I write fiction; thrillers, actually. No way could I have imagined a killer as potent as Stephen Paddock or write a believable scenario as deadly. If this was a novel, a hero should have busted down the door to stop Paddock at the last second. But this was real, and heroes only emerged in the bloody aftermath. 

Some of those heroes were civilians, others were first responders, firefighters, medics and police officers, both on and off-duty. Brave, courageous, and trained to act in a crisis, they are not immune to tragedy. In the first few years of their careers, they see more despair, destruction, and human cruelty than the rest of us will see in a lifetime. Except for death and injury to children, most small scale tragedies can be metabolized with the tincture of time and support from family, peers, and employers. But large-scale tragedies, like the massacre in Las Vegas, require large scale responses. And tragedies perpetrated by humans have a greater negative impact that those unpreventable events generated by a natural disaster.

In 2016, The National Alliance for Mental Illness (NAMI), in conjunction with the Office of Community Oriented Policing Services, released a report titled "Preparing for the Unimaginable: How Chiefs Can Safeguard Officer Mental Health Before and After Mass Casualty Events." This valuable document lays out a before, during, and after blueprint for dealing with events that are, sadly, no longer unimaginable. I wish every department had a copy on hand. 

Mass casualty incidents create particularly unique memories. In the San Bernadino massacre, officers remember the agonizing decision to bypass the wounded who were begging for help to secure the building from potential other shooters. In Orlando, it was the sound of cell phones ringing for the dead. In Sandy Hook, it ranged from intimate exposure to the extreme suffering of parents' who had lost children, the sight of so many dead and mutilated children, the smell of gun powder and the overwhelming task of dealing with an army of self-deployed volunteers along with a tsunami of mail, gifts, and donations for the victims. 

Large-scale events bring on a large-scale media presence, making it hard for officers to do their jobs without scrutiny or intrusive questions. Inaccurate reporting or blatantly false posts on social media, some of which may be prematurely critical of the police response, can have a triggering effect. Officers may already be  feeling helpless or self-critical because someone came into their community, the community they have sworn to serve and protect, and killed people. After a close brush with death and injury, some will still be in survival mode, fearful for their safety. Many will be grieving for friends and colleagues killed or wounded. Others will be struggling with gruesome images. Some will be wondering if they can or should go back to work. There will be a range of responses; mentally replaying the event over and over, nightmares, irritability at home, extreme guilt over not being able to save the victims, and an exaggerated startle response. Many will feel fine and then worry that they have grown calloused. Now is the time to respect and understand individual differences. 

Every officer involved with the event needs a quick conversation, sometimes called psychological first aid, with a culturally competent mental health professional (someone who understands policing and the police culture) or a peer supporter before going home after the event. The conversation would focus on safety and immediate needs, bring up essential coping strategies, express concern and appreciation, and create an opportunity to triage those who may need more intense immediate attention.

Following the event, officers and their families need access to confidential psychological debriefing services where they can talk about their reactions, learn about trauma, triggers, self-care, healthy coping, resilience-building, and when and how to access additional support. A long-term plan to follow up on officer wellness should be established, one that includes off duty personnel who may be suffering with guilt for not being on scene to support their fellow officers. Not to be overlooked are civilian staff such as dispatchers and community service officers.  

Mental health services are best buffered by a robust peer support and chaplaincy program. Officers who are resistant to talking to mental health professionals may be less resistant opening up to a fellow officer or a spiritual advisor.

MattPopovich/Unsplash
Source: MattPopovich/Unsplash

Care must be taken to avoid re-injuring an already injured officer. Paradoxically, one of the way to injure an officer is to call him or her a "hero." Cops hate to be called heroes. They are part of a team. To be singled out from their co-workers in award ceremonies or specialized media coverage, can separate them from the people they need most in the aftermath of a crisis. 

Long-term reactions are to be expected. Wise and caring police managers will anticipate triggering events. Every mass killing is an echo of the one that went before it. Memories and feelings come roaring back to the victims, including the cops, temporarily destabilizing their efforts to let go and move on. 

Wise and caring police managers will also attempt to establish healing rituals that commemorate an anniversary or a significant marker of an event. Ways to bring people together and effect positive change. Encouraging officers to visit the wounded, attend funerals, memorials, or meet with victims in a private ceremony without the media, can have a particularly therapeutic effect on everyone involved. Golf tournaments, marathons, gift drives—there are many ways to restore community, strengthen connection, build resilience, and turn madness into meaning.

References

Usher, Laura, Stefanie Friedhoff, Sam Cochran, and Anand Pandya. 2016. Preparing for the Unimaginable: How Chiefs Can Safeguard Officer Mental Health Before and After Mass Casualty Events. Washington, DC: Office of Community Oriented Policing Services. 

https://www.nami.org/getattachment/Press-Media/Press-Releases/2016/Mass-Tragedies,-Police-and-Mental-Health-NAMI-Rel/Preparing_for_Unimaginable_16may24_FINAL.pdf

Supporting the Psychological Recovery of First Responders Following a Mass Casualty Event

John Nicoletti, PhD, ABPP, Nicoletti­Flater Associates; Sara Garrido, PsyD, Nicoletti­Flater Associates; and Mark J. Kirschner, PhD, ABPP, Behavioral Health Consultants, LLC. The Police Chief, July 2016. http://nicoletti-flater.com/page48.php.

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