PTSD: The Hidden Toll of Policing
One night eight years ago, Mark DiBona was in a very dark place.
The police officer felt unappreciated, unhappy with his weight, emotional. He had recurring nightmares of scenes he had witnessed at work—death, shootings, child molestation, fatal crashes.
Too embarrassed to reach out for help, he put a gun in his mouth.
Ready to pull the trigger, DiBona thought of his wife, and put the gun down. But emotions consumed him again, and the gun was back in his face.
DiBona again put down the gun and called a friend, who convinced him to get help.
DiBona’s 31 years in law enforcement began in 1985 at the Braintree Police Department in Massachusetts and then the Amtrak Police Department.
He is currently a deputy sheriff in central Florida and a police academy instructor. He also travels around the country to give seminars on mental health and suicide.
Three years ago, DiBona was diagnosed with post-traumatic stress disorder (PTSD). He is also battling anxiety and depression.
The 52-year-old was in denial for a long time.
He is one of many police officers who have suffered from traumatic experiences in their careers—and he’s one of thousands who have contemplated suicide.
In 2008, 141 police officers committed suicide in the United States, according to the Badge of Life, an organization that specializes in police suicide prevention. In 2009, there were 143 suicides, and in 2012 there were 126—a significant drop, possibly attributed to generational changes and younger cops in law enforcement.
Ron Clark, a retired sergeant of the Connecticut State Police and chairman of Badge of Life, said more officers die of suicide than from gunfire and traffic accidents combined.
Mental health is the “invisible elephant in the room that no one wants to talk about,” Clark said. “None of them come in to acquire PTSD, but they end up with it and end up with the suicides.”
An estimated 100,000 active U.S. police officers have PTSD, according to the organization. However, the numbers are not conclusive.
“It’s impossible to get accurate numbers on PTSD,” said Clark, who believes a national study should be conducted. Officers often don’t reach out for help because of the profession’s “macho, suck-it-up mentality.”
“I don’t think there’s one department that doesn’t have an officer who has PTSD,” he said. “Police officers have feelings. They have a tough job to do.”
He said mental illness in general “is a scandal” in the United States surrounded by stigma and the idea that “mental illness always happens to someone else.”
He recommends that police officers have annual check-ins for mental health, as well as peer support, where they can talk to active or retired officers.
Clark also said recruiters and trainers should be open about mental health, starting from the beginning of police officers’ careers.
DiBona has had four law enforcement friends lose their lives to suicide. One of them committed suicide 18 months ago—she was one of his academy students.
The many traumatic scenes he experienced throughout his career continue to haunt him. He arrived in Manhattan just a few days after the 9/11 attacks and teamed up with NYPD officers, who playfully taunted him for being a Red Sox fan.
But what he saw at Ground Zero was shocking. He remembers arriving at the scene and being hit by the smell of death in the air and the sight of so many bodies. The experience eventually led to his PTSD.
Extreme situations like 9/11 may not be the only triggers, said Ellen Kirschman, a psychologist who volunteers for First Responders Support Network in California. She is the author of several books, including “Counseling Cops: What Clinicians Need to Know.”
In her experience, the most common trigger for PTSD symptoms in officers is having to deal with horrible incidents involving children.
PTSD symptoms are not always triggered right after a violent event. Minor incidents can also set individuals off, especially as police officers are exposed to so much trauma throughout their careers—and many stay on the job for more than 20 years.
Kirschman remembers an officer telling a story about when he was collecting evidence after a 16-year-old had committed suicide. As he covered the scene, in the same way he had for previous incidents, the mother of the deceased showed up and threw her arms around him. She did not let go as she sobbed.
That moment took him days to shake off. His wife would ask him what was wrong and he wouldn’t tell her, so she thought he was mad at her instead. Kirshman said the officer, who had kids of his own, was experiencing strong emotions, but refused to talk about it.
“Being the silent type is not a good way to cope. ‘You don’t bring your job home’ is baloney,” she said. “Explain yourself, explain your bad mood.”
Kirschman describes law enforcement as a family occupation. She offers counseling for officers and their spouses in group workshops.
Often, she said, police officers express relief when they are diagnosed with PTSD, saying, “I didn’t know I had PTSD, I thought I was crazy or weak.”
It opens the door for them to get help and not feel so ashamed, she said.
But for most, it’s not that easy. Many officers don’t reach out because they think it makes them look weak and they worry about confidentiality. They tend to try to care for themselves and battle through their symptoms, suffering in silence and sometimes self-medicating with alcohol.
“Cops are good at masking their symptoms,” said Kirschman.
Coping With PTSD
DiBona approaches his PTSD, depression, and anxiety with an arsenal of activities.
He sees a therapist, who is a former police officer, and takes medication. He exercises and listens to music while going for walks.
His wife of almost 25 years, who has a background in psychology, has supported him 100 percent, he said.
Their “incredible and dedicated” pet dog, a 9-year-old German shepherd, plays a crucial role for DiBona too.
Right now, DiBona says he is doing very well but still has “some difficult nights, some days anxiety kicks in and I feel like I can’t get out of bed.”
But he reminds himself that he has to be strong, for himself and for others, and forges on.
DiBona is outgoing, laughs a lot, and likes to joke around, but there is much more going on beneath the surface. He is very open about his experiences with PTSD, but says that at the beginning, he disclosed his situation to very few people. “I was very embarrassed, I didn’t want to reach out at all,” he said. He was also afraid of losing his job.
He wants others who are too embarrassed to admit they have mental health issues to get help.
“If it can affect me, it can affect anybody,” he said.
DiBona is due to retire from law enforcement in three years. He wants to continue his work at Badge of Life, where he knows he makes a difference.
“You convinced me to get help,” an officer told DiBona at a seminar as he hugged him after hearing about his battle with PTSD.
Combating PTSD in the NYPD
Between 1994 and 1995 there were 26 officer suicides in the NYPD. In 1996, the Police Organization Providing Peer Assistance (POPPA) was founded. The organization voluntarily staffed by 175 officers provides a hotline number for officers to call before they get to the point of suicide.
There are two lines: one for active officers and another for retirees. Each call starts with a conversation with a POPPA volunteer and may be followed up with a face-to-face meeting, all confidential. Clinicians are also available for those who need further treatment.
POPPA gets an average of four to five calls a day. There are no consistent times or seasons in which the calls go up, but they do increase when a cop commits suicide.
The program has been a success. Mental health professionals estimate that POPPA has prevented about 150 suicides since it began serving cops. The number of suicides is much lower than it was in the ’90s, according to POPPA Executive Director John Petrullo.
Petrullo, a retired officer from the 63rd Precinct in Brooklyn, said more organizations like POPPA are needed across the country.
“Police officers are the helpers, but sometimes they may need help,” he said. “They go out and fix everyone’s problems, but what about theirs?
“What police officers see every day is not good stuff,” he said.
POPPA offers educational programs to other units as part of its outreach and two-day trainings for officers on what to look out for in a partner who might be suffering from PTSD.
The organization gets calls from FBI agents and federal marshals who want to attend training. POPPA has also dispatched teams to other parts of the country, including Boston during the marathon bombings.
“They need to know there’s a place they can go where they feel safe,” said Petrullo.