Mental disorders, suicidal ideation, plans and attempts among Canadian police

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Abstract

Background

Recent investigations have demonstrated a significant prevalence of mental health disorders, including post-traumatic stress disorder (PTSD), and suicidal ideation, plans and attempts among Canadian public safety personnel, including police officers. What remains unknown is the relationship between mental disorders and suicide among sworn police officers, and the prevalence of both among civilian police workers.

Aims

To examine the relationship between suicidal ideation, plans and attempts and positive mental health screens for depression, anxiety, panic disorder, alcohol abuse and PTSD among Canadian sworn and civilian police employees.

Methods

Participants completed an online survey that included self-report screening tools for depression, anxiety, panic disorder, alcohol abuse and PTSD. Respondents were also asked if they ever contemplated, planned or attempted suicide. Between-group (Royal Canadian Mounted Police [RCMP], provincial/municipal police and civilians) differences on mental health screening tools were calculated using Kruskal–Wallis analyses. The relationship between mental disorders and suicidal ideation, plans and attempts was evaluated with a series of logistic regressions.

Results

There were 4236 civilian and sworn officer participants in the study. RCMP officers reported more suicidal ideation than other police and scored highest on measures of PTSD, depression, anxiety, stress and panic disorder, which were significantly associated with suicidal ideation and plans but not attempts. Relative to provincial and municipal police, civilians reported more suicide attempts and scored higher on measures of anxiety.

Conclusions

The results identify a strong relationship between mental health disorders and increased risk for suicidal ideation, plans and attempts among sworn and civilian Canadian police employees.

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Most cited references 18

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Mental Disorders, Comorbidity and Suicidal Behavior: Results from the National Comorbidity Survey Replication

MK Nock, Irene I. L. Hwang, NA Sampson … (2009)

Mental disorders are among the strongest predictors of suicide attempts. However, little is known about which disorders are uniquely associated with suicidal behavior due to high levels of psychiatric comorbidity. We examined the unique associations between individual disorders and subsequent suicidal behavior (suicide ideation, plans, and attempts) using data from the National Comorbidity Survey Replication, a nationally representative household survey of 9,282 US adults. Results revealed that approximately 80% of suicide attempters in the US have a temporally prior mental disorder. Anxiety, mood, impulse-control, and substance disorders all significantly predict subsequent suicide attempts in bivariate analyses (odds ratios=2.7-6.7); however, these associations decrease substantially in multivariate analyses controlling for comorbidity (odds ratios=1.5-2.3) but remain statistically significant in most cases. Disaggregation of the observed effects reveals that depression predicts suicide ideation, but not suicide plans or attempts among those with ideation. Instead, disorders characterized by severe anxiety/agitation (e.g., PTSD) and poor impulse-control (e.g., conduct disorder, substance disorders) predict which suicide ideators go on to make a plan or attempt. These results advance understanding of the unique associations between mental disorders and different forms of suicidal behavior. Future research must further delineate the mechanisms through which people come to think about suicide and progress from suicidal thoughts to attempts.

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Multicenter collaborative panic disorder severity scale.

M. Katherine Shear, D Sholomskas, R Money … (1997)

To address the lack of a simple and standardized instrument to assess overall panic disorder severity, the authors developed a scale for the measurement of panic disorder severity. Ten independent evaluators used the seven-item Panic Disorder Severity Scale to assess 186 patients with principal DSM-III-R diagnoses of panic disorder (with no or mild agoraphobia) who were participating in the Multicenter Collaborative Treatment Study of Panic Disorder. In addition, 89 of these patients were reevaluated with the same scale after short-term treatment. A subset of 24 patients underwent two independent assessments to establish interrater reliability. Internal consistency, convergent and discriminant validity, and sensitivity to change were also determined. The Panic Disorder Severity Scale was associated with excellent interrater reliability, moderate internal consistency, and favorable levels of validity and sensitivity to change. Individual items showed good convergent and discriminant validity. Analysis suggested a two-factor model fit the data best. The Panic Disorder Severity Scale is a simple, efficient way for clinicians to rate severity in patients with established diagnoses of panic disorder. However, further research with more diverse groups of panic disorder patients and with a broader range of convergent and discriminant validity measures is needed.

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Mental Disorder Symptoms among Public Safety Personnel in Canada

R Nicholas Carleton, Tracie O Afifi, Sarah Turner … (2017)

Background: Canadian public safety personnel (PSP; e.g., correctional workers, dispatchers, firefighters, paramedics, police officers) are exposed to potentially traumatic events as a function of their work. Such exposures contribute to the risk of developing clinically significant symptoms related to mental disorders. The current study was designed to provide estimates of mental disorder symptom frequencies and severities for Canadian PSP. Methods: An online survey was made available in English or French from September 2016 to January 2017. The survey assessed current symptoms, and participation was solicited from national PSP agencies and advocacy groups. Estimates were derived using well-validated screening measures. Results: There were 5813 participants (32.5% women) who were grouped into 6 categories (i.e., call center operators/dispatchers, correctional workers, firefighters, municipal/provincial police, paramedics, Royal Canadian Mounted Police). Substantial proportions of participants reported current symptoms consistent with 1 (i.e., 15.1%) or more (i.e., 26.7%) mental disorders based on the screening measures. There were significant differences across PSP categories with respect to proportions screening positive based on each measure. Interpretation: The estimated proportion of PSP reporting current symptom clusters consistent with 1 or more mental disorders appears higher than previously published estimates for the general population; however, direct comparisons are impossible because of methodological differences. The available data suggest that Canadian PSP experience substantial and heterogeneous difficulties with mental health and underscore the need for a rigorous epidemiologic study and category-specific solutions.

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Author and article information

Journal

Journal ID (nlm-ta): Occup Med (Lond)

Journal ID (iso-abbrev): Occup Med (Lond)

Journal ID (publisher-id): occmed

Title: Occupational Medicine (Oxford, England)

Publisher: Oxford University Press (UK )

ISSN (Print): 0962-7480

ISSN (Electronic): 1471-8405

Publication date (Print): May 2020

Publication date (Electronic): 10 March 2020

Publication date PMC-release: 10 March 2020

Volume: 70

Issue: 3

Pages: 183-190

Affiliations

[1 ] Office of Applied Research and Graduate Studies, Justice Institute of British Columbia , New Westminster, British Columbia, Canada

[2 ] Department of Sociology, Memorial University , St. John’s, Newfoundland, Canada

[3 ] Department of Psychology, University of Regina , Regina, Saskatchewan, Canada

[4 ] Department of Psychiatry, Queen’s University , Kingston, Ontario, Canada

Author notes

Correspondence to: Gregory S. Anderson, Office of Applied Research and Graduate Studies, Justice Institute of British Columbia, 715 McBride Boulevard, New Westminster, BC V3L 5T4 Canada. Tel: +1 604 528 5617; e-mail: ganderson@ 123456jibc.ca

Author information

P M Di Nota http://orcid.org/0000-0003-4282-6129

R Ricciardelli http://orcid.org/0000-0002-0905-8968

D Groll http://orcid.org/0000-0001-6913-5710

Article

Publisher ID: kqaa026

DOI: 10.1093/occmed/kqaa026

PMC ID: 7252497

PubMed ID: 32154872

SO-VID: 3148764d-57ad-457a-bfd6-92ae9b1ed65f

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com

History

Page count

Pages: 8

Funding

Funded by: Justice Institute of British Columbia;

Funded by: Canadian Institutes of Health Research, DOI 10.13039/501100000024;

Award ID: 285489

Award ID: 162545

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Mental disorders, suicidal ideation, plans and attempts among Canadian police

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Abstract

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Special series on COVID-19 and Mental Health

Most cited references 18

Mental Disorders, Comorbidity and Suicidal Behavior: Results from the National Comorbidity Survey Replication

Multicenter collaborative panic disorder severity scale.

Mental Disorder Symptoms among Public Safety Personnel in Canada

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