Abstract
Policing demands are widely acknowledged to negatively impact on the physical and mental health of police officers and staff. Research has documented the need for greater insight into the stressors and trauma that impact police officers, with a current national drive towards enhancing the police wellbeing agenda: namely, Oscar Kilo and the National Wellbeing Service. To understand the current wellbeing strategies in place, 34 Blue Light Wellbeing Frameworks were analysed. A mixed methods approach was adopted: quantitative data was descriptively examined, with thematic analyses employed to explore the qualitative data. Findings from the review highlight developments in police wellbeing, as well as areas for future development.
Literature review
Policing responsibilities and demands are widely acknowledged to negatively impact on the physical and mental health of police officers and staff (Clements et al., 2020). Following the 2017 launch of Oscar Kilo
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(OK) and the Blue Light Wellbeing Framework
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(BLWF; Hesketh and Williams, 2017), the Front Line Review was conducted (Home Office, 2019) and the National Police Wellbeing Service
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(NPWS) was launched in 2019. During this time, a range of national wellbeing activities have been promoted, with ongoing work to continue to support the delivery of the wellbeing agenda. Police Federation of England and Wales (2020) recently emphasised the importance of mental health in policing and launched a
Recent developments in police wellbeing
Extensive academic research has documented the need for greater insight into the multifaceted stressors and traumas that impact police officers; not only to ensure individual and collective wellbeing of officers and forces, but also as it is a pressing public health issue that needs addressing (Miller et al., 2019). In the UK, several recent campaigns and evaluations that reinforce these concerns have occurred. As noted above, the past few years has seen the launch of OK, the BLWF (Hesketh & Williams, 2017) and the NPWS. The Front Line Review captured evidence from police forces across England and Wales and documented the variety of issues affecting the working lives of both officers and staff – with wellbeing being one of the key themes evaluated (Home Office, 2019; Knight, 2019). The findings of the review are echoed in other research, highlighting increased demand but increasingly limited capacity, persistent organisational and operational stressors, a lack of time and commitment by management in enabling individuals to focus on activities which positively promote wellbeing, the complexity of evaluating and seeking ways to improve wellbeing, and the prevailing scepticism about the wellbeing agenda being put forward – particularly relating to its consistency in implementation, and ability to have a lasting impact (Knight, 2019; Ordon et al., 2019; Phythian et al., 2021).
As well as their
Academic studies continue to document the ‘high-risk’ nature of the profession and the unique physical and mental challenges the work presents (Kamkar et al., 2020). Considerable emphasis is placed on the extensive mental health burdens that ensue for current individual officers, in addition to wider personal circles such as friends and family (Edwards and Kotera, 2020; Knaak et al., 2019). Recent studies have especially centred on: the importance of understanding, monitoring and preventing psychological work injuries from exposure to trauma, such as post-traumatic stress disorder (PTSD) (Foley and Massey, 2019; Grupe et al., 2019; Miller et al., 2019); the lack of emphasis on understanding the ‘moral injuries’ that arise from the conflicts that occur when officers try to uphold the law, but also adhere to personal moral and spiritual values (Papazoglou, 2019; Papazoglou et al., 2020; Wagner et al., 2019); and tackling mental health stigma, which is argued to remain embedded in police culture (Edwards and Kotera, 2020).
Psychological work injuries
Police officers are regularly exposed to threats to their, or others’, physical safety from dealing with routine criminal activity, in addition to risks which come from more extraordinary or extreme events such as natural disasters (Kerswell et al., 2019; Regehr et al., 2019). Persistent exposure to ‘violence, aggression, environmental stressors and traumatic events’ has resulted in poor physical and mental health in the police force (Liakopoulou et al., 2020: 1). Specific and pronounced concerns surrounding psychological work injuries such as PTSD, depression, anxiety and suicide have been evidenced recently across a variety of geographical contexts (see Clements et al., 2020; Foley and Massey, 2019; Mona et al., 2019; Sheard et al., 2019; Soomro and Yanos, 2019).
In the UK, there have been several studies and media articles that have detailed some of the tangible effects of the psychological injuries being experienced by officers. Currently, the Trauma Resilience in the UK Policing project (2019) is utilising a series of qualitative and quantitative methods to explore the prevalence of trauma exposure in operational policing and find ways to support trauma processing and maintain resilience. Preliminary findings from their online survey of 16857 officers and operational staff, conducted in 2018, show that 20 per cent of participants who had experienced trauma had symptoms of some form of PTSD (BBC, 2019, Policing: The Job & the Life, 2019). Furthermore, ‘66 percent of all respondents reported a psychological or mental health issue which they felt was a direct result of police work’ (Policing: The Job & the Life, 2019). Foley and Massey (2019: 24) highlight a steady increase in police officer illness in the preceding 3 years to their study due to ‘psychological disorders’ in the Metropolitan Police Service. Moreover, in 2019, it was also reported that numbers of police officers being signed off sick with stress and anxiety had doubled in the prior 5 years following a Freedom of Information request of 40 forces across the UK (The Telegraph, 2019b).
However, as Sheard et al. (2019) argue, recent studies do not always assess the prevalence of such psychological injuries according to the role that officers have. Their survey of 602 officers in North East England found that, while most questionnaire respondents reported having experienced mental health difficulties, the role held had a significant effect on levels of certain psychological difficulties. For example, ‘resolution without deployment officers reported higher levels of secondary traumatic stress and lower compassion satisfaction than individuals in a number of other roles’ (Sheard et al., 2019: 273). In Syed et al.’s (2020) systematic review of 16 databases and over 11000 publications on mental health problems in police personnel spanning the last 40 years, they emphasise the need for studies to centre on the variety of mental health problems, and subsequent secondary conditions, experienced. This is to complement the disproportionate (although important) centring of research on PTSD. They found that officers demonstrate a considerable range of conditions; for example, one in 10 across their dataset met the criteria for an anxiety disorder or suicidal ideation, with potentially damaging coping mechanisms also noted, such as the hazardous drinking that approximately ‘one in four police officers’ screened positive for (Syed et al., 2020: 3).
Police culture and mental health stigma
A prevailing barrier to police wellbeing that continues to feature in recent research is that of police culture, especially regarding mental health stigma (see Demou et al., 2020; Purba and Demou, 2019). Contreras-Negretti (2019) argue that hegemonic masculinity still pervades the police, normalising the ‘silencing of distress’ (p. 11) and causing the suffering individuals to be emotionally alienated. Edwards and Kotera (2020) state that the UK-based police officers they interviewed experienced discrimination and stigmatising attitudes from colleagues upon developing mental health issues. Cohen et al. (2019) highlight that traditional police culture restricts the creation and implementation of appropriate wellness agendas, as there is a lack of investment from leaders due to persistent notions of ‘toughness’ being required for the job. This, they argue, in turn generates reluctance from individuals to speak out (Bell and Eski, 2016). Mental health stigma filters into decision-making to manage symptoms by the individual, such as refraining from taking time off (Stamatakis, 2019), which generates perceived devaluation of skills and abilities (Knaak et al., 2019), and causes delays in pursuing treatment (Velazquez and Hernandez, 2019). Velazquez and Hernandez (2019) also allude to the need for more research centring on endorsement (conscious or otherwise) of negative stereotypes about people with mental health issues by police officers. Syed et al. (2020) argue that effective preventative mechanisms for mental health problems should be focused on tackling negative police cultures via stigma reduction strategies to promote more positive peer and leader attitudes towards mental health.
Summary
Recent literature highlights the need for police forces globally to be adapting to new technological, socio-economic and political contexts which consistently bring new physical and mental challenges. These include: austerity and other financial or resource constraints (Hesketh et al., 2019; Miller et al., 2019); technological advances which have generated new, or adaptations of pre-existing, crimes; and increased prevalence of crimes that typically present traumatic experiences for officers (such as child sexual exploitation [CSE], see Gray & Rydon-Grange, 2020). Whilst there are encouraging developments through the implementation of both national and local wellbeing initiatives, literature indicates that more work is needed to reduce stigma and to develop a positive police culture to ensure appropriate support is available to police staff and officers who continue to work in a developing and increasingly complex society. What is more, amongst the plethora of interventions and training that have arose over the past few years, it is critical to ensure progress and efficacy is regularly reviewed and evaluated. This study proposes to review BLWFs to understand the current wellbeing strategies in place, in addition to the areas of wellbeing that UK forces deem to require development.
Method
Blue light wellbeing framework
The BLWF consists of six sections within wellbeing and policing:
Research design
The research used a mixed methods approach incorporating both qualitative and quantitative methodologies. Put simply, quantitative approaches use statistical methods to measure and analyse numerical data, which is often associated with greater accuracy, validity and reliability of data, allowing for comparison and replicability. However, whilst quantitative methods are adept in illustrating straightforward information and trends, they do not explain the nuances as to why a particular outcome is taking place. This is why qualitative approaches are illuminating as they provide meaning as well as providing contextual information to enhance the quantitative data. Furthermore, Clements et al. (2020) highlight the dearth of qualitative studies that have examined the social context of wellbeing, with quantitative studies having previously dominated.
Procedure and analysis
Each of the frameworks were individually extracted from the Oscar Kilo website (a cut-off date of 23rd March 2020 was applied) and imported into MS Excel. During the compiling of data, each framework was pseudo-anonymised by the researchers by assigning an ID number to each framework. A total of 34 frameworks were available for analysis (a further four frameworks were excluded from analysis due to missing data).
Both quantitative and qualitative analyses were conducted on data collected using the BLWF. Self-assessment scores (UD, ID, FD) were collected and quantitatively coded for each of the framework’s six sections (i.e. 1 = UD; 2 = ID; 3 = FD). Upon completion of data cleaning, the dataset was then imported into SPSS IBM v.26 for descriptive analysis. As each of the six theme scores were summed to create the total development score, Cronbach’s alpha was used to test the internal consistency of the total development score. The test found that the total development score had an almost excellent internal consistency,
Results
Quantitative overview of the BLWF
To first understand the extent to which each framework was complete, the number of answers to each was examined. The average total number of questions answered was 86.53 (
Development self-assessment: total development score
Each question in the six themes were scored (1 = UD; 2 = ID; 3 = FD); this score was totalled across each theme to generate total theme scores, and further summed to form an overall ‘total development score’ across all 34 frameworks. The total development score ranged between 93 (if a force was UD across all 93 questions) and 279 (if a force was FD across all 93 questions), meaning a higher total score reflected greater development of the overall organisation. The average total development score was 220.65 ( Proportion of development across each of the six themes, using the total development score as a benchmark for comparison.
As seen within Figure 1,
Qualitative overview of the BLWF
Numerous policies, interventions and training were reported across the frameworks (see Table 1 for a full list). Thematic analyses identified three themes: 1. Risk assessments and psychological monitoring; 2. Empowering and supporting staff; 3. The role and responsibility of management. List of policies, interventions and training.
Risk assessments and psychological monitoring
To support staff in an appropriate and meaningful way, forces utilise various forms of data (i.e. sickness, assault, occupational health [OH] data) to understand the needs specific of their staff; data is broken down ‘ i. ii. iii.
Empowering and supporting staff
Methods are in place to support the individual and meet their working needs, as it was recognised that the organisation ‘ “Policing is a 24-7 operation. The demands on our people are therefore significant and the public expects its police officers to step forward in situations where everyone else is running the other way. This takes courage and great commitment and that should never be taken for granted, neither should the complexity of the crucial work undertaken by our police staff.”
Four subthemes were reported: i.) a holistic approach; ii.) an inclusive working environment; iii.) psychological and physical wellbeing; and iv.) personal responsibility and accountability. i. ii. iii. iv.
The role and responsibility of management
There was a clear responsibility on management to ensure their staff received consistent and continuous support. Attendance management training is provided to managers, so they fully understand ‘ i.) ii.) iii.) iv.)
Areas for improvement
Areas for improvement.
Discussion
To understand the current wellbeing strategies in place, the progress that has been made nationally and the areas of wellbeing that UK forces deem to require development, a total of 34 BLWFs were analysed. Findings from the review indicated developments in police wellbeing; based on the development score of the overall sample, forces were perceived to be ‘fully developed’ with the levels of development of sections within the framework falling within the expected development levels: absence management was the most developed section of the framework and personal resilience remained to be the most underdeveloped (see analysis of earlier BLWF data, Phythian et al., 2021). Whilst methodological limitations prevent a statistical comparison between the 2018 and 2020 BLWF data, descriptive statistics indicate a development in national police wellbeing (i.e. total development score
The qualitative analysis reflected the overall development levels presented in the quantitative analysis; absence management and leadership contained detailed accounts of multiple policies, procedures, initiatives and services, yet this is much more limited when reviewing the personal resilience and protecting the workforce sections. Moreover, physical health appeared to be better understood with a wealth of provisions in place; whilst psychological support was evident, this was somewhat sporadic. In comparison to the BLWF data explored in 2018 (Phythian et al., 2021), references to using an evidence-base and adopting research-informed approaches were evident, with forces engaging in self-assessment to identify areas for improvement. Whilst developments are in progress, inhibitors to a positive wellbeing environment remain, such as culture, management support and awareness, and negative perceptions, as well as sporadic adherence to and application of organisational processes (i.e. RTW interviews).
Progress is promising. Yet, in a constantly evolving and increasingly complex society, it is imperative that the support in place for police wellbeing continues to develop in a way that can be sustained nationally. As discussed in the literature review, culture and stigma constitute barriers to care and recovery from psychological work injuries for the police (Bell and Eski, 2016; Velazquez and Hernandez, 2019); it is critical to value staff and ensure they are fully supported when fulfilling their roles. Therefore, it is essential that management have the necessary awareness and emotional intelligence in response to wellbeing (e.g. Houdmont et al., 2020). Areas for improvement include consistency in the application and delivery of policy and processes, management training, developing a supporting culture and clear signposting; generally, uncertainties remained in
Recommendations and implications for practice
Evidence-based and targeted approaches
During the short time period since the launch of OK and the NPWS, developments in activities and the promotion of national conversations surrounding police wellbeing are evident. Whilst there are increasing examples of evidence bases being consulted and used to inform future actions, there is still limited clarity on which initiatives are informed by research and which have undergone evaluation. Such resources and evidence on ‘what works’ are available via OK. Measures of engagement with OK and the various guidance should be collected; this would assist in understanding the ongoing awareness of UK policing, as well as identifying trends and implementing an appropriate response (i.e. does an increase in engagement with personal resilience resources align with force perceptions of being underdeveloped? Could additional evidence-based guidance assist?).
With the increasing body of knowledge available, ‘recommended’ approaches (i.e. interventions, strategies) and ‘good practice’ should be actively shared with forces, with the view to achieving a consistent and informed national stance, saving valuable funding, time and resources. Consequently, this would support in clarifying the inconsistencies in the policies and interventions that are reported. It is currently difficult (without further scrutiny) to determine if the policy in one force is the same as that in another force, albeit with a different policy name. However, whilst national consistency supports sharing best practice and the development of a unified approach, force-specific nuances and needs are acknowledged.
A consistent approach to completing the BLWF
Inconsistencies in the use and completion of the BLWF were observed. To evaluate and compare progress, and to identify and share best practice, consistency in the data collected would be useful. For example, clarification as to the desired type of response would reduce the variations in the data, such as one force leaving the response blank, another responding with a ‘
Organisational and individual perspectives of wellbeing
As recommended previously (see Phythian et al., 2021), it is critical to align organisational and individual perspectives to achieve a shared understanding of wellbeing and success. Whilst improvements to the development levels across multiple forces were apparent, there are indications that individual-based wellbeing remains
Limitations
Inconsistencies in the frameworks and challenges to evaluating progress persist, such as missing data and variations in the level of detail provided. Some forces failed to provide a self-assessed level of development for individual statements within the framework; for analytical purposes, the current research categorised forces with missing levels of development as ‘underdeveloped’, yet caution must be taken as the reason for failing to select a level of development is unknown. Additionally, due to the specificity of the statements within the framework, much of the content surrounding the themes was descriptive. This resulted in descriptive, as opposed to analytical, content. Additionally, the variations in level of detail provided resulted in difficulties identifying specific elements, and themes, of wellbeing applied and acknowledged by forces. There was a degree of overlap in the content provided in each of the six sections; it was not clear which overlap represented a ‘natural overlap’ or ‘relationship’ in the data, and which was indicative of a lack of a clear understanding of how one section is distinct to another (i.e. between personal resilience and protecting the workforce).
Conclusion
Recent national developments have supported in driving the wellbeing agenda forward. Whilst awareness of wellbeing is increasing, and open and honest conversations are taking place, progress is still to be made. Developments in national police wellbeing should be mindful of existing initiatives and training that may be available, as well as those which have undergone evaluation, whilst also being cognisant of individual employee needs and perspectives to ensure they are aligned to the organisation. Considering the areas of improvement identified by forces, future developments of police wellbeing should consider: how to support the implementation of evidence-based, targeted approaches; how to guide practitioners in completing the BLWF, in a consistent way that would be conducive to supporting peer review, development of wellbeing and analysis of progress; and how to align the perspectives of the individual to the organisation, and to capture this data in the BLWFs.
Footnotes
Acknowledgements
Special thanks to academics and practitioners who have supported and provided data for this study, particularly the National Police Wellbeing Service team and Oscar Kilo.
Declaration of conflicting interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The research was commissioned by the National Police Wellbeing Service.
