Working with the police
BACP Workplace, January 2022

It’s almost impossible for me to describe what I’ve learnt and the experiences I’ve had in the last nine years since I’ve been working with, for or around policing and police officers. What I can say without hesitation is that working with the police is probably the hardest work I have ever done, not only in terms of the content of client material, but also because of the frustrations of working in a service that is chronically underfunded and under-resourced. 

I’m writing this article to uncover another side of policing, away from some of the negative narratives, which have been so prevalent. It’s about the work that I and my colleagues across policing are providing to support better emotional, psychological and physical wellbeing. The need is great, as the police have become the punchbags of society, caught between decisions made by the Government and an increasingly frustrated society, and yet they are the people we will call when we are in need. They run towards what we run away from. 

I first began working in policing when I joined the Metropolitan Police’s occupational health (OH) department in 2013 as a staff counsellor. I transitioned from that role in 2017 to run a national police psychological health surveillance programme, and I now lead a larger version of this as part of the National Police Wellbeing programme, via the College of Policing. 

My experience of working with the police, whether as clients or colleagues, has been overwhelmingly positive. I’ve met some of the kindest, most hardworking people I know, who genuinely care about what they do and who want to do the best for us, despite working under some incredibly difficult conditions. As the saying goes, the police are the public (and the public are the police). They are just like the rest of us, human, fallible, but overall good and caring. And they are often frustrated by the lack of staff and resources. The police suffer the same day-to-day struggles as the rest of us – anxiety, financial worries, relationship breakdowns and family bereavements – and they still go out and deal with some of the worst aspects of humanity on a daily basis.

Culture in policing

That said, I am in no way condoning or excusing some of the behaviour of some officers over recent months, and neither do the vast majority of officers. As with all workplaces, there are some fundamental problems that need to be addressed, and police organisations are clearly not without issue. 

The kidnap, rape and murder of Sarah Everard, by Wayne Couzens, a serving Met police officer has rightly shone a spotlight on policing and raised questions about the culture within it. The horror and sadness felt by the public was also felt across policing, and I know that the desire to restore trust is one of urgency. As a therapist, this resonates with my own experience of working with clients who have had a damaging or unethical experience with another therapist – the actions of one person can reflect badly on the whole of our profession.

Morale and burnout

Morale in policing, as in other public sector organisations, is low. A high turnover of staff, due to sickness, disillusionment with the role, and changes to pensions, means that new officers no longer see policing as a job for life. A loss of experienced older officers and fewer people doing more work, as a result of repeated cuts to funding greater pressures due to the changing nature of crime, and filling the gaps that other services are no longer able to fill, such as the rise of calls related to mental health, have all impacted on staff morale.

According to the Police Federation' there are around 30,000 assaults on police across the country every year...

that's just under 100 officers a day (and that's only the
ones who report it)

Burnout rates among police officers are high, not only due to cutbacks and a lack of resources, but also from undertaking work that continuously exposes them to traumatic events, whether they be response officers attending incidents multiple times a day, or officers viewing distressing images as part of child abuse investigation teams.

In addition, increasing public scrutiny brings with it additional stress. In my role, I have been filmed by a member of the public when I attended an incident with a policing team, and I can attest that it is both unnerving and intrusive to be filmed while trying to do your job under very difficult circumstances, with no control over where that footage will end up. Police now wear body video  cameras in order to record incidents, to protect both the public and themselves.

Assaults and injuries 

Policing is a risky business, both physically and mentally. According to the Police Federation,¹ there are around 30,000 assaults on police across the country every year. That’s just under 100 officers a day (and that’s only the ones who report it).

There is an acceptance that being assaulted is just a part of the job, and it would be unrealistic to expect no injuries, given what policing involves. However, the level of violence experienced, for most of us, would be life changing, whereas for the police, it is normal. I have worked with officers who have been stabbed, or shot, run over, or had their jaw or limbs broken; and, most horrifically, set on fire. Unfortunately, these were not unusual or rare incidents.

Life stories and suicide 

Other factors are the culture and personality types of the people who make up a large proportion of the police force. Policing is a vocation that draws people to the profession to do good and to right wrongs, sometimes stemming from personal experience and adverse childhood experiences – a police version of the wounded healer. As with other vocational and public sector roles, there is a culture of ‘keeping on, keeping on’, and being affected by your job is to an extent perceived by individuals as a failing or a weakness, often resulting in officers becoming very unwell before coming to therapy. All police departments are overstretched, there is no give, so taking time off work doesn’t feel like much of an option because your colleagues will have to take up the slack, and they are overworked too. The level of suicides in policing is something that I naively did not expect. I have worked with many officers who were struggling with severe mental health issues, and unfortunately officer suicides are not rare events.²

Historically, forces have not recorded officer suicides, but with the work that is being done to recognise the impact that police work has on mental health, there is a now a national programme to record and acknowledge officer suicides.

Exposure to trauma 

The broad range of roles that police undertake, on its own, is something that I think the general public have little idea of. Most of us think of the people in uniform who drive cars with blue lights, attending traffic incidents, burglaries, assaults, robberies, stabbings, shootings and accidents; and while that is a large part of policing, there are also a multitude of other policing roles that go unseen. For example, there are police who are trained to deal with people who are suicidal or in mental distress, and who do this as a voluntary role on top of their substantive role. Police officers were also the primary responders to deaths at home from COVID-19 during the height of the pandemic, with some officers attending up to 15 deaths in a day.³

TV dramas

Our love of police dramas, such as Line of Duty and Unforgotten⁴ (the latter having the most realistic representation of the difficulties of medical retirement due to PTSD that I have seen), can give unrealistic expectations of policing, particularly in relation to our expectations of the impact of the work, in that somehow police officers should remain untouched by what they deal with, or because of the stereotype of the hardened cop with a bottle of whisky in his desk drawer. Certainly, when I first joined the Met, I was unprepared for the levels of mental distress, not always from the immediate stress of the job itself, but from the losses, where lives couldn’t be saved and where officers felt they had failed, despite going above and beyond to save life in exceptionally difficult circumstances.

So many people I worked with, who had many different lengths of service, had stories of incidents they had attended that stayed with them for years, if not for their whole careers: from the first dead body, or stabbing, to seeing colleagues seriously injured or being injured themselves, and sometimes fearing for their lives. Much of the work I have done, including training around trauma and mental health, has been to normalise responses to traumatic incidents and educate officers that feeling distressis not a failing.

Systemic change

Having shifted from working with individual police officers therapeutically, my role now is part of a wider national police wellbeing programme that provides guidance, tools and training for police and OH staff to deal with the complex issues that are specific to policing, such as post-incident and trauma response, or death in service. I lead the programme which supports officers in high-risk roles, such as traffic collision investigators, child abuse investigation teams and firearms officers, who have a higher than average exposure to traumatic events, by providing an annual health surveillance questionnaire, comprising a selection of clinical questionnaires.

It was developed by Dr Noreen Tehrani to capture the particular impact that police work can have early on and prevent more serious, undetected, trauma-related illness from emerging later on. I work with senior police officers, force leads and national groups in 43 police forces that are taking part in the programme.

We currently have funding to support 6,000 officers across the country, and there are always more requests than we are able to provide for. Fortunately, awareness of mental health in policing is growing, and stigma around asking for help is slowly reducing, which, while positive in itself, is highlighting the lack of funding and structured support in policing. As with all other areas, OH is chronically underfunded and overstretched. Some forces have outsourced this provision to EAPs, which can bring its own issues. Gaps in psychological/mental health provisions are often filled by well-meaning but unqualified volunteers. The fashion for wellbeing and mindfulness, while offering useful additional tools, does not provide the structured clinical support that many officers need.

Occupational health teams 

The OH staff who support the police include nurses, psychotherapists, psychiatrists, psychologists, counsellors and medical officers – dedicated professionals, who repeatedly go above and beyond to look after their clients. Many OH staff have backgrounds in the NHS, as nurses or GPs, or are experienced in working in a variety of mental health settings. Experience and training in working with high-level trauma, such as trauma-focused CBT or EMDR, is necessary, as is an ability to work with hard-to-engage clients. Most therapeutic work in policing is short term, often six to 10 sessions, so an ability to work with complex issues in a short-term setting is key. I also think robustness and a strong stomach are requirements. I never considered myself squeamish at all, but I have definitely heard stories that have affected me and will stay with me forever.

Alongside the tragedy of officer suicides, given the dangerous nature of policing, deaths of officers involved in accidents on duty or as victims of murder – such as those of Keith Palmer, Andrew Harper and Matt Ratana – while relatively rare, are not unusual. The impact on colleagues and friends, as well as the wider organisation, is something I have not experienced in other workplaces when someone has died. When there is a death of an officer, I become most aware of the closeness of the ‘police family’ and I find it another unique aspect of working clinically in policing. As a therapist, the risk of losing a client to suicide or injury on duty is very real, and something that I have experienced more than once.

Under investigation

A large part of therapeutic work with police officers is supporting those who are under investigation. There was a time when these investigations made up about 70% of my overall caseload. Investigations can go on for years, and more often than not, result in no case to answer, causing a huge strain on the officers being investigated, their families and also the wider police workforce as, while under investigation, officers are removed from public-facing roles.

As a therapist, an ability to remain objective when clients and cases are being discussed in the press is needed. I have on more than one occasion opened the news on my phone while travelling home from work and seen articles mentioning clients, which can be frustrating and unnerving.

Regular, high-quality supervision is fundamental, and I also find peer supervision with other therapists working in policing incredibly useful. However, I have found supervision – either individual or peer – with those who don’t have experience in policing, to be counterproductive, as an understanding of the culture is paramount. Towards the end of my time working clinically with officers, I suffered chronic burnout after dealing with high numbers of extreme trauma cases, on top of being part of the response team following the Westminster Bridge attack.

Responding to major incidents, such as the Grenfell Tower fire, the Manchester Arena attack or the London Bridge attacks are also part of the unique work that OH staff undertake, providing post-incident debriefs for those who were involved and ongoing support to those who have been injured or suffered trauma. This can be emotionally and physically draining, and the sheer scale of need can overwhelm even the most well-staffed departments.

Closing thoughts

Looking ahead, the OH workforce is an ageing one, with many nurses and counsellors nearing retirement age. It seems that OH work in policing is not a role many people want to undertake, so we are facing a future crisis in staffing, which is concerning.

I believe that, if we expect police to run into danger on a daily basis, in return we have an obligation to mitigate the impact that this role can have by properly funding OH departments, providing a national standard of clinical support to all forces, regardless of size, that would offer post-incident debriefing as standard, alongside quality therapeutic interventions with qualified and experienced staff, and for this to be seen as a basic need, rather than a luxury.

need, rather than a luxury. Working in policing is the hardest job I have undertaken so far in my career, not only due to the lack of funding, resources and negative press, but also due to the sheer horror of the work that officers carry out and the effort of trying to support people in such difficult circumstances. However, it has also been the job I have loved most, and I have met some of the most incredible people, who deal with some of the worst aspects of humanity. My desire to provide support for those who protect us has not yet been diminished. There is much work still to do and I am keen to undertake research on the impacts of a 30-year career in policing and how it affects those who do this work, in order to inform how we can better support those who protect us.