Exploring Barriers,Facilitators,and Needs Related to Mental Health Promotion for Police Officers: A Qualitative Approach

Abstract

Police officers are vulnerable to psychological distress and trauma since they are constantly exposed to significant physical and mental violence. Poor mental health can lead to increased healthcare costs for individuals, organizations, and nations and negatively impacts public safety. Mental health interventions tailored to the nature of police work are needed; however, a research gap exists regarding understanding the mental health of police officers. This study aimed to explore the barriers, facilitators, and needs for mental health promotion among police officers. This study adopted a qualitative approach in South Korea. Twelve police officers working in a metropolitan city were recruited using purposive sampling methods. One-on-one interviews were conducted with open-ended questions regarding barriers, facilitators, and needs for improving mental health. Content analysis was used to derive relevant themes. The participants included 3 women and 9 men, with an average age of 37.8 years and working experience of 12.6 years. Three themes and 9 subcategories emerged. The theme related to barriers was “difficulty accessing resources”; the theme related to facilitators was “supportive environment for mental health prevention and management”; and the theme related to needs was “education and policies to promote mental health.” Considering the occupational and organizational characteristics of the police profession, individual and organizational interventions and policies are needed to adequately manage the mental health of police officers.

Keywords

police officers mental health qualitative study stress burnout

What do we already know about this topic?

The work environment of police officers poses a risk to their mental health, and as a result, they can experience stress, trauma, anxiety, and depression. There is a lack of research on their experiences and the difficulty of promoting mental health among police officers.

How does your research contribute to the field?

The difficulties and facilitators identified related to the promotion of mental health among police officers were access to resources and environmental support, respectively. The police officers desired education and policies for the promotion of mental health.

What are your research’s implications toward theory, practice, or policy?

It is necessary to develop policies and interventions to promote the mental health of police officers, taking into account their occupational environment and needs in managing their mental health.

Introduction

Police officers serve as the first responders to various criminal incidents and are exposed to a variety of physical and mental violence on a daily basis.^1,2 Police officers experience emotional distress in the process of dealing with criminals, disasters, and traumatic events. Previous studies reported that police officers are prone to mental health problems such as depression, anxiety, burnout, and post-traumatic stress disorder (PTSD).^1,2 In addition, police officers may experience organizational stress resulting from shift work, exposure to chemicals during investigations, and hierarchical organizations, which can have a negative impact on mental health.^2,3 A cohort study of newly recruited police officers in South Korea reported a lower prevalence of mental health problems than the general population when they first entered the police force, but a pattern of worsening mental health was observed after 10 years of follow-up.⁴ Also, a meta-analysis of mental health conditions among police officers reported a high incidence of mental health problems, including PTSD (15%), depression (14%), generalized anxiety disorder (11%), and hazardous drinking (25%).⁵

Poor mental health in police officers can influence their working and judgment and can impact public safety.^6,7 To promote mental health, programs and policies are needed that consider the participants and their circumstances, including work environment and characteristics.^8,9 Police officers have higher stress levels than other working professionals and perform special tasks related to crime. In South Korea, police officers have been found to be more vulnerable to mental health problems than other public servants, including firefighters.⁴ Thus, a deeper understanding of police officers’ work can provide new perspectives on their daily experiences, work environment, and organizational structure as they relate to mental health promotion.

Previous studies related to mental health have examined the factors influencing mental health,⁴ stress and burnout levels,¹⁰ intentions for help-seeking behavior,¹¹ barriers to help-seeking behavior,¹² and psychological experiences of emergency service staff seeking help.¹³ These studies have identified mainly individual characteristics that affect the mental health of police officers. There is limited scientific evidence on the identification of promoting mental health among police officers in South Korea. Police officers have inherent norms and work in situations that are vulnerable to mental health, and it is necessary to explore their work lives and physical and mental health. Therefore, understanding their experience is essential for providing future nursing interventions and policy making during the professional adjustment process of new officers. In addition, providing the necessary interventions will ultimately help reduce depression, anxiety, and trauma among officers.

The Medical Research Council suggests that intervention development should investigate barriers, facilitators, and need assessment associated with behavior change.¹⁴ The ultimate aim of this study was to provide evidence for interventions and policy development related to mental health promotion for police officers. Accordingly, the study aimed to explore barriers, facilitators and needs associated with improving mental health among police officers. This study applied the Predisposing, Reinforcing, and Enabling Constructs in Educational Diagnosis and Evaluation-Policy, Regulatory, and Organizational Constructs in Educational and Environmental Development (PRECEDE-PROCEED) model.¹⁵ This model can facilitate the planning, implementation, and evaluation of health promotion programs. This model consists of 8 stages: social assessment, epidemiological assessment, educational/ecological assessment, administrative/policy assessment and intervention planning, implementation, process evaluation, impact evaluation, and performance evaluation. The phenomenon of health problems can be explained through the educational/ecological assessment stage. The educational/ecological assessment stage includes prerequisites, reinforcing factors, and enabling factors. Prerequisites are necessary to motivate individuals’ behaviors. Reinforcing factors help individuals maintain behaviors within the community. Enabling factors increase the adoption of health promotion behaviors.^9,15 This study aims to explore the phenomenon of barriers, facilitators, and supporting factors related to the promotion of mental health of police officers through a qualitative approach by applying the PRECEDE-PROCEED model.

Methods

Research Design

This was a qualitative descriptive study to explore barriers, facilitators, and needs related to mental health promotion among police officers in South Korea. The interview questions and analyses were based on the PRECEDE-PROCEDE model. This study was reported according to the Standards for Reporting Qualitative Research guideline.¹⁶ The researchers as interviewers in this study have extensive experience in mental health-related fields and qualitative research. In particular, the researchers included a female nursing scholar whose main research topic is about the health of police officers.

Participant Recruitment and Selection

The study participants were police officers working at police stations or district offices in a metropolitan city in South Korea. We chose participants working in urban areas because these areas are generally more demanding and intense than suburban areas, which can make the officers in these areas more vulnerable to mental health problems. Inclusion criteria were: (1) those who are currently working as police officers and (2) those who agree with the purpose and value of the interview and are willing to participate. Exclusion criteria were those whose experience as a police officer is less than 1 month.

Before starting participant recruitment, the study was approved by Public Institutional Bioethics Committee in South Korea (Ref no: P01-202212-01-001). The recruitment of participants was performed using a purposeful sampling method from January to March 2023. Specifically, the researcher visited 5 police stations and police offices in the district in person or contacted them by phone and explained the purpose of this study. Those who were willing to participate in the study were given a detailed explanation of the study method, ethics, and process, and they voluntarily signed a written informed consent.

The adequate number of participants was determined based on previous qualitative studies on stress related to police officers (3-15).^17,18 Twelve police officers were included in the study.

Data Collection

Questionnaire

Before starting the interview, we asked participants to fill out a questionnaire to better understand the mental health needs of police officers. The questionnaire consisted of 10 items, including age, sex, education level, current department, job title, length of employment, shift work, and history of visiting a mental health counseling center inside or outside the agency.

Interview

The date and place of the interview were decided based on the participants’ schedules or requests. The places were mostly separate locations from work (eg, meeting rooms or cafes) where privacy was protected. The in-depth interview was performed one-on-one using a semi-structured interview guide (Supplemental File). Prior to the interview, we asked the participants about their history of mental illness or substance use. The main question was “What do you think is most necessary for improving the mental health of police officers?” The questionnaire was reviewed and validated by a professor of police administration. The interviewer listened to participants without preconceptions and maintained a neutral attitude during the interview. When listening, field notes were taken to record the interview atmosphere and participants’ responses. All participants had 1 interview each, and the interview length was approximately 50 min. The interviews were audio recorded and transcribed verbatim.

Analysis

The audio data and transcriptions were stored on a secure computer device accessible only to researchers. All data was deidentified to prevent personal information from being exposed. Data were analyzed by the research team through qualitative content analysis as follows.^19,20 Transcripts and recorded data were repeatedly coded for analysis to grasp the overall meaning. The transcripts were then read multiple times, focusing on the officers’ experiences, to identify meaningful phrases directly related to their mental health experiences and to break them down into meaningful units. Then, each block was connected to a theme and categories. The components of the transcript described in the participants’ everyday language were translated into terms that better described the essence of the phenomenon. Additionally, terms were coded as temporal, causal, or positive/negative in nature, and relationships between components and common attributes were coded. Finally, the results of the analysis were reviewed against the transcripts. Research team members confirmed qualitative saturation when no additional themes emerged through discussion during the interview and analysis process.

Trustworthiness

We considered 4 criteria for ensuring the trustworthiness of the qualitative research—credibility, transferability, dependability, and confirmability.²¹ In the research design stage, we collected and analyzed data related to barriers, facilitation, and needs related to improving the mental health of police officers based on PRECEDE-PROCEDE model. We invited and recruited police officers based on the inclusion criteria to depict daily experiences of mental and management concerns. We provided a comfortable space and atmosphere for the interview and actively listened to participants’ views. We also discussed the prejudices and assumptions about the mental health of police officers that we, as the research team, might have introduced during the interviews. A member check was conducted with some participants regarding the research results. To enhance the validity and reliability of qualitative research, it is recommended to encourage intensive and long-term participation and detailed descriptions from the participants.^22,23 We conducted interviews after building relationships with the interviewees, and the research setting, participants, and topics were described in detail so that the readers could understand the participants’ experiences.

Results

Participants

Participants’ characteristics are described in Table 1. The mean age was 37.8 years, and the majority were male (n = 9; 75.0%). Among the 12 police officers, 5 worked in shifts, 2 had received counseling from the National Police Agency’s counseling center, and none had received mental health counseling outside the agency. None of the participants reported a history of mental illness or substance use.

Table 1.

Participants’ Characteristics.

Characteristics	Categories	Mean (SD) or n (%)
Age (years)		37.8 (SD: 12.9)
Sex	Male	9 (75.0)
	Female	3 (25.0)
Education level	High school	3 (25.0)
	Bachelor’s degree	6 (50.0)
	Master’s degree	3 (25.0)
Department	Investigation	6 (50.0)
	Riot police	4 (33.3)
	Police station	2 (16.7)
Rank	Police officer	3 (25.0)
	Senior police officer	2 (16.7)
	Assistant inspector	2 (16.7)
	Inspector	3 (25.0)
	Senior inspector	2 (16.7)
Working duration (year)		11.8 (SD: 11.8)
Shift work	Yes	5 (41.7)
	No	7 (58.3)
History of visiting a police agency’s counseling center	Yes	2 (16.7)
History of visiting a police agency’s counseling center	No	10 (83.3)
History of visiting mental health counseling outside the agency	Yes	0
	No	12 (100)

Note. SD = standard deviation.

Findings

A total of 89 meaningful statements were analyzed. As a result, 3 main themes and 9 categories emerged (Table 2).

Table 2.

Themes and Categories.

Themes	Categories
Difficulties accessing mental health promotion resources	• Difficulty expressing mental concerns due to stigma
	• Hard to take care of mental well-being due to the workload
	• Feeling emotionally exhausted even before finding the resource
The supportive environment around me	• Professional attitude toward the job
	• Empathy from colleagues
	• Having relaxation time and activities that suit me
Needs for education and policies promoting mental health	• Necessity of knowledge and self-monitoring of mental health care
	• Easy access to information about the mental health management system
	• Mental health management programs and policies for all police officers

The main themes were “difficulties accessing mental health promotion resources,” “the supportive environment around me,” and “needs for education and policies promoting mental health.”

Theme 1: Difficulties Accessing Mental Health Promotion Resources

Participants revealed that in their role as police officers, they frequently encounter clients (eg, criminals) and are exposed to a variety of work environments, such as theft, assault, violence, and even death, that cause mental distress. They are having difficulties expressing their concerns about their own mental distress because this might result in being stigmatized as a person who needs treatment or is weak. They do not have enough time to take care of their mental well-being because they are busy and experience burnout before they find the resources to help them. All these difficulties are barriers to the proper management of their mental distress or illness.

Difficulty expressing mental concerns due to stigma: “Like most government employees, in fact, our public mental health center has something called a Decode, or a mental code? I used to be afraid of getting that code, so I didn’t go (to the mental health center). These days, even though the perspective on mental clinic has changed, I still have to say that if I am going to the center, it infers me a victim.” (Participant 8)

“Mental illness. I think there’s still prejudice. When there’s a personnel transfer, other people would say, ‘Hey, she/he went to the (mental) center.’ I think that having been to a mental center would have any effect on the transfer, although it’s not 100%. That’s why we don’t talk about it (mental problems). I wish the use of mental centers would become more active, but there is still prejudice in our country.” (Participant 5)

“Since we have various ways to get promoted, we always have a certain degree of competition, and it is stressful to talk about mental health concerns. So, I became careful to talk to my colleagues; of course, I’ll talk to close friends. I think it can be difficult to rule out mental health issues in the chances of promotion.” (Participant 12)

Hard to take care of mental well-being due to the workload: “I can take sick leave, but then, I must pass on my work to other workers. If I had serious mental distress while working, other colleagues may recognize the seriousness of it. Then, they would willingly let me take sick leave. . .(but I don't want to pass on my work to colleagues).” (Participant 9)

“People like us (working in the police station) can't apply for counseling because the work piles up. The people who are applying for counseling are those at the police office in the district. There are such disadvantages. For example, the work of police officers in the district has a beginning and an end time. There might be some stress from the start of work to the end. However, they may feel relieved when the work ends. Bigger departments (police stations) still have homework (even after the work ends).” (Participant 11)

Feeling emotionally exhausted even before finding the resource: “There are criminals (or clients) who constantly harass (us). They hang out for their demands to the end. In those cases, I feel very stressed at the end of the day. They know how to harass people psychologically. They don’t feel guilty, (they) make fun of us, and (they) demand their needs, so I psychologically get angry. (Participant 6)

“There are always a lot of people who are extremely outraged (in the police station/offices). So, at that time, I felt like my heart was getting hardened. . . Yes, I felt my emotions drying up and stuff. I’ve been experiencing such situations a lot.” (Participant 9)

“I feel like I shouldn’t show my emotional distress and feelings. There was a situation when citizens were running wild and entering the city hall, and we were blocking them and were out of our minds. At the time, I was out of my mind, so I didn't notice my distress, but when I shook everything off and got on the police bus. . . I suddenly thought, 'What was going on?' That kind of afterimage lingers for a long time.” (Participant 5)

Theme 2: The Supportive Environment Around Me

There were also positive aspects that helped police officers relieve mental distress. These facilitators included pride as a police officer and a good image as a social guardian in society. Colleagues empathize with and support them. Also, hobbies such as exercise alleviated their distress.

Professional attitude toward the job: “There are a lot of negative articles or news. If you see a negative article and are damned at work, then you think, ‘This is a job that you damned, so you want to quit (this job).’ But there are more positive articles and news about police officers. . . you think, ‘Yeah, since I’m doing a good job, there are people who recognize this.’ In this way, it calms my mind.” (Participant 7)

Empathy from colleagues: “I think the senior police officer who I was close with recognized that I was having a hard time talking about it. So, he/she bought me a drink and gave me some advice while I drank. It was not a one-time thing, but he/she kept calling me, talking to me, and taking care of me. That person took good care of me until now.” (Participant 3)

“In the case of my department, my colleagues and I together often wait incognito at the site. Since we’re all tired, we talk about trivial things when we’re on call. At that time, they tell me how to control my mind. That helps me calm down and feel more comfortable.” (Participant 3)

Having relaxation time and activities that suit me: “It’s too stressful to do this job without a hobby. But if I have a hobby and do it on my days off, it definitely helps me heal. Since I like exercising, I exercise a lot, and I’ve been able to overcome it (mental distress).” (Participant 3)

“When something happens at the site, I get very tired and mentally exhausted after work. At that time, I almost always exercise a lot. I try to exercise almost every day without missing a day, and when I exercise and sweat, I feel like my mind calms down a bit. I get organized, I don’t think much, and I sleep a lot. (Participant 12)

Theme 3: Needs for Education and Policies Promoting Mental Health

There was an expressed need for education or systems to manage police officers’ mental health. This included education related to knowledge and methods for self-monitoring. The participants preferred methods were the use of devices such as cell phones or including mental health assessment as a mandatory part of health checkups so that others would not notice.

Necessity of knowledge and self-monitoring of mental health care: “I don’t even know if I need some help or not. To put it simply, as I said earlier, our colleagues kept watching the scene of the Itaewon accident where people were dying, and they said, ‘I feel like I’m going to have a nightmare on that night, and I feel uneasy.’ Well, if there were a healthcare professional like you, they could say, ‘Oh, you should go to the mental health center and get some counseling.’ (Participant 6)

“In my opinion, after checking all (mental health) assessment questionnaires, it is needed to recommend that ‘You need to go a center to get a help.’ For example, depending on the assessment score, if you have this level, ‘You are okay to recover on your own without the help of a center.’ For instance, if the score is lower than 30 points, a message is given that ‘Go and get help. ’ (Participant 7)

Easy access to information about the mental health management system: “It would be nice to have a mental health intervention that can be done on the phone even in 10 minutes or so. We're in a patrol car waiting for a report somewhere. I think it would be nice to put it on for a little while waiting, meditate, and organize (my) thoughts.” (Participant 3)

“We only encounter criminals, mentally ill people, and people who file complaints. There are always people who have bad intentions and file complaints maliciously at every police station. Because we vocationally have to keep encountering such people, I think that tailored mental health coaching is necessary for all those who have this job.” (Participant 9)

Mental health management programs and policies for all police officers: “Wouldn’t it be good to receive mandatory counseling for mental health? There were many police officers who had a hard time and caused their own accidents since they had no time to resolve mental distress.” (Participant 7)

“If it is linked to the regular mental health checkup program and make it mandatory for everyone to do it, later on, they will feel, ‘Oh, it’s helpful to manage mental distress.’ I think that’s a good way.” (Participant 8)

“If it is mandatorily included in the health checkup items, I think people will not be reluctant to (use) the mental health counseling or centers. Since it is just a health checkup, there will be no resistance. If you think that it is not psychiatric treatment but rather examining your mental health, it will be okay. So, if everyone thinks that it is something that should be done naturally. . .I think it will be good because the prejudice or burden of receiving psychiatric treatment or counseling will disappear.” (Participant 8)

Discussion

In this study, we explored issues related to the mental health of police officers through topics, block frames, themes, categories, and meaning units. The themes of this study indicated that police officers experience stress and trauma on a daily basis, try to regulate their emotions frequently, and need practical help (eg, interventions and policies) to promote their mental health.

In our study, stigma was one of the barriers related to mental health promotion. Participants experienced stress and trauma due to the nature of their jobs but were reluctant to seek resources due to the stigma related to mental health. They perceived seeking mental health resources as an indication of weakness since police officers are expected to be mentally strong. In addition, police officers recognized that they experience stress every day and may be vulnerable to mental health, but they perceived seeking help as uncomfortable. This was similar to a previous study reporting difficulties in help-seeking behavior among US police officers.¹² Police officers sometimes encounter criminals with serious mental health conditions on their job. Thus, police officers may have narrow interpretations, biases, and stereotypes about mental health.¹² In this study, police officers reported experiencing mental distress and being vulnerable to mental health issues in the workplace; they also felt disadvantaged regarding promotion due to perceptions of professional norms. A similar phenomenon was observed in similar professional groups, including intensive care unit nurses^24
-26 and firefighters,²⁶ all of whom are first responders. They had difficulty expressing symptoms such as stress, PTSD, and anxiety due to their professional identity and sense of responsibility. In our study, the participants also reported difficulties making time to seek professional help because of competing work demands. In a previous study on stress targeting police officers, the work-life balance was not well maintained due to the lack of personal time and the excessive workload.²⁷ Participants in our study also had the same experience, and in the process, they endured stressful situations and handled crime-related work every day. They were also concerned that their sick leave or days off could influence and negatively affect their colleagues as they have to work in an organized manner rather than alone. This finding was in line with previous studies showing police officers experience organizational stress and work-related stress.^7,10

In this study, a professional attitude was the facilitating factor. Albeit difficult, the sense of accomplishment and pride as a law enforcement professional helped police officers to maintain their mental health. This was similar to a previous report on the experience of nurses,’ who showed strong dedication to their professional duties.²⁸ Police officers experienced challenging situations every day yet experienced positive feelings such as “professional pride.” Similarly, a meta-analysis on nurses illustrated that professional pride and resilience were factors that helped them overcome difficulties during the COVID-19 pandemic.²⁹

Participants felt empathy when they talked about their feelings during work with their colleagues, and in this process, they relieved tension. A qualitative study involving British police officers also reported that conversations with colleagues helped them understand their experiences.³⁰ Empathy can be seen in the context of support from colleagues, and social support has a positive effect on reducing emotional exhaustion, depression, and job stress.^1,7 Social support is a positive factor in increasing resilience through stress coping,^1,10 and empathy and social support from colleagues were found to be facilitating factors for mental health. Securing personal time is necessary as described in the category about “having relaxation time and activities that suit me.” In a previous study, annual leave guarantees were reported as a factor in the discrepancy in the medical needs of police officers,³¹ and relaxing activities were reported as a protective factor.³⁰ Therefore, promoting mental health through sufficient rest and leisure activities can be a positive factor in promoting mental health among police officers.

Participants of this study needed to promote mental health as described in the category of “necessity of knowledge and self-monitoring of mental health care.” Police officers are a group of professionals with a high prevalence of mental health prejudice^12,32 and stigma.^13,33 This is not something that can be solved individually but must be solved organizationally. Help-seeking intentions and behaviors have been promoted through education programs that reduce stigma; help-seeking attitudes increased as self-stigma decreased.¹¹ Stigma related to mental health disorders is related to the risk of PTSD, and the odds ratio for PTSD risk was 5.25 times higher when there is stigma.²⁶ The results of this study suggested that personalized interventions are necessary. Stress and emotional experiences related to traumatic events and work vary depending on individual characteristics. For instance, women are more vulnerable to stress than men,⁴ and differences have been reported based on personality and individual coping skills.^34,35

Our findings revealed the need for knowledge about mental health management and a self-monitoring system. Education that encourages police officers to recognize individual psychological changes is necessary to promote mental health.¹³ Furthermore, mandatory management may be necessary rather than targeting a specific group within the police force since the reporting rate of mental health symptoms among police officers is low.³² A previous study showed that mandatory management was helpful in mental health promotion, although participants were initially reluctant due to public stigma.³⁶

Mental health promotion involves not only preventing mental illness but also protecting mental health, developing resilience, and achieving well-being.³⁷ Therefore, individualized interventions are needed to help police officers cope with stress and prevent professional burnout, reflecting the results of this study. Intervention methods with an easily accessible platform are needed for all police officers so that they can develop and maintain resilience in their daily lives. This requires consideration of easy-to-use electronic resources^12,37 to maintain confidentiality.¹² Intervention content should also include allowing individuals to monitor their own stress and emotional states. Content that suggests mental management methods according to each individual’s stress and emotional state would be helpful. Nurses can play a central role in police officer health promotion education and management of interventions to promote mental health. In South Korea, the National Police Agency and police hospitals can provide references to policies of mental health management, and police hospital nurses can provide nursing interventions based on the results of this study.

This study has some limitations. We did not consider the various police departments. In the police workforce, the professional roles are diverse, including investigation, security, and traffic control. The facilitators and needs may differ depending on the characteristics of each department. Therefore, future research should include more diverse roles among individuals who are vulnerable to mental health conditions. In addition, the sample size was small; hence, it may be difficult to generalize the results of this study, and our results must be interpreted with caution. We suggest that future studies include larger sample sizes. Qualitative studies on the mental health challenges and management experiences of officers who seek help and those who do not are needed in the future to provide knowledge that can be used to increase help-seeking behavior.

Conclusion

This study described the challenges encountered by police officers in mental health promotion due to their work environment. There is a requirement for policies and interventions related to mental health promotion specific to police officers. The results of our study can serve as a basis for developing tailored interventions and policies to improve police officers’ mental health. It also provides insights into developing police policies and appropriate support that can contribute to improving the mental health of police officers in their daily lives. A mental health promotion platform that is easily accessible to all officers, rather than a policy or intervention that applies only to certain officers, is needed. Police officers with mental health challenges usually face stigma, so we need a system involving mental health platforms that everyone can access to monitor themselves and get help when they need it. In addition, supervisors need to support the creation of a supportive workplace environment and provide police officers with timely and appropriate help for preventing the exacerbation of anxiety and depression.

Supplemental Material

sj-docx-1-inq-10.1177_00469580251317931 – Supplemental material for Exploring Barriers, Facilitators, and Needs Related to Mental Health Promotion for Police Officers: A Qualitative Approach

Supplemental material, sj-docx-1-inq-10.1177_00469580251317931 for Exploring Barriers, Facilitators, and Needs Related to Mental Health Promotion for Police Officers: A Qualitative Approach by Gi Wook Ryu and Ji Yeon Lee in INQUIRY: The Journal of Health Care Organization, Provision, and Financing

Footnotes

Acknowledgements

We would like to thank all the police officers who participated in this study.

Author Contribution Statement

Conception or design of the work: GWR and JYL. Data collection: GWR. Data analysis and interpretation: GWR and JYL. Drafting and the article: GWR and JYL. Critically reviewed, edited, and approved the final manuscript: GWR and JYL.

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: This work has supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT) (2022R1G1A1009132).

Ethical Approval

This study was approved by the Public Institutional Bioethics Committee in South Korea (Reference Number: P01-202212-01-001) on December 1, 2022.

Consent Statement

All participants provided written informed consent prior to their participation in this study.

ORCID iDs

Gi Wook Ryu

Ji Yeon Lee

Supplemental Material

Supplemental material for this article is available online.

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