Improving Mental Health Service and Practice for Police

Traumatology | 2025, Vol. 31, No. 2, p. 252-261

Improving Mental Health Service and Practice for Police: A Qualitative Assessment

Hussain-Abdulah Arjmand; Phoenix Australia Centre for Posttraumatic Mental Health, University of Melbourne

Meaghan Louise O’Donnell; Phoenix Australia Centre for Posttraumatic Mental Health, University of Melbourne

Nicole Sadler; Phoenix Australia Centre for Posttraumatic Mental Health, University of Melbourne

Jane Nursey; Phoenix Australia Centre for Posttraumatic Mental Health, University of Melbourne

Tim Peck; Phoenix Australia Centre for Posttraumatic Mental Health, University of Melbourne

Tracey Varker; Phoenix Australia Centre for Posttraumatic Mental Health, University of Melbourne

Police experience mental health conditions at higher rates than the general population. To improve mental health and enhance quality of care, services and treatment practices can be better tailored to their needs and preferences. This study examined the experiences of Australian police members who received mental health treatment to understand how services and practice can be improved. Semistructured qualitative interviews were conducted with 13 current or retired Victorian police members. Interviews were transcribed verbatim, and interpretative phenomenological analysis was performed. Three aspects of treatment were discussed: accessing treatment, delivery of treatment by mental health providers, and efficacy of treatments delivered. Findings highlight the importance of improving access by increasing awareness of treatment options, offering specialist mental health services, encouraging access through trusted sources, and reducing barriers. Findings indicate that treatment can be improved by supporting providers to develop cultural competence and expertise in treating trauma-related symptoms. Finally, treatments can be improved by delivering evidence-based trauma-focused therapies and utilizing measurement-based care approaches. This study provides insights into how mental health services can be improved based on real-world, first-person experiences which health professionals and treatment services may use to refine and tailor practices according to the needs and preferences of this population.

Police, law enforcement, mental health, treatment, qualitative research

“Police officers provide essential services to ensure public health and safety. Due to the nature of their work, they are regularly exposed to potentially traumatic events and distressing incidents, which makes them vulnerable to the development of mental health conditions such as depression, anxiety, and posttraumatic stress disorder… Accordingly, in recent times, dedicated programs and services, underpinned by mental health strategies and frameworks, have started to be developed to support the mental health treatment needs of police members…Despite the availability of services, uptake can often be low as police commonly encounter numerous barriers to mental health care. This includes barriers such as not knowing where to get help, low mental health literacy, poor previous experiences with mental health providers, as well as concerns around confidentiality and long-term impacts on careers… To improve treatment uptake in this population, it is important to understand these perceptions and explore how mental health services and practice can be improved according to police member needs “ (p. 252 - 253).

“Prior qualitative research in police has focused on understanding mental health stigma or barriers and facilitators to help-seeking in police. To our knowledge, there have not been any qualitative studies examining the treatment experiences of police or their perspectives on how to improve mental health services. Interviewing police who have accessed mental health treatment and asking about their experiences provides researchers and practitioners an opportunity to better understand how to improve mental health services and practices to best meet the needs of police” (p. 253).

“The aim of this study is to use a qualitative research methodology to investigate the experience of police officers who have engaged mental health services. The study involved conducting semistructured interviews with current or retired police officers who have previously accessed specialist mental health services targeted at police and first responders requiring psychological treatment. Interview questions focus on three domains of service delivery: (a) access to treatment, (b) delivery of treatment by mental health providers, and (c) the efficacy of treatments delivered…Participants were current or retired police officers who had completed an episode of care through two Australian mental health treatment services… The sample size for the study was determined based on thematic saturation… Participants completed one, approximately 1-hr semistructured interview with one member of the research team” (p. 253). 

“The findings indicate that improving treatment accessibility can improve mental health service delivery and practice. This can be achieved by (a) increasing awareness of treatment options, (b) offering specialist mental health services (e.g., services for police or first responders), (c) encouraging treatment access via endorsement by reputable sources, and (d) reducing common barriers and making access to treatment easy. Participants reported low levels of awareness of the treatment options available to them, as well as a poor understanding of what’s involved when engaging in treatment. This is consistent with previous research in police and who report low levels of understanding about where to get help… Recommendations or endorsement from peers, colleagues, or reputable and trusted sources is another means of increasing awareness of treatment options and increasing the likelihood of engaging with treatment… Finally, mental health services can be improved by making treatment access easy and reducing barriers to care” (p. 257-258).

“Participants reported that having a good rapport and being able to communicate easily with their mental health provider was important to effectively engage in treatment…. In the current study, developing trust with the providers related to multiple factors, including trusting that the provider was working in the patient’s best interests, trusting that the provider understood them, and trusting providers’ clinical expertise in treating trauma symptoms. Professional experience working with police and clinical expertise treating trauma-related symptoms or disorders were important treatment factors noted by participants” (p. 258).

“Finally, participants discussed their experiences receiving treatments delivered by mental health providers. Although participants received treatments for several symptom experiences and disorders (e.g., depression, anxiety, substance abuse, anger, etc.), participants frequently expressed satisfaction receiving treatments for their posttraumatic stress symptoms… The effectiveness of treatment was noted as a primary reason behind participant satisfaction. Participants expressed the severity of their symptom experience and surprise when symptoms were effectively treated” (p. 259).

Treatment Access: Participants described significant challenges in accessing treatment, primarily due to low awareness of available services and uncertainty about how to engage them. They noted that internal emails were often overlooked and emphasized the value of physical materials like posters or flyers to increase visibility. Officers consistently preferred specialized mental health services designed for police and first responders, seeing them as more tailored and trustworthy than generic services. Recommendations from respected colleagues or the police union played a major role in motivating help-seeking. Easy and streamlined access was critical, as logistical barriers such as long wait times, travel demands, and parking difficulties made engagement difficult—especially when officers were already struggling with severe symptoms. Telehealth options reduced these burdens, particularly for those in rural areas. Finally, participants stressed that privacy, confidentiality, and independence from their police organization were essential for feeling safe enough to seek treatment.

Delivery of Treatment by Mental Health Providers: Participants highlighted that the relationship with the mental health provider was one of the most important aspects of treatment. Trust, rapport, and a sense of genuine understanding were essential for officers to open up, particularly given the closed and insular nature of police culture. Negative early experiences—such as providers who did not follow up—often led to long-term disengagement from mental health services. Officers valued providers with strong cultural competence, including familiarity with police culture, language, and daily realities, which reduced the need to explain basic aspects of their work. Clinical expertise in treating trauma and police-related mental injuries was seen as equally critical. Providers who had worked extensively with police or emergency services inspired confidence and willingness to participate in evidence-based treatments. In contrast, providers lacking this background left officers feeling misunderstood, leading some to terminate treatment early.

Efficacy of Treatments Delivered: Participants reported high satisfaction with the treatments they received when these interventions effectively reduced their symptoms, particularly PTSD-related distress such as nightmares, triggers, and sleep disruptions. Noticing improvement reinforced their commitment to continue attending sessions, and positive feedback from family members further strengthened engagement. Officers appreciated having multiple treatment options and valued approaches that addressed different aspects of their symptoms rather than relying on a single modality. Feeling in control of their treatment—through collaboration with providers, access to explanations, and opportunities to review educational materials—helped build comfort and trust. Understanding the overall treatment plan or “roadmap” also improved their sense of direction and reduced anxiety about the therapeutic process. Participants emphasized the importance of being able to return to treatment when needed and noted the benefit of incorporating discussions about family into sessions.

“A strength of this study was its qualitative methodology which provided current and retired police members the opportunity to share their real-world treatment experiences and perspectives on how mental health services can be improved. Although qualitative research has been conducted previously in police population, this study is the first to investigate first-person mental health service experiences directly from police members. Notwithstanding, the study had some limitations. The study population was predominantly male and limited to police members from one Australian police force so the degree to which it generalizes to other police forces is unknown. In addition to this, participants were sampled from dedicated mental health services for police and first responders, and perspectives of police members accessing nonspecialized services were not captured in this study. As such, findings may not be representative of the full range of treatment experiences of police members who have accessed mental health treatment. 

It is also important to acknowledge that many themes identified in this study are not limited to mental health treatment of police officers alone, but also relate to best practices for any clinical treatment or counseling setting (e.g., being informed treatment to be received, working collaboratively with providers, improving accessibility to treatment, offering multiple treatment options). This study’s findings confirm and contextualize these themes within police settings, but also highlights treatment needs specific to police experiences such as privacy and confidentiality (e.g., reporting obligations which may affect police ability to perform operational duties), cultural competency (e.g., compassion fatigue, vicarious trauma, and moral injury), and clinical expertise (e.g., expert PTSD treatment for recurring workplace trauma)” (p. 259).