One in five UK police officers suffers from Post-Traumatic Stress Disorder or Complex Post-Traumatic Stress Disorder, yet there is no gold standard measure of trauma exposure available.
Research from Dr Jess Miller has produced the UK's first Police Traumatic Events Checklist for use on the front line.Read the research
Encountering events that are traumatic is commonplace in UK policing and global law enforcement. Experiencing a traumatic event (defined as ‘an extremely threatening or horrific event or series of events’ is required for a diagnosis of post-traumatic stress disorder. Over 90% of serving officers and staff report exposure to such events and one in five police officers currently have either Post-Traumatic Stress Disorder (PTSD) or Complex Post-Traumatic Stress Disorder. Even in the absence of PTSD, trauma is known to significantly impair cognitive function, wider health and performance – including vital routine skills such as situational awareness. Currently, however, there is no gold standard by which trauma exposure is measured in UK policing. Here we report the development of a new measure of trauma exposure based on the narratives of over 1,500 police officers and staff.
Police-oriented trauma exposure checklists are non-UK based and seem to fall under the categories of those which reflect ‘firsts, worsts and mosts’ (first trauma exposures early in career, most severe exposure and most frequent trauma exposures). The lists have been generated in different ways, including: revisiting established checklists from early studies, consulting with psychologists and ‘paraphrasing’ qualitative data, but none make reference to original trauma descriptions from policing.
To our knowledge this study is the first to systematically code original trauma descriptions in large numbers to generate a checklist from a UK policing population. Our approach has been greatly aided by the existence of coding technology (such as NVivo) to manage large datasets.
A limitation of this study was the variation in roles (specifically those designated to staff or warranted officers) and ranks will no doubt mean that The Police Traumatic Events Checklist will be more relevant to some than others. For those in higher rank, it may be less relevant for current daily exposure monitoring, but maybe useful as a tool by which one can reflect on historic cumulative trauma exposure, if that is useful for individuals. For those in back-office staff roles, the checklist again may be less relevant for individuals’ own daily work, but may yet be useful to understand the breadth and range of trauma exposures experienced by those they may be supporting (directly or indirectly) on a daily basis.
The Police Traumatic Events Checklist will benefit from further development as a clinical and research tool. Validation of the list of exacerbating situational contexts through large scale surveys could improve its viability for assessing the interaction between working conditions in policing and UK prevalence rates of PTSD (Brewin et al., 2021). The checklist may also be used by forces in their psychological risk assessment of specific roles which may be known to expose individuals to the trauma types depicted. Cognitive testing of the Police Traumatic Events Checklist will take place throughout 2021 with the University of Cambridge, involving 30–45 semi-structured interviews (and an online survey) with serving police officers and staff and stakeholders, such as The Police Federation of England and Wales, the College of Policing, the National Police Chiefs’ Council, and Police Care UK. There is also the development option of digitising the checklist and matrix for use in a mobile application or online platform. Results of the validation (and any associated technological development) of the Trauma Exposure Checklist will be made available through The University of Cambridge and Police Care UK.
Over one in five UK police officers and staff are probable cases of PTSD or Complex PTSD and, until now, means of consistently measuring trauma impact on the job (as opposed to non-work-related trauma) have been limited. The study provides an assessment tool that identifies over 75% of UK police trauma exposure and is based on the recent experiences of over 1,500 officers and staff on the front line. The Police Traumatic Events Checklist may be useful for self-assessment, for monitoring cumulative load during an officer’s career, for supporting Trauma Risk Management (TRiM) and Occupational Health treatment pathways, and for enhancing Psychological Risk Assessment for specific roles. It has potential applications in a variety of operational settings including supervisions, peer support activities, wellbeing assessments, and training. The checklist can be used in matrix format (see Appendix 4), enabling individuals to record the situational contexts that influenced the impact of the event at the time (such as few resources or being first on scene). More generally, the Checklist may go some way towards properly documenting the types and levels of traumatic stress to which police officers and staff are routinely exposed.
PTEC is a tool to support officers’ and staff to manage the trauma exposure they experience in their work. You can use the matrix to help understand why a single incident may be difficult or to monitor your own exposure over time. PTEC can support conversations with peers, supervisors, counsellors and health care advisers as well as in Occupation Health, TRiM and other wellbeing interventions.
This grid depicts the most common types of traumatic incidents UK police officers and staff report as their worst experience in the job.
The rows represent typical incidents and the columns typical contexts in which they arise. You can also use the Other boxes to describe incidents and contexts that don’t appear on the list.
You are welcome to share PTEC with peers, family and friends. If you would like more information on how to use the tool, contact email@example.com.