Abstract
Unaddressed occupational stress and trauma contribute to elevated rates of mental illness and suicide in policing, and to violent and aggressive behavior that disproportionately impacts communities of color. Emerging evidence suggests mindfulness training with police may reduce stress and aggression and improve mental health, but there is limited evidence for changes in biological outcomes or the lasting benefits of mindfulness training. We conducted a randomized controlled trial (RCT) of 114 police officers from three Midwestern U.S. law enforcement agencies. We assessed stress-related physical and mental health symptoms, blood-based inflammatory markers, and hair and salivary cortisol. Participants were then randomized to an 8-week mindfulness intervention or waitlist control (WLC), and the same assessments were repeated post-intervention and at 3-month follow-up. Relative to waitlist control, the mindfulness group had greater improvements in psychological distress, mental health symptoms, and sleep quality post-training, gains that were maintained at 3-month follow-up. Intervention participants also had a significantly lower cortisol awakening response (CAR) at 3-month follow-up relative to waitlist control. Contrary to hypotheses, there were no intervention effects on hair cortisol, diurnal cortisol slope, or inflammatory markers. In summary, an 8-week mindfulness intervention for police officers led to self-reported improvements in distress, mental health, and sleep, and a lower CAR. These benefits persisted (or emerged) at 3-month follow-up, suggesting that this training may buffer against the long-term consequences of chronic stress. Future research should assess the persistence of these benefits over a longer period while expanding the scope of outcomes to consider the broader community of mindfulness training for police.Clinical Trial Registration: ClinicalTrials.gov#NCT03488875.
Highlights
There is a pressing need for evidence-based interventions to address twin crises of police officer mental health and the violent and discriminatory treatment of communities of color and marginalized groups by police
Two pilot studies demonstrated the acceptability, feasibility, and preliminary efficacy of mindfulness-based interventions (MBIs) adapted for police personnel (Christopher et al, 2016; Grupe et al, 2021a), and three randomized controlled trials (RCTs) have demonstrated benefits of mindfulness training relative to waitlist control (WLC) for self-reported stress, burnout, mindfulness, alcohol use, negative affect, and global health (Christopher et al, 2018; Krick and Felfe, 2019; Trombka et al, 2021)
Adding to a growing literature on the benefits of mindfulness training for police officers, we found a police-specific, 8-week MBI led to improvements in psychological distress, mental health, and subjective sleep quality, with no impact on pain, physical health, or occupational stress
Summary
No studies to our knowledge have investigated the impact of mindfulness training on inflammation in police officers, one study provided tentative evidence for a lower cortisol awakening response (CAR) following mindfulness training (Christopher et al, 2018). One RCT in 61 United States police officers failed to find group differences 3 month post-training (Christopher et al, 2018) whereas another RCT in 170 Brazilian police officers reported robust benefits for mindfulness training vs waitlist at 6-month follow-up for quality of life, anxiety, and depression (Trombka et al, 2021). In addition to self-reported stress and mental/physical health, we collected data on biomarkers of cortisol release and inflammation immediately post-training and at 3-month follow-up. In the interest of coherence and brevity, additional outcomes are described briefly below but results will be reported elsewhere
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