Stephen Barron, PsychLaw Conference Police Officer Suicide: NSW Police Force to 2005 Stephen W. Barron

Stephen Barron, PsychLaw Conference Research Goals: To investigate suicide by NSW Police Officers using a Psychological Autopsy Protocol. To investigate suicide by NSW Police Officers using a Psychological Autopsy Protocol. Identify the key psychological, social and occupational factors associated with police officer suicide. Identify the key psychological, social and occupational factors associated with police officer suicide.

Stephen Barron, PsychLaw Conference SUICIDE: A MULTI-FACTORIAL EVENT Neurobiology Severe Medical Illness Impulsiveness Access To Weapons Hopelessness Life Stressors Family History Suicidal Behavior Personality Disorder/Traits Psychiatric Illness Co-morbidity Psychodynamics/ Psychological Vulnerability Substance Use/Abuse Suicide

Stephen Barron, PsychLaw Conference PSYCHOSOCIAL SITUATION: LIFE STRESSORS  Recent severe, stressful life events associated with suicide in vulnerable individuals (Moscicki 1997).  Stressors include interpersonal loss or conflict, economic problems, legal problems, and moving (Brent et al 1993b, Lesage et al 1994, Rich et al 1998a, Moscicki 1997).  High risk stressor: humiliating events, e.g., financial ruin associated with scandal, being arrested or being fired (Hirschfeld and Davidson 1988) – can lead to impulsive suicide.  Identify stressor in context of personality strength, vulnerabilities, illness, and support system. All studies are reviews

Stephen Barron, PsychLaw Conference PROTECTIVE FACTORS  Children in the home, except among those with postpartum psychosis  Pregnancy  Deterrent religious beliefs  Life satisfaction  Reality testing ability  Positive coping skills  Positive social support  Positive therapeutic relationship

Stephen Barron, PsychLaw Conference The Psychological Autopsy protocol. An investigative technique where the aim is to gather enough information about the circumstances of a persons death (suicide) to gain an understanding of the reasons for that death (suicide), An investigative technique where the aim is to gather enough information about the circumstances of a persons death (suicide) to gain an understanding of the reasons for that death (suicide), Hawton et al (1998)

Stephen Barron, PsychLaw Conference Psychological Autopsy Method is speculative, probabilistic and results in a professional opinion regarding the causes and events which may have contributed to the decision to suicide. Method is speculative, probabilistic and results in a professional opinion regarding the causes and events which may have contributed to the decision to suicide. Present protocol was adapted from De Leo & Evans (2002) study of suicide in Qld. Present protocol was adapted from De Leo & Evans (2002) study of suicide in Qld.

Stephen Barron, PsychLaw Conference Methodology/Data Comprehensive review of all deaths reported to the NSW Coroner of Police Officers – 1999 to May Comprehensive review of all deaths reported to the NSW Coroner of Police Officers – 1999 to May Mortality rate of serving police officers was 190 deaths (NSW Police HR data) within the sampled years, with Mortality rate of serving police officers was 190 deaths (NSW Police HR data) within the sampled years, with 103 deaths reported to the NSW Coroner. 103 deaths reported to the NSW Coroner.

Stephen Barron, PsychLaw Conference NSW Police Mortality Heart Disease – 10 deaths, Heart Disease – 10 deaths, Accidents – 8 deaths, Accidents – 8 deaths, Motor Vehicle collisions – 11 deaths, Motor Vehicle collisions – 11 deaths, Homicide – 8 deaths, Homicide – 8 deaths, Alcohol related abuse – 2 deaths, Alcohol related abuse – 2 deaths, Suicide – 35 deaths, Suicide – 35 deaths, Other causes – 25 deaths, Other causes – 25 deaths, Unknown causes – 4 deaths. Unknown causes – 4 deaths.

Stephen Barron, PsychLaw Conference NSW Police Mortality cont’d 9 deaths of police officers whilst on duty: 9 deaths of police officers whilst on duty: 4 traveling in police vehicles, 4 traveling in police vehicles, 3 firearm related wounds, and 3 firearm related wounds, and 2 officers stabbed. 2 officers stabbed. Overall: 4.7% of all deaths are on duty, Overall: 4.7% of all deaths are on duty, Suicide rate accounts for 18% of all NSW police officer deaths. Suicide rate accounts for 18% of all NSW police officer deaths.

Stephen Barron, PsychLaw Conference Suicide Rate comparison. NSW (2005) – suicide rate 11.5 per 100,000 (gen. pop’n.) NSW (2005) – suicide rate 11.5 per 100,000 (gen. pop’n.) NSW Police (2005) – suicide rate of 20.7 per 100,000. NSW Police (2005) – suicide rate of 20.7 per 100,000. U.S. best ‘guestimate’ – 18 per 100,000 U.S. best ‘guestimate’ – 18 per 100,000 (Aamodt & Werlick, 1999)

Stephen Barron, PsychLaw Conference Suicide Frequency ( )

Stephen Barron, PsychLaw Conference Demographic Data. Males – 32:Females – 2 Males – 32:Females – 2 Mean age: 35 years, Mean age: 35 years, Marital status: Marital status: Married: 40% Married: 40% Single: 31.5% Single: 31.5% De facto:11.5% De facto:11.5% Separated:14% Separated:14% Divorced:3% Divorced:3%

Stephen Barron, PsychLaw Conference Demographic data cont’d. Religious affiliation: Religious affiliation: Catholic – 74% Catholic – 74% Anglican, Church of England – 17% Anglican, Church of England – 17% (1995 study of police recruits – 35% C of E and 36% Roman Catholic).

Stephen Barron, PsychLaw Conference Demographic data cont’d. Location – 47% at home: 20% at a police station, Location – 47% at home: 20% at a police station, Years of service – 34% with less than 12 months service (average), and 51% with less then 10 years of years of service, Years of service – 34% with less than 12 months service (average), and 51% with less then 10 years of years of service, 57 % of officers committed suicide had children. 57 % of officers committed suicide had children.

Stephen Barron, PsychLaw Conference Occupational Stressors. Performance/adjustment issues – 31%, Performance/adjustment issues – 31%, Problematic work relationships – 17%, Problematic work relationships – 17%, Under investigation – 22% (underestimate: since internal complaint figures were not available), Under investigation – 22% (underestimate: since internal complaint figures were not available), Work related trauma – 8.5%. Work related trauma – 8.5%.

Stephen Barron, PsychLaw Conference Method of Suicide. Hanging - 17%, Hanging - 17%, Firearm - 43%, Firearm - 43%, Drug overdose - 14%, Drug overdose - 14%, Motor Vehicle exhaust - 9%, Motor Vehicle exhaust - 9%, Other - 17%. Other - 17%.

Stephen Barron, PsychLaw Conference Suicide Communication. Overall: 43% communicated suicide intent with other persons, including family, friends and work colleagues. Overall: 43% communicated suicide intent with other persons, including family, friends and work colleagues. 38% of officers who committed suicide left a suicide note. 38% of officers who committed suicide left a suicide note.

Stephen Barron, PsychLaw Conference Contact with Medical Practitioners prior to death. Visited their G.P’s within 1 day – 3 months prior to death – 34%, Visited their G.P’s within 1 day – 3 months prior to death – 34%, Visited mental health professional within 12 months of their death – 40%, Visited mental health professional within 12 months of their death – 40%, Taking medications at time of death – 40% (anti-depressants most common). Taking medications at time of death – 40% (anti-depressants most common).

Stephen Barron, PsychLaw Conference Presence of Mental Illness at time of death. Overall: 77% of deceased officers indicated some evidence of mental illness, Overall: 77% of deceased officers indicated some evidence of mental illness, Of these: Of these: Depressive Disorders – 31.5%, Depressive Disorders – 31.5%, Personality Disorders – 14%, Personality Disorders – 14%, Anxiety - 14%, Anxiety - 14%, Schizophrenia - 6%, Schizophrenia - 6%, No indications - 23%. No indications - 23%.

Stephen Barron, PsychLaw Conference Other Results. Acute events – 40% of deaths, Acute events – 40% of deaths, Binge or heavy alcohol use – 30%, Binge or heavy alcohol use – 30%, Smokers – 66%, Smokers – 66%, Referred by NSW Police for intervention – 51.5%, Referred by NSW Police for intervention – 51.5%, Presence of negative life events – 63%, Presence of negative life events – 63%, Presence of trigger event – 20%, Presence of trigger event – 20%, Relationship b’down within 12 months – 60%. Relationship b’down within 12 months – 60%.

Stephen Barron, PsychLaw Conference Officer Suicide Risk Profile. Characteristics: Characteristics: Personal - male, about 35 years of age, married, catholic, residing at home with spouse/partner and children, smoker. Personal - male, about 35 years of age, married, catholic, residing at home with spouse/partner and children, smoker. Social – moderate to heavy drinker, affected by alcohol at death, access to firearm, communicated intention to family or work colleague, relationship breakdown within 12 months and increased negative life events within 3 months of death. Social – moderate to heavy drinker, affected by alcohol at death, access to firearm, communicated intention to family or work colleague, relationship breakdown within 12 months and increased negative life events within 3 months of death.

Stephen Barron, PsychLaw Conference Risk Profile cont’d. Characteristics Cont’d: Characteristics Cont’d: Occupational – less than 10 years of service, currently under investigation for work related incident or performance issue, referred for workplace support/assessment, whose work related problems are known by colleagues and/or managers. Occupational – less than 10 years of service, currently under investigation for work related incident or performance issue, referred for workplace support/assessment, whose work related problems are known by colleagues and/or managers. Psychological – recent history of mental illness (usually depression), taking prescribed medication, no previous history or suicide, no previous attempts, visited medical practitioner 3 months prior to death. Psychological – recent history of mental illness (usually depression), taking prescribed medication, no previous history or suicide, no previous attempts, visited medical practitioner 3 months prior to death.

Stephen Barron, PsychLaw Conference ‘Healthy Worker’ bias effect. (Carpenter, 1987). Form of positive selection bias regarded as occupational protective factors re suicide risk: Form of positive selection bias regarded as occupational protective factors re suicide risk: Pre-recruitment and selection screening, including multi-level selection processes, Pre-recruitment and selection screening, including multi-level selection processes, Cohesiveness of the organisation, Cohesiveness of the organisation, Medical and mental illness support, Medical and mental illness support, Perceived meaningfulness of employment. Perceived meaningfulness of employment. (Violanti, 1996; Hourani et al, 1999; Miller, 2000; Agerbo, 2005). (Violanti, 1996; Hourani et al, 1999; Miller, 2000; Agerbo, 2005).

Stephen Barron, PsychLaw Conference Issue. When we consider the ‘Healthy Worker’ effect, excluding the unemployed, mentally ill, elderly, young and adolescent risk takers, drug and alcohol abusers, people with no access to support:- When we consider the ‘Healthy Worker’ effect, excluding the unemployed, mentally ill, elderly, young and adolescent risk takers, drug and alcohol abusers, people with no access to support:- For police we might then expect a lower than general population average for suicide – or does the availability of firearms explain the difference? For police we might then expect a lower than general population average for suicide – or does the availability of firearms explain the difference?

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