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PTSD vs. PTSI: Considerations for Professional Wellness


Criminal Justice

There are power and value in shared experiences within our criminal justice system (CJS) field, resulting from personal, professional, and leadership perspectives that uncover employee wellness concepts. These shared experiences and conversations stem from exposure to secondary and vicarious trauma influencing post-traumatic stress disorder (PTSD) and post-traumatic stress injury (PTSI).

Since 1980, Post-Traumatic Stress Disorder (PTSD) has been an accepted diagnosis described as “A psychiatric disorder that can occur in people who have experienced or witnessed a traumatic event” (APA, 2020, para. 1). Therefore, PTSD refers to a disorder, while PTSI refers to a biological injury after experiencing or witnessing a terrifying event that creates a nervous system division (Global, 2015). PTSI induces system overstimulation and inability to self-calm, promoting anxiety, restlessness, panic, hyperactivity, and failure to self-regulate aggressive and anger-rooted behavior. These symptoms may appear similar; however, PTSI may not necessarily morph into PTSD as a diagnosable disorder.

PTSI – A name change? Could it be that simple to normalize and increase acceptance of the condition, ultimately diminishing the stigma and perception of betrayal from levels within the organization, administrative, individual, and community? The prime argument for the name change is centered on the stigma. There is the perception that the word disorder prevents an individual from seeking help. The overshadowing idea is that changing the name alone, without any other intentional action-oriented modifications, still won’t change the stigma.

PTSD is considered a mental and physical stress response triggered by consistent, cumulative everyday trauma-exposed events that do not fade away over time. CJS professionals’
the commonality is that they disavow their experiences of trauma; ultimately, it alters one’s perception of injury as a routine and becomes a culturally acceptable term within their profession. Thereby, violence becomes a part of their experience’s natural landscape; however, nothing could be farther away from the reality of their intra-psychological experience.

Denial and numbing help keep away the pain for a while; when left unattended, it rears its ugly head when you least expect it. The emotional loss may be associated with unprocessed and unrealized trauma. When trauma is denied, the culture of silence does not forget, resulting in delayed trauma processing. This somatosensory overload of feelings is confusing, terrifying, painful, and isolating, often resulting in physical aches and chronic pain from suffering in silence.

Suppose the bigger picture is creating and sustaining a robust wellness culture that prioritizes human service professionals’ physical and emotional health within the multi-systemic criminal justice. Can we readily identify where we are gaining momentum or failing in our attempts?

Is a name change the answer? With the increase in unrecognized or undiagnosed PTSD or PTSI, we now realize an alarming rise in officer-related suicide upward of 24% in 2019 (Lehmann, 2020); this does not include statistics involving our human service colleagues (firefighters, paramedics, EMTs, first responders, Corrections, Probation, and social service). This may be a cause for concern that this is becoming an epidemic.

Why wellness matters: policing is dangerous, perplexing, challenging, and stressful. It requires an elevated level of physical and mental health than many other professions. Criminal Justice practitioners are subject to physical health risks (dangerous exposures, sleeping disorders, and poor health), increasing the risk of obesity, heart disease, and injury (subsequently increasing early retirement and significantly lowering life expectancy). Like any profession, officers face the same consequences when physical and mental health issues go unaddressed, decreased performance, impaired decision-making, poor-community engagement, and increased personal time-off usage. So, what does this so-called officer-wellness strategy really mean? And in what ways can we be proactive in providing early and consistent evaluations throughout the career span? Could it be as easy as incorporating exercise participation plans, encouraging healthier nutrition strategies, strategizing enhanced sleeping techniques, increasing resilience, and coping strategies, and ultimately reducing officer stress?

Many so-called wellness services, such as employee assistance programs (EAP), peer support, police chaplains, check-up-from-the-neck-up, Physical fitness challenges, on-duty workouts, and stress management training have been the focus for over a decade; however, they are not proving to be fruitful in the overarching goal of creating and sustaining a robust culture of wellness that prioritizes the physical and emotional health of human service professionals, namely CJS

There are examples of CJS’ use of force or misuse of power, involving Garner, Smith, Farah, and the most recent Floyd incident. This begs us to ponder, should we consider the root cause of these incidents on either party’s part, including (1) Person of Interest: Criminal behavior, drug-induced, and physical or comorbid mental health components exacerbated the situation. (2) Officer: lack of training in emergency medical care, crisis intervention team training, or general mental health symptom awareness; alternatively, misinformed training about excited delirium and outdated policies, secondary/vicarious trauma, compassion fatigue, burnout, biased response, and racial response.

A name change may be the first step. However, this is the challenge we are facing, intentional and action-oriented efforts toward a systemic change. Recognizing people who have problems and difficulties in their personal lives and how it directly impacts their work-life is an excellent example of systemic leadership. If you don’t understand this, you are missing a massive segment of those you work with. It is imperative to void tunnel vision by focusing on just the job, the division, and your shift, and essential to look on a broader scale. Noticing differences, asking questions, and staying connected will help you pick up clues quicker. Understanding how others within the lives of CJS practitioners and how it affects them is also vitally important. The responsibilities on the shoulders of CJ practitioners and their families can be immense – remember, everybody has their own story.

American Psychiatric Association. (2020). What Is Posttraumatic Stress Disorder? families/PTSD/what-is-PTSD

Global. (2015). PTSD vs. PTSI. ptsi

Lehmann, E. (2020). Study: Police are more likely to die by suicide than in the line of duty. dy-police-more-likely-to-die-by suicide-than-in-line-of-duty

About the Author:
Janina Cich, MA, is a retired Law Enforcement Officer with two decades of Criminal Justice experience and is the Criminal Justice Department, Chair at Concordia University, St. Paul. She is a professor in the Criminal Justice & Forensic Mental Health Programs, Hennepin Technical College – Skills Program, and has been instructing at local colleges and universities since 2003. Janina is a frequent lecturer for various professional entities. She conducts Crisis Intervention Training and coaching for law enforcement and mental health practitioners, focusing on awareness, assessment, intervention, de-escalation techniques, and
prevention approaches for mental health populations in the criminal justice systems. She currently serves as the Chief Operating Officer of the American Institute for the Advancement of Forensic Studies (AIAFS). She has co-authored several Criminal Justice and Forensic Mental Health articles and book chapters. She serves as a peer-review peer member of Forensic Scholars Today (FST) and editor of the Forensic mental Health Insider (FMHI). Janina is a Board Member of MNCIT, MN POST Focus Board Team Member; Crisis Intervention, Mental Illness Crises, Conflict Management; and Fraser Mental Health Advisory Team.