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      Police use of force during street protests: A pressing public mental health concern

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      a , d , * , b , c
      EClinicalMedicine
      Elsevier

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          Abstract

          Street protests are a common means of civic expression and occur across the globe. In the past few years, millions of citizens have attended street protests worldwide. Sometimes however, street protests can constitute significantly stressful and violent contexts. Research has highlighted the physical health impact of street protests due to clashes between protesters and law enforcement or use of CS gas [1]. In addition, police use of less-lethal weapons, such as rubber pellet launchers, is known to cause severe ocular injuries [2]. Besides these physical health effects, research has recently shifted focus on the mental health aspects of streets protests. For instance, the 2019 Hong-Kong anti-extradition bill protests is responsible for increased probable depression and suspected PTSD prevalence rates among the Hong-Kong population [3]. These mental health consequences were attributed to the stressful context of mass street protests as they happened in Hong-Kong (e.g. lootings). Yet, increased use of force by Hong Kong law enforcement in 2019 (e.g. 16,000 rounds of teargas fired vs. 87 in the Occupy Central protests of 2014 [4]), could partly explain the rise in probable PTSD and depression cases. Besides physical health consequences, the traumatic nature of police use of force may have lasting mental health consequences on citizens. Thus, police use of force may constitute a risk factor for public mental health, but the issue remains under-researched. In a recent study conducted among 523 Yellow Vests protesters in France, we assessed self-reported exposure to police violence-related traumas (yes/no items; physical abuse, rubber pellet ammunitions), to other protest-related traumas (e.g. physical injury, custody) as well as post-traumatic stress and depression symptoms [5]. Across analyses and despite adjustment on a range of potential confounds (demographics, political orientation, custody and hospitalization) a systematic negative association between exposure to police violence and mental health symptoms was observed. More specifically, compared to non-exposed protesters, those exposed to at least one form of police violence were 1.54 times more likely to suffer from severe depressive symptoms and 2.58 more likely to meet the criteria for a tentative PTSD diagnosis. Therefore, we argue that police use of force during street protests may have mental health consequences for exposed individuals. Epidemiological investigations should be conducted using longitudinal designs to assess whether police use of force is a risk factor for population mental health. Given the prevalence of police use of force during street protests, there could be important implications for public mental health. Author contributions All authors designed the study and revised the manuscript. JAT and YM collected the data. JAT and EC analysed the data. JAT drafted the manuscript. Declaration of Interests None.

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          Most cited references4

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          • Article: not found

          Depression and post-traumatic stress during major social unrest in Hong Kong: a 10-year prospective cohort study

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            • Abstract: not found
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            Ocular injuries caused by less-lethal weapons in France

              • Record: found
              • Abstract: found
              • Article: found
              Is Open Access

              Exposure to the Riot Control Agent CS and Potential Health Effects: A Systematic Review of the Evidence

              o-Chlorobenzylidene malononitrile (CS) is one of the most extensively used riot control agents. Our aim was to conduct a systematic review of the potential health effects related to CS exposure. We searched for papers in English between 1991 and 2014. Thirty five (35) studies (25 case reports, seven descriptive studies and three analytical studies) were included in the review. In the twenty five case reports/series 90 cases of exposure to CS and their clinical effects are presented. Their mean age was 25.7 years and 62.0% were males. In addition, 61% of the cases described dermal, 40% respiratory, 57% ocular clinical effects. Life threatening situations as well as long-term health effects were found and were related with exposure to confined/enclosed space. Descriptive and analytical studies have shown attack rates ranging from 12% to 40%. Subjects who were sprayed by the police more often needed special treatment and reported adverse health effects. Apart from transient clinical effects, CS could have lasting and serious effects on human health. Better surveillance of the subjects exposed to CS and completion of cohort studies among exposed populations will illuminate the spectrum of the health effects of exposure to CS.

                Author and article information

                Contributors
                Journal
                EClinicalMedicine
                EClinicalMedicine
                EClinicalMedicine
                Elsevier
                2589-5370
                21 August 2020
                September 2020
                21 August 2020
                : 26
                : 100509
                Affiliations
                [a ]Department of Psychology, Aix-Marseille University, France
                [b ]Department of Psychology, Istanbul Şehir University, Turkey
                [c ]Department of Psychology, Paris-5 University, France
                [b ]Department of International studies, American University of Sharjah, Sharjah, UAE
                Author notes
                [* ]Correspondence to: College of Arts and Sciences at the American University of Sharjah, University City, Sharjah, United Arab Emirates. jadam@ 123456aus.edu
                Article
                S2589-5370(20)30253-4 100509
                10.1016/j.eclinm.2020.100509
                7565085
                6e3010c7-a12d-4e93-a77c-7fac9a581b68
                © 2020 The Author(s)

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 30 July 2020
                : 31 July 2020
                Categories
                Letter

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