs” (n.p.). This work contributes to the existing literature by providing empirical evidence to support the need for law enforcement administrators and systems to take a more proactive approach in addressing the mental health and well-being of law enforcement officers. The 2017 Law Enforcement Mental Health and Wellness Act and other subsequent studies provide evidence demonstrating that police agencies who have implemented holistic proactive approaches to officer’s mental health report a decline in the negative impacts of job-related stressors. In an attempt to encourage more of these cultural changes and reduce stigmas associated with police mental health, there are federal grant opportunities for law enforcement agencies to take advantage of to help fund programming. These grants can offer police agencies an opportunity to implement critical infrastructure changes as well as important and evidenced based mental health programming. Investing in our police and their mental and physical well-being may help reduce instances of alcohol abuse, relationship conflict, suicidal ideation, negative perception of others, abuse of authority and excessive force complaints, and officer turnover.

Law enforcement agencies with proactive approaches to mental health report that these efforts lead to recruiting stronger candidates. A mental health paradigm shift from stigma to support can help officers learn strategies to cope with police stressors and traumatic events in a healthy way. The importance of all stakeholders, politicians, police administrators, police unions, and the rank-in file officers themselves, need to “buy-in” to this paradigm shift as a collaborative effort between law enforcement and mental health professionals to help heal our police officers is crucial.

As with any new relationship, and especially in the police culture where suspicion and doubt have become second nature, there needs to be adequate time for trust and a bond to form so that officers feel they can openly and honestly discuss without fear of administrative reprisals. This relationship should ideally begin during the cadet phase and be encouraged to continue throughout the officer’s career. The results of this current study demonstrate that the longer the officer is on the job, the more likely they are to experience traumatic events, thus leading to deleterious mental health outcomes. Therefore, the open lines of trust and communication must be present throughout the officer’s entire tenure with the department.

Critical incidents and job stressors are an unfortunate part of being a law enforcement officer. The key to success, however, is openly acknowledging them, removing the long-standing stigma, having open and honest discussions, and learning strategies of coping with them. Further studies on police stress and mental health outcomes are necessary to be explored in large and small departments as well as rural and urban police agencies. Law enforcement agencies spend millions of dollars each year in training and equipment for officers to ensure their protection and safety. Implementing holistic proactive approaches to that same officer’s mental health and well-being should be treated as an additional piece of equipment they carry with them that allows them to be more effective in their respective roles of protecting and serving the public.

Recommendations for Intervention Strategies

As mentioned earlier, this population is unique in the willingness to seek psychological assistance and support in the first place. Officer perceptions of stigma can be considered an enormous barrier to treatment (Milot  2019 ). Police departments can provide stronger support for their officers by seeking to employ evidenced based and trauma informed assistance. The impact that policing has on an officer’s “worldview” and the ability to navigate the bombardment of traumatic exposure is the challenge for law enforcement executives. Officers are immersed in the experience of interacting with people when they are at their worst. These officers have a front row seat to human suffering. This trauma informed compassion fatigue, burnout, cynicism, and other deleterious psychological outcomes should be a wake-up call to policymakers. Early intervention methods, counseling and psychological services, and peer support are among the common intervention strategies. Stigma and fear of job security are among the reasons that officers are not engaging in these strategies. An officer who is experiencing the impact that traumatic events have on psychological well-being and overall mental health reluctant to come to the supervisor with an honest appraisal of their psychological well-being for fear of having their guns taken away from them and being placed on desk duty. Police executives and policymakers need to investigate intervention strategies that align with the officer’s comfort zone.

There are evidence-based officer mental health and wellness policies and programs that afford officers the proper treatment needed for depression, anxiety, alcohol and prescription medication abuse, and post-traumatic stress syndrome. At the policymaking level, police departments could implement a broad continuum of officer mental health and wellness policies and programs. These strategies include providing officers with access to information on mental health resources, annual mental health wellness checks, in-service stress management awareness training, peer support initiatives, and psychological services (McManus and Argueta 2019 ). Until police executives, administrators, policymakers, legislators, and others in authority are willing to spend the resources, personnel, time, and energy in improving mental health services for police officers, we will continue to see the deleterious impact that trauma and critical event exposure have on these men and women in blue.

Availability of Data and Material

SPSS data electronically stored and available.

Balaban S, Doubek J (2019) After husbands' suicides, 'best widow friends' want police officers to reach for help. NPR.org. https://www.npr.org/2019/06/09/724283309/after-husbands-suicides-best-widow-friends-want-police-officers-to-reach-for-hel . Accessed 30 Jul 2020

Barron S (2010) Police officer suicide within the New South Wales police force from 1999 to 2008. Police Pract Res 11(4):371–382. https://doi.org/10.1080/15614263.2010.496568

Article   Google Scholar  

Blue H.E.L.P (n.d.)  https://www.bluehelp.org . Accessed 30 Jul 2020

Bonifacio P (1991) The psychological effect of police work. Plenum Press

Book   Google Scholar  

Brown JM, Wormald J, Campbell EA (1994) Stress and policing: Sources and strategies. John Wiley & Son

Chopko B, Palmieri P, Adams R (2013) Associations between police stress and alcohol use: Implications for practice. J Loss Trauma 18(5):482–497. https://doi.org/10.1080/15325024.2012.719340

Cerel J, Jones B, Brown M, Weisenhorn D, Patel K (2019) Suicide exposure in law enforcement officers. Suicide Life Threat Behav 49(5):1281–1289

Chopko B, Palmieri P, Adams R (2015) Critical incident history questionnaire replication: frequency and severity of trauma exposure among officers from small and midsize police agencies. J Trauma Stress 28(2):157–161. https://doi.org/10.1002/jts.21996

Article   PubMed   Google Scholar  

Chopko B, Palmieri P, Adams R (2018) Relationships among traumatic experiences, PTSD, and posttraumatic growth for police officers: a path analysis. Psychol Trauma Theory Res Pract Policy 10(2):183–189

Copple C, Copple J, Drake J, Joyce N, Robinson M, Smoot S, Stephens D, Villaseñor R (2019) Law enforcement mental health and wellness programs: eleven case studies (371). Department of Justice. https://cops.usdoj.gov/RIC/Publications/cops-p370-pub.pdf . Accessed 30 Jul 2020

Cox S, Massey D, Koski C, Fitch B (2019) Introduction to Policing. 4th ed., Sage Publications. Washington, D. C

Cross C, Ashley L (2004) Police trauma and addiction: coping with the dangers of the job. PsycEXTRA Dataset. https://doi.org/10.1037/e311382005-006

Dawson J (2019) Fighting stress in the law enforcement community. Natl Inst Justice J. https://nij.ojp.gov/topics/articles/fighting-stress-law-enforcement-community . Accessed 30 Jul 2020

Geronazzo-Alman L, Eisenberg R, Shen S, Duarte C, Musa G, Wicks J, Fan B, Doan T, Guffanti G, Bresnahan M, Hoven C (2017) Cumulative exposure to work-related traumatic events and current post-traumatic stress disorder in New York city’s first responders. Compr Psychiatry 74:134–143. https://doi.org/10.1016/j.comppsych.2016.12.003

Hackett D, Violante J (2003) Police suicide: tactics for prevention. Springfield, IL: C. C. Thomas

Hillard J (2019) New study shows police at highest risk for suicide than any profession. Addiction Center. https://www.addictioncenter.com/news/2019/09/police-at-highest-risk-for-suicide-than-any-profession/ . Accessed 30 Jul 2020

Karaffa K, Openshaw L, Koch J, Clark H, Harr C, Stewart C (2015) Perceived impact of police work on marital relationships. Fam J 23(2):120–131. https://doi.org/10.1177/1066480714564381

Law Enforcement Mental Health and Wellness Act. U.S.C. S.867 (2017) https://www.congress.gov/bill/115th-congress/senate-bill/867 . Accessed 30 Jul 2020

Lowell A, Suarez-Jimenez B, Helpman L, Zhu X, Durosky A, Hilburn A, Schneier F, Gross R, Neria Y (2017) 9/11-related PTSD among highly exposed populations: a systematic review 15 years after the attack. Psychol Med 48(4):537–553. https://doi.org/10.1017/s0033291717002033

Article   PubMed   PubMed Central   Google Scholar  

Marshall E (2006) Cumulative career traumatic stress (CCTS): a pilot study of traumatic stress in law enforcement. J Police Crim Psychol 21(1):62–71. https://doi.org/10.1007/bf02849503

McManus HD, Argueta J Jr (2019) Officer wellness programs: research evidence and a call to action. Police Chief 86(10):16. Retrieved from https://ezproxylocal.library.nova.edu/login?url=https://www.proquest.com/trade-journals/officer-wellness-programs-research-evidence-call/docview/2307719208/se-2?accountid=6579 . Accessed 22 Oct 2021

Ménard K, Arter M (2013) Police officer alcohol use and trauma symptoms: associations with critical incidents, coping, and social stressors. Int J Stress Manag 20(1):37–56. https://doi.org/10.1037/a0031434

Milot M (2019) Stigma as a barrier to the use of employee assistance programs. A Workreach Solutions research report

Moore T, Celona L (2019) Off-duty veteran NYPD cop commits suicide, ninth this year. New York Post. https://nypost.com/2019/08/14/off-duty-veteran-nypd-cop-shoots-himself-in-the-head-in-queens/ . Accessed 30 Jul 2020

Morash M, Haarr R, Kwat D (2006) Multilevel influences on police stress. J Contemp Crim Justice 22(1):26–43. https://doi.org/10.1177/1043986205285055

Mumford E, Liu W, Taylor B (2021) Profiles of U.S. law enforcement officers’ physical, psychological, and behavioral health: results from a nationally representative survey of officers. Police Q. https://doi.org/10.1177/1098611121991111

O’Hara A, Violanti J, Levenson R, Clark R (2013) National police suicide estimates: web surveillance study III. Int J Emerg Ment Health and Human Resilience 15(1):31–38

Pai A, Suris A, North C (2017) Posttraumatic stress disorder in the DSM-5: controversy, change, and conceptual considerations. Behav Sci 7(4):7. https://doi.org/10.3390/bs7010007

Article   PubMed Central   Google Scholar  

Pinellas County Sheriff's office (2017) 17–238 off-duty sergeant dies of self-inflicted gunshot wound in Largo -. Pinellas County Sheriff's Office. https://pcsoweb.com/17-238-off-duty-sergeant-dies-of-self-inflicted-gunshot-wound-in-largo . Accessed 30 Jul 2020

Price M (2017) Psychiatric disability in law enforcement. Behav Sci Law 35:113–123

Shane J (2010) Organizational stressors and police performance. J Crim Just 38:807–818

Sheehan DD, Van Hasselt VB (2003) Identifying law enforcement stress reactions early. PsycEXTRA Dataset, 12-17. https://doi.org/10.1037/e314622004-002

Soomro S, Yanos P (2018) Predictors of mental health stigma among police officers: the role of trauma and PTSD. J Police Crim Psychol 34:175–183

Spence DL, Fox M, Moore GC, Estill S, Comrie N (2019) Law enforcement mental health & wellness act: report to congress. Department of Justice. https://cops.usdoj.gov/RIC/Publications/cops-p370-pub.pdf . Accessed 30 Jul 2020

Spielberger CD, Westberry LG, Grier KS, Greenvield G (1981a) Police stress survey: sources of stress in law enforcement. https://www.ncjrs.gov/pdffiles1/Digitization/80993NCJRS.pdf . Accessed 30 Jul 2020

Spielberger CD, Westberry LG, Grier KS, Greenvield G (1981b) Police stress survey (PSS). Statistics Solutions. https://www.statisticssolutions.com/police-stress-survey-pss/ . Accessed 30 Jul 2020

Stephens C, Long N (1999) Posttraumatic stress disorder in the New Zealand police: the moderating role of social support following traumatic stress. Anxiety Stress Coping 13(3):247–265

Stinchcomb JB (2004) Searching for stress in all the wrong places: combating chronic organizational stressors in policing. Police Pract Res 5(3):259–277. https://doi.org/10.1080/156142604200227594

Substance Abuse and Mental Health Data Archive (2018) Disaster technical assistance center supplemental research bulletin: first responders: behavioral health concerns, Emergency response, and trama. https://www.samhsa.gov/sites/default/files/dtac/supplementalresearchbulletin-firstresponders-may2018.pdf . Accessed 30 Jul 2020

Substance Abuse and Mental Health Data Archive (2019) National Survey of Drug Use and Health 2019. https://www.samhsa.gov/data/release/2019-national-survey-drug-use-and-health-nsduh-releases . Accessed 30 Jul 2020

Telesco GA (2019) Never forget, sometimes forgotten, often haunted. Journal of the American Academy of Experts in Traumatic Stress, Fall Issue

Tucker JM (2015) Police officer willingness to use stress intervention services: the role of perceived organizational support (POS), confidentiality and stigma. OMICS 17(1):304–314

Van Hasselt VB, Sheehan DC, Malcolm AS, Sellers AH, Baker MT, Couwels J (2008) The law enforcement officer stress survey (LEOSS). Behav Modif 32(1):133–151. https://doi.org/10.1177/0145445507308571

Violanti JM (2011) Police organizational stress: the impact of negative discipline. Int J Emerg Ment Health 13(1):31–36

PubMed   Google Scholar  

Wagner S, White N, Fyfe T, Matthews L, Randall C, Regehr C, White M, Alden L, Buys N, Carey M, Corneil W, Fraess- Phillips A, Krutop E, Fleishmann M (2020) Systematic review of post traumatic stress disorder in police officers following routine work-related critical incident exposure. Am J Ind Med 63:600–615

Weiss D, Brunet A, Best S, Metzler T, Liberman A, Pole N, Fagan J, Marmar C (2010) Frequency and severity approaches to indexing exposure to trauma: the critical incident history questionnaire for police officers. J Trauma Stress 23(6):734–743. https://doi.org/10.1002/jts.20576

Witt H (2005) Jim Ramsey: tragedy haunts the heroes. Chicago Tribune. https://www.chicagotribune.com/business/careers/chi-0504180178apr18-story.html . Accessed 30 Jul 2020

Download references

Author information

Authors and affiliations.

Department of Social Science, 344 Gilchrist Education and Psychology Complex (Office), Division of Academic Affairs, Elizabeth City State University, 1704 Weeksville Road, Elizabeth City, NC, 27909, USA

Tina B. Craddock

Abraham S. Fischler College of Education, School of Criminal Justice, Nova Southeastern University, 3301 College Ave, Davie, FL, 33314, USA

Grace Telesco

You can also search for this author in PubMed   Google Scholar

Corresponding author

Correspondence to Tina B. Craddock .

Ethics declarations

Ethics approval.

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Consent to Participate

Informed consent was obtained from all individual participants included in the study.

Conflict of Interest/Competing Interests

The authors declare no competing interests.

Additional information

Publisher's note.

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Craddock, T.B., Telesco, G. Police Stress and Deleterious Outcomes: Efforts Towards Improving Police Mental Health. J Police Crim Psych 37 , 173–182 (2022). https://doi.org/10.1007/s11896-021-09488-1

Download citation

Accepted : 25 October 2021

Published : 09 November 2021

Issue Date : March 2022

DOI : https://doi.org/10.1007/s11896-021-09488-1

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

• PTSD in law enforcement
• Critical Incidents
• Cumulative Career Traumatic Stress
• Work-related stressors in law enforcement
• Find a journal
• Publish with us
• Track your research

Police stressors and health: a state-of-the-art review

Affiliations.

• 1 The State University of New York at Buffalo, Buffalo, New York, USA.
• 2 Health Effects Laboratory, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA.
• PMID: 30846905
• PMCID: PMC6400077
• DOI: 10.1108/PIJPSM-06-2016-0097

Purpose –: The purpose of this paper is to provide a state-of-the-art review on the topic of police stressors and associated health outcomes. Recent empirical research is reviewed in the areas of workplace stress, shift work, traumatic stress, and health. The authors provide a comprehensive table outlining occupational exposures and related health effects in police officers.

Design/methodology/approach –: A review of recent empirical research on police stress and untoward psychological and physiological health outcomes in police officers.

Findings –: The results offer a conceptual idea of the empirical associations between stressful workplace exposures and their impact on the mental and physical well-being of officers.

Research limitations/implications –: A key limitation observed in prior research is the cross-sectional study design; however, this serves as a motivator for researchers to explore these associations utilizing a longitudinal study design that will help determine causality.

Originality/value –: This review provides empirical evidence of both mental and physical outcomes associated with police stress and the processes involved in both. Research findings presented in this paper are based on sound psychological and medical evidence among police officers.

Keywords: Law enforcement; Post-traumatic stress disorder; Psychological health; Resilience; Traumatic events; Work schedules.

Grants and funding

• CC999999/Intramural CDC HHS/United States
• R01 OH010807/OH/NIOSH CDC HHS/United States

•   UMB Digital Archive
• School of Social Work
• Employee Assistance Archive School of Social Work

Police stressors and health: a state-of-the-art review

Description

Rights/terms, identifier to cite or link to this item, collections.

The following license files are associated with this item:

• Creative Commons

entitlement

Export search results

The export option will allow you to export the current search results of the entered query to a file. Different formats are available for download. To export the items, click on the button corresponding with the preferred download format.

By default, clicking on the export buttons will result in a download of the allowed maximum amount of items.

To select a subset of the search results, click "Selective Export" button and make a selection of the items you want to export. The amount of items that can be exported at once is similarly restricted as the full export.

After making a selection, click one of the export format buttons. The amount of items that will be exported is indicated in the bubble next to export format.

• Research article
• Open access
• Published: 15 October 2019

The relationship between organisational stressors and mental wellbeing within police officers: a systematic review

• Amrit Purba 1 &
• Evangelia Demou   ORCID: orcid.org/0000-0001-8616-525X 2  

BMC Public Health volume  19 , Article number:  1286 ( 2019 ) Cite this article

39k Accesses

137 Citations

16 Altmetric

Metrics details

Occupational stressors in police work increase the risk for officer mental health morbidities. Officers’ poor mental wellbeing is harmful to the individual, can affect professionalism, organisational effectiveness, and public safety. While the impact of operational stressors on officers’ mental wellbeing is well documented, no review has systematically investigated organisational stressor impacts. This study aimed to conduct a systematic review to assess the relationship between organisational stressors and police officer mental wellbeing.

Systematic review conducted following PRISMA and Cochrane Collaboration guidelines. Literature search was undertaken from 1990 to May 2017 on four databases (EBSCOHOST Medline/SocINDEX/PsycINFO/OVID Embase) and grey literature. Included articles were critically appraised and assessed for risk of bias. Narrative and evidence syntheses were performed by specific mental health outcomes.

In total, 3571 results were returned, and 15 studies met the inclusion criteria. All included studies were published in English between 1995 and 2016, had cross-sectional study designs, spanned across four continents and covered 15,150 officers. Strong evidence of significant associations was identified for organisational stressors and the outcomes of: occupational stress, psychiatric symptoms/psychological distress, emotional exhaustion and personal accomplishment. The organisational stressors most often demonstrating consistently significant associations with mental health outcomes included lack of support, demand, job pressure, administrative/organisational pressure and long working-hours.

Conclusions

This review is the first to systematically examine organisational stressors and mental health in police officers. Organisational stressors that can be targeted by interventions and policy changes to secure officer wellbeing, a healthy work environment, and benefits to the organisation and the public are identified.

Peer Review reports

Mental wellbeing (MW) in police officers

Mental health (MH) disorders are a leading cause of long-term work incapacity and sickness absence [ 1 ]. The rise in MH problems over the past decade in the working population has spurred increased public, policy and academic interest [ 2 , 3 , 4 ], leading to a focus of research on the role of work environments and lifestyle behaviours on mental wellbeing (MW) across occupational groups [ 5 , 6 , 7 ].

The police work environment has many occupational stressors and exposures that can lead to increased risk for mental health morbidities [ 8 ]. Policing is one of the most stressful occupations as maintained by academic researchers, police practitioners, health-care professionals and psychologists [ 9 , 10 , 11 , 12 ] and it ranks in the top three occupations in the Occupational Disease Intelligence Network (ODIN) system for Surveillance of Occupational Stress and Mental Illness (SOSMI) [ 13 ]. Police officers experience the same combination of MH issues as the general working population [ 14 , 15 ]; however, their work is compounded by frequent exposure to inherently dangerous situations, which require a different level of physical and mental ability to respond effectively [ 16 , 17 , 18 ]. While this can predispose police officers to stress, some research suggests that individual coping mechanisms can become embedded in police officers personalities, allowing them to cope and accept stressful situations as natural requirements of their role [ 19 , 20 ] and be more resilient to stress than civilians [ 5 ]. Fitness for work is central to professional police standards [ 21 , 22 ]. Therefore, determining which occupational stressors are related to specific MW outcomes may improve police officer wellbeing and contribute to organisational effectiveness [ 22 ].

Occupational stressors in police work

Intrinsic to police work is the daily experience of intensely stressful situations in often higher frequencies than most other occupations [ 23 , 24 ]. Constant exposure to people suffering distress and pain, threats to officer safety and wellbeing, having to be in control of emotions when provoked, the inconclusive nature of police work, the responsibility of being in possession of a firearm and more importantly the responsibility of protecting the lives of citizens have been recognised as significant sources of stress [ 25 ]. These daily activities are constantly under scrutiny due to the societal and political expectations put on human-service professions [ 26 ]. As human-service jobs entail a great deal of interaction with the public, police officers are often expected to display and/or manage particular feelings as part of their job, considered a form of ‘emotional labour’ [ 27 , 28 ].

Territo and Vetter [ 29 ] suggested the stressors affecting police officers could be grouped into four categories (organisational practices and characteristics, criminal justice system practices and characteristics, public practices and characteristics and police work itself). These four categories can be further classified into operational and organisational stressors [ 30 , 31 ]; the former associated with the very nature of police work, including job-related violence [ 32 ], exposure to danger and facing the unknown [ 32 ], court overtime [ 33 , 34 ], and the latter related to organisational administration, management, structure and processes [ 32 ].

Organisational stressors have been suggested to be a greater source of stress for police officers [ 35 , 36 ] because officers may recognise them as oppressive [ 37 ], unnecessary [ 37 ], unavoidable [ 37 ] and uncontrollable [ 38 , 39 ]. Organisational stressors suggested to contribute to the manifestation of stress include lack of support, heavy work load [ 32 ], interpersonal conflict with colleagues and supervisors [ 40 ], inadequate resources, time pressure, and an overly bureaucratic organisational system, punitive of staff and strictly managed [ 40 , 41 ]. These findings seem to hold over cross-cultural comparisons cross the UK [ 30 , 42 , 43 ], USA [ 44 , 45 ], South Africa [ 46 , 47 ] and other foreign police agencies [ 44 , 45 ]. Within the existing evidence base the MW outcomes commonly demonstrating or suggested to be associated with organisational stressors in police officers are occupational stress [ 48 , 49 ], anxiety [ 50 ], depression [ 50 , 51 ], psychiatric symptoms (PS)/psychological distress (PD) [ 51 , 52 ], burnout [ 51 , 53 ] and suicidal ideation [ 54 ].

Understanding the risk factors to mental wellbeing in the police workforce is paramount [ 11 , 42 , 55 ], as police play a vital role in the maintenance of society. A previous systematic review [ 56 ], assessed coping behaviours adopted by police but did not focus on associations between occupational stressors and MW. The aim of our review, is to examine the associations of organisational stressors in police work with the mental wellbeing outcomes of: occupational stress, anxiety, depression, psychological distress (PD), psychiatric symptoms (PS), burnout (a composite measure of depersonalisation (DP), personal accomplishment (PA) and emotional exhaustion (EE)), and suicidal ideation.

Systematically review the literature to assess the relationship between organisational stressors and police officer mental wellbeing.

Review methodology

The review was carried out systematically following the Cochrane Handbook for Systematic Reviews [ 57 ] and PRISMA Statement [ 58 ] guidance; the narrative synthesis followed the Economic and Social Research Council (ESRC) guidelines [ 59 , 60 ].

Eligibility criteria

Inclusion criteria were set priori and were based on the Population, Intervention, Comparison and Outcome (PICO) framework [ 59 , 61 ] (Additional file  2 : Table S2). A scoping search was conducted in EMBASE to pre-test the suitability and adequacy of the PICO criteria. Inclusion criteria included: police personnel from various ranks of any age or gender, including trainees and recruits; studies that considered other occupational groups as well as the police were suitable if a separate analysis of the relationship between organisational stressors and police MW could be extracted (study population); studies identifying one or more organisational stressors in relation to police MW (exposure); MH outcomes measured by general measures of wellbeing such as self-reported perceptions of health status, subjective MH, studies considering physiological, organisational or personal outcomes as well as MW outcomes, were suitable if a separate analysis of the relationship between organisational stressors and police MW outcomes could be extracted (outcomes); all study designs were included.

Studies were excluded if they involved correctional, prison, probation officers, police veterans, military, army and navy personnel, police forensic personnel, civilian (non-sworn police) and traffic police; stressors not inherent in police work; physiological/biological indicators of MH and organisational and personal outcomes (i.e. job satisfaction, job commitment); poster articles and information pieces; and studies that only assessed the prevalence of organisational stressors or MW outcomes.

Databases and information sources

A comprehensive literature search was conducted from the period of 10th May to 16th May 2017. The electronic medical and social science databases consulted were Medline, PsycINFO, SocINDEX and Embase. In addition, grey literature sources were searched using the same criteria [ 62 ]. Prior to checking grey literature sources, a literature search on police accountability and governance was conducted to ensure all professional bodies and regulators relevant to the police force were considered. The final grey literature sources consulted are reported in Additional file 2 : Table S3. Additionally, experts in the field of police stress literature were contacted (Personal Communication 1, See Additional file  1 : Table S1).

Search strategy

An initial scoping search with no restrictions or limitations was conducted using a combination of free-text search terms [ 63 ]. Returned search results were reviewed to identify potentially relevant subject headings, free-text terms and phrases. The final search strategies were constructed from combinations of MeSH and keywords/free-text terms, adjusted for each database. Search results were limited to studies published in English with no geographic restrictions (potential concerns due to cultural differences were noted [ 64 ]). Studies published between 1990 to search date (16th May 2017) were considered. The detailed search strategies are presented in Additional file 2 : Tables S4, S5, S6 and S7.

Study selection

The PICO inclusion criteria were incorporated into an electronic screening tool [ 65 ], to standardise the selection process (Additional file  3 : Table S8); and piloted on 30 studies [ 59 , 66 ]. All titles and abstracts were then screened for eligibility using the PICO criteria [ 67 ]. Full-texts were screened by one reviewer (AP) and analogous to abstract and title screening, 10% of full-text studies were screened independently by a second reviewer (ED). Hand searching was conducted on the reference lists (AP). Grey literature sources and Google scholar results were also screened (AP) using the electronic screening tool on abstracts and titles. Sources, which could inform the review, but did not satisfy the inclusion criteria were noted. A data extraction form was developed to facilitate and standardise data extraction [ 59 , 68 , 69 ]; this was piloted on 10 included studies [ 57 ]. Study authors were contacted if further information or clarification was required (Personal Communication 2, See Additional file 1 : Table S1).

Risk of Bias assessment

Eligible studies were assessed for risk of bias [ 57 , 58 ], using a previously modified version of the Newcastle-Ottawa Scale (NOS) [ 70 , 71 ]. Studies scored as high (7–10 stars), intermediate (5–7 stars) or low quality (1–4 stars) [ 72 , 73 , 74 , 75 ]. The modified NOS, was piloted on five studies prior to use [ 65 ]. A single reviewer (AP) assessed and ranked each study based on total score and the results were then discussed with the second reviewer (ED). Data extraction occurred prior to risk of bias assessment, to protect against reporting bias [ 65 ].

Narrative & Evidence Synthesis

The results were narratively synthesised, and findings presented by MW outcome of interest. Evidence synthesis was a stepwise process analysed by MW outcome and was based on study design, methodological quality, consistency with regards to the presence or absence of associations between organisational stressors and specific MW outcomes and the magnitude of these associations [ 76 , 77 , 78 ].

The reporting of the organisational stressors was mapped onto the WHO Organisational Stress-related Hazard Categorisation [ 79 ]. Six of the nine categories were represented in the findings: organisational culture ; workload and work pace; working hours; interpersonal relationships ; participation and control, and career development, status and pay . For the purposes of this review, workload, work pace and working hours were combined into one category. The evidence synthesis process involved combining the degree of evidence with the magnitude of respective association.

A rating system was used to assess the degree of evidence wherein the modified NOS risk of bias grade of each included study was combined with a second assessment which graded the degree of adjustment by confounders conducted within each included study. The rating system was adapted from previous systematic reviews [ 71 , 76 , 77 , 78 ] and the underlying developmental process was in accordance with expert recommendations (Personal Communication 3, See Additional file 1 : Table S1). Evidence was graded as Strong: if consistent findings were reported in more than two studies of high quality (at least one study adjusted for participant demographics and additional exposure variables) ; Moderate: if consistent findings were reported in two studies of high quality or one high quality study and one intermediate quality study, or between more than two studies of intermediate quality (at least one study has adjusted for participant demographics or additional exposure variables) ; and Insufficient: if identification of only one study or inconsistent findings across studies.

To assess the magnitude of associations the process included: Step 1-the organisational stressors reported were coded/re-coded under the WHO categories [ 79 ] to standardise the reporting of the same/similar organisational stressors presented with different terminology. Step 2 addressed the heterogeneity in the reported measures of effect, including correlation and unstandardized/standardised-beta coefficients, and odds ratios, by developing and applying threshold values previously reported in the literature [ 71 , 76 , 77 , 78 ] for each effect measure. The final threshold value criteria (see Table  1 ), were discussed with colleagues having expertise in evidence synthesis (Personal Communication 3, See Additional file 1 : Table S1), Using these threshold values (see Table 1 ), the effect size of each organisational stressor and MW outcome relationship was graded and scored (a weight to indicate each grade’s relative importance) as High (+++/3 points), Intermediate (++/2 points), Low association (+/1 point), No association (−/0 point) and unclear (±/0 point). In Step 3, a weighted average was estimated to account for the levels of relative importance across the five grades by: (i) multiplying the number of effect sizes per grade by the number of points (weight) allocated to that grade; (ii) adding the results across all grades for each MH outcome; and (iii) dividing the total by the sum of the weights (number of grades applied per MW outcome). This weighted average resulted in the mean magnitude of association of included studies by MW outcome. Finally, in Step 4 a RAG (Red, Amber and Green) threshold scale was applied to the overall magnitude of association, where a score of 0 to 1.9 was deemed ‘low/no association’ (Red), 2 to 3.9 was ‘intermediate association’ (yellow), and ≥ 4 was ‘high association’ (green). See Supplementary Material S12 for further detailed process.

The study selection process is documented in Fig.  1 . No concerns were raised following second reviewer input in screening titles, abstracts or full-text studies. In total, 15 studies [ 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 , 96 ] met the inclusion criteria and 134 full text studies were excluded (see Fig. 1 and Additional file  4 : Table S9).

Study selection PRISMA Flow Diagram [ 58 ]

Study characteristics

The characteristics of the 15 included studies are summarised in Table  2 . All studies were published in English, between 1995 and 2016. No RCTs or cohort studies met the inclusion criteria; all included studies had a cross-sectional study design. The majority were undertaken in the developed world; five from North America [ 82 , 88 , 90 , 92 , 93 ], five from Europe [ 84 , 85 , 86 , 89 , 91 ], three from Asia [ 87 , 95 ] and two from Africa [ 83 , 94 ]. Included studies covered a total of 15,150 male and female police officers, with the smallest study [ 90 ] having 78 participants and the largest [ 86 ] 3272 participants. Three studies failed to report final response rates [ 90 , 94 , 95 ], the remaining 12 studies included response rates ranging from 33.9% [ 82 ] to 96% [ 96 ]. The studies which provided information on gender [ 82 , 83 , 84 , 85 , 86 , 87 , 89 , 90 , 91 , 92 , 93 , 94 , 96 ] covered 9706 male and 2592 female study participants; for those that provided mean age, the mean age of participants ranged from 33 to 40 years [ 82 , 83 , 84 , 85 , 86 , 87 , 90 , 91 , 94 ]. Two studies [ 93 , 96 ] adopted an ordinal scale for age; one study [ 89 ] dichotomised age; and three studies failed to provide any information on the participant age [ 88 , 92 , 95 ]. Police work tenure ranged from 2.9–17.2 years [ 82 , 83 , 84 , 85 , 89 , 91 , 92 , 94 , 96 ]. Only three studies provided information on rank, which included police constables, corporals, sergeants, inspectors, captains, superintendents and senior superintendents [ 83 , 89 , 94 ]. Several studies reported educational background [ 83 , 84 , 87 , 88 , 90 , 91 , 92 , 94 , 96 ], marital status [ 84 , 85 , 86 , 90 , 91 , 94 , 96 ] and race or ethnicity [ 88 , 92 , 93 , 94 ]. Only one study failed to report participant demographics [ 95 ].

Outcomes reported across studies

The included studies reported a number of outcomes of interest including occupational stress [ 88 , 93 , 96 ], anxiety [ 86 ], depression [ 86 , 87 ], PD [ 82 , 89 , 90 ], PS [ 84 ], burnout [ 95 ] (a composite measure of EE [ 82 , 83 , 85 , 86 , 89 , 91 , 92 , 94 , 95 ], DP [ 85 , 86 , 89 , 91 , 94 , 95 ], PA [ 86 , 89 , 91 , 95 ]) and suicidal ideation [ 86 ].

Risk of Bias

All studies were cross-sectional, therefore the modified NOS [ 70 ] was used to assess risk of bias. Overall 13 studies were ranked as high [ 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 93 , 94 , 96 ], one as intermediate [ 92 ] and one as low quality [ 95 ] (Additional file  5 : Tables S10, S11). The cross-sectional design of the included studies precludes causal inference [ 97 ] and the direction of association cannot be established.

Response rates varied, and all studies employed self-reporting questionnaires. Questionnaires are considered appropriate, as they can provide information about health status, attitudes and behaviours of police officers [ 98 ], especially those experiencing MW issues [ 89 ]. However, self-reporting questionnaires can lead to method variance bias [ 99 ] , resulting in overestimation of associations [ 100 ] and raise issues of recall bias [ 101 ]. Online questionnaires were adopted by three studies [ 82 , 89 , 92 ]. Online surveys often have good data quality and generally confer lower measurement errors, however low response rates are often a challenge [ 102 ]. This is demonstrated in these cases, which reported response rates of 33.85 to 57% [ 82 , 89 , 92 ].

Since all studies failed to provide information on the demographics of both respondents and non-respondents, non-response bias cannot be assessed. Response bias may be a problem for topics concerning mental wellbeing, particularly in masculine environments such as policing. One study [ 88 ] employed Dillman’s Total Design Method [ 103 ] to achieve high response rate and mitigate non-response bias [ 104 ]. Eight studies [ 82 , 84 , 86 , 87 , 89 , 93 , 94 , 96 ] adjusted for additional exposure variables, such as operational stressors and ten studies [ 83 , 84 , 85 , 86 , 89 , 90 , 91 , 93 , 94 , 96 ] controlled for potential confounders, enhancing internal validity.

Eight studies failed to report the sampling method [ 82 , 84 , 86 , 89 , 90 , 94 , 95 , 96 ]. The other studies, adopted probability sampling [ 83 , 85 , 88 , 91 , 92 , 93 ] of which one study adopted random gender stratified sampling [ 85 ] and four studies used random sampling [ 83 , 88 , 91 , 92 ]. One study failed to provide information on the type of probability sample adopted [ 93 ]. Purposeful sampling was adopted by one study [ 87 ]. None of the studies accounted for officers who were not in work (e.g. court, special assignment, annual leave, off sick) and therefore not included in the study samples. Present state bias cannot be ruled out, if officers more vulnerable to stress have left the profession, creating a more resilient population than that of the general police population [ 102 ]. All studies involved voluntary participation, as such all were prone to volunteer bias; which could affect external validity [ 105 ].

Synthesis of results by outcome

All MW outcomes identified in the initial scoping search were reported in the included studies. The results from the included studies are presented by outcome of interest (see also Supplementary material S12–13) [ 57 , 58 ]. Table  3 shows the organisational stressor and MW outcome associations of included studies by outcome, the assigned effect size grades and corresponding significance levels.

Occupational stress

Three high quality studies [ 88 , 93 , 96 ] assessed occupational stress, covering a total of 3060 participants, almost half of which (47%; n  = 1427) were from one study [ 88 ].

Most organisational stressors had low or no association with occupational stress (Table 3 ). Only ‘ridicule and set-ups’ had an intermediated effect size grade in one study [ 96 ], and this was the strongest association observed [ 88 , 93 , 96 ] (Table 3 ). In this study on South Korean police officers [ 96 ], ‘ridicule and set-ups’ was significantly associated with occupational stress (ß = .53, p  < .01) following adjustment for both participant demographics and additional exposure variables, including sexual/language harassment, feeling invisible, length of service, rank etc. In a study on US officers [ 93 ], the same association was graded as low but the relationship remained significant (ß = .12, p  < .01) following adjustment for participant demographics and other exposure variables, including lack of advancement opportunity or influence, bias, etc.

Dealing with ‘bias’ from co-workers was predictive of occupational stress in US police officers when adjusting for participant demographics and additional exposure variables (ß = .29, p  < .01) [ 93 ]. Officers who exhibited high levels of occupational stress reported stress as a consequence of ethnic or racial bias [ 93 ]. Moreover, officers reported considerable time and energy was spent helping co-workers deal with this prejudice and bias, consequently elevating their levels of occupational stress [ 93 ]. High levels of ‘superior support’ resulted in low levels of occupational stress in the study conducted on South Korean police officers [ 96 ] (ß = -.26, p  < .01), after adjustment for participant demographics and exposure variables including public disrespect and expressed feelings. However, no evidence of a significant association between high levels of ‘work group support’ and occupational stress was observed (ß = .04, p =  ns ) in US police officers [ 93 ]. Τhe organisational stressor poor ‘personnel relations’ (b = .055, p =  ns ) was not significantly associated with occupational stress in a study of police executives either, although should be noted that this study did not account for possible confounding variables [ 88 ].

‘Department issues’ (e.g. the department budget, personnel retention and employee labour organisations) was significantly associated (‘low’ effect size grade) with occupational stress (b = .197, p  < .05) [ 88 ]. A ‘lack of influence’ over the way policing is conducted, procedures and policies, was significantly associated with occupational stress (ß = .18, p  < .01), however ‘lack of advancement opportunity’, (ß = .03, p =  ns ) was not, following adjustment for participant demographics and additional exposure variables [ 93 ] .

The organisational stressor ‘language harassment’ was significantly associated with occupational stress in US police officers (ß = .10, p  < .01) [ 93 ], controlling for participant demographics and exposure variables including stigma and appearance and feeling invisible. In the same study, ‘sexual harassment’ was significantly negatively associated with occupational stress (ß = −.08, p  < .05) [ 93 ]. Yet, in the study [ 96 ] conducted on South Korean police officers no significant association between occupational stress and either ‘language harassment’ (ß = .07, p  =  ns ) or ‘sexual harassment’ (ß = .01, p  =  ns ) was reported.

One high quality study, covering 3272 participants, assessed anxiety , and demonstrated that ‘job pressure’ was a significant predictor of anxiety symptoms (OR 2.0, 95%; 95%CI:1.5–2.7; p  < .001) after adjustment for demographics and other exposure variables such as lack of support, subjective health complaints, etc., whereas ‘lack of support’ (OR 1.2; 95%CI: 0.9–1.7; p =  ns ) was not [ 86 ].

Two high quality studies [ 86 , 87 ] covering 4104 participants, with 80% ( n  = 3272) originating from one study [ 86 ], assessed depression . Significant associations, graded as intermediate (Table 3 ), were reported between ‘heavy workload’ (OR 1.73; 95%CI:1.19–2.50; p  = .004) and ‘judgement from peers’ and depression (OR 2.35; 95%CI:1.31–4.23; p = .004) after controlling for exposure variables, such as judgement from peers, little time to spend with families, job performance, etc. [ 87 ]. There was no evidence of a significant association between ‘job pressure’ (OR 1.0, 95%CI:0.7–1.4; p =  ns ) or ‘lack of support’ (OR 1.3, 95%CI:0.9–1.99; p =  ns ) and depression in the adjusted models [ 86 ].

Psychological distress (PD) and psychiatric symptoms (PS)

Four high quality studies assessed psychological distress (PD) and psychiatric symptoms (PS) [ 82 , 84 , 89 , 90 ]. These covered 1854 police officers, of which 66% ( n  = 1226) were from one study [ 89 ].

The strongest predictor of PS, high effect size grade, was ‘lack of support from superiors and organisation’ (OR 3.58, 95%CI:1.58–8.13; β = 1.28; p  = .002), after controlling for additional exposure variables such as inadequate work schedule, high mental/intellectual demand, etc. [ 84 ]. Intermediate but significant predictors of PS were ‘inadequate work schedule’ (OR 2.84, 95% CI:1.22–6.62; β = 1.04, p  = .016) and ‘high mental/intellectual demand’ (OR 2.56, 95%CI:1.12–5.86; β = .94, p  = .026) in adjusted models [ 84 ].

For PD, ‘long working hours’ (≥ 49 h/week) demonstrated a high and significant association (OR 2.05, 95%CI:1.57–2.68; p  < .05), after controlling for age, gender, rank, departmental tenure and years of service [ 89 ]; while ‘insider social stressors’- defined as stress arising from co-workers and supervisors- displayed an intermediate but significant association (β = .45, p  < .01) when controlling for outsider social stressors (e.g. stressor from interactions with civilians/suspects) [ 82 ]. The odds of PD caseness in participants working ‘long working hours’, was double that of officers working ‘normal working hours’ (≤48 h/week) following full adjustment [ 89 ]. ‘Effort-reward imbalance’ (β = .24, p < .05) and ‘over-commitment’ (β = .40, p  < .01) were low but significant predictors of PD, after adjusting for age, gender, marital status and education [ 90 ].

Burnout (defined as a composite measure of EE, DP and PA)

Only one low quality study, assessed burnout as a composite measure of emotional exhaustion (EE), depersonalisation (DP) and personal accomplishment (PA) [ 95 ]; but nine studies assessed associations of organisational stressors and EE [ 82 , 83 , 85 , 86 , 89 , 91 , 92 , 94 , 95 ]. Of the latter, six studies further assessed DP [ 85 , 86 , 89 , 91 , 94 , 95 ] and four of these studies additionally assessed PA [ 86 , 89 , 91 , 95 ]. Seven of the studies investigating EE, DP and/or PA were of high quality [ 82 , 83 , 85 , 86 , 89 , 91 , 94 ], one of medium quality [ 92 ], and one of low quality [ 95 ]. The studies covered 10,853 participants, 30% of which ( n  = 3272) were from one study [ 86 ].

Burnout (composite measure of EE, DP and PA)

‘Police stress’ measured by the Police Stress Survey (r = .301, p < .01) and ‘administrative organisational pressure’ (r = .347, p < .01) were significantly correlated and had low associations with burnout, however the authors did not adjust for participant demographics or additional exposure variables [ 95 ].

Emotional exhaustion (EE)

Four of the nine studies- three of high [ 85 , 86 , 94 ] and one of low [ 95 ] quality- investigating EE demonstrated that the strongest predictor of EE was the ‘demand’ inherent in police work. A significant relationship between high ‘demand’ and EE in both male (OR 5.97; 95%CI:3.32–10.71; p  < .05) and female police officers (OR 7.69; 95%CI:4.21–14.03; p < .05) was reported after adjusting for age [ 85 ]. Job ‘demands’ (β = .22, p  < .001) and ‘lack of resources’ (β = .20, p < .001) both exhibited low but significant relationships with EE, after controlling for both participant demographics and other exposure variables, including conscientiousness, emotional stability, etc. [ 94 ]. Intermediate and significant associations were reported for ‘job pressure’ and EE (OR 2.1; 95%CI:1.8–2.5; p  < .001) [ 86 ]. The odds of high EE in police officers working long hours (> 49 h/ week) were double that of officers working normal hours (< 48 h/ week) (OR 1.99, 95%CI:1.52–2.59; p  < .05) [ 89 ]. However, another study found no significant association in adjusted models between ‘overtime work’ and EE (β = .07, p =  ns ) [ 91 ].

Similar to burnout, ‘police stress’ (r = .256, p  < .01) and ‘administrative/organisational pressure’ (r = .310, p < .01) were significantly correlated with EE [ 95 ]. Low ‘decision latitude’ demonstrated intermediate and significant associations with EE in both female (OR 2.44; 95%CI:1.38–4.30; p  < .05) and male police officers (OR 3.94; 95%CI:2.02–7.70; p < .05), following adjustment for age [ 85 ]. Yet, lack of ‘autonomy’ was not a significant predictor of EE (β = −.10, p =  ns ) [ 91 ].

Several social stressors exhibit intermediate and low associations with EE [ 82 , 85 , 86 , 91 , 92 ]. Social support from colleagues and superiors is generally associated with lower levels of EE [ 85 , 86 , 91 , 92 ], concluded that ‘lack of support’ was significantly associated with EE (OR 1.8; 95%CI:1.5–2.2; p < .001). Martinussen et al. [ 91 ] (β = −.25, p  < .05) and McCarty et al. [ 92 ] (b = −.44, p < .05) demonstrated that as levels of social support increased levels of EE decreased; while ‘social support’ was significantly associated with EE in both male (OR 3.47; 95%CI:2.02–5.96; p < .05) and female police (OR 2.79; 95%CI:1.73–4.51; p < .05), after controlling for age [ 85 ]. ‘Internal social stressors’ were significantly associated with EE (β = .44, p  < .01) when controlling for ‘outsider social stressors’ [ 82 ]. Work conflict (β = .01, p =  ns ) [ 91 ] was not found to be a significant predictor of EE. In the same study, ‘leadership’ was not identified as a significant predictor of EE (β = −.11, p =  ns ) [ 85 , 91 ]. Similarly, Backteman-Erlanson et al. [ 85 ] did not identify a significant association between ‘leadership’ and EE in both male (OR 0.72, 95% CI:0.53–0.99, p =  ns ) and female police officers (OR 0.56, 95% CI:.42–.75, p =  ns ).

In terms of workplace climate and culture, ‘organisational climate’ and ‘organisational culture’ showed intermediate and significant associations with EE in both female (climate: OR 2.48, 95%CI:1.79–3.45; p  < .05 & culture: OR 2.28, 95%CI:1.61–3.21; p < .05)) and male police (climate: OR 2.17, 95%CI:1.56–3.01; p < .05 and culture: OR 2.09, 95%CI:1.44–3.04; p < .05) following adjustment for age [ 85 ]. Two studies, further examined a component of organisational culture by investigating ‘overall perceived fairness’ of police organisations [ 83 , 92 ]. The first study, reported that 10% of the total variance in EE experienced by participants was attributed to ‘perceived workplace fairness’; and that as ‘perceived workplace fairness’ increased levels of EE decreased (β = −.23, p  < .01) [ 83 ]. Similarly, the second study demonstrated that ‘unfairness of the organisation’ was significantly associated with EE (b = .31, p  < .05) [ 92 ].

Depersonalisation (DP)

The organisational stressor demonstrated to be the strongest predictor of DP was low ‘decision latitude’ and this association was identified in both male (OR 2.68; 95%CI:1.37–5.24; p < .05) and female (OR 1.77, 95%CI:1.05–2.99; p < .05) police officers, following adjustment for age [ 85 ]. On the contrary, another study did not find any evidence of a significant association between lack of ‘autonomy’ and DP (β = −.04, p =  ns ) after adjustment for confounding [ 91 ].

Four studies investigated the impact of high job demand and pressure on DP [ 85 , 86 , 94 , 95 ] and three found intermediate [ 85 ] and low [ 94 , 95 ], but significant associations. High job ‘demand’ was significantly associated with DP (β = .11, p  < .001) after controlling for confounding [ 94 ], and similarly was a significant predictor of DP in both male (OR 1.96, 95%CI:1.20–3.20; p  < .05) and female police officers (OR 2.54, 95%CI:1.57–4.13; p < .05) after adjusting for age [ 85 ]. ‘Administrative/organisational pressure’ (r = .218, p  < .01) and ‘police stress’ (r = .165, p  < .01) were significantly associated with DP [ 95 ]. Conversely, one study found no evidence of an association between ‘job pressure’ and DP (OR 0.9, 95%CI:0.8–1.1; p =  ns ) in the adjusted model [ 86 ]. Analogous to EE, ‘long working hours’ (OR 1.30; 95%CI:1.00–1.71; p  < .05) [ 89 ] and ‘lack of resources’ (β = .17, p  < .001) [ 94 ] were significantly associated with DP, while ‘overtime work’ (β = .06, p =  ns ) was not [ 91 ] .

Three studies investigated organisational stressors related to interpersonal relationships at work [ 85 , 86 , 91 ]. Similar to EE, high levels of ‘social support’ from co-workers and supervisors resulted in decreased levels of DP (β = −.33, p  < .001) [ 91 ], while the lack of ‘social support’ significantly predicts DP in both male (OR 2.18; 95%CI:1.28–3.71; p  < .05) and female (OR 1.62, 95%CI:1.06–2.48; p < .05) police officers following adjustment for age [ 85 ]. However, one study found no significant association between ‘lack of support’ and DP (OR 0.9, 95% CI:0.8–1.1; p =  ns ) [ 86 ] . Similar to EE, there was no significant association between ‘work conflict’ and DP (β = .07, p =  ns ) [ 91 ].

Assessing stressors related to organisational culture demonstrated that adoption of appropriate ‘leadership’ significantly decreased DP levels (β = −.24, p  < .01) [ 91 ], but another study found no association between appropriate ‘leadership’ and DP in both male (OR 0.85; 95%CI:0.62–1.15; p =  ns ) and female police officers (OR 0.94, 95%CI:0.73–1.22; p =  ns ) [ 85 ]. Poor ‘organisational culture’ was identified as a significant risk factor for DP in both male (OR 1.59, 95%CI:1.12–2.25; p < .05) and female police officers (OR 1.49, 95%CI:1.11–1.99; p < .05), whereas ‘organisational climate’ was as a significant risk factor for female police officers only (OR 1.64, 95%CI: 1.22–2.19; p < .05) and not for males (OR 1.27, 95%CI:0.94–1.73; p =  ns ) [ 85 ].

Personal accomplishment (PA)

Of the four studies investigating PA, the organisational stressors, social support and job pressure were the strongest predictors of PA, as examined in two high quality studies [ 86 , 91 ] and one low quality study [ 95 ]. ‘Job pressure’ was significantly related to PA (OR 1.3, 95% CI:1.1–1.6; p  < .001), after controlling for age, gender, lack of support, anxiety, depression, subjective health complaints, suicidal ideation, EE and DP [ 86 ]. Similarly, ‘police stress’ (r = .167, p  < .01) and ‘administrative/organisational pressure’ (r = .152, p  < .01) were statistically significant correlated with PA, independent of adjustment for confounders [ 95 ]. Neither ‘long working hours’ (OR 0.99, 95%CI:0.75–1.32; p =  ns ) [ 89 ], nor ‘overtime work’ (β = .01, p =  ns ) [ 91 ] were significantly associated with PA.

After adjusting for leadership, work conflict, overtime work, autonomy, work-family pressures, age and gender, high levels of ‘social support’ from co-workers and supervisors (β = .23, p < .01) and PA [ 91 ] were significantly correlated. This relationship however was not significant in the study conducted by [ 86 ] (OR 1.1, 95% CI: 0.9–1.2; p =  ns ). No significant relationship with PA was observed for ‘leadership’ (β = .13, p =  ns ) [ 91 ], ‘work conflict’ (β = −.03, p =  ns ) [ 91 ] and ‘autonomy’ (β = .09, p =  ns ) [ 91 ] in adjusted models.

Suicidal ideation

One high quality study [ 86 ] assessed the association between organisational stressors and suicide ideation, covering 3272 participants. This study revealed that neither ‘job pressure’ (OR 0.8, 95%CI:0.6–1.19; p =  ns ) nor ‘lack of support’ (OR 1.3, 95%CI:0.9–1.7; p =  ns ) were significantly associated with suicidal ideation after controlling for confounders [ 86 ].

Evidence synthesis

Thirty-six organisational stressors were identified, of which twenty-five demonstrated significant associations with one or more MW outcomes (Table 3 ). Overall, a strong degree of evidence with a high magnitude of associations between organisational stressors and MW outcomes (Table  4 and Additional file  6 : Table S12 and S13), was observed for the outcomes of PS/PD [ 82 , 84 , 89 , 90 ], EE [ 82 , 83 , 85 , 86 , 89 , 91 , 94 , 95 ] and DP [ 85 , 86 , 89 , 91 , 94 , 95 ]. Strong evidence of intermediate magnitude was identified for studies investigating the relationship between organisational stressors and occupational stress [ 88 , 93 , 96 ] and PA [ 86 , 89 , 91 , 95 ]. Studies investigating burnout [ 95 ], anxiety [ 86 ] and depression [ 86 , 87 ] provided an insufficient degree of evidence, however the magnitude of associations was rated as intermediate. The degree of evidence and the magnitude of associations were insufficient and low, respectively, for suicidal ideation [ 86 ].

The thirty-six organisational stressors were mapped under the amended WHO Organisational Stress-related Hazard Categories: organisational culture; workload and working hours; working hours; interpersonal relationships; participation and control and career development. Within the organisational culture category stressors included ‘organisational climate’ and ‘organisational culture’ both of which were significant predictors of EE [ 85 ] and DP [ 85 ]. ‘Perceived workplace fairness’/‘unfairness of the organisation’ were significant risk factors for EE [ 83 , 92 ] only. ‘Department issues’ was a significant risk factor for occupational stress [ 88 ], while ‘leadership’ was identified as a significant predictor for DP only [ 91 ]. ‘Job demands’ [ 85 , 94 ], high mental/intellectual demand [ 84 ], pressure [ 86 , 95 ] and heavy workload [ 87 ], were shown to be significant predictors of PS/PD [ 84 ], anxiety [ 86 ], burnout [ 95 ], EE [ 85 , 86 , 94 , 95 ], DP [ 85 , 94 , 95 ], PA [ 86 , 95 ] and depression [ 87 ].

Within the Workload and working hours category, ‘long working hours (≥ 49h/week)’ [ 89 ] demonstrated an increased risk of PS/PD [ 89 ], EE [ 89 ] and DP [ 89 ] however did not increase risk of PA [ 89 ]. A ‘lack of resources’ [ 94 ] in the organisation was recognised as increasing the risk of EE [ 94 ] and DP [ 94 ]. The Interpersonal relationships category comprised of stressors including ‘lack of support’, ‘ridicule and set ups’ and ‘bias’. ‘Lack of support’ significantly increased the risk of number of MW outcomes including occupational stress [ 96 ], PS/PD [ 82 , 84 ], EE [ 82 , 85 , 91 , 92 ], DP [ 85 , 91 ], and PA [ 91 ]. ‘Ridicule and set ups’ [ 93 , 96 ], ‘sexual and language harassment’ [ 93 ] and ‘bias’ [ 93 ] predicted occupational stress, whilst ‘judgement from peers’ was identified as a significant risk factor for depression [ 87 ]. There were a small number of stressors which fell under the Participation and Control category. Low ‘decision latitude’ was a significant predictor of EE and DP [ 85 ], while ‘lacking influence’ in one’s work was predictive of occupational stress [ 93 ]. ‘Autonomy’ was not identified as a significant risk factor when investigated in relation to EE, DP and PA [ 91 ].

Organisational stressors in the Career Development category, included ‘effort-reward imbalance’ [ 90 ], ‘over commitment’ [ 90 ] and ‘lack of advancement’ [ 93 ]. The former two were significant predictors for PD/PS [ 90 ], while the latter was not a significant risk factor for occupational stress.

Summary of findings

This review systematically summarises the organisational stressors intrinsic to police work that significantly contribute to the adverse MW outcomes of occupational stress, anxiety, depression, PS/PD, Burnout, EE, DP, and suicidal ideation. The findings are based on the available evidence established through a systematic search using predefined PICO inclusion criteria set for this review. Fifteen studies met the inclusion criteria, covering relationships between 36 different organisational stressors with MW outcomes, of which twenty-five, including examples such as: organisational culture and climate, perceived workplace fairness/unfairness, leadership, department issues, job demands, high mental/intellectual demand, job pressure, heavy workload, long working hours, lack of resources and support, ridicule and set ups, sexual and language harassment, bias, judgement from peers, low decision latitude, lacking influence, effort-reward imbalance and over commitment, were identified as statistically significant predictors of MW outcomes and demonstrated a strong degree of evidence with high or intermediate magnitudes of associations with the MW outcomes studied..

Review in the context of previous studies

The majority of the evidence collated for this review has indicated the MW outcomes PS/PD [ 82 , 84 , 89 , 90 ], EE [ 82 , 83 , 85 , 86 , 89 , 91 , 94 , 95 ] and DP [ 85 , 86 , 89 , 91 , 94 , 95 ] demonstrate the strongest relationships with organisational stressors, including lack of support from superiors and organisation, long working hours, inadequate work schedule, high mental/intellectual demand, job demand, organisational climate, organisational culture and low decision latitude. Within the wider literature ‘job demand’ is identified as an important risk factor for the manifestation of MW outcomes, analogous to our review findings. In a systematic review covering the general working population, there was strong evidence that high job demand was a significant predictor of PD [ 106 ]. A narrative review of ‘high quality’ longitudinal studies, conducted by de Lange et al., [ 107 ] found evidence of causal effects of job demands on PS, concluding that the psychosocial work environment at work is vital for mental health. While this narrative review did not consider police personnel specifically, its purpose was to test the effects of a combination of job characteristics (demand, control and support) on PS [ 107 ], all of which are inherent in police work [ 35 ]. . Our review did not identify any studies investigating the impact of job demand on depression, anxiety and occupational stress, however a review on the general population, demonstrated that high job demands are associated with increased rates of depression, anxiety and occupational stress [ 1 ] .Moreover, within the broader law enforcement literature occupational stress and burnout have been reported to arise as a result of high job demands [ 108 ]; and with emotional exhaustion in a recent study of German police officers [ 109 ], illustrating the spectrum of MW outcomes associated with exposure to this stressor.

On consideration of other organisational stressors related to workload and working hours, job pressure, was identified as the strongest predictor of anxiety, PA and burnout. This finding is in line with reviews on correctional officers where job pressure was identified as a significant predictor of burnout [ 110 , 111 ] and with a recent study where effort-reward imbalance was positively associated with burnout scores in police officers [ 112 ]. Long working hours was identified as increasing the risk of PS/PD, EE and DP in police officers within our review. Two reviews were identified that have investigated the relationship between atypical working hours and MW outcomes in the general working population [ 113 , 114 ] and the results attest similar findings. One concluded that working more than 48 h a week increased the risk of psychological health difficulties [ 113 ], whilst the second concluded that working more than 40 h per week or more than 8 h a day increased the risk of developing symptoms of anxiety or depression [ 114 ]. No systematic review or meta-analyses that examined the impact of long working hours on police officers were identified.

The impact of interpersonal relationships was examined within our review. Research on correctional officers have illustrated that relationships with co-workers and the resultant feelings of isolation are significant predictors of occupational stress [ 110 ]. Confirming the impact of interpersonal relationships on MW, were the results of a study conducted on 1206 police officers that demonstrated that co-worker discourteous and disrespectful behaviours were significant sources of occupational stress [ 115 ]. However, this study did not formally assess associations between stressors and MW outcomes. A recent study showed that job resources (team support, shared values and perceived fairness) predicted wellbeing and decreased EE in police officers [ 109 ]. Furthermore, judgement from peers was identified as a significant risk factor for depression, consistent with studies on the general working population which provide strong evidence of relationships between workplace bullying and increased depression symptoms [ 116 ] , anxiety [ 117 ], and stress related psychological symptoms [ 117 ]. This emotional demand interpersonal relationships can pose on police officers is often referred to as emotional labour [ 115 ], where officers have to manage the display of their emotions and maintain the appropriate demeanour expected by both their work and the greater public. The presence of such interpersonal relationship organisational stressors can have consequential effects, given that police officers rely on colleagues in their work [ 118 ].

In the wider organisational stress literature, high levels of social support at work from colleagues and supervisors have been found to be protective of mental health [ 5 , 106 , 110 , 119 ]. Systematic reviews on the general working population have indicated that low levels of support result in increased levels of PD [ 106 ] and predict the onset of depression [ 119 ]. Another review of 14 longitudinal studies revealed that lack of social support enhanced depression [ 120 ], and a review on correctional officers demonstrated increased levels of occupational stress resulting from lack of support [ 110 ]. A study conducted on a special police force unit demonstrated lack of support was a significant risk factor for DP [ 5 ]. Similarly, our review identified that low levels of social support resulted in an increased risk of a number of MW outcomes including occupational stress [ 96 ], PS/PD [ 84 ], EE [ 86 , 91 , 92 ], DP [ 85 , 91 ] and PA [ 91 ]. Only one study in our review investigated the relationship with anxiety and found no evidence of an association [ 86 ], whereas no study investigated the relationship between social support and depression.

Lack of support showed no association with suicidal ideation, although only one study investigated this relationship [ 86 ]. Only two systematic reviews exist, to the best of our knowledge, which investigate the issue of suicide in the police – Cantor et al. [ 121 ] and Hem et al. [ 122 ]. Following a review of ten studies, four of which had sample size of 10 or less, Cantor et al. [ 121 ] reported evidence of elevated suicide rates in police officers, however specific relationships between suicide and organisational stressors could not be extracted in this study. Hem et al. [ 122 ] compared levels of suicide in the police with the general working population and contrarily reported no elevated suicide rates in police officers.

Strengths & Limitations

The primary strength of this review is that it is the first to our knowledge that examines associations across a number of organisational stressors and police officer MW outcomes. Included studies either only looked at police officer populations or carried out sub-analyses, that allowed the relationship between organisational stressors and police officer MW to be extracted. The review was performed and reported in accordance with guidance for undertaking a systematic review [ 57 , 63 ], adhered to the PRISMA checklist [ 58 ], and adopted guidelines for the narrative synthesis where possible [ 60 ], making it methodologically robust and reproducible. While the study was not included in an international review database, we have documented every step in a transparent and reproducible fashion (see Additional files  1 , 2 , 3 , 4 , 5 and 6 ). One reviewer undertook selection/assessment of studies, with a proportion checked by second reviewer, to reduce bias and enable discrepancies to be resolved via discussion [ 57 ]. Expert opinions and advice were sought from systematic review and epidemiology academics on the development of the research protocol.

All included studies were rated as either high (13 of the 15 included studies) or intermediate (1 of the 15 included studies) quality and adopted self-reporting validated measures for both exposure and outcome data.

Summarising the evidence without or with incomplete statistical pooling has been advocated as useful for reviews but can be considered arbitrary and subjective [ 123 , 124 ]. Whilst, the labels adopted within the evidence synthesis, should be interpreted with caution, the advantage of the followed strategy is that the underlying process is explicit and reproducible.

The studies included in this review were undertaken across four continents, i.e. Europe, North America, Africa and Asia. In general, all demonstrated similar findings regarding the associations between specific organisational stressors and MW outcomes in police officers, with some differences noted, thereby strengthening the generalizability of the results on an international scale.

As with all systematic reviews, new potentially eligible studies may have been published since the literature search was conducted, which could be a limitation. We have identified three studies that have been published since our search that examine organisational risk factors (shift work [ 36 ], job demands and resources [ 109 ] and supervisor support [ 125 ]) and mental health outcomes (stress [ 36 , 125 ], EE and wellbeing [ 109 ]). The results of these studies are in agreement with the outcomes of our review [ 109 , 125 ], and present a new significant association between shift work and occupational stress [ 36 ]. Additionally, a number of potentially eligible studies could not be accessed in full-text. In addressing this limitation, efforts were made to document the studies which could not be accessed, as well as the efforts undertaken to attempt to retrieve these studies (see Additional file  7 : Table S14). Whilst strategies were employed to reduce the odds of missing studies on this subject, the chance that a study was omitted cannot be excluded. Moreover, due to the cross- sectional nature of all included studies, causal relationships could not be established. As demonstrated the significant relationships are complex and of varying strengths, with many stressors occurring concurrently and impacting on numerous outcomes. It cannot be discounted that some organisational stressor and MW outcome relationships have not been identified in the evidence collated for this review. Moreover, due to the paucity of literature on this topic it is possible that a number of organisational stressor and MW outcome relationships still require investigation.

Public health and policy implications

Beneficiaries from a mentally healthy police workforce include the police officers themselves, police organisations, their families, and the public [ 126 ]. Reducing poor police officer MW can increase morale, productivity, effectiveness, efficiency and general wellbeing [ 127 ], as well as having the potential to reduce compensations claims, on-the-job accidents, civil liabilities for counter-productive behaviour, early retirement and negative perceptions from both the media and public [ 127 ].

This review has highlighted the organisational stressors which can be targeted by policies and interventions to reduce the hazard they pose to police officer MW. The organisational stressors shown to impact on police officer mental wellbeing, including lack of support, demand, and interpersonal relationships with colleagues and supervisors, are all amenable to change. It is important therefore to identify the interventions, workplace and other policy changes which address these organisational stressors to promote optimal MW in police officers and these should be incorporated into policing organisational and public health strategies [ 82 ]. In addressing lack of support, potential interventions could be aimed at changing the police culture by expanding training and promotion programmes. Flattening the hierarchal structure has also been proposed [ 41 ]. Moreover, training specifically for police leaders has been recommended, focusing on awareness of the organisational stressors their employees face, to help reduce their occurrence and mitigate their effects [ 88 ].

The success of the recommendations outlined, rely on the resources available to the policing profession. Budget cuts, for instance in the UK police force, in the past decade have seen a decrease in police officer numbers, therefore increasing the demand placed on active officers [ 128 ]. Scarce resources allocation could be optimised through increasing police officer numbers; prioritising interventions aimed at promoting support seeking and support services for police officers, therefore shifting the police culture from one that values self-reliance and stoicism to one that promotes the overall wellbeing of their employees [ 129 ].

The findings of this review, examining the relationship between organisational stressors and MW in police officers, provide evidence of an association between organisational stressors and occupational stress, depression, PS/PD, Burnout, EE, DP, PA. Those organisational stressors which demonstrated significant relationships with the MW outcomes considered included lack of support from colleagues, supervisors and the organisation, ridicule and set ups, job demand and pressure, and long working hours.

The evidence identified suggests that due to the extent to which police organisational culture, structure and practice can create stressors, strategies which address how officers treat each other, promote support seeking for mental health issues, and provide police leaders with the knowledge to identify and mitigate occupational stress, could be the most effective. However, there is still a lack of evidence surrounding many organisational stressors and specific MW outcomes and especially a lack of evidence on the effectiveness of proactive and reactive strategies to reduce occupational stressors within policing, reinforcing the need for further research. The evidence base should be enhanced with more longitudinal studies, including understudied factors such as interpersonal conflicts and emotional demands [ 106 ]. Advancement in this field can lead to improvement in the MW of this occupational group and concomitantly result in benefits for both policing organisations as well as the greater public in which they serve.

Availability of data and materials

All data collected from the literature and analysed during this study are included in this published article and its supplementary information files.

Abbreviations

Centre for Reviews and Dissemination

Depersonalisation

Disaster Related Psychological Screening Test

Economic and Social Research Council

General Health Questionnaire

Hospital Anxiety and Depression Scale

Her Majesties Inspectorate of Constabulary Scotland

Health and Safety Executive

International Committee of Medical Journal Editors

Job Stress Survey

Maslach Burnout Inventory

Maslach Burnout Inventory- General Survey

Maslach Burnout Inventory-Human Service Survey

Mental Health

Mental Wellbeing

Newcastle Ottawa Scale

Occupational Disease Intelligence Network

Office for National Statistics

Personal Accomplishment

Psychological Distress

Psychiatric Symptoms

Police Stress Survey

Red, Amber, Green

Surveillance of Occupational Stress and Mental Illness

World Health Organisation

Harvey SB, Modini M, Joyce S, Milligan-Saville JS, Tan L, Mykletun A, Bryant RA, Christensen H, Mitchell PB. Can work make you mentally ill? A systematic meta-review of work-related risk factors for common mental health problems. Occup Environ Med. 2017;74(4):301–10.

Article   PubMed   Google Scholar  

Office for National Statistics (ONS), Full report: Sickness absence on the labour market, February 2014. In.: Office for National Statistics (ONS); 2014. Available from: https://www.ons.gov.uk/employmentandlabourmarket/peopleinwork/labourproductivity/articles/sicknessabsenceinthelabourmarket/2014-02-25 .

Executive HS. Work related stress, anxiety and depression statistics in Great Britain 2016. Suffolk: Health and Safety Executive; 2016.

Google Scholar  

Deschamps F, Paganon-Badinier I, Marchand A-C, Merle C. Sources and assessment of occupational stress in the police. J Occup Health. 2003;45(6):358–64.

Garbarino S, Cuomo G, Chiorri C, Magnavita N. Association of work-related stress with mental health problems in a special police force unit. BMJ Open. 2013;3(7).

Article   PubMed   PubMed Central   Google Scholar  

Cherry NM, Chen Y, McDonald JC. Reported incidenc and precipitating factors of work-related stress and mental ill-health in the United Kingdom (1996-2001). Occup Med. 2006;56:414–21.

Article   Google Scholar  

Garbarino S, Guglielmi O, Puntoni M, Bragazzi NL, Magnavita N. Sleep quality among police officers: implications and insights from a systematic review and meta-analysis of the literature. Int J Environ Res Public Health. 2019;16(5):885.

Article   PubMed Central   Google Scholar  

Penalba V, McGuire H, Leite JR. Psychosocial interventions for prevention of psychological disorders in law enforcement officers. Cochrane Database of Systematic Reviews 2008, Issue 3. Art. No.: CD005601. https://doi.org/10.1002/14651858.CD005601.pub2 .

Cooper C, Davidson M, Robinson P. Stress in the police service. J Occup Med. 1982;24(1):30–6.

CAS   PubMed   Google Scholar  

Cooper C, Grimley PJ. Stress among police detectives. J Occup Med. 1983;25(7):534–40.

Biggam FH, Power KG, MacDonald RR, Carcary WB, Moodie E. Self-perceived occupational stress and distress in a Scottish police force. Work Stress. 1997;11(2):118–33.

Brown JM, Campbell EA. Stress and policing: sources and strategies. Oxford: Wiley; 1994.

COEH CfOEH. Occupational physicians reporting activiity. Quarterly report. Manchester: University of Manchester; 2000.

Mind UK [ http://www.mind.org.uk ].

Bell S, Eski Y. ‘Break a leg- its all in the mind’: police officers’ attitudes towards colleagues with mental health issues. Policing. 2016;10:1–7.

Rollinson D. Organisational behaviour and analysis: an integrated appraoch. 3rd ed. London: Pearson Education Limited; 2005.

Anshel MH. A conceptual model and implications for coping with stressful events in police work. Crim Justice Behav. 2000;27(3):375–400.

Agolla JE. Occupational stress among police officers: the case of Botswana police service. Res J Bus Manag. 2009;3:25–35.

Rand SR, Manuele CA. Stress and police officer performance: an examination of effective coping behavior. Police Stud. 1987;10:122–31.

Ward GE. Physiological, psychological and social issues specifically related to the police profession. Law Order. 1979;27(1):12.

Standards of Professional Behaviour [ http://www.scotland.police.uk/assets/pdf/327931/327936/327976/328759/standards-of-professional-behaviour ].

Policing Co. Code of ethics a code of practice for the principles and standards of professional behaviour for the policing profession of England and Wales. Coventry: College of Policing Ltd; 2014.

Jaramillo F, Nixon R, Sams D. The effect of law enforcement stress on organizational commitment. Policing. 2005;28(2):321–36.

Goldstein H. Policing a free society. Cambridge: Ballinger Publishing; 1977.

Justice NIo. On-the-job stress in policing reducing it, preventing it. Washington: National Institute of Justice; 2000.

ICMJE ICoMJEI. Recommendations on the conduct, reporting, editing and publication of scholarly work in medical journals. USA: International Committee of Medical Journal Editors (ICMJE); 2015.

Ballard D, McGlone M. Work pressures: new agendas in communication. New York: Routledge; 2017.

Schaufeli WB, Maslach C, Marek T. Profesional burnout: recent developments in theory and research. Washington: Taylor & Francis; 1993.

Territo L, Vetter HJ. Stress and police personnel. J Police Sci Adm. 1981;9(2):195–208.

Alexander DA, Walker LD, Innes G, Irving BL. Police stress at work. London: The Police Foundation; 1993.

Evans BJ, Coman GJ. General versus specific measures of occupational stress: an Australian police survey. Stress Med. 1993;9(1):11–20.

Kop N, Euwema M, Schaufeli W. Burnout, job stress and violent behaviour among Dutch police officers. Work Stress. 1999;13(4):326–40.

Savery L, Soutar G, Weaver J. Stress and the police officer: some Western Australian evidence. Police J. 1993;66(3):227–90.

Crank J, Cullberton R, Hewit J, Regoli B. An assessment of work stress among police executives. J Crim Just. 1993;21:313–24.

UNISON. 2014 police staff stress survey report. London: UNISON; 2014.

Galanis P, Fragkou D, Kaitelidou D, Kalokairinou A, Katsoulas TA. Risk factors for occupational stress among Greek police officers. Policing: An Int J. 2019;42(4):506–19.

Kroes WH. Society’s victims- the police: an analysis of job stress in policing. 2nd ed. Springfied: Charlie Thomas; 1985.

Davey JD, Obst PL, Sheehan MC. Demographic and workplace characteristic which add to the prediction of stress and job satisfaction within the police workplace. J Police Crim Psychol. 2001;16(1):29–39.

Alexander DA, Innes G, Irving BL, Sinclair S, Walker LG. Health, stress and policing: a study in Grampion police. London: The Police Foundation; 1991.

Luceño-Moreno L, García-Albuerne Y, Talavera-Velasco B, Martín-García J. Stress in Spanish police force depending on occupational rank, sex, age and work-shift. Psicothema. 2016;28(4):389–93.

PubMed   Google Scholar  

Brough P, Biggs A: Occupational stress in police and prison staff. In: The Cambridge handbook of forensic psychology. Edited by Brown JM, Campbell EA. New York: Cambridge University Press; 2010: 707–717. Brown JM, Campbell EA.

Chapter   Google Scholar  

Brown JM, Campbell EA. Sources of occupational stress in the police. Work Stress. 1990;4(4):305–18.

Alexander D, Walker L, Innes G, Irving B. Police stress at work. UK: Police Foundation; 1993.

Violanti JM, Aron F. Ranking police stressors. Psychol Rep. 1994;75(2):824–6.

Article   CAS   PubMed   Google Scholar  

Kirkcaldy B, Cooper CL, Ruffalo P. Work stress and health in a sample of U.S. police. Psychol Rep. 1995;76(2):700–2.

Koortzen P. The dimensionality of police stressors. Acta Criminologiae et Medicinae Legalis Japonica. 1996;9(2):55–63.

Guelle G, Tredoux C, Foster D. Inherent and organizational stress in the SAPS: an empirical survey in the Western cape. S Afr J Psychol. 1998;28:129–34.

Kim JL, Wells W, Vardalis JJ, Johnson SK, Lim H. Gender difference in occupational stress: a study of the south Korean National Police Agency. Int J Law Crime Justice. 2016;44:163–82.

Oweke JA, Muola J, Ngumi O. Causes of occupational stress in relation to level of occupational stress among police constables in Kisumu County, Kenya. J Humanit Soc Sci. 2014;19(11):13–20.

Husain W. The levels of depression, anxiety and stress in police officers. Acad Res Int. 2014;5(4):458–65.

Marchand A, Durand P. Psychological distress, depression, and burnout: similar contribution of the job demand-control and job-demand-control-support models. J Occup Environ Med. 2011;53(2):185–9.

Liberman AM, Best SR, Metzler TJ, Fagan JA, Weiss DS, Marmar CR. Routine occupational stress and psychological distress in police. Policing: An Int J Police Strateg Manag. 2002;25(2):421–39.

Burke RJ. Work-family stress, conflict, coping, and burnout in police officers. Stress Med. 1993;9(3):171–80.

McCafferty Fl MCE, McCafferty MA. Stress and suicide in police officers: paradigm of occupational stress. South Med J. 1992;85(3):233–43.

Health and Safety Executive (HSE). Striking the balance between operational and health and safety duties in the police service. Suffolk: Health and Safety Executive; 2008.

Kapade-Nikam P, Shaikh M. Occupational stress, burnout and coping in police personnel: findings from a systematic review. Am Int J Res Humant Arts Soc Sci. 2014;14(377):144–8.

Higgins JP, Green S. Cochrane handbook for systematic reviews of interventions version 5.0.2. London: The Cochrane Collaboration; 2009.

Moher D, Liberati A, Fau - Tetzlaff J, Tetzlaff J, Fau - Altman DG, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement; 2015. p. 1539–3704. (Electronic)

Bettany-Saltikov J. How to do a systematic literature review in nursing a step-by-step guide. England: Open University Press; 2012.

Popay J, Roberts H, Sowden A, Petticrew M, Arai L, Rodgers M, Britten N, Roen K, Duffy S. Guidance on the conduct of narrative synthesis in systematic reviews. A product from the ESRC methods programme. Final report. Lancaster University: Lancaster; 2006.

Torgerson C. Systematic reviews. London: Continuum; 2003.

Song F, Parekh S, Hooper L, Loke YK, Ryder J. Dissemination and publication of research findings: an updated review of related biases. Health Technol Assess. 2010;14(8):234.

CRD CfRaDC. Systematic reviews: CRD’s guidance for undertaking reviews in health care. York: Centre for Reviews and Dissemination; 2009.

Bioethics NCo. The findings of a series of engagement activites exploring the culture of scientific research in the UK. London: Nuffield College of Bioethics; 2014.

Boland A, Cherry G, Dickson R. Doing a systematic review a students guide. London: SAGE Publications; 2014.

Aveyard H, Payne S, Preston N. A post-graduates guide to doing a literature review in health and social care. England: Open University Press; 2016.

Whittaker A. Research skills for social work. 2nd ed. London: Learning Matters; 2012.

Data extraction forms [ http://dplp.cochrane.org/data-extraction-forms ].

Savage E, Callery P. Parental participation in the care of hospitalised children: a review of the research evidence. In: Glasper EA, Ireland L, editors. Evidence based child health care: challenges for practice. Houndmills: Macmillan; 2000. p. 57–87.

The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses [ http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp ].

Herzog R, Álvarez-Pasquin MJ, Díaz C, Del Barrio JL, Estrada JM, Gil Á. Are healthcare workers’ intentions to vaccinate related to their knowledge, beliefs and attitudes? A systematic review. BMC Public Health. 2013;13:154.

Takahashi N, Hashizume M. A systematic review of the influence of occupational organophosphate pesticides exposure on neurological impairment. BMJ Open. 2014;4(6):e004798.

Patra J, Bhatia M, Suraweera W, Morris SK, Patra C, Gupta PC, Jha P. Exposure to second-hand smoke and the risk of tuberculosis in children and adults: a systematic review and meta-analysis of 18 observational studies. PLoS Med. 2015;12(6):e1001835.

Hermont AP, Oliveira PAD, Martins CC, Paiva SM, Pordeus IA, Auad SM. Tooth Erosion and eating disorders: a systematic review and meta-analysis. PLoS One. 2014;9(11):e111123.

Article   PubMed   PubMed Central   CAS   Google Scholar  

McPheeters ML, Kripalani S, Peterson NB, Idowu RT, Jerome RN, Potter SA, Andrews JC. Quality improvement interventions to address health disparities. Closing the quality gap: revisiting the state of the science. Evidence report no.208. Rockville: Agency for Healthcare Research and Quality (ARHQ); 2012.

Rodriguez-Jareño MC, Demou E, Vargas-Prada S, Sanati KA, Škerjanc A, Reis PG, Helimäki-Aro R, Macdonald EB, Serra C. European working time directive and doctors’ health: a systematic review of the available epidemiological evidence. BMJ Open. 2014;4(7):e004916.

Bernard B. A critical review of epidemiological evidence for work-related muscoloskeletal disorders of the neck, upper extremity and low back. Cincinnati: National Institute for Occupational Safety and Health; 1997.

Steenstra I, Verbeek J, Heymans M, Bongers P. Prognostic factors for duration of sick leave in patients sick listed with acute low back pain: a systematic review of the literature. Occup Environ Med. 2005;62(12):851–60.

Article   CAS   PubMed   PubMed Central   Google Scholar  

Leka S, Griffiths A, Cox T. Protecting workers health series No 3: Work organization & stress. Geneva: World Health Organization (WHO); 2004.

Krehbiel TC. Correlation coefficient rule of thumb. Decis Sci J Innov Educ. 2004;2(1):97–100.

How large can a standardized coefficient be? [ http://www.ssicentral.com/lisrel/techdocs/HowLargeCanaStandardizedCoefficientbe.pdf ].

Adams GA, Buck J. Social stressors and strain among police officers: It’s not just the bad guys. Crim Justice Behav. 2010;37(9):1030–40.

Adebayo DO, Sunmola AM, Udegbe IB. Workplace fairness and emotional exhaustion in Nigeria police: the moderating role of gender. Anxiety Stress Coping. 2008;21(4):405–16.

Arial M, Gonik V, Wild P, Danuser B. Association of work related chronic stressors and psychiatric symptoms in a Swiss sample of police officers; a cross sectional questionnaire study. Int Arch Occup Environ Health. 2010;83(3):323–31.

Backteman-Erlanson S, Padyab M, Brulin C. Prevalence of burnout and associations with psychosocial work environment, physical strain, and stress of conscience among Swedish female and male police personnel. Police Pract Res. 2013;14(6):491–505.

Berg AM, Hem E, Lau B, Ekeberg Ø. An exploration of job stress and health in the Norwegian police service: a cross sectional study. J Occup Med Toxicol (London, England). 2006;1:26.

Chen H-C, Chou FH-C, Chen M-C, Su S-F, Wang S-Y, Feng W-W, Chen P-C, Lai J-Y, Chao S-S, Yang S-L, et al. A survey of quality of life and depression for police officers in Kaohsiung, Taiwan. Qual Life Res. 2006;15(5):925–32.

Crank JP, Regoli R, Hewitt JD, Culbertson RG. Institutional and organizational antecedents of role stress, work alienation, and anomie among police executives. Crim Justice Behav. 1995;22(2):152–71.

Houdmont J, Randall R. Working hours and common mental disorders in English police officers. Occup Med (Oxford, England). 2016;66(9):713–8.

Article   CAS   Google Scholar  

Janzen BL, Muhajarine N, Zhu T, Kelly IW. Effort-reward imbalance, overcommitment, and psychological distress in Canadian police officers. Psychol Rep. 2007;100(2):525–30.

Martinussen M, Richardsen AM, Burke RJ. Job demands, job resources, and burnout among police officers. J Crim Just. 2007;35(3):239–49.

McCarty WP, Skogan WG. Job-related burnout among civilian and sworn police personnel. Police Q. 2013;16(1):66–84.

Morash M, Haarr R, Hoon Kwak D. Multilevel influences on police stress. J Contemp Crim Justice. 2006;22(1):26–43.

Mostert K, Rothmann S. Work-related well-being in the south African police service. J Crim Just. 2006;34(5):479–91.

Xavier P, Prabhakar K. A study of police stress and burnout among Tamil Nadu police. Int J Pharm Sci Rev Res. 2016;38(2):159–61.

Morash M, Kwak D, Hoffman V, Lee C, Cho S, Moon B. Stressors, coping resources and strategies, and police stress in South Korea. J Crim Just. 2008;36(3):231–9.

Sedgwick P. Cross sectional studies: advantages and disadvantages. Br Med J. 2014;349:g2276.

Breakwell GM, Smith JA, Wright DB. Research methods in psychology. 4th ed. London: SAGE Publications; 2012.

Gorrell G, Ford N, Madden A, Holdridge P, Eaglestone B. Countering method bias in questionnaire-based used studies. J Doc. 2011;67(3):507–24.

Schaufeli WB, Enzmann D, Girault N. Measurement of burnout: a review. In: Schaufeli WB, Maslach C, Marek T, editors. Professional burnout: recent developments in theory and research. Washington D.C: Taylor and Francis; 1993. p. 199–215.

Donnelly E. Work-related stress and posttraumatic stress in emergency medical services. Prehosp Emerg Care. 2012;16(1):76–85.

Babbie E. The basics of social research. 6th ed. USA: CENGAGE Learning; 2014.

Hoddinott SN, Bass MJ. The Dillman Total design survey method. Can Fam Physician. 1986;32:2366–8.

CAS   PubMed   PubMed Central   Google Scholar  

Phillips AW, Reddy S, Durning SJ. Improving response rates and evaluating nonresponse bias in surveys: AMEE guide no. 102. Med Teach. 2016;38(3):217–28.

Bhopal R. Concepts of epidemiology. 3rd ed. Oxford: Oxford University Press; 2016.

Book   Google Scholar  

Nieuwenhuijsen K, Bruinvels D, Frings-Dresen M. Psychosocial work environment and stress-related disorders, a systematic review. Occup Med (Lond). 2010;60(4):277–86.

de Lange AH, Taris TW, Kompier MAJ, Houtman IL, Bongers PM. ‘The very best of the Millenium’ : longitudinal research and the demand-control-(support) model. J Occup Health Psychol. 2003;8(4):282–305.

Whitehead J, Lindquist C. Job stress and burnout among probation/parole officers: perceptions and causal factors. Int J Offender Ther Comp Criminol. 1985;29(2):109–19.

Wolter C, Santa Maria A, Wörfel F, Gusy B, Lesener T, Kleiber D, Renneberg B. Job demands, job resources, and well-being in police officers—a resource-oriented approach. J Police Crim Psychol. 2019;34(1):45–54.

Finney C, Stergiopoulos E, Hensel J, Bonato S, Dewa CS. Organizational stressors associated with job stress and burnout in correctional officers: a systematic review. BMC Public Health. 2013;13:82.

Schaufeli WB, Peeters MCW. Job stress and burnout among correctional officers: a literature review. Int J Stress Manag. 2000;7(1):19–48.

Violanti JM, Mnatsakanova A, Andrew ME, Allison P, Gu JK, Fekedulegn D. Effort-reward imbalance and Overcommitment at work: associations with police burnout. Police Q. 2018;21(4):440–60.

Sparks K, Cooper C, Fried Y. The effects of hours of work on health: a meta-analytic review. J Occup Organ Psychol. 1997;70:391–408.

Bannai A, Tamakoshi A. The association between long working hours and health: a systematic review of epidemiological evidence. Scand J Work Environ Health. 2014;40:5–18.

Collins PA, Gibbs AC. Stress in police officers: a study of the origins, prevalence and severity of stress-related symptoms within a county police force. Occup Med (Oxford). 2003;53(4):256–64.

Theorell T, Hammarstrom A, Aronssen G. A systematic review including meta-analysis of work environment and depressive symptoms. BMC Public Health. 2015;15:738.

V B, Atasayi S, Molendijk ML. Workplace bullying and mental health: a meta-anlysis on cross-sectional and longitudinal data. PLoS One. 2015;10(8):e0135225.

Graf F. The relationship between social support and occupational stress among police offciers. J Police Sci Adm. 1986;14:178–86.

Stansfeld S, Candy B. Psychosocial work environment and mental health- a meta-analytic review. Scand J Environ Health. 2006;32(6):443–62.

Netterstrom B, Conrad N, Bech P, Fink P, Olsen O, Rugulies R, Stansfeld S. The relation between work-related psychosocial factors and the development of depression. Epidemiol Rev. 2008;30:118–32.

Cantor CH, Tyman R, Slater PJ. A historical survey of police suicide in Queensland Australia 1843-1992. Suicide Life Threat Behav. 1995;25:499–507.

Hem E, Berg AM, Ekeberg AO. Suicide in police--a critical review. Suicide Life Threat Behav. 2001;31(2):224–33.

de Vet HC, Van Tulder MW, Bouter LM. Levels of evidence: intellectual aid or absolute judgement. J Clin Epidemiol. 2003;56:917–78.

Ferreira PH, Ferreira ML, Maher CG. Effect of applying different ‘levels of evidence’ criteria on conclusios of Cochrane reviews of interventions for low back pain. J Clin Epidemiol. 2002;55:1126–9.

Li JCM, Cheung JCK, Sun IY. The impact of job and family factors on work stress and engagement among Hong Kong police officers. Policing: An Int J. 2019;42(2):284–300.

Dewa CS, McDaid D, Ettner SL. An international perspective on worker mental health problems: who bears the burden and how are costs addressed? Can J Psychiatr. 2007;52(6):346–56.

Finn P, Tomz JE. Developing a law enforcement stress program for officers and their families. In: Issues and practices in criminal justice. Washington D.C: National Insitute of Justice; 1996.

Elliot-Davies M, Houdmont J. Officer demand, capacity and welfare survey descriptive statistics summary report: mental health and wellbeing January 2017. Surrey: Police Federation of England and Wales (PFEW); 2017.

Brown J. From cult of masculinity to smart macho: gender perspectives on police occupational culture. In: O’Neil M, Marks M, Singh AM, editors. Police occupational culture: new debates and discussion. Oxford: Elsevier; 2007. p. 189–210.

Download references

Acknowledgements

AP would like to acknowledge the advice and assistance of Dr. Cathy Johnman, Dr. Hilary Thompson, Ms. Mhairi Campbell, and Paul Cannon on approaches, methodology and searches.

Medical Research Council (MC_PC_13027) to ED for her fellowship. The views and opinions expressed are those of the authors and do not necessarily reflect those of the Medical Research Council. The funding body had no role in the study design, in the collection, analysis, and interpretation of data and in writing the manuscript.

Author information

Authors and affiliations.

Public Health, Institute of Health and Wellbeing, University of Glasgow, Glasgow, G12 8RZ, UK

Amrit Purba

MRC/CSO Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, Glasgow, G2 3AX, UK

Evangelia Demou

You can also search for this author in PubMed   Google Scholar

Contributions

AP conducted all the literature searches, screened the studies, conducted data extraction and analysis and drafted the manuscript. ED screened a proportion of studies, contributed to data interpretation and writing of the manuscript. Both authors read and approved the final manuscript.

Corresponding author

Correspondence to Evangelia Demou .

Ethics declarations

Ethics approval and consent to participate.

Not applicable

Consent for publication

Competing interests.

No conflict of interest. ED is a member of the editorial board (Associate Editor) of BMC Public Health. After undertaking this review, ED has received part-funding from a police organisation to conduct a different project on police wellbeing issues.

Additional information

Publisher’s note.

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Additional file 1: table s1..

Personal Communications with experts.

Additional file 2: Tables S2, S3, S4, S5, S6

and S7. PICO Statement (S2), Grey literature sources (S3), and Search Strategies Adopted for Systematic Review (Table S4-S7).

Additional file 3: Table S8.

PICO Screening Template (Table S8).

Additional file 4: Table S9.

Excluded Studies with Reason for Exclusion (Table S9).

Additional file 5: Tables S10

and S11. Results of Modified NOS Risk of Bias Assessment for all Included Studies (Table S10) and Summary of Included Studies (Table S11).

Additional file 6: Tables S12

and S13. Process Adopted to Determine Overall Magnitude of Association of Included Studies by Outcome (Table S12) and Overall Degree of Evidence Grade by MW Outcome (Table S13).

Additional file 7: Table S14.

Eligible Studies following Title and Abstract Screening, which could not be accessed in Full-text (Table S14).

Rights and permissions

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/ ), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/ ) applies to the data made available in this article, unless otherwise stated.

Reprints and permissions

About this article

Cite this article.

Purba, A., Demou, E. The relationship between organisational stressors and mental wellbeing within police officers: a systematic review. BMC Public Health 19 , 1286 (2019). https://doi.org/10.1186/s12889-019-7609-0

Download citation

Received : 04 March 2019

Accepted : 10 September 2019

Published : 15 October 2019

DOI : https://doi.org/10.1186/s12889-019-7609-0

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

• Mental health
• Organisational stressor

BMC Public Health

ISSN: 1471-2458

• Submission enquiries: [email protected]
• General enquiries: [email protected]

ORIGINAL RESEARCH article

Burnout and stress measurement in police officers: literature review and a study with the operational police stress questionnaire.

• 1 Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
• 2 Psychology Unit of the Portuguese National Police, Lisbon, Portugal
• 3 Center for Health Technology and Services Research (CINTESIS), Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
• 4 School of Health of the Polytechnic of Porto, Porto, Portugal
• 5 Department of Education and Psychology, University of Aveiro, Aveiro, Portugal

Research has demonstrated that policing is a stressful occupation and that this stress has a negative impact on police officers’ mental and physical health, performance, and interactions with citizens. Mental health at the workplace has become a concern due to the costs of depression, anxiety, burnout, and even suicide, which is high among police officers. To ameliorate occupational health, it is therefore crucial to identify stress and burnout levels on a regular basis. However, the instruments frequently used to measure stress have not valorized the specificity of policing tasks. This study aims to: (i) conduct a literature review to identify questionnaires used to assess occupational stress and burnout among police officers; (ii) analyze the psychometric characteristics of a Portuguese version of Operational Police Stress Questionnaire (PSQ-Op); and, using the PSQ-Op and other questionnaires, (iii) to identify operational stress, burnout, and distress levels among Portuguese police officers. The literature review identified 108 studies which use a multiplicity of questionnaires to measure burnout or occupational stress among police officers, but few studies use specific police stress questionnaires. Sample sizes were mostly below 500 participants and studies were mainly developed in the last decade in the USA and Brazil, but also in another 24 countries, showing the extent of the interest in this topic. This study applied to 2057 police officers from the National Portuguese Police, a force policing urban centers, and used the PSQ-Op, as well the Spanish Burnout Inventory and the Kessler Psychological Distress Scale. The results show that the psychometric properties of the Portuguese version of PSQ-Op are adequate. Factorial analysis revealed two dimensions defined as social and work issues, which were associated with measures of distress and burnout. Fit indices suggested a second-order solution called operational police stress. Overall, and considering the scale range of each questionnaire, the results showed moderate values of operational stress, distress, and burnout. However, considering their cut-off points, 85% of the sample presented high operational stress levels, 11% critical values for burnout, and 28% high distress levels, with 55% of the sample at risk of a psychological disorder. These results reinforce the need to prevent stress and to invest in police officers’ occupational health.

Introduction

According to recent systematic reviews, being a police officer seems to be a highly demanding and stressful occupation, due to the current characteristics of modern societies. For a police officer, those characteristics include: the uncertainty and danger related to the permanent threat of terrorist attacks, the increase of violence with firearms in urban areas, low human and material resources, team or supervision difficulties, criticism from citizens and society, and lack of understanding from family or friends ( Cumming et al., 1965 ; Webster, 2013 ; Magnavita et al., 2018 ; Purba and Demou, 2019 ). Numerous studies have tried to map police officers’ stress and its sources, a topic highlighted in the 1980s by the NIOSH technical report ( Hurrell et al., 1984 ), and in the 1990s by Norvell et al. (1993) , whose study focused on the influence of gender differences on law enforcement officers. Brown and Campbell (1994) , Violanti and Aron (1995) , and Stinchcomb (2004) also studied the sources of policing stress. However, this topic has attracted more interest in the last decade, with studies developed, for example, by Hickman et al. (2011) , Luceño-Moreno et al. (2016) , and Violanti et al. (2017) , all of whom continue to identify police officers’ stress sources and its negative impact on police officers’ health and job performance. More recently, Baldwin et al. (2019) , Wassermann et al. (2019) , and Ermasova et al. (2020) have contributed to the study of police officers’ stress and psychological/physical health. Related studies have focused more specifically on occupational stress (e.g., Agolla, 2009 ; Maran et al., 2015 ; Gutshall et al., 2017 ; Johnson et al., 2019 ), while others have investigated police officers’ burnout (e.g., Aguayo et al., 2017 ; Adams and Mastracci, 2019 ).

This has led to an increasing interest in police officers’ psychological well-being, with researchers emphasizing the negative impact of working with negative social situations, such as crime and death ( Henry, 2004 ), which can affect mental health and elicit physical fatigue, compassion fatigue, and even moral suffering ( Basinska and Wiciak, 2012 ; Papazoglou, 2016 ; Papazoglou et al., 2017 , 2020 ; Violanti et al., 2019 ). Moreover, studies have concluded that job stress has consistently increased among police officers in the last decade, and this chronic job stress negatively affects both the person and the organization. Individually, it leads to poor mental health ( Baldwin et al., 2019 ; Castro et al., 2019 ), work-family conflict ( Griffin and Sun, 2018 ), non-adaptive coping strategies and job stress ( LeBlanc et al., 2008 ; Zulkafaly et al., 2017 ), emotional labor ( van Gelderen et al., 2007 ), burnout ( Pines and Keinan, 2005 , 2007 ; Rosa et al., 2015 ), and even suicide ( Violanti, 1996 ; Blazina, 2017 ; Costa et al., 2019 ; Grassi et al., 2018 ). Organizationally, it affects performance ( Shane, 2010 ; Bertilsson et al., 2019 ; Kelley et al., 2019 ), counterproductive work behaviors ( Smoktunowicz et al., 2015 ), and inappropriate interactions with citizens, such as the use of excessive force ( Neely and Cleveland, 2011 ; Mastracci and Adams, 2019 ).

A number of news sources have recently reported that France 1 faces an increasing number of police officers committing suicide, especially after the intense work due to the “yellow vests/jackets” manifestations, while Spain 2 and Portugal 3 have also experienced several suicides of police officers, which motivated police officers to demonstrate in the streets and show their anger with job conditions in France 4 and Portugal 5 . Hard working conditions and colleagues’ suicides elicit continuous suffering and psychological pain that affects police officers, their families, and their tasks in important domains of urban life: safety and security. Additionally, stressful situations can increase the use of antidepressants, anxiolytics, or tranquilizers to alleviate psychological suffering, with Portugal being one of the countries where this increased use is the highest in Europe ( OECD, 2019 ), suggesting the need to invest in stress and anxiety prevention and in occupational health.

Despite the increased number of studies analyzing occupational stress and burnout among police officers, researchers frequently use measurement instruments developed for other professional groups which do not apply to the specificities of police tasks, including emotional labor and physical risks. This study aims to: (i) conduct a literature review to identify questionnaires that have been used to assess occupational stress and burnout among police officers; (ii) analyze the psychometric characteristics of a Portuguese version of Operational Police Stress Questionnaire (PSQ-Op), developed by McCreary and Thompson (2006) , to assess the specificities of job stress among police officers; and, using the PSQ-op and other questionnaires, (iii) identify operational stress, burnout, and distress levels among Portuguese police officers.

Regarding burnout and occupational stress measurement among police officers, in the 1970s Freudenberger (1974) and Maslach (1976) identified the symptoms of burnout and defined burnout syndrome as a psychological disorder triggered by chronic exposure to work stress. Burnout has attracted considerable interest in the scientific community and has become a concern for workers, being recognized as a serious professional hazard and a psychosocial risk at work. The definition presented by Maslach and Jackson (1981) seems to be the most consensual, and states that burnout is a three-dimensional syndrome that affects workers whose job tasks are mainly related to helping and delivering care or services to other persons. Burnout is expressed by emotional exhaustion (feeling fatigued and powerless to provide more support to others), depersonalization (showing a disengaged, cynical, cold, and unsympathetic attitude toward persons at work, especially those who seek help or ask for services), and feelings of low professional achievement (feeling personal and professional inadequacy, and having a higher likelihood of committing errors during job tasks). Later, as a result of continuous research on burnout ( Maslach and Leiter, 2016 , 2017 ; Maslach, 2017 ) stated that burnout occurs more frequently among professionals who work with other persons, especially as service providers where, over the years, they must respond to the client’s demands in a society increasingly based on service exchanges, which elicits job stress.

Burnout appears as a response to chronic job stress ( Schaufeli, 2017 ) and has become an epidemic phenomenon with costs for workers and organizations, which is a concern that has been repeatedly highlighted by the European Agency for Safety and Health at Work ( EU-OSHA, 2018 ), namely with its “Healthy Workplaces” campaign. Moreover, several key organizations have reinforced the importance of burnout in modern society. On 10 October 2017, the World Health Organization (WHO) defined mental health in the workplace as the theme for World Mental Health Day, highlighting job stress among specific professional groups, and in 2019 the WHO defined suicide prevention as the theme 6 , alerting the public to the risk of suicide among specific professional groups. In September 2018, the European Foundation for the Improvement of Living and Working Conditions ( EUROFOUND, 2018 ) published the report “Burnout in the workplace: A review of data and policy responses in the EU,” which found that burnout had become a serious problem in Europe and that measures were needed to assess its levels among different occupations. In May 2019, the WHO 7 recognized burnout as an occupational phenomenon to be included in the next version of the International Classification of Diseases. Also in 2019, the European Agency for Safety and Health at Work ( EU-OSHA, 2019a , b ) referred again to “The value of occupational safety and health and the societal costs of work-related injuries and diseases.” Again in 2019, the results of the “Third European Survey of Enterprises on New and Emerging Risks (ESENER-3”) reinforced the negative impact of job stress and the importance of occupation health in preventing occupational stress among other psychosocial risks, a topic that the WHO 8 also highlighted.

According to Lazaus and Folkman (1984 , p. 21), “psychological stress, therefore, is a relationship between the person and the environment that is appraised by the person as taxing or exceeding his or her resources and endangering his or her well-being.” Based on this definition, the concept of stress at the workplace, job stress, or occupational stress can be defined as a “pattern of physiological, emotional, cognitive, and behavioral responses that occur when workers are presented with work demands not matched to their knowledge, skills, or abilities and which challenge their ability to cope” ( Patel et al., 2017 , p. 1), negatively influencing the worker’s wellbeing, performance, and productivity ( Quick and Henderson, 2016 ). Moreover, stress, especially job stress and occupational stress, are related and can predict burnout, since job stress can result from the relationship between job demands and job resources, or from the effort-reward imbalance ( Peiró et al., 2001 ; Lin et al., 2013 ; Chirico, 2016 ; Patel et al., 2017 ; Salvagioni et al., 2017 ; Wang et al., 2017 ). Furthermore, burnout can be a long-term process of resource depletion and inadequate responses to chronic job stress ( Maslach et al., 2001 ; Schaufeli, 2017 ). Burnout is difficult to distinguish from depression since they share similar symptoms ( Bianchi et al., 2015 ; Golonka et al., 2019 ; Koutsimani et al., 2019 ; Bianchi, 2020 ).

Using instruments that allow burnout and stress to be measured is therefore a vital necessity before designing intervention programs for resilience, stress management, and burnout or suicide prevention. However, for police officers as a professional group, those instruments must be chosen carefully, considering the specificity of their policing tasks. To identify the instruments used to measure burnout and stress among police officers, a literature search was performed between January and December 2019 on the EBSCO database of scientific papers, using the following search expression: “police officers” and “burnout or stress” and “instruments or tools or scale or questionnaire or inventory or measurement or assessment or evaluation.” The search found 191 scientific published papers after removing duplicated references. However, 49 papers were focused exclusively on post-traumatic stress disorder; 26 were written in languages other than English, Portuguese, or Spanish, or the complete paper was unavailable; 5 were theoretical papers; and 3 used qualitative methods. Thus, a final number of 108 studies were analyzed, identifying the publication year, number of participants, country of the sample, and instruments used for burnout and stress or occupational stress measurement.

Results of the literature review ( Table 1 ) revealed that most of the studies are recent ( Figure 1 ), though the interest in questionnaires to assess burnout or job stress began in the 1970s. In detail, 11 studies were published between 1979 and 1989, 13 between 1990 and 1999, 18 between 2000 and 2009, and 66 between 2010 and 2019. The samples came from 26 countries ( Figure 2 ), mostly the USA (33), but Brazil appears with 12 studies, 4 or 5 studies were found in the UK, Poland, India, Canada, Spain, and the Netherlands, and 2 or 3 in Switzerland, Sweden, Portugal, Taiwan, Jamaica, Italy, Greece, Germany, and Finland. Three papers used samples from several countries in the same study. Finally, countries with only one study included Thailand, Sri Lanka, South Korea, South Africa, Pakistan, Lithuania, Israel, and China. These data express the global interest of scientific research in stress among police officers.

Table 1. Studies using questionnaires to measure burnout or occupational stress of police officers.

Figure 1. Distribution of papers according year of publication.

Figure 2. Distribution of papers according country of the study.

The sample sizes varied between 11 and 13,146 participants ( M = 595; SD = 1358.56). However, a more detailed analysis ( Figure 3 ) revealed that 28 studies sampled 11–95 participants, 24 studies sampled 101–289, 20 studies sampled 305–489, 22 studies sampled 500–951, and 13 studies sampled 1000–4500 participants. One study collected data from 13,146 police officers in the USA ( McCarty et al., 2019 ).

Figure 3. Distribution of papers according sample size.

The analysis of measurement instruments revealed that 51 studies measured burnout ( Figure 4 ), with the Maslach Burnout Inventory being prevalent (32 studies), while the Oldenburg Burnout Inventory was used in five studies. Three studies used other measures or developed questionnaires adapted from other instruments, while nine studies used specific but different burnout measures. Measures of job stress were found ( Figure 5 ) in 72 studies: six used the Perceived Stress Scale, four used the Lipp Stress Inventory (from Brazil), five used the Police Stress Questionnaire, and 11 used several different police stress questionnaires. However, 10 studies used several occupational stress inventories, 15 used several job stress questionnaires, 15 used several stress questionnaires, and six used other instruments assessing health symptoms other than stress. This review revealed the proliferation of stress measures, although some studies already used specific police stress questionnaires. It can be concluded that measuring burnout and stress among police officers is a concern for the scientific community.

Figure 4. Distribution of papers according burnout measurement instrument.

Figure 5. Distribution of papers according stress measurement instrument.

In Portugal, for burnout measurement among police officers, a study used the Spanish Burnout Inventory ( Gil-Monte, 2011 ) and demonstrated that this questionnaire had adequate psychometric properties for a sample of Portuguese police officers ( Figueiredo-Ferraz et al., 2014 ). Another study ( Queirós et al., 2013 ) used the Maslach Burnout Inventory, analyzing only Cronbach’s alphas but not validating a Portuguese version. Regarding stress measurement, one study used a global measure of stress ( Gomes and Afonso, 2016 ), but no studies were found with specific stress measures for policing. Following the analysis of the specific stress instruments found in the literature review, we decided to translate and validate a Portuguese version of the Police Stress Questionnaire for operational stress. The Police Stress Questionnaire ( McCreary and Thompson, 2006 ) is a short measure (20 items) allowing for the assessment of operational or organizational police stress, it is freely available for research purposes and has established stress levels with cut-off points. Since some studies used global measures of stress or stress symptoms, it was decided to also use the short questionnaire Kessler Psychological Distress Scale (K10), which has a recent Portuguese version ( Pereira et al., 2019 ). Thus, this study can contribute to the development of a Portuguese version of a specific police stress instrument, and to identify stress and burnout levels of a sample of police officers using validated instruments.

Materials And Methods

Participants.

The sample was composed of 2057 police officers of the Portuguese National Police ( Polícia de Segurança Pública, PSP ), a police force that works only in the cities of all 18 Portuguese districts and the Azores and Madeira Islands. The sample constitutes nearly 10% of this force and all districts were represented: Lisbon contributed 45% of the sample, Porto 19%, Setubal 6%, Faro and Azores 4%, Madeira 3%, and other districts between 0.3 and 2.5%.

Regarding police officers’ positions, 78.8% were in the “ agent ” category (the lowest-ranking officer), 14.6% were “chief,” and 6.5% commander (the highest rank). The most frequent tasks were patrolling (52%), criminal investigation (17%), and road traffic management (13%). Other participants worked in integrated special police units, rapid intervention teams, specific proximity teams (e.g., schools or elderly safety programs), administrative services, and commander teams.

The age of the participants varied between 21 and 65 years old ( M = 42.47; SD = 8.785), with 33.4% between 21 and 38 years, 32.5% between 39 and 45, and the rest between 46 and 65. Job experience in the Portuguese National Police varied between 1 and 41 years ( M = 19.267; SD = 9.036), with 32.3% of the sample between 1 and 14 years, 34.7% between 15 and 23 years, and the rest between 24 and 41 years. Regarding gender, 92% were men and 8% women, while overall women represent nearly 10% of the police force. To avoid the possible identification of individuals from the matching of position, age, gender, and district, no statistical analyses were performed that combined these data, and no other sociodemographic data were collected.

The questionnaire was composed of four major groups of questions, the first characterizing the sociodemographic data (age, sex, job experience, district, position, and job task). The second group was composed of the Operational Police Stress Questionnaire (PSQ-Op), developed by McCreary and Thompson (2004 , 2006) to assess the specificities of job stress among police officers both for operational and organizational stress sources (PSQ-Op and PSQ-Org). This study used the operational stress sources only. The PSQ-Op questionnaire is composed of 20 items evaluated on a 7-point scale ranging from 1 (“not at all stressful” or “no stress at all”) to 7 (“very stressful” or “a lot of stress”), with 4 indicating moderate stress. The authors were contacted by email to obtain permission for the Portuguese version, but no answer was obtained for the PSQ-Op as it is provided free for non-commercial, educational, and research purposes 9 . In later developments, McCreary et al. (2017) established norms and cut-off values, with values below 2.0 indicating low stress, between 2.1 and 3.4 moderate stress, and above 3.5 high stress. As far as we know, no Portuguese version of the PSQ-Op has been published, and two psychologists (one conducting research about policing and police forces, another working with police officers) translated the questionnaire into Portuguese. Another researcher, unfamiliar with police officers’ work, subsequently back-translated the questionnaire into English and compared it with the original version. Finally, these three researchers discussed each item with two police officers (a patrol police officer and a police station commander) until a lexical and cultural consensus was obtained, including suggestions from the police officers to add some examples adapted for Portuguese situations ( Table 2 ). A pilot study was performed with 20 police officers to ensure that the questionnaire was easy to complete and was applicable to the Portuguese situation, and no major changes were made.

Table 2. PSQ-Op original and Portuguese versions.

The third group of questions was composed from the Spanish Burnout Inventory (SBI, Gil-Monte, 2011 ), using a Portuguese version already tested on police officers, having demonstrated adequate psychometric properties ( Figueiredo-Ferraz et al., 2014 ). This instrument considers burnout as a process of cognitive and emotional deterioration, involving attitudes of indifference and guilt ( Gil-Monte and Manzano-García, 2015 ). It includes 20 items organized on four scales: (1) enthusiasm for the job (demonstrating, for instance, the ambition to accomplish a person’s professional goals because they are a source of personal achievement); (2) psychological exhaustion (emotional and physical exhaustion related to job tasks, increased by dealing every day with people who present difficulties or problems); (3) indolence (negative attitudes of indifference and cynicism when dealing with persons demanding things related to a person’s job tasks); and (4) guilt (negative feelings, behaviors, and attitudes in the workplace, elicited by interactions during labor relations). Each item is assessed by a 5-point frequency scale ranging from 0 (never) to 4 (very frequent or every day). Low scores on Enthusiasm for the Job, along with high scores on Psychological Exhaustion, Indolence, and Guilt, indicate high levels of burnout. Scores for each of the four scales are calculated using the mean of the items that compose each scale, and a global score for burnout is then calculated after reversing the items of the Enthusiasm scale. According to Poletto et al. (2016) , it is possible to use percentile analysis to identify burnout at very low levels ( P ≤ 10), low levels (11 < P ≤ 33), moderate levels (34 < P ≤ 66), high levels (67 < P ≤ 89), and critical levels ( P ≥ 90).

The fourth and last group of questions was composed from the Kessler Psychological Distress Scale (K10), from Kessler et al. (2002 , 2003) . We used the Portuguese version by Pereira et al. (2019) , who described K10 as having 10 items that assess the frequency of non-specific psychological distress symptoms during the last month, being a self-report measure based on questions about the symptoms of anxiety and depression. All items are assessed on a 5-point scale (1 = “none of the time” to 5 = “all of the time”) and the sum of the scores indicates the stress level, where high scores correspond to high stress levels. Using this sum it is possible to identify cut-off points of stress levels, where 10–15 points correspond to “low distress,” 16–21 points to “moderate,” 22–29 points to “high,” and 30–50 points to “very high.” Values between 22 and 50 points indicate a risk of developing a psychological disorder ( Andrews and Slade, 2001 ; Pereira et al., 2019 ).

After formal authorization by the Directorate of the Portuguese National Police to develop the study and collect data among the police officers, an online questionnaire was prepared on Google Forms with a link inviting participation in a study of burnout and occupational stress among police officers. The Directorate disseminated this link to the police officers using their professional email addresses. There was no direct contact between participants and researchers, and data were collected in September and October 2019. No exclusion criteria existed, and participation was voluntary. The participation rate was nearly 10% of the number of police officers that constitute this police force. Researchers were unable to identify how many police officers read the email and/or followed the link and decided not to participate. This study was carried out in accordance with the recommendations of the Ethics guidelines of the FPCEUP Ethics Committee, having online informed consent from all participants in accordance with the Declaration of Helsinki. Thus, before responding to the questionnaire, participants were asked to provide their informed consent, with the notification that data would be gathered anonymously. Data were accessed by one researcher only, who downloaded the Excel file and converted it to SPSS format.

Data Analysis

Statistical analysis was performed using Statistical Package for Social Sciences, version 24 (SPSS Inc., Chicago) and Analysis of Moment Structures (AMOS) version 24. In the first stage, preliminary analyses were conducted in order to assess descriptive statistics, and normality and non-multicollinearity at item level. To test the factorial structure of the PSQ-Op, we used a combination of Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA). The sample was randomly split into two samples through the randomization function in SPSS. With the first part of the sample ( n = 636), an EFA using Principal Axis Factoring (PAF) with direct oblimin rotation was conducted to identify a viable factor structure by extracting the minimum number of factors that explained the maximum variance in the 20-item scale. With the remaining sample, a CFA was performed to verify if the solution obtained from the EFA presented an acceptable fit. The root mean square error of approximation (RMSEA), the comparative fit index (CFI), and the standardized root mean square residual (SRMR) were the three indicators used to evaluate the model’s fit. An acceptable-fit model was determined if RMSEA ≤ 0.08, CFI > 0.90, and SRMR < 0.10 ( Kline, 2005 ). The chi-square test (χ 2 ) was reported for completeness, but not used to check the model fit due to its sensibility to large samples ( Kelloway, 1995 ). Based on the multivariate normality violations, CFA used the maximum likelihood estimation with bootstrapping (1000 resamples). The Bollen-Stine bootstrap p was an index fit also reported. Alternative factor models were generated and tested according to the modification indexes (MI > 11).

Convergent validity was assessed by computing the average variance extracted with values of AVE ≥ 0.50 indicating satisfactory validity. In turn, in order to investigate the evidence of discriminant validity, we examined whether the AVE values were equal to or greater than the squared correlation between the factors ( r 2 DV ) ( Maroco, 2014 ). Following the model specification, reliability was investigated using (a) Cronbach’s alpha coefficient and (b) composite reliability for each factor and for the overall scale.

Finally, the relationship between the PSQ-Op dimensions and distress and burnout symptoms was determined from the Pearson correlation coefficients including the entire sample, as well as the descriptive statistics, which allowed us to identify burnout, distress, and operational stress levels.

Since there are no specific measures for operational stress among police officers, it was necessary to evaluate the psychometric properties of the Portuguese version of the PSQ-Op before identifying burnout, distress, and operational stress levels.

Preliminary Analysis: Item Properties

As shown in Table 3 , all possible Likert-scale answer values for each item were observed. The mean for most items was close to 5. The overall mean response for the 20 items was 4.97 ( SD = 0.45) No deviations from the normal distribution were found considering skewness ( Sk , < 3.0) and kurtosis ( Ku , ≤ 7.0) absolute values ( Byrne, 2016 ). All items presented significant positive corrected item-total correlations (≥0.40) and low variation in reliability if the item was deleted. Inter-correlations among all items were significant and no multicollinearity was obtained (0.390 ≤ r ≤ 0.731) ( Tabachnick and Fidell, 2001 ). Based on this analysis, 20 items were retained for subsequent analyses.

Table 3. Descriptive statistics about PSQ-Op items ( n = 2057).

Exploratory Factor Analysis (EFA)

In order to examine the factor structure, an EFA was conducted based on a randomized split of the data in the sample ( n = 636). EFA using principal axis factor analysis with promax rotation determined the factor structure of the 20 items of the questionnaire. The Kaiser-Meyer-Olkin (KMO) measure presented a value of 0.964 and Bartlett’s test of sphericity was significant (χ 2 = 9621.92, p < 0.001), validating the correlation matrix structure. EFA yielded a 20-item measure with a two-factor solution ( Table 4 ): nine items included content related to social issues (items 7, 8, and 14–20), which expressed the feeling that a police officer is always on the job, as well as facing difficulties in managing personal life or balancing work and family, and having to deal with the public/social image of the police force and citizens’ negative comments; the other eleven items included content that reflected work issues (items related to specific details of policing tasks such as shift work, paperwork, injuries, fatigue, and traumatic events). These two factors together (social issues and work issues) accounted for 60.30% of the total variance. A good internal consistency for each factor was estimated using Cronbach’s alpha coefficients: factor 1, α = 0.937 and factor 2, α = 0.933.

Table 4. Factors extracted from the exploratory factor analysis (EFA): communalities and factor loadings ( n = 636).

Confirmatory Factor Analysis (CFA)

Two-factor model.

Mardia’s coefficient for the PSQ-Op was 181.19, indicating violation of the multivariate normality, so a maximum likelihood estimation with bootstrapping was used to generate accurate estimations of standard errors (bias-corrected at the 95% confidence level). The two-factor model derived from EFA was then cross-validated on 1421 participants retained from the entire sample. This solution was run and demonstrated a marginal fit, since the CFI value was above 0.87 and RMSEA and SRMR values were below 0.10 ( Bong et al., 2013 ). The factor loadings of items were above 0.65 ( Table 5 ). The Bollen-Stine value ( p = 0.001) suggested a poor fit ( p > 0.05 according to Bollen and Stine, 1992 ), but this result might have been affected by the large sample size. High correlations between factors were observed.

Table 5. Confirmatory factor analysis (CFA): fit indexes for each model tested ( n = 1421).

Convergent and Discriminant Validity Evidence

Values of AVE indicated the construct’s convergent evidence. AVE was determined for social issues (AVE = 0.59) and work issues (AVE = 0.54). Concerning the discriminant validity, AVE of the factors was compared to the r 2 DV . AVE for the two scales was smaller than r 2 DV= 0.76 . These data confirmed that the factors are strongly related to each other, indicating that a unidimensional model or a second-order latent model may be admissible solutions.

Unidimensional and Second-Order Models

A single latent model where the factor of operational police stress loads on all 20 items presented a poor fit. Higher error covariance was observed in more than 50% of the items. Based on this result, no additional covariance paths were allowed between error terms. Thus, we examined fit indices for a second-order solution called operational police stress ( Table 5 ), integrating the social and work issues. Based on the high modification indices, allowing errors to covary for items 3 and 5, 4 and 6, 10 and 11, and 15 and 16 improved the model fit. The PSQ-Op second-order construct ( Figure 6 ) presented an acceptable fit based on the values of CFI, RMSEA, and SRMR fit indices. All factor loadings were statistically significant ( p < 001). The constrained structural weights from operational police stress to social and work factors were high ( Ý = 0.89, Ý = 0.98, p < 0.001, respectively).

Figure 6. Final confirmatory factor analysis: second-order model with correlated errors.

Internal Consistency Evidence

To examine the reliability of the scores in the final model, we used Cronbach’s alpha coefficient and composite reliability. Good internal consistency was obtained in the higher-order construct (α = 0.96) and, simultaneously, for the first-order factors (α = 0.93). Composite reliability coefficients presented values of 0.92 and 0.93 respectively for factors with content related to work and social issues.

Relationship of PSQ-Op Factors to Distress and Burnout

The PSQ-Op dimensions obtained from the factorial analysis were associated with measures of distress and burnout for the overall sample ( Table 6 ). Positive and moderate to strong correlations ( Ratner, 2009 ) were found, demonstrating the convergent validity of this tool (except for Guilt where correlations were weaker). Higher scores on operational police stress dimensions, such as problems directly related to working conditions and to the impact of work on family and social life, were associated with increased scores in other scales of distress and burnout, except for Enthusiasm, which presented negative correlations. Considering the correlation values, it seems that social-related issues contributes most for burnout and distress compared to work-related issues.

Table 6. Relationship between PSQ-OP latent variables and distress and burnout symptoms ( n = 2057).

Psychological Indicators

Analyses of all the questionnaire scales ( Table 7 ) revealed that the sample presented at least one participant with the minimum or maximum value allowed by the scales’ range. The mean values for operational stress were moderate, being higher for Social-related issues than for Operational stress global score and Work-related issues. Moderate mean values were also found for burnout, being higher for Psychologic Exhaustion and Indolence than for Enthusiasm and Burnout, while Guilt presented a low value. Finally, moderate values were found for Distress, being higher (proportionally) for Anxiety and Distress than for Depression, though very similar. These results are based on mean values of the sample inside each scale range.

Table 7. Descriptive statistics of operational stress, distress and burnout.

However, a more detailed analysis was performed considering established levels and cut-off points for each questionnaire ( Table 8 ). For operational stress, the sample presented high stress for 89% on Work-related issues, 84.8% for Operational stress, and 76.2% for Social-related issues, while low stress was recorded at 2.5, 2.7, and 5.9%, respectively for each dimension, suggesting that police officers are experiencing high stress levels and, as referred, not moderates stress according to the mean values. Regarding burnout, 10.6% of the sample presented a very low level and 25.3% a low level for Enthusiasm, while 16.5% presented a high level and 10.6% a critical level for Psychological Exhaustion. For Indolence, those values were respectively 21.8 and 9.7% for Guilt, 20.3 and 8.9%, and for Burnout 21.9 and 10.7%. Finally, for Distress, 21.2% presented low stress, 26.5% high stress, and 28% very high stress, with 54.5% at risk of developing a psychological disorder. This suggests the importance of using cut-off points for each instrument, since they allow us to obtain more detailed information.

Table 8. Sample’s frequency (and percentage) distribution according established level (cut-off points).

The literature review showed that the most used psychological measures are not specific nor validated for the specificities of policing tasks. A previous study ( Figueiredo-Ferraz et al., 2014 ) demonstrated that the Spanish Burnout Inventory has adequate psychometric properties for police officers. Furthermore, the Portuguese version of the Police Stress Questionnaire for operational stress also revealed adequate psychometric properties, having a second-order construct but also the possibility to consider two scales that measure work-related issues and social-related issues. However, Irniza et al. (2014) found a unidimensional construct on PSQ-Op for Malay police officers.

Using those two measures combined with a short measure of distress, it was possible to identify burnout, distress, and operational stress among a large national sample of Portuguese police officers, representing nearly 10% of the entire Portuguese police force. The results showed that the mean values of burnout, distress, and operational stress were moderate, but the cut-off points revealed that operational stress and its scales of work-related issues and social-related issues presented high stress levels for more than 75% of the sample (85, 89, and 76%, respectively).

These results are in line with other studies, such as the research by Lipp et al. (2017) , who found that 52% of their sample felt stressed, and the study by Brown and Cooper (1996) , who also found high stress levels. In the original study for the development of the PSQ-Op, McCreary and Thompson (2006) found that the mean values among Canadian police officers for the 20 items varied between 2.66 and 4.40 and that operational stress had a mean value of 3.32, while the Portuguese sample presented values between 4.02 and 5.57 with operational stress having a mean value of 4.98. Despite the difference between the time of data collection and cultural differences between the countries, given that the maximum value in the range is 7 points, the data suggest a higher level of stress among the Portuguese than the Canadian police officers. Summerlin et al. (2010) found high stress levels among American police officers for some operational tasks (e.g., 68% of the sample considered paperwork to be highly stressful and 73% considered handling the public image to be so), but other tasks were considered as highly stressful only for a few participants (e.g., 16% for activities during days off), while the Portuguese sample considered all tasks as either moderately or highly stressful. Bergman et al. (2016) reported mean values for operational stress among American police officers as 3.4, and 2.91 after a mindfulness intervention. Kaplan et al. (2017) reported mean values for operational stress (also among American police officers) as 3.47. All of these values are smaller than the Portuguese sample in the current study.

The sample presented moderate values for distress symptoms, but 28% of the sample presented very high distress levels, with 55% at risk of developing a psychological disorder. Additionally, the depression scale presented higher values than anxiety. As stated by the European Agency for Safety and Health at Work ( EU-OSHA, 2018 , 2019a , b ), stress has become one of the most important psychosocial risks in the workplace, and it is crucial to develop measures to prevent it. Moreover, anxiety and depression are increasing ( OECD, 2019 ) and are related to distress and burnout, which increases the difficulty of identifying and distinguishing these psychological problems ( Bianchi et al., 2015 ; Golonka et al., 2019 ; Koutsimani et al., 2019 ; Bianchi, 2020 ).

The sample also presented moderate values for burnout, with Guilt having the lowest average, while Psychological Exhaustion and Indolence were higher. However, the analysis of cut-off points revealed that 11% of the sample presented critical values for Burnout, while values between 9 and 11% were found for other burnout dimensions. These values are less than those found by McCarty et al. (2019) who found that 19% of a sample of American police officers suffered with emotional exhaustion and 13% with depersonalization. However, Gutshall et al. (2017) found moderate burnout levels for American police officers, whereas Solana et al. (2013) found high levels of burnout for Spanish police officers. As studies have revealed that burnout decreases self-protective behaviors and increases aggressive behaviors ( Euwema et al., 2004 ; Queirós et al., 2013 ; Ellrich, 2016 ), it seems important to assess burnout levels on a regular basis.

Finally, analysis of the correlation between operational stress, distress, and burnout found that higher scores for operational stress, such as problems directly related to working conditions and the impact of work on family and social life, were associated with higher scores for other scales of distress and burnout. Furthermore, it seems that social-related issues interfere most with burnout and distress compared to work-related issues. This may be due to the fact that currently a police officer is not so well respected by society, especially when they are from a national police force that works in urban centers, such as the Portuguese police officers sampled in this study. This means that a large number of participants are away from their families and friends, working in large urban cities such as Lisbon or Oporto, and have difficulties receiving social support from their relatives. This situation contributes to a difficult balance between work and family, and Portugal is a country where professionals work more hours and have more work-family conflicts according to the OECD Better Life Index 2019 10 .

Burnout and stress among police officers has received increased attention from the scientific community and society, due to the psychological suffering they inflict on the individual, but also because of their impact on the performance of police officers and their interactions with citizens, leading to the increased possibility of all interactions being considered a threat, or to a tendency to use excessive force. Thus, it is crucial to develop stress management interventions ( Patterson et al., 2014 ) and resilience interventions focused on policing specificities, such as those developed by projects like BCOPS ( Wirth et al., 2017 ), HEROES ( Thornton et al., 2020 ), POWER ( Papazoglou and Blumberg, 2019 ), or POLICE ( Trombka et al., 2018 ). However, before implementing an intervention, we need to identify burnout and stress levels, both in the early and later stages of a career. This implies a regular assessment of police officers and will be made easier if short and specific instruments are available and validated for policing stressors. Moreover, occupational health has become a concern, along with the need to identify critical situations early that might, without intervention, lead to situations that are more dangerous. Training mental strength, resilience, or emotional intelligence seems to be a possibility ( Papazoglou and Andersen, 2014 ; Meulen et al., 2017 ; Romosiou et al., 2018 ), as well as reflecting the work values of police officers ( Basinska and Daderman, 2019 ), since motivations for becoming a police officer have changed in recent decades ( Lester, 1983 ; White et al., 2010 ). Furthermore, according to Blumberg et al. (2019 , p. 1), new directions should be taken in police academy training, preparing police officers “to meet the contemporary challenges of police work,” and also to develop psychological skills, such as by including in the curricula stress prevention and management programs, as well as topics such as the stress-burnout relationship.

Psychological suffering among police officers can be expressed to others through disengagement or cynical behavior, or impact on the self in the form of depression, sometimes leading to suicide. In fact, suicide among police has become a serious problem and is commonly carried out with the service handgun ( Costa et al., 2019 ). Discussing the current study can help to increase awareness of psychological problems, especially those that are chronic and may result in burnout, and also to reduce burnout stigma and the stigma to seek help ( Endriulaitiene et al., 2019 ). The results highlight the importance of occupational health services in risk prevention and the recovery of workers who play a crucial role in society, such as police officers who deal with safety and security at a national level. Studies that seek to identify police officers’ stress and burnout levels must be continued and will contribute to identifying the risk and protective factors that influence a person’s well-being, quality of life, job performance, and mental health, and also their families and the beneficiaries of police services (society and citizens).

Theoretical Implications

This study highlights the need to continue research on burnout and stress among police officers to develop our understanding of specific police stressors, such as those evaluated by the PSQ-Op. The literature review reinforces the importance of developing psychological instruments focused on policing tasks, while the data of the sample allow us to verify the relationship between job stress, stress symptoms, and burnout, which present moderate to strong correlations, suggesting they are independent constructs. Furthermore, these results can contribute to scientific research on police forces, a topic that has received increased attention globally, with a particular focus on the causes of stress and burnout. Both the World Health Organization and the European Agency for Safety and Health at Work have highlighted the need to prevent and manage job stress and to valorize mental health in the workplace, as well as the need to view burnout as an occupational phenomenon that must be considered among other psychosocial risks at work.

Practical Implications

This study provides preliminary data for the Portuguese version of the Police Stress Questionnaire, which presents adequate psychometric properties. Being a short measure, it can be used easily in the future to identify early police officers at risk of developing psychological problems, since occupational stress is related to burnout as an inadequate method of managing chronic job stress. This study used data from a large sample of Portuguese police officers, representing 10% of the entire national force, and the results can be used to identify stress and burnout levels before implementing intervention programs. Additionally, the literature review can be used to identify scientific studies that have assessed stress and burnout among police officers using questionnaires. These kinds of studies can contribute to reducing the stigma of seeking help when police officers confirm that a large number of colleagues are experiencing the same symptoms and difficulties.

Limitations

In the literature review, the search was focused on studies using questionnaires. This does not reflect all studies of police stress and burnout, which have increased enormously in the last decade. Moreover, the review did not consider post-traumatic stress, which can occur among professionals such as police officers who work in dangerous situations and frequently face critical incidents that can be potentially traumatic. Regarding data collection, the sample came from only one of the Portuguese police forces (called Polícia de Segurança Pública , a civil force). Despite the data being a national sample, no data were collected from police officers working in rural areas (from a militarized force called Guarda Nacional Republicana ), or from a judicial/criminal force (called Polícia Judicária ), which together comprise the three major Portuguese police forces. Furthermore, data analysis focused on the psychometric properties of the PSQ-Op and on stress/burnout identification levels. The analyses did not compare individual and professional characteristics such as age, gender, or career position. It is worth noting that the meta-analysis of Aguayo et al. (2017) found that sociodemographic factors can be associated with police officers’ burnout.

Future Research

It will be important in future research to include samples from other Portuguese police forces to verify the invariance of PSQ-Op structure and validity. It will also be necessary to analyze the organizational stressors, which form the second part of the Police Stress Questionnaire. Moreover, the impact of individual and professional characteristics on stress and burnout must be considered, since the literature frequently suggests that different genders deal differently with emotions and stressors, with women feeling more emotional exhaustion, whereas men feel more disengagement, depersonalization, or indolence, and react differently to shift work ( Violanti et al., 2018 ). Additionally, other psychological variables such as coping and resilience must be included, since they can affect stress responses and the process of stress and burnout development ( Allison et al., 2019 ).

Data Availability Statement

The datasets generated for this study are available on request to the corresponding author, after National Portuguese Police authorization.

Ethics Statement

This study was carried out in accordance with the recommendations of the Ethics guidelines of the FPCEUP Ethics Committee, having online informed consent from all participants in accordance with the Declaration of Helsinki. The study was approved by the Portuguese National Police.

Author Contributions

CQ, FP, AP, and CS designed the study. CQ and FP developed the theoretical framework. CQ and AM performed the literature review. AB, AP, and CQ performed the statistical analyses. All authors participated in results’ discussion and final version of the manuscript. All authors of this research manuscript have directly participated in the planning, execution, and analysis of this study.

This work was funded by the Center for Psychology at the University of Porto, Portuguese Science Foundation (FCT UID/PSI/00050/2013) and EU FEDER through COMPETE 2020 program (POCI-01-0145-FEDER-007294).

Conflict of Interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Acknowledgments

We wish to reinforce there are several acknowledgements Directorate of Portuguese National Police who approved and disseminated the study; all police officers of the PSP (from the first professional positions through to the high commanders) who generously spent their time participating in and disseminating the study, allowing us to collect data from a national sample; Professor Pedro Gil-Monte and TEA Ediciones, Spain, who authorized the use of SBI Portuguese version; and Sara Faria and Sílvia Monteiro Fonseca, who helped with the literature search, its organization, and preliminary analysis.

• ^ https://apnews.com/aa2ac2c871a349ecbdb98313b644634b (August 2019).
• ^ www.facebook.com/zerosuicidiopolicial/ (January 2020) and https://www.elespanol.com/reportajes/grandes-historias/20170909/245476036_0.html (September 2017).
• ^ https://www.publico.pt/2019/07/17/sociedade/noticia/sindicatos-querem-ministerio-publico-investigue-suicidios-policia-1880178 (July 2019).
• ^ https://www.euronews.com/2019/10/02/thousands-of-french-police-protest-for-better-working-conditions-and-answer-to-high-suicid (October 2019).
• ^ https://sicnoticias.pt/pais/2019-11-21-Dia-de-manifestacao-de-policias-em-Lisboa-sob-olema-tolerancia-zero (November 2019).
• ^ https://www.who.int/mental_health/world-mental-health-day/en/ .
• ^ https://www.who.int/mental_health/evidence/burn-out/en/ .
• ^ https://www.who.int/occupational_health/topics/stressatwp/en/ .
• ^ https://www.midss.org/sites/default/files/psq-op.pdf .
• ^ https://stats.oecd.org/Index.aspx?DataSetCode=BLI .

Adams, I., and Mastracci, S. (2019). Police body-worn cameras: effects on officers’ burnout and perceived organizational support. Police Q. 22, 5–30. doi: 10.1177/1098611118783987

CrossRef Full Text | Google Scholar

Agolla, J. E. (2009). Occupational stress among police officers: the case of botswana police service. Res. J. Bus. Manag. 3, 25–35. doi: 10.3923/rjbm.2009.25.35

Aguayo, R., Vargas, C., Cañadas, G. R., and Fuente, E. I. (2017). Are socio-demographic factors associated to burnout syndrome in police officers? A correlational meta-analysis. An. Psicol. 33, 383–392. doi: 10.6018/analesps.33.2.260391

Alberti, J. M., Niñerola, J., Figueras, A., Higueras, E., Gutiérrez, M., Melero, A., et al. (2016). Burnout symptoms can be predicted by personality traits and psychopathology in a sample of Catalan police officers. Pers. Individ. Diff. 101:516. doi: 10.1016/j.paid.2016.05.302

Albuerne, M., Nieto, M., and Moreno, L. (2015). Turnos y estrés psicosocial en los policías locales de Madrid. Ansiedad Estres 21, 57–70.

Google Scholar

Allison, P., Mnatsakanova, A., McCanlies, E., Fekedulegn, D., Hartley, T. A., Andrew, M. E., et al. (2019). Police stress and depressive symptoms: role of coping and hardiness. Policing Int. J. [Epub ahead of print]. doi: 10.1108/pijpsm-04-2019-0055

Almeida, D. M., Lopes, L. F., Costa, V. M., and Santos, R. T. (2018). Policiais militares do estado do rs: relação entre satisfação no trabalho e estresse ocupacional. Admin. Públ. Gestão Soc. 10, 55–65. doi: 10.21118/apgs.v10i1.1366

Andrews, G., and Slade, T. (2001). Interpreting scores on the kessler psychological distress scale (K10). Austral. New Zeal. J. Public Health 25, 494–497. doi: 10.1111/j.1467-842x.2001.tb00310.x

Anshel, M. H., and Brinthaupt, T. M. (2014). An exploratory study on the effect of an approach-avoidance coping program on perceived stress and physical energy among police officers. Psychology 5, 676–687. doi: 10.4236/psych.2014.57079

Anson, R. H., Johnson, B., and Anson, N. W. (1997). Magnitude and source of general and occupation-specific stress among police and correctional officers. J. Off. Rehabil. 25, 103–113. doi: 10.1300/J076v25n01_07

Antoniou, A. S. (2009). Occupation-specific precursors of stress among greek police officers: the roles of rank and gender. Int. J. Police Sci. Manag. 11, 334–344. doi: 10.1350/ijps.2009.11.3.136

Arnetz, B. B., Arble, E., Backman, L., Lynch, A., and Lublin, A. (2013). Assessment of a prevention program for work-related stress among urban police officers. Int. Arch. Occup. Environ. Health 86, 79–88. doi: 10.1007/s00420-012-0748-6

PubMed Abstract | CrossRef Full Text | Google Scholar

Baka, L. (2015). The effects of job demands on mental and physical health in the group of police officers. Testing the mediating role of job burnout. Stud. Psychol. 57, 285–299. doi: 10.21909/sp.2015.03.700

Bakker, A. B., and Heuven, E. (2006). Emotional dissonance, burnout, and in-role performance among nurses and police officers. Int. J. Stress Manag. 13, 423–440. doi: 10.1037/1072-5245.13.4.423

Baldwin, S., Bennell, C., Andersen, J. P., Semple, T., and Jenkins, B. (2019). Stress-activity mapping: physiological responses during general duty police encounters. Front. Psychol. 10:2216. doi: 10.3389/fpsyg.2019.02216

Basinska, B. A., and Daderman, A. M. (2019). Work values of police officers and their relationship with job burnout and work engagement. Front. Psychol. 10:442. doi: 10.3389/fpsyg.2019.00442

Basinska, B. A., and Wiciak, I. (2012). Fatigue and professional burnout in police officers and firefighters. Intern. Security 4, 267–275.

Basinska, B. A., Wiciak, I., and Daderman, A. M. (2014). Fatigue and burnout in police officers: the mediating role of emotions. Policing Int. J. Police Strateg. Manag. 37, 665–680. doi: 10.1108/pijpsm-10-2013-0105

Bergman, A. L., Christopher, M. S., and Bowen, S. (2016). Changes in facets of mindfulness predict stress and anger outcomes for police officers. Mindfulness 7, 851–858. doi: 10.1007/s12671-016-0522-z

Bertilsson, J., Niehorster, D., Fredriksson, P., Dahl, M., Granér, S., Fredriksson, O., et al. (2019). Towards systematic and objective evaluation of police officer performance in stressful situations. Police Pract. Res. 5, 1–15. doi: 10.1080/15614263.2019.1666006

Bianchi, R. (2020). Do burnout and depressive symptoms form a single syndrome? Confirmatory factor analysis and exploratory structural equation modeling bifactor analysis. J. Psychos. Res. 131:109954. doi: 10.1016/j.jpsychores.2020.109954

Bianchi, R., Schonfeld, I. S., and Laurent, E. (2015). Is it time to consider the “burnout syndrome” a distinct illness? Front. Public Health 3:158. doi: 10.3389/fpubh.2015.00158

Blazina, B. (2017). The characteristics of suicide among Slovene Police officers over the past seven decades. Rev. Kriminalistiko Kriminologijo 68, 333–358.

Blumberg, D. M., Schlosser, M. D., Papazoglou, K., Creighton, S., and Kaye, C. C. (2019). New directions in police academy training: a call to action. Int. J. Environ. Res. Public Health 16:4941. doi: 10.3390/ijerph16244941

Bollen, K. A., and Stine, R. A. (1992). Bootstrapping goodness-of-fit measures in structural equation models. Sociol. Methods Res. 21, 205–229. doi: 10.1177/0049124192021002004

Bong, M., Woo, Y., and Shin, J. (2013). Do students distinguish between different types of performance goals? J. Exp. Educ. 81, 464–489. doi: 10.1080/00220973.2012.745464

Brown, J., and Cooper, C. (1996). Occupational stress among senior police officers. Br. J. Psychol. 87, 31–41. doi: 10.1111/j.2044-8295.1996.tb02575.x

Brown, J., and Fielding, J. (1993). Qualitative differences in men and women police officers’ experience of occupational stress. Work Stress 7, 327–340. doi: 10.1080/02678379308257072

Brown, J. M., and Campbell, E. A. (1994). Stress and Policing: Sources and Strategies. Chichester: John Wiley & Sons.

Burke, R. J. (1993). Work-family stress, conflict, coping, and burnout in police officers. Stress Med. 9, 171–180. doi: 10.1002/smi.2460090308

Burke, R. J. (1994). Stressful events, work-family conflict, coping, psychological burnout, and well-being among police officers. Psychol. Rep. 75, 787–800. doi: 10.2466/pr0.1994.75.2.787

Burke, R. J., and Deszca, E. (1986). Correlates of psychological burnout phases among police officers. Hum. Relat. 39, 487–501. doi: 10.1177/001872678603900601

Burke, R. J., and Mikkelsen, A. (2005). Burnout, job stress and attitudes towards the use of force by Norwegian police officers. Policing 28, 269–278. doi: 10.1108/13639510510597906

Burke, R. J., and Mikkelsen, A. (2006). Burnout among norwegian police officers: potential antecedents and consequences. Int. J. Stress Manag. 13, 64–83. doi: 10.1037/1072-5245.13.1.64

Burke, R. J., Shearer, J., and Deszca, E. (1984). Correlates of burnout phases among police officers. Group Organ. Manag. 9, 451–466. doi: 10.1177/105960118400900403

Byrne, B. M. (2016). Structural Equation Modelling with AMOS: Basic Concepts, Applications and Programming , 3rd Edn. Abingdon: Routledge.

Carvalho, A. L., Cury, A., and Garcia, R. (2008). Prevalence of bruxism and emotional stress and the association between them in Brazilian police officers. Braz. Oral Res. 22, 31–35. doi: 10.1590/S1806-83242008000100006

Castro, M. C., Rocha, R., and Cruz, R. (2019). Mental health of the Brazilian police policy: theoretical-methodological trends. Psicol. Saúde Doença 20, 525–541. doi: 10.15309/19psd200220

Charles, E., Slaven, E., Mnatsakanova, A., Ma, C., Violanti, J., Fekedulegn, D., et al. (2011). Association of perceived stress with sleep duration and sleep quality in police officers. Int. J. Emerg. Ment. Health 13, 229–242.

PubMed Abstract | Google Scholar

Chen, Y. F. (2009). Job stress and performance: a study of police officers in central Taiwan. Soc. Behav. Pers. 37, 1341–1356. doi: 10.2224/sbp.2009.37.10.1341

Chirico, F. (2016). Job stress models for predicting burnout syndrome: a review. Ann. Dell’Istituto Super. Sanita 52, 443–456. doi: 10.4415/ANN_16_03_17

Chitra, T., and Karunanidhi, S. (2018). The impact of resilience training on occupational stress, resilience, job satisfaction, and psychological well-being of female police officers. J. Police Criminal Psychol. 3, 1–16. doi: 10.1007/s11896-018-9294-9

Chongruksa, D., Parinyapol, P., Sawatsri, S., and Pansomboon, C. (2012). Efficacy of eclectic group counseling in addressing stress among Thai police officers in terrorist situations. Counsel. Psychol. Q. 25, 83–96. doi: 10.1080/09515070.2012.666424

Collins, P. A., and Gibbs, A. (2003). Stress in police officers: a study of the origins, prevalence and severity of stress-related symptoms within a county police force. Occup. Med. 53, 256–264. doi: 10.1093/occmed/kqg061

Costa, T., Passos, F., and Queirós, C. (2019). Suicides of male Portuguese police officers – 10 years of national data. Crisis 40, 360–364. doi: 10.1027/0227-5910/a000570

Couto, G., Vandenberghe, L., and Brito, E. (2012). Interações interpessoais e estresse entre policiais. Arq. Bras. Psicol. 64, 47–63.

Cumming, E., Cumming, I., and Edell, L. (1965). Policeman as philosopher, guide and friend. Soc Probl. 12, 276–286. doi: 10.2307/798933

Daderman, A., and Colli, D. (2014). The significance of the sense of coherence for various coping resources in stress situations used by police officers in on-the-beat service. Int. J. Occup. Med. Environ. Health 27, 3–15. doi: 10.2478/s13382-014-0227-2

Ellrich, K. (2016). Burnout and violent victimization in police officers: a dual process model. Policing 39, 652–666. doi: 10.1108/PIJPSM-10-2015-0125

Endriulaitiene, A., Zardeckaite-Matulaitiene, K., Pranckeviciene, A., Marksaityte, R., Tillman, D. R., and Hof, D. D. (2019). Self-Stigma of seeking help and job burnout in mental health care providers: the comparative study of Lithuanian and the USA samples. J. Workplace Behav. Health 34, 1–20. doi: 10.1080/15555240.2019.1586549

Ermasova, N., Cross, A. D., and Ermasova, E. (2020). Perceived stress and coping among law enforcement officers: an empirical analysis of patrol versus non-patrol officers in illinois, USA. J. Police Crim. Psychol. doi: 10.1007/s11896-019-09356-z

EU-OSHA (2018). Healthy Workers, Thriving Companies - A Practical Guide to Wellbeing at Work. Luxembourg: Publications Office of the European Union.

EU-OSHA (2019a). The Value of Occupational Safety and Health and the Societal Costs of Work-Related Injuries and Diseases. Luxembourg: Publications Office of the European Union.

EU-OSHA (2019b). Third European Survey of Enterprises on New and Emerging Risks (ESENER-3). Luxembourg: Publications Office of the European Union.

EUROFOUND (2018). Burnout in the Workplace: A Review of Data and Policy Responses in the EU. Luxembourg: Publications Office of the European Union.

Euwema, M. C., Kop, N., and Bakker, A. B. (2004). The behavior of police officers in conflict situations: how burnout and reduced dominance contribute to better outcomes. Work Stress 18, 23–38. doi: 10.1080/0267837042000209767

Figueiredo-Ferraz, H., Gil-Monte, P. R., Queirós, C., and Passos, F. (2014). Validação fatorial do “Spanish Burnout Inventory” em policiais portugueses. Psicol. Reflexão Crit. 27, 291–299. doi: 10.1590/1678-7153.201427209

Freudenberger, H. J. (1974). Staff burn-out. J. Soc. Issues 30, 159–165. doi: 10.1111/j.1540-4560.1974.tb00706.x

Garbarino, S., Cuomo, G., Chiorri, C., and Magnavita, N. (2013). Association of work-related stress with mental health problems in a special police force unit. BMJ Open 3, 1–12. doi: 10.1136/bmjopen-2013-002791

Garbarino, S., and Magnavita, N. (2019). Sleep problems are a strong predictor of stress-related metabolic changes in police officers. A prospective study. PLoS One 14:e0224259. doi: 10.1371/journal.pone.0224259

Gerber, M., Hartmann, T., Brand, S., Holsboer-Trachsler, E., and Pühse, U. (2010a). The relationship between shift work, perceived stress, sleep and health in Swiss police officers. J. Crim. Just. 38, 1167–1175. doi: 10.1016/j.jcrimjus.2010.09.005

Gerber, M., Kellmann, M., Hartmann, T., and Pühse, U. (2010b). Do exercise and fitness buffer against stress among Swiss police and emergency response service officers? Psychol. Sport Exerc. 11, 286–294. doi: 10.1016/j.psychsport.2010.02.004

Gershon, R., Barocas, B., Canton, A. N., Xianbin, L., and Vlahov, D. (2009). Mental, physical, and behavioral outcomes associated with perceived work stress in police officers. Crim. Just. Behav. 36, 275–289. doi: 10.1177/0093854808330015

Gil-Monte, P. R. (2011). CESQT, Cuestionario Para la Evaluación del Síndrome de Quemarse Por el Trabajo [Spanish Burnout Inventory]. Madrid: TEA Ediciones.

Gil-Monte, P. R., and Manzano-García, G. (2015). Psychometric properties of the Spanish Burnout Inventory among staff nurses. J. Psychiatr. Ment. Health Nurs. 22, 756–763. doi: 10.1111/jpm.12255

Golonka, K., Mojsa-Kaja, J., Blukacz, M., Gawłowska, M., and Marek, T. (2019). Occupational burnout and its overlapping effect with depression and anxiety. Int. J. Occup. Med. Environ. Health 32, 229–244. doi: 10.13075/ijomeh.1896.01323

Gomes, A. R., and Afonso, J. M. P. (2016). Occupational stress among Portuguese military police officers. Avances Psicol. Latinoam. 34, 47–65. doi: 10.12804/apl34.1.2016.04

Goodman, A. M. (1990). A model for police officer burnout. J. Bus. Psychol. 5, 85–99. doi: 10.1007/BF01013947

Grassi, C., Casale, A., Ferracuti, S., Cucè, P., Santorsa, R., Pelliccione, A., et al. (2018). How do recruits and superintendents perceive the problem of suicide in the Italian state police? Ann. Dell’Istituto Super. Sanita 54, 82–89. doi: 10.4415/ANN_18_02_02

Griffin, J. D., and Sun, I. Y. (2018). Do work-family conflict and resiliency mediate police stress and burnout: a study of state police officers. Am. J. Crim. Just. 43, 354–370. doi: 10.1007/s12103-017-9401-y

Gutshall, C. L., Hampton, D. P., Sebetan, I. M., Stein, P. C., and Broxtermann, T. J. (2017). The effects of occupational stress on cognitive performance in police officers. Police Pract. Res. 18, 463–477. doi: 10.1080/15614263.2017.1288120

Hartley, T. A., Violanti, J. M., Mnatsakanova, A., and Andrew, M. E. (2013). Military experience and levels of stress and coping in police officers. Int. J. Emerg. Ment. Health Hum. Resil. 15, 229–239.

Hassell, K. D., Archbold, C. A., and Stichman, A. J. (2011). Comparing the workplace experiences of male and female police officers: examining workplace problems, stress, job satisfaction and consideration of career change. Int. J. Police Sci. Manag. 13, 37–53. doi: 10.1350/ijps.2011.13.1.217

Hawkins, H. C. (2001). Police officer burnout: a partial replication of Maslach’s burnout inventory. Police Q. 4, 343–360. doi: 10.1177/109861101129197888

Henry, V. E. (2004). Death Work: Police, Trauma, and The Psychology of Survival. Oxford: Oxford University Press.

Hickman, M. J., Fricas, J., Strom, K. J., and Pope, M. W. (2011). Mapping police stress. Police Q. 14, 227–250. doi: 10.1177/1098611111413991

Houdmont, J. (2013). UK police custody officers’ psychosocial hazard exposures and burnout. Policing 36, 620–635. doi: 10.1108/pijpsm-11-2012-0109

Hu, Q., Schaufeli, W. B., and Taris, T. W. (2017). How are changes in exposure to job demands and job resources related to burnout and engagement? A longitudinal study among Chinese nurses and police officers. Stress Health J. Int. Soc. Investig. Stress 33, 631–644. doi: 10.1002/smi.2750

Hurrell, J. J., Pate, A., and Kliesmet, R. (1984). NIOSH Technical Report: Stress Among Police Officers. Ohio: US Departement of Health and Human Services.

Husain, W., Sajjad, R., and Rehman, A. (2014). Depression, anxiety and stress among female and male police officers. Pakistan J. Clin. Psychol. 13, 3–14.

Irniza, R., Emilia, Z. A., Saliluddin, S. M., and Isha, A. S. N. (2014). A psychometric properties of the Malay-version police stress questionnaire. Malays. J. Med. Sci. 21, 42–50.

Johnson, O., Russo, C., and Papazoglou, K. (2019). Job exposure & occupational challenges: the importance of mindfulness for today’s law enforcement professional. Crisis Stress Hum. Resil. Int. J. 1, 187–191.

Kaplan, J. B., Christopher, M. S., and Bowen, S. (2017). Dispositional mindfulness moderates the relationship between occupational stressors and perceived stress among law enforcement personnel. J. Police Crim. Psychol. 33, 227–232. doi: 10.1007/s11896-017-9246-9

Kelley, D. C., Siegel, E. H., and Wormwood, J. B. (2019). Understanding police performance under stress: insights from the biopsychosocial model of challenge and threat. Front. Psychol. 10:1800. doi: 10.3389/fpsyg.2019.01800

Kelloway, E. K. (1995). Structural equation modeling in perspective. J. Organ. Behav. 16, 215–224. doi: 10.1002/job.4030160304

Kessler, R. C., Andrews, G., Colpe, L. J., Hiripi, E., Mroczek, D. K., Normand, S. L. T., et al. (2002). Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychol. Med. 32, 959–976. doi: 10.1017/s0033291702006074

Kessler, R. C., Barker, P. R., Colpe, L. J., Epstein, J. F., Gfroerer, J. C., Hiripi, E., et al. (2003). Screening for serious mental illness in the general population. Arch. Gen. Psychiatry 60, 184–189.

Kirkcaldy, B. (1993). Job stress and satisfaction: international police officers. Psychol. Rep. 72:386. doi: 10.2466/pr0.1993.72.2.386

Kirkcaldy, B. D., Brown, J., and Cooper, C. L. (1994). Occupational stress profiles of senior police managers: cross-cultural study of officers from Berlin and northern Ireland. Stress Med. 10, 127–130. doi: 10.1002/smi.2460100209

Kirkcaldy, B. D., and Cooper, C. L. (1992). Managing the stress of change: occupational stress among senior police officers in Berlin. Stress Med. 8, 219–231. doi: 10.1002/smi.2460080404

Kirkcaldy, B. D., Cooper, C. L., and Brown, J. M. (1995). The role of coping in the stress-strain relationship among senior police officers. Int. J. Stress Manag. 2, 69–78. doi: 10.1007/bf01566162

Kline, R. (2005). Principles and Practice of Structural Equation Modeling , 2nd Edn. New York, NY: Guilford.

Kop, N., Euwema, M., and Schaufeli, W. (1999). Burnout, job stress and violent behaviour among Dutch police officers. Work Stress 13, 326–340. doi: 10.1080/02678379950019789

Kop, N., and Euwema, M. C. (2001). Occupational stress and the use of force by Dutch police officers. Crim. Just. Behav. 28, 631–652. doi: 10.1177/009385480102800505

Korre, M., Farioli, A., Varvarigou, V., Sato, S., and Kales, S. N. (2014). A survey of stress levels and time spent across law enforcement duties: police chief and officer agreement. Policing 8, 109–122. doi: 10.1093/police/pau001

Koutsimani, P., Montgomery, A., and Georganta, K. (2019). The relationship between burnout, depression, and anxiety: a systematic review and meta-analysis. Front. Psychol. 10:284. doi: 10.3389/fpsyg.2019.00284

Kuo, S. Y. (2014). Occupational stress, job satisfaction, and affective commitment to policing among Taiwanese police officers. Police Q. 18, 27–54. doi: 10.1177/1098611114559039

Kwak, H., McNeeley, S., and Kim, S. H. (2018). Emotional labor, role characteristics, and police officer burnout in South Korea: the mediating effect of emotional dissonance. Police Q. 21, 223–249. doi: 10.1177/1098611118757230

Lambert, E. G., Qureshi, H., Frank, J., Klahm, C., and Smith, B. (2017). Job stress, job involvement, job satisfaction, and organizational commitment and their associations with job burnout among indian police officers: a research note. J. Police Crim. Psychol. 33, 85–99. doi: 10.1007/s11896-017-9236-y

Lambert, E. G., Qureshi, H., Keena, L. D., Frank, J., and Hogan, N. L. (2019). Exploring the link between work-family conflict and job burnout among Indian police officers. Police J. 92, 35–55. doi: 10.1177/0032258X18761285

Lazaus, R., and Folkman, S. (1984). Stress Appraisal and Coping. New York, NY: Springer.

LeBlanc, V. R., Regehr, C., Jelley, R. B., and Barath, I. (2008). The relationship between coping styles, performance, and responses to stressful scenarios in police recruits. Int. J. Stress Manag. 15, 76–93. doi: 10.1037/1072-5245.15.1.76

Lester, D. (1982a). Perceived stress in police officers and belief in locus of control. J. Gen. Psychol. 107, 157–158. doi: 10.1080/00221309.1982.9709918

Lester, D. (1982b). Subjective stress and sources of stress for police officers. Psychol. Rep. 50:1094. doi: 10.2466/pr0.1982.50.3c.1094

Lester, D. (1983). Why do people become police officers: a study of reasons and their predictions of success. J. Police Sci. Admin. 11, 170–174.

Lester, D., Leitner, L. A., and Posner, I. (1984). The effects of a stress management training program on police officers. Appl. Psychol. 33, 25–31. doi: 10.1111/j.1464-0597.1984.tb01414.x

Lester, D., Leitner, L. A., and Posner, I. (1985). A note on locus of control and stress in police officers. J. Commun. Psychol. 13, 77–79. doi: 10.1002/1520-6629(198501)13:1<77::AID-JCOP2290130110<3.0.CO;2-T

Lester, D., and Mink, S. R. (1979). Is stress higher in police officers? An exploratory study. Psychol. Rep. 45:554. doi: 10.2466/pr0.1979.45.2.554

Lester, D., and Solis, A. (1980). Type a personality, stress, and job satisfaction in police officers. Percept. Mot. Skills 51:890. doi: 10.2466/pms.1980.51.3.890

Levitov, J. E., and Thompson, B. (1981). Stress and counseling needs of police officers. Couns. Educ. Supervis. 21, 163–168. doi: 10.1002/j.1556-6978.1981.tb01686.x

Lima, F. R., Ferreira Lima, D. L., Ramos de Oliveira, A. A., Ferreira, E., and Neto, P. (2018). Identificação preliminar da síndrome de burnout em policiais militares. Motricidade 14, 150–156.

Lin, Q., Jiang, C., and Lam, T. H. (2013). The relationship between occupational stress, burnout, and turnover intention among managerial staff from a sino-Japanese joint venture in Guangzhou, China. J. Occup. Health 55, 458–467. doi: 10.1539/joh.12-0287-oa

Lipp, M. E. (2009). Stress and quality of life of senior Brazilian police officers. Span. J. Psychol. 12, 593–603. doi: 10.1017/S1138741600001967

Lipp, M. E., Costa, K. R., and Nunes, V. (2017). Estresse, qualidade de vida e estressores ocupacionais de policiais: sintomas mais frequentes. Rev. Psicol. Organ. Trabalho 17, 46–53. doi: 10.17652/rpot/2017.1.12490

Louw, G. J. (2014). Burnout, vigor, big five personality traits and social support in a sample of police officers. S. Afr. J. Ind. Psychol. 40, 1–13. doi: 10.4102/sajip.v40i1.1119

Lucas, T., Weidner, N., and Janisse, J. (2012). Where does work stress come from? A generalizability analysis of stress in police officers. Psychol. Health 27, 1426–1447. doi: 10.1080/08870446.2012.687738

Luceño-Moreno, L., Albuerne, Y., Velasco, B., and García, J. (2016). Estrés en policías españoles según rango ocupacional, sexo, edad y turno de trabajo. Psicothema 28, 389–393. doi: 10.7334/psicothema2015.310

Magnavita, N., Capitanelli, I., Garbarino, S., and Pira, E. (2018). Work-related stress as a cardiovascular risk factor in police officers: a systematic review of evidence. Int. Arch. Occup. Environ. Health 91, 377–389. doi: 10.1007/s00420-018-1290-y

Maran, D., Varetto, A., Zedda, M., and Ieraci, V. (2015). Occupational stress, anxiety and coping strategies in police officers. Occup. Med. 65, 466–473. doi: 10.1093/occmed/kqv060

Maria, A. S., Wolter, C., Gusy, B., Kleiber, D., and Renneberg, B. (2019). The impact of health-oriented leadership on police officers’ physical health, burnout, depression and well-being. Policing 13, 186–200. doi: 10.1093/police/pay067

Maroco, J. (2014). Análise de Equações Estruturais: Fundamentos Teóricos, Software e Aplicações , 2nd Edn. Pero Pinheiro: ReportNumber.

Martinussen, M., Richardsen, A. M., and Burke, R. J. (2007). Job demands, job resources, and burnout among police officers. J. Crim. Just. 35, 239–249. doi: 10.1016/j.jcrimjus.2007.03.001

Maslach, C. (1976). Burned-out. Hum. Behav. 5, 16–22.

Maslach, C. (2017). Finding solutions to the problem of burnout. Consul. Psychol. J. Pract. Res. 69, 143–152. doi: 10.1037/cpb0000090

Maslach, C., and Jackson, S. (1981). The measurement of experienced burnout. J. Occup. Behav. 2, 99–111.

Maslach, C., and Leiter, M. P. (2016). Understanding the burnout experience: recent research and its implications for psychiatry. World Psychiatry 15, 1–9. doi: 10.1002/wps.20311

Maslach, C., and Leiter, M. P. (2017). Understanding Burnout. Handb. Stress Health 51, 36–56. doi: 10.1002/9781118993811.ch3

Maslach, C., Schaufeli, W. B., and Leiter, M. P. (2001). Job burnout. Annu. Rev. Psychol. 52, 397–422.

Mastracci, S. H., and Adams, I. T. (2019). It’s not depersonalization, It’s emotional labor: examining surface acting and use-of-force with evidence from the US. Int. J. Law Crime Just. 2019:100358. doi: 10.1016/J.IJLCJ.2019.100358

McCarty, W. P., Aldirawi, H., Dewald, S., and Palacios, M. (2019). Burnout in blue: an analysis of the extent and primary predictors of burnout among law enforcement officers in the United States. Police Q. 22, 278–304. doi: 10.1177/1098611119828038

McCarty, W. P., Solomon, Z. J., and Garland, B. E. (2007). Occupational stress and burnout between male and female police officers. Policing 30, 672–691. doi: 10.1108/13639510710833938

McCreary, D. R., Fong, I., and Groll, D. L. (2017). Measuring policing stress meaningfully: establishing norms and cut-off values for the Operational and Organizational Police Stress Questionnaires. Police Pract. Res. 18, 612–623. doi: 10.1080/15614263.2017.1363965

McCreary, D. R., and Thompson, M. M. (2004). The Development of a Reliable and Valid Measure of Stressors in Policing - A Summary of Findings from WSIB Development Grant #02-051. Toronto: Defense R&D Canada-Toronto.

McCreary, D. R., and Thompson, M. M. (2006). Development of two reliable and valid measures of stressors in policing: the operational and organizational police stress questionnaires. Int. J. Stress Manag. 13, 494–518. doi: 10.1037/1072-5245.13.4.494

Meulen, E., Bosmans, M. W. G., Lens, K. M. E., Lahlah, E., and Velden, P. G. (2017). Effects of mental strength training for police officers: a three-wave quasi-experimental study. J. Police Crim. Psychol. 33, 385–397. doi: 10.1007/s11896-017-9247-8

Neely, P., and Cleveland, C. S. (2011). The impact of job-related stressors on incidents of excessive force by police officers. Am. J. Health Sci. 3, 63–74. doi: 10.19030/ajhs.v3i1.6755

Nelson, K. V., and Smith, A. P. (2016). Occupational stress, coping and mental health in Jamaican police officers. Occup. Med. 66, 488–491. doi: 10.1093/occmed/kqw055

Norvell, N. K., Hills, H. A., and Murrin, M. R. (1993). Understanding stress in female and male law enforcement officers. Psychol. Women Q. 17, 289–301. doi: 10.1111/j.1471-6402.1993.tb00488.x

OECD (2019). Health at Glance 2019, OECD Indicators. Paris: OECD Publishing.

Padyab, M., Backteman-Erlanson, S., and Brulin, C. (2016). Burnout, coping, stress of conscience and psychosocial work environment among patrolling police officers. J. Police Crim. Psychol. 31, 229–237. doi: 10.1007/s11896-015-9189-y

Papazoglou, K. (2016). Managing effective transitions: presenting the different shades of police life and the pivotal role of mental health care providers in promoting officers’ wellbeing. Int. J. Med. Health Sci. 5, 121–122.

Papazoglou, K., and Andersen, J. P. (2014). A guide to utilizing police training as a tool to promote resilience and improve health outcomes among police officers. Traumatology 20, 103–111. doi: 10.1037/h0099394

Papazoglou, K., and Blumberg, D. M. (2019). POWER: Police Officer, Wellness, Ethics, and Resilience. Cambridge: Academic Press.

Papazoglou, K., Blumberg, D. M., Kamkar, K., Mc-Intyre-Smith, A., and Koskelainen, M. (2020). Addressing moral suffering in police work: theoretical conceptualization and counselling implications. Can. J. Counsel. Psychother. 54, 71–87.

Papazoglou, K., Koskelainen, M., and Stuewe, N. (2018). Exploring the role of compassion satisfaction and compassion fatigue in predicting burnout among police officers. Open J. Psychiatry Allied Sci. 9, 107–112. doi: 10.5958/23942061.2018.00020.4

Papazoglou, K., Koskelainen, M., Tuttle, B. M., and Pitel, M. (2017). Examining the role of police compassion fatigue and negative personality traits in impeding the promotion of police compassion satisfaction: a brief report. J. Law Enforcement 6, 1–14.

Patel, R., Huggard, P., and Toledo, A. (2017). Occupational stress and burnout among surgeons in Fiji. Front. Public Health 5:41. doi: 10.3389/fpubh.2017.00041

Patterson, B. (1992). Job experience and perceived job stress among police, correctional, and probation/parole officers. Crim. Just. Behav. 19, 160–285. doi: 10.1177/0093854892019003004

Patterson, G. T. (2003). Examining the effects of coping and social support on work and life stress among police officers. J. Crim. Just. 31, 215–226. doi: 10.1016/s0047-2352(03)00003-5

Patterson, G. T., Chung, I. W., and Swan, P. W. (2014). Stress management interventions for police officers and recruits: a meta-analysis. J. Exp. Criminol. 10, 487–513. doi: 10.1007/s11292-014-9214-7

Peiró, J. M., González-Romá, V., Tordera, N., and Manas, M. A. (2001). Does role stress predict burnout over time among health care professionals? Psychol. Health 16, 511–525. doi: 10.1080/08870440108405524

Pelegrini, A., Cardoso, T., Laumann, G., Pinto, A., and Felden, E. P. (2018). Percepção das condições de trabalho e estresse ocupacional em policiais civis e militares de unidades de operações especiais. Cadernos Bras. Terapia Ocup. 26, 423–430. doi: 10.4322/2526-8910.ctoAO1160

Pereira, A., Oliveira, C. A., Bártolo, A., Monteiro, S., Vagos, P., and Jardim, J. (2019). Reliability and factor structure of the 10-item kessler psychological distress scale (K10) among Portuguese adults. Ciência Saúde Coletiva 24, 729–736. doi: 10.1590/1413-81232018243.06322017

Perez, L. M., Jones, J., Englert, D. R., and Sachau, D. (2010). Secondary traumatic stress and burnout among law enforcement investigators exposed to disturbing media images. J. Police Crim. Psychol. 25, 113–124. doi: 10.1007/s11896-010-9066-7

Pines, A. M., and Keinan, G. (2005). Stress and burnout: the significant difference. Pers. Individ. Diff. 39, 625–635. doi: 10.1016/j.paid.2005.02.009

Pines, A. M., and Keinan, G. (2007). Stress and burnout in israeli police officers during a palestinian uprising (Intifada). Int. J. Stress Manag. 14, 160–174. doi: 10.1037/1072-5245.14.2.160

Poletto, N. A., Probst, L. F., Oliveira, T. L., Guerra, L. M., Ambrosano, G. M. B., Cortellazzi, K. L., et al. (2016). Burnout Syndrome in municipal health managers. Cadernos Saúde Coletiva 24, 209–215. doi: 10.1590/1414-462X201600020005

Purba, A., and Demou, E. (2019). The relationship between organizational stressors and mental wellbeing within police officers: a systematic review. BMC Public Health 19:1286. doi: 10.1186/s12889-019-7609-0

Queirós, C., Kaiseler, M., and Silva, A. (2013). Burnout as predictor of aggressivity among police officers. Eur. J. Polic. Stud. 1, 110–134.

Quick, J., and Henderson, D. (2016). Occupational stress: preventing suffering, enhancing wellbeing. Int. J. Environ. Res. Public Health 13, 459–570. doi: 10.3390/ijerph13050459

Ratner, B. (2009). The correlation coefficient: its values range between +1/-1, or do they? J. Target. Meas. Anal. Mark. 17, 139–142. doi: 10.1057/jt.2009.5

Romosiou, V., Brouzos, A., and Vassilopoulos, S. P. (2018). An integrative group intervention for the enhancement of emotional intelligence, empathy, resilience and stress management among police officers. Police Pract. Res. 20, 460–478. doi: 10.1080/15614263.2018.1537847

Rosa, J., Passos, F., and Queirós, C. (2015). Um estudo exploratório sobre burnout e indicadores psicopatológicos em polícias. Int. J. Work. Condit. 10, 101–119. doi: 10.11606/s1518-8787.2020054000854

Roz, H. B., and Raval, D. T. (2017). A study of occupational stress, burnout, presumptive life events, depression and anxiety among Ahmedabad city police officers. Indian J. Health Wellbeing 8, 1485–1492.

Russell, L. M., Cole, B. M., and Jones, I. R. J. (2014). High-risk occupations: how leadership, stress, and ability to cope influence burnout in law enforcement. J. Leadersh. Accountabil. Ethics 11, 49–69.

Salvagioni, D. A. J., Melanda, F. N., Mesas, A. E., González, A. D., Gabani, F. L., and Andrade, S. M. (2017). Physical, psychological and occupational consequences of job burnout: a systematic review of prospective studies. PLoS One 12:e0185781. doi: 10.1371/journal.pone.0185781

Santana, A. M., Gomes, J. K., Marchi, D., Girondoli, Y. M., Rosado, L. E., Rosado, G. P., et al. (2012). Occupational stress, working condition and nutritional status of military police officers. Work 41, 2908–2914. doi: 10.3233/WOR-2012-0543-2908

Sarason, I. G., Johnson, J. H., Berberich, J. P., and Siegel, J. M. (1979). Helping police officers to cope with stress: a cognitive-behavioral approach. Am. J. Commun. Psychol. 7, 593–603. doi: 10.1007/BF00891964

Schaible, L. M., and Gecas, V. (2010). The impact of emotional labor and value dissonance on burnout among police officers. Police Q. 13, 316–341. doi: 10.1177/1098611110373997

Schaufeli, W. B. (2017). “Burnout: a short socio-cultural history,” in Burnout, Fatigue, Exhaustion: An Interdisciplinary Perspective on a Modern Affliction , eds S. Neckel, A. K. Schaffner, and G. Wagner (London: Palgrave Macmillan), 105–127. doi: 10.1007/978-3-319-52887-8_5

Schilling, R., Colledge, F., Brand, S., Ludyga, S., and Gerber, M. (2019). Psychometric properties and convergent validity of the shirom–melamed burnout measure in two german-speaking samples of adult workers and police officers. Front. Psychiatry 10:536. doi: 10.3389/fpsyt.2019.00536

Schlichting, A. M. Jr., Silva, F. C., Bernardo, V. M., Gonçalves, E., Gutierres Filho, P. J., and Silva, R. (2014). The occupational stress affects the health conditions of military police officers. Rev. Cubana Med. Militar 43, 293–306.

Shane, J. M. (2010). Organizational stressors and police performance. J. Crim. Just. 38, 807–818. doi: 10.1016/j.jcrimjus.2010.05.008

Shipley, P., and Baranski, J. V. (2002). Police officer performance under stress: a pilot study on the effects of visuo-motor behavior rehearsal. Int. J. Stress Manag. 9, 71–80. doi: 10.1023/A:1014950602826

Silveira, N. M., Vasconcellos, S. J., Cruz, L. P., Kiles, R. F., Silva, T. P., Castilhos, D. G., et al. (2005). Assessment of burnout levels in a sample of police officers. Rev. Psiquiatria Rio Grande Sul 27, 159–163. doi: 10.1590/S0101-81082005000200006

Smoktunowicz, E., Baka, L., Cieslak, R., Nichols, C. F., Benight, C. C., and Luszczynska, A. (2015). Explaining counterproductive work behaviors among police officers: the indirect effects of job demands are mediated by job burnout and moderated by job control and social support. Hum. Perform. 28, 332–350. doi: 10.1080/08959285.2015.1021045

Solana, E. F., Extremera, R. A., Pecino, C. V., and Fuente, G. (2013). Prevalence and risk factors of burnout syndrome among Spanish police officers. Psicothema 25, 488–493. doi: 10.7334/psicothema2013.81

Stinchcomb, J. (2004). Searching for stress in all the wrong places. Police Pract. Res. 5, 259–277. doi: 10.1080/156142604200227594

Summerlin, Z., Oehme, K., Stern, N., and Valentine, C. (2010). Disparate levels of stress in police and correctional officers: preliminary evidence from a pilot study on domestic violence. J. Hum. Behav. Soc. Environ. 20, 762–777. doi: 10.1080/10911351003749169

Tabachnick, B. G., and Fidell, L. S. (2001). Using Multivariate Statistics , 4th Edn. Boston, MA: Allyn and Bacon.

Talavera-Velasco, B., Luceño-Moreno, L., Martín-García, J., and García-Albuerne, Y. (2018). Psychosocial risk factors, burnout and hardy personality as variables associated with mental health in police officers. Front. Psychol. 9:1478. doi: 10.3389/fpsyg.2018.01478

Tang, T., and Hammontree, M. (1992). The effects of hardiness, police stress, and life stress on police officers’ Ilness and absenteeism. Public Pers. Manag. 21, 493–510. doi: 10.1177/009102609202100406

Tavares, J. P., and Lautert, L. (2017). Relationship between psychosocial stress dimensions and salivary cortisol in military police officers. Rev. Latino Am. Enfermagem 25, 1–9. doi: 10.1590/1518-8345.1199.2873

Thornton, A. R., Blumberg, D. M., Papazoglou, K., and Giromini, L. (2020). “The HEROES project: mental health intervention and treatment of first responders and emergency workers,” in Mental Health Intervention and Treatment of First Responders and Emergency Workers , eds C. A. Bowers, D. C. Beidel, and M. R. Marks (Pennsylvania: IGI Global), 154–168. doi: 10.4018/978-1-5225-9803-9.ch009

Trombka, M., Demarzo, M., Bacas, D. C., Antonio, S. B., Cicuto, K., Salvo, V., et al. (2018). Study protocol of a multicenter randomized controlled trial of mindfulness training to reduce burnout and promote quality of life in police officers: the POLICE study. BMC Psychiatry 18:151. doi: 10.1186/s12888-018-1726-7

van Gelderen, B., Heuven, E., Veldhoven, M., Zeelenberg, M., and Croon, M. (2007). Psychological strain and emotional labor among police-officers: a diary study. J. Vocat. Behav. 71, 446–459. doi: 10.1016/j.jvb.2007.09.001

Violanti, J. M. (1996). Police Suicide: Epidemic in Blue. Springfield: Charles C Thomas.

Violanti, J. M., and Aron, F. (1995). Police stressors: variations in perception among police personnel. J. Crim. Just. 23, 287–294. doi: 10.1016/0047-2352(95)00012-f

Violanti, J. M., Charles, L. E., McCanlies, E., Hartley, T. A., Baughman, P., Andrew, M. E., et al. (2017). Police stressors and health: a state-of-the-art review. Policing 40, 642–656. doi: 10.1108/PIJPSM-06-2016-0097

Violanti, J. M., Owens, S. L., Fekedulegn, D., Ma, C. C., Charles, L. E., and Andrew, M. E. (2018). An exploration of shift work, fatigue, and gender among police officers: the BCOPS study. Workplace Health Saf. 66, 530–537. doi: 10.1177/2165079918754586

Violanti, J. M., Owens, S. L., McCanlies, E., Fekedulegn, D., and Andrew, M. E. (2019). Law enforcement suicide: a review. Policing 42, 141–164. doi: 10.1108/pijpsm-05-2017-0061

Vuorensyrja, M., and Malkia, M. (2011). Nonlinearity of the effects of police stressors on police officer burnout. Policing 34, 382–402. doi: 10.1108/13639511111157474

Wang, Z., Liu, H., Yu, H., Wu, Y., Chang, S., and Wang, L. (2017). Associations between occupational stress, burnout and well-being among manufacturing workers: mediating roles of psychological capital and self-esteem. BMC Psychiatry 17:364. doi: 10.1186/s12888-017-1533-6

Wassermann, A., Meiring, D., and Becker, J. R. (2019). Stress and coping of police officers in the South African police service. S. Afr. J. Psychol. 49, 97–108. doi: 10.1177/0081246318763059

Webster, J. H. (2013). Police officer perceptions of occupational stress: the state of the art. Policing 36, 636–652. doi: 10.1108/pijpsm-03-2013-0021

White, J., Lawrence, P., Buggerstaff, C., and Grubb, T. (1985). Factors of stress among police officers. Crim. Just. Behav. 12, 111–128.

White, M. D., Cooper, J. A., Saunders, J., and Raganella, A. J. (2010). Motivations for becoming a police officer: re-assessing officer attitudes and job satisfaction after six years on the street. J. Crim. Just. 38, 520–530. doi: 10.1016/j.jcrimjus.2010.04.022

Wickramasinghe, N. D., and Wijesinghe, P. R. (2018). Burnout subtypes and associated factors among police officers in Sri Lanka: a cross-sectional study. J. Forensic Legal Med. 58, 192–198. doi: 10.1016/j.jflm.2018.07.006

Wirth, M. D., Andrew, M. E., Burchfiel, C. M., Burch, J. B., Fekedulegn, D., Hartley, T. A., et al. (2017). Association of shiftwork and immune cells among police officers from the Buffalo Cardio-metabolic occupational police stress study. Chronobiol. Int. 34, 721–731. doi: 10.1080/07420528.2017.1316732

Wray, C. A., and Jarrett, S. B. (2019). The relationship between burnout and suicidal ideations among Jamaican police officers. Int. J. Police Sci. Manag. 21, 181–189. doi: 10.1177/1461355719856026

Zukauskas, G., Burba, B., Rukšenas, O., Grigaliuniene, V., and Mitchell, J. T. (2009). A study of stress affecting police officers in Lithuania. Int. J. Emerg. Ment. Health 11, 205–214.

Zulkafaly, F., Kamaruddin, K., and Hassan, N. H. (2017). Coping strategies and job stress in policing: a literature review. Int. J. Acad. Res. Bus. Soc. Sci. 7, 458–467. doi: 10.6007/IJARBSS/v7-i3/2749

Keywords : burnout, distress, operational stress, police officers, questionnaire validation

Citation: Queirós C, Passos F, Bártolo A, Marques AJ, da Silva CF and Pereira A (2020) Burnout and Stress Measurement in Police Officers: Literature Review and a Study With the Operational Police Stress Questionnaire. Front. Psychol. 11:587. doi: 10.3389/fpsyg.2020.00587

Received: 04 January 2020; Accepted: 12 March 2020; Published: 07 May 2020.

Reviewed by:

Copyright © 2020 Queirós, Passos, Bártolo, Marques, da Silva and Pereira. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Cristina Queirós, [email protected]

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Occupational stress in policing: What the research says and what leaders can do about it

Police leaders must recognize the importance of a physically and mentally healthy workforce and address occupational stress among personnel.

The literature indicates that organizational, operational and personal factors such as work environment and external support systems contribute to or exacerbate, occupational stress.

Aristide Economopoulos | NJ Advance Media

For additional resources on officer wellness, download Smash the stigma: Building a culture that supports officer wellness .

By Richard Segovia, Ed.D.

Police work is stressful, and law enforcement officers are indoctrinated to high levels of stress at the onset of their careers, and beyond. It is vital that officers maintain their mental wellness for their own safety and for the safety of their community. There is a direct correlation between officer wellness and public safety; police agencies and communities benefit from healthy officers. It is therefore a police leader’s duty to recognize the importance of a physically and mentally healthy workforce, and their ethical obligation to address occupational stress among staff.

To explore the effects of policing on occupational stress, this article provides a contemporary analysis of scholarly research and web sources that examine contributing factors to police occupational stress; the impact stress has on an officer, their agency and their communities; and strategies police leaders employ to mitigate workforce stressors.

Unsurprisingly, the literature indicates that organizational, operational and personal factors such as work environment and external support systems contribute to or exacerbate, occupational stress.

Literature review

The literature and research regarding police stress are considerable, and the reviewed literature in this article offers three global perspectives on the topic. First, is a study on occupational stress from Turin, Italy, that examines stress levels and anxiety at a large metropolitan police agency. Second, scholars at the University of Toronto analyzed the effect of stress and trauma on officer wellness in British Columbia, Canada. Third, American researchers studied factors that affect stress among law enforcement officers in New York state.

Occupational stress in Italy

In an occupational medicine journal on police stress, anxiety and coping strategies, researchers at Universita di Tornio suggest that occupational stress among law enforcement officers is related to the deterioration of their psychological health and social welfare. [1] Researchers used questionnaires and a Distress Thermometer (a rating scale used to measure stress) to capture stress data, assess stressors and evaluate the coping strategies of 617 Italian police officers. The study identified stress differences between male and female officers, with men experiencing more organizational stress and women experiencing more operational stress.

According to researchers, examples of organizational stress include long hours, changes in duties and role conflict. [2] On the other hand, operational stress might include being exposed to human suffering or violent situations. [1]

Despite the stress experienced by both genders, each exhibited effective stress coping strategies. Namely, gaining social, emotional, instrumental, and behavioral support. Other positive coping strategies include self-distraction, active coping, positive reframing, and acceptance. Researchers concluded that training and support were critical to navigating the rigors of police work and how gender, position and assignment are associated with a particular stressor.

Resiliency in British Columbia

In 2015, an article in a scholarly law enforcement journal on police resiliency analyzed the connection between training and elasticity – defined as an officer’s ability to stretch mentally and physically stretch themselves to the point before breaking – among 297 law enforcement officers in British Columbia, Canada. [3] Specifically, researchers examined how mental preparedness techniques might mitigate stressors officers face and the benefits these techniques have on officers and policy-makers. The study concluded that trauma could result from an officer’s exposure to stress. Moreover, the trauma officers are susceptible to can be physically and psychologically damaging. A proactive approach to addressing potential stress is critical to mitigating physical and psychological trauma while promoting an officer’s overall well-being.

Researchers concluded that post-stress treatment is less effective than pre-stress treatment. Researchers assert that a proactive approach and investment in mental preparedness techniques are vital to longevity and stress management in policing.

Coping with stress in New York

A 2018 article studied the work-stress axis among police officers. [4] Researchers used data from 594 peace officers across 21 different New York state law enforcement agencies to study factors that affect officer stress. Specifically, researchers determined occupation stress was influenced by variables including demographics, education level, rank, tenure, internal and external factors, support systems and cumulative stress. Other factors included lack of a support system, pre susceptibility to stress and preexisting physical, mental and emotional conditions. Moreover, agencies with counseling services positively influenced how officers cope with stress, resulting in improved welfare and elasticity. Researchers concluded that officers who employ stress coping techniques are more effective in reducing and managing stress.

Media Analysis

A number of other sources offer anecdotal and data-driven evidence regarding police stress. Notably, information from web sources is considerable, and an analysis of three web-based articles from reputable professional sources offers perspective.

Healthy officers are healthy communities

A publication from the International Association of Chiefs of Police (IACP) on officer wellness concluded that healthy officers in healthy communities are interrelated. [5] The study showed that policies such as wellness training, fitness programs and peer support help officers adopt healthy lifestyles and mitigate occupational stress.

Stress leads to physical and mental complications

A 2008 study from the University of Buffalo suggests that pressures experienced by law enforcement officers are precursors to many physical and mental health complications, including heart disease and post-traumatic stress disorder. [6]

The online article also cites a National Institute of Justice (NIJ) study that measured officer stress. The NIJ study found that officers over 40 years old have a higher chance of experiencing cardiac issues, and the unpredictable and dangerous nature of police work is psychologically demanding to officers. Like the study in British Columbia, researchers at the University of Buffalo concluded that early intervention might assist officers in handling the stressors of policing, thereby limiting the physical and psychological damage caused by trauma.

Mental preparedness techniques help officers deal with stress by visualizing preparation measures, thereby reducing the effects of critical events and incidents.

In her article How Police Can Reduce and Manage Stress , Michelle L. Beshears, Ph.D., highlights the types and causalities of work-related and individual stressors, such as poor management, shift work and changes in duties. [7] The article discusses the consequences of stress, such as PTSD, reduced efficiency and physical health problems, while illustrating the importance of stress reduction and management strategies.

Improvement strategies

The literature on police stress indicates that occupational stress is concerning to law enforcement leaders, line-level officers and community members. Coping strategies that mitigate stressors vary depending on the programs and policies of a particular law enforcement agency. [8-10] Here are a few research-based strategies leaders can consider implementing to lessen officer stressors in the workplace:

• Formal fitness and wellness programs: Physical fitness decreases the risk that first responders succumb to job-related physical and mental health issues. [11] In their systematic review, MacMillan et al. determined that organizations with structured health intervention programs had better health-related results compared to organizations that do not have such programs.
• Implement wellness policies: Wellness and self-care policies that address social support and healthy lifestyles are critical to an effective and healthy workforce. Policies based on quantitative and qualitative studies reduce occupational risk, stress and unhealthy lifestyles among police officers [12]. Accordingly, another strategy that might mitigate stress among officers is the implementation of wellness policies throughout the law enforcement community.
• Incorporate family support: Family members play a critical role in stress management for police officers, and unstable family support results in work-family conflicts, which adversely affects an officer’s physical and mental well-being. Although officers are trained and equipped to handle these situations, researchers assert that familial support alleviates potential work and family-related conflicts. [13-15] It is logical for law enforcement leaders to develop policies and programs that incorporate familial support to help improve officer stress.

Organizational, operational, and personal factors contribute to occupational stress, and research indicates a positive correlation between improved public safety and officer wellness. Police wellness policies and programs positively impact the officer, their agency and the communities they serve. Business ethics and federal statutes suggest that employers have a moral and legal obligation to protect their employees and provide them with as safe a work environment as possible. OHSA is the guiding statute on all things workplace safety from a legal perspective. Ethically, researchers assert that business executives take workplace safety and employee health very seriously and suggest that leaders have a moral obligation to ensure the health and well-being of their workforce. [16]

Police leaders are faced with a cost conundrum: their obligation to provide a reasonably safe working environment through wellness policies, and the cost of implementing those policies. Law enforcement leaders face a choice between the financial cost or public safety cost, and there’s no straightforward answer. However, proper budgeting and outreach to philanthropies and corporations can help offset financial burdens to agencies. [13] In the end, today’s police leaders must acknowledge the importance of mitigating occupational stress and establish wellness programs to help officers cope with their stressors.

1. Acquadro MD, Varetto A, Zedda M, Ieraci V. (2015). Occupational stress, anxiety and coping strategies in police officers. Occupational Medicine, 65(6), 466-473.

2. Cohen IM, McCormick AV, Rich B. (2019). Creating a Culture of Police Officer Wellness. Policing, 13(2), 213–229.

3. Andersen JP, Papazoglou K, Nyman M, Koskelainen M, Gustafsberg H. (2015). Fostering resilience among police.

4. Tsai LC, Nolasco C, Vaughn MS. (2018). Modeling job stress among police officers: Interplay of work environment, counseling support, and family discussion with co-workers. Police Practice and Research, 19(3).

5. Practices in Modern Policing: Officer Safety and Wellness. (2018). Retrieved from https://www.theiacp.org/sites/default/files/2018-11/IACP_PMP_SafetyandWellness.pdf

6. University at Buffalo. (2008). Impact of Stress On Police Officers’ Physical And Mental Health. ScienceDaily.

7. Beshears M. How police can reduce and manage stress. Police1.

8. Hickman MJ, Fricas J, Strom KJ, Pope MW. (2011). Mapping Police Stress. Police Quarterly, 14(3), 227–250.

9. Burke R. (Ed.). (2017). Stress in Policing. London: Routledge.

10. Bano B, Talib P. (2017). Understanding police stress towards a secure and sustainable society. International Journal of Police Science & Management, 19(3), 159-170.

11. MacMillan F, Karamacoska D, El Masri A, McBride KA, Steiner GZ, Cook A, George ES. (2017). A systematic review of health promotion intervention studies in the police force: Study characteristics, intervention design and impacts on health. Occupational and Environmental Medicine, 74(12), 913.

12. Kuehl KS, Elliot DL, MacKinnon DP, O’Rourke HP, DeFrancesco C, Miočević M, Kuehl H. (2016). The SHIELD (safety & health improvement: Enhancing law enforcement departments) study: Mixed methods longitudinal findings. Journal of Occupational and Environmental Medicine, 58(5), 492-498.

13. Griffin JD, Sun IY. (2018). Do work-family conflict and resiliency mediate police stress and burnout: A study of state police officers. American Journal of Criminal Justice, 43(2), 354-370.

14. Kinman G, McDowall A, Cropley M. (2012). Work-family conflict and job-related wellbeing in UK police officers: The role of recovery strategies. In Proceedings from Institute of Work Psychology International Conference: Work, Wellbeing and Performance, Sheffield.

15. Ola M, Mathur R. (2016). The convergent and divergent impact of work environment, work-family conflict, and stress coping mechanisms on female and male police officers. International Journal of Education & Management Studies, 6(1), 19–24.

16. Jesper H, Huhtamäki F, Dennis S. (2022). Ruthless Exploiters or Ethical Guardians of the Workforce? Powerful CEOs and their Impact on Workplace Safety and Health: JBE. Journal of Business Ethics, 177(3), 641-663.

About the author

Dr. Richard “Rich” Segovia served with law enforcement for over 29 years at the local and state levels. He worked in several areas throughout his career, including patrol operations, investigations, training, and other specialized assignments. Rich is currently with the Texas Health and Human Services Office of the Inspector General Special Investigations Group and serves as an Adjunct Professor/Dissertation Chair with Liberty University. He is a certified California and Texas law enforcement instructor with robust instructional experience. Rich earned a bachelor’s degree in business management, a master’s degree in management and leadership, an MBA, an Ed.D. in Educational Leadership, and a Ph.D. in Advanced Educational Studies.