Silent Struggles: Traumatic Brain Injuries and Mental Health in Law Enforcement

Jaclyn B Caccese; Carly R Smith; Nathan A Edwards; Angela M Emerson; Enora Le Flao; Jeffrey J Wing; Joshua Hagen; Scott Paur; Joshua Walters; James A Onate

doi:10.1097/HTR.0000000000000986

Silent Struggles: Traumatic Brain Injuries and Mental Health in Law Enforcement

J Head Trauma Rehabil. 2024 Aug 5. doi: 10.1097/HTR.0000000000000986. Online ahead of print.

Authors

Jaclyn B Caccese¹, Carly R Smith, Nathan A Edwards, Angela M Emerson, Enora Le Flao, Jeffrey J Wing, Joshua Hagen, Scott Paur, Joshua Walters, James A Onate

Affiliation

¹ Author Affiliations: Chronic Brain Injury Program (Dr Caccese); School of Health and Rehabilitation Sciences (Drs Caccese, Smith, Onate, and Le Flao), Human Performance Collaborative (Dr Edwards, Emerson, Drs Hagen, and Le Flao), and Department of Epidemiology (Dr Wing), The Ohio State University, Columbus, Ohio; and Franklin County Sheriff's Office (Mrs Paur and Walters), Columbus, Ohio.

PMID: 39106530
DOI: 10.1097/HTR.0000000000000986

Abstract

Objective: To determine the prevalence of head injuries (HIs), posttraumatic stress disorder (PTSD), and depressive symptoms in law enforcement officers (LEOs) and (2) the association between HIs and psychological health conditions.

Setting: County-level survey administered via Research Electronic Data Capture.

Participants: A total of 381 LEOs completed the survey (age = 43 ± 11 years; 40 [11%] females; time as LEO = 1-50 years, median = 15 years).

Design: Cross-sectional study.

Main measures: We examined the prevalence of HIs (the Ohio State University Traumatic Brain Injury Identification Method), PTSD (PTSD Checklist-Civilian [PCL-C]), and depressive symptoms (Patient Health Questionnaire-9 [PHQ-9]). We used Mann-Whitney U and chi-square analyses to compare PTSD and depressive symptoms between those with and without a HI history.

Results: There were 282 (74%) participants who reported a lifetime history of 1 or more HIs; 116 (30%) sustained 1 or more HIs on the job. PCL-C scores ranged 17 to 85 (median = 27); 33 (10%) participants met or exceeded the clinical cutoff score of 50 to indicate a positive PTSD screening. Participants with a HI history (median = 29) had higher PCL-C scores than those with no HI history (median = 24; P < .001), but the proportion of participants who met the clinical cutoff for PTSD was not different between those with ( n = 28, 11%) and without ( n = 5, 5%) a HI history (X 2 = 2.52, P = .112, odds ratio = 2.18; 95% confidence interval, 0.82-5.83). PHQ-9 scores ranged 0 to 20 (median = 3); 124 (36%) participants reported mild or greater depressive symptoms. Participants with a HI history (median = 3) had higher depressive symptoms than those with no HI history (median = 2; P = .012). The proportion of participants with mild or greater depressive symptoms was higher among those with a HI history ( n = 99, 39%) than without ( n = 25, 27%; X 2 = 4.34, odds ratio = 1.74; 95% confidence interval, 1.03-2.93).

Conclusion: HIs are prevalent in LEOs, which may have consequences for their performance, well-being, and career longevity. PTSD and depressive symptoms are higher in those with a HI history, suggesting LEOs need better traumatic brain injuries and mental health resources.