Vol. 77, No. 3External submissions

Beacon of hope

Research aims to enhance RCMP mental health care

More than 300 RCMP officers in Saskatchewan completed a survey last year that will offer Dr. Nicholas Carleton and his team of researchers a preliminary snapshot of current mental health and resilience in the force. Credit: RCMP


The RCMP is the world's most recognized police force — the image of a stoic officer in red serge bracing against a Canadian winter, an unbending beacon of hope against darkness, is globally iconic. Canadian pride in Mounties is well-deserved and prolific, but what of the people behind the icon?

Something that becomes obvious very early in clinical work with RCMP officers is the tremendous humanity behind the serge. That humanity is too easily overlooked when we focus on one of our most cherished icons. When we try to reconcile that humanity with the icon, we encounter many challenges, perhaps none more intense than the pervasive stigma associated with mental health.

Canadians need the RCMP to stand fast in the face of tremendous stress, while simultaneously showcasing very human qualities such as professionalism, compassion and respect

However, being this Canadian icon is a tall order. The fact that so many officers meet that expectation so often makes it easy to believe, in error, that the human in the serge is unaffected as they stand against decades of traumatic stress.

Nearly a century ago, researchers working with the military began trying to understand the impact of stress on a soldier's mental health. At the start of the First World War, the general consensus was that physical health issues were real and mental health issues were not, unless there was a readily apparent physical ailment, such as damage to the brain. As such, the vast bulk of mental health symptoms were instead considered the result of character flaws.

The First World War brought with it an unprecedented number of causalities and historic numbers of people reporting significant mental health symptoms following traumatic stressors. The highly publicized and initial response from military commanders at the time was to blame the soldiers for the symptoms — with one commander going as far as to refer to them as a "manifestation of childishness and femininity" or "cowardice."

The culture at the time was quick to accept these explanations, supported by civilians with insufficient perspective on the realities of war. Efforts were made, to no avail, to create tools for discriminating between malingering and real mental health problems. Many treatments were attempted, also meeting with limited success.

By the Second World War, any gains made regarding post-traumatic stress and mental health had largely been forgotten or dismissed. However, researchers were faster to engage with symptoms, seeking patterns and solutions.

Despite ongoing focus on identifying malingering and cowardice, one reliable pattern emerged: 100 per cent of soldiers would become symptomatic after 240 days of combat exposure. It still took more than three decades before post-traumatic stress disorder (PTSD) became an accepted diagnosis and two more decades before other symptoms — such as depression or substance abuse, among others — would be associated with traumatic exposure. Ongoing disputes remain regarding which experiences would be sufficient to accept that a person could have the diagnosis.

In December 2012, some 70 years after researchers discovered that 240 days of traumatic exposure was too long, Alberta became the first province to grant first responders, who often endure 25 years of stress or more, the right to claim PTSD as a presumptive injury in the context of their employment. Manitoba has recently begun the same process.

Recognizing the impact of stressors on mental health for RCMP members has been a long time coming. Unfortunately, the recent recognition had been hindered by stigma, limited access to effective and credentialed care and inadequate research attention to improving mental health.

Despite this, researchers have remained dedicated to better understanding the complex interactions between stress, risk variables, resiliency variables, coping and mental health. While the majority of the available research has focused on military and civilian populations, I would argue that using data from military and civilian populations is insufficient to understand stress and mental health in the RCMP.

The RCMP faces a set of unique challenges, growing in complexity, with politicians and the public demanding ever more from the world's best and most recognized police force.

For example, unlike many military personnel, RCMP officers are posted here at home, where they also live and play, which blurs the line between safe and threatening zones. The people that threaten RCMP members and the public are also the civilians they are sworn to protect. Someone who is safe one day may not be safe the next. Nevertheless, an officer must both protect and serve, because all too often they themselves are the line between danger and safety.

RCMP members are also deployed significantly longer — for often more than 25 years — than many military personnel. Military personnel and municipal police typically benefit from substantial support as part of large teams, whereas RCMP officers often work in much smaller groups, especially in remote areas.

In addition, the RCMP is increasingly being deployed outside of Canada — like the military — to fulfil international policing roles. As such, the RCMP deserves dedicated research to support the mental health of its members.

My team of researchers and I at the University of Regina have begun such research, including studying post-traumatic stress and post-traumatic growth in RCMP officers. Factors such as optimism and a broad support network are suspected to protect an officer against the negative consequences of trauma, whereas factors such as childhood adversity or work disengagement may put an officer more at risk.

More than 300 RCMP officers in Saskatchewan completed a survey in fall 2014 and the resulting data will offer a preliminary snapshot of current mental health and resilience in the force. But a snapshot is only a start. Research that begins before a cadet starts training and then follows that cadet through his or her career is urgently needed for researchers to truly understand critical elements for mental health.

In several recent public lectures, most notably in a testimony to the House of Commons Standing Committee on Health, I have underscored the significant commitment of first responder leadership — particularly RCMP leadership — to reducing stigma and improving mental health through evidence-based research, interventions and prevention.

Available research evidence, support from senior leadership and calls for change from members have all come together, allowing us to take action in support of RCMP mental health.

But why are we acting now and not before? Acting before may have been impossible. There has been a broad cultural shift towards recognizing the importance and value of mental health. There has been a recent convergence of cross-sectional snapshot research into risk and resiliency variables for the development of stress-related injuries, along with preliminary long-term evidence.

We can now communicate instantly across vast distances with advanced technologies. There is the pending release of new technology for continuous physiological measurement. We now have the critical scientific resources available to the RCMP, which are geographically associated with Depot through the University of Regina. Lastly, the first responder community and their families, politicians and the public are all looking for national leadership in this area. Accordingly, the RCMP will take this new opportunity to lead and innovate in mental health.

As such, I am leading a multi-university, multi-expert group of internationally recognized leaders who are collaborating with RCMP senior leadership to conduct a transformative research project into mental health care for its members. Current mental health care systems are reactive, with help coming after the injury has been sustained — often too long after. That health-care model is economically unsustainable and morally insufficient.

The planned project will use available research evidence to make imminent improvements, collect never-before available data, and design a better system for supporting mental health care. It will be proactive instead of reactive, reduce risk, increase resiliency and reduce stigma.

The project will also use recent advances to enhance care by integrating evidence-based practice first into the RCMP Cadet Training Program and then throughout the membership. The project should improve the quality of life for members and their families, and ultimately save millions in annual economic costs.

The planned national project will be highly visible. It will inform policies and programming by turning the aspirational standards from the Mental Health Commission of Canada into actionable and measurable improvements — first for the RCMP, then for all first responders, and ultimately for all Canadians. As they have done so often before, the RCMP will again stand as a beacon of hope, this time for mental health, supported by many of our best and brightest researchers.

Dr. Nicholas Carleton is a professor in the psychology department at the University of Regina and has been working with trauma and stress responses for the past 15 years. He began clinical work with military and paramilitary officers, including RCMP officers, in 2010.

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