robinson, you probably recognize her because she's the former assistant attorney general for the office of justice programs both in this administration with president obama and also in the administration with president clinton. and to professor robinson's left is police commissioner charles ramsey, and to those in the

district who also recognize him he's been the police commissioner for, i want to say, six years and was the district police chief for eight, almost nine years and has spent time in chicago. the way we will do this today is we will have a series of a panel of experts that will provide testimony to the task force, and that testimony will then be considered by the task force as it goes into deliberations. let me say this. for the witnesses we have today, one, thank you for being here. for the first time of the task force, we're also going to have several witnesses come in through -- and i'm going to get myself in trouble because i'm not a tech person so i apologize ahead of time -- through skype. because of some of the weather conditions, efforts to get here some flights were canceled people couldn't make it. but to show you the level of commitment that our witnesses have and the country has in dealing with this topic, not only did they try to get here ask maneuver on any plane they could, some were able to do it

some logistically just couldn't, but they agreed to still participate, so we're going to take our hand using 21st century technology to talk about 21st century policing, and if it doesn't work blame the other side of the equation -- no i'm just kidding. we'll do our best in letting them accommodate, and we are glad they did their best try and get here and don't read anything into it other than mother nature spoke and we have to respond. i'll turn it over to the co-chairs in you. >> ron, thank you very much. and before proceeding further, i do want to thank ron davis and the terrific staff of the cops' office for all of their support through the task force's work. they have been terrific and really want to recognize all of their assistance. i am lori robinson as ron said,

a professor at george mason university formerly with the department of justice. and it has been a distinct honor to co-chair the task force. the president gave us a clear mission. he gave us 90 days in which to get the job done. he asked us for very practical recommendations and gave us direction to come back with a very distinct and clear path that can be -- recommendations that can be implemented. ron davis laid out the fact that we've already had six listing sessions and we are now on our last two hearings, today and tomorrow. the subject of our hearing today on officer safety and wellness is very much one of interest

not only to those who are gathered here today asknd watching us around the country but to so many working in this field and to communities around this country. i look forward to hearing from our witnesses today. we have a wonderful panel here, and those succeeding them. i also want to recognize the fact that one of my students from george mason is here with us. i know others are going to be joining us later today. i'm very pleased at the number of people who have come to our listening sessions and who have been watching us through the streaming of these sessions. i've had many comments from people who have watched our hearings, and i think that reflects the interest from communities around the country in the subject matter of these hearings. with that, let me turn to my distinguished co-chair charles

ramsey ramsey. >> thank you, lori, and welcome everyone. it's good to be with you here again. lori has already described how the task force came about and what our charge is so i won't repeat that, but it is truly a pleasure to be here with all of you today and i look forward to listening to all of the testimony that will be presented. my name is chuck ramsey. i'm currently the police commissioner in philadelphia, pennsylvania. i've served in that capacity now for seven years. prior to that, i was the district of columbia police chief for nearly nine years, and i began my career in chicago i'm a native chicagoan and began my career in the chicago police department spending nearly 30 years in that department. so i've been in law enforcement for quite some time. before i introduce or allow the other panelists or task force members to introduce themselves,

we do have two that are not physically with us here today. connie rice will be joining us via conference call throughout the session today, and brian stevenson is on travel. he is going to join us later this evening. he's coming in all the way from australia, and obviously you can imagine if you had trouble flying across the united states, try to trying to get back from australia would really prove a bit challenging. so he wasn't able to make it on time for this session but he is going to be here later on today we're told. so with that, let me begin having our task force members introduce themselves. we're going to start with dr. cedric alexander to my far right. >> good morning. can you hear me? okay. good morning.

anyway i'm cedric alexander. i'm currently a public safety director in caffe county, georgia. i also serve on the black noble executives. i subsequent went to miami-dade police department where i originally finished my career and decided to go back to school and get a doctorate in clinical psychology where i practiced psychology for a number of years before returning back into police as an administrator. i'd like to say welcome and thank you, all for being here as well, too and looking forward to what testimony you have to share in regards to the health and well-being of officers across this country. thank you. >> good morning. my name is jose lopez. i'm the leader organizer of make the road new york, a

community-based organization in new york city and new york state. most of my work focuses on issues of police account dability housing rights and workers' rights. our community is partnering with the community graduate center doing work on the impacts of the stop, question and frisk program in new york city on young people between the ages of 14 and 24, so i've been engaged in some of that work as well. i echo sentiments to the panel. thank you for coming out, folks in the audience. happy to be here. >> good morning. my name is brittany packnet. in my full-time role i'm executive director of teach america in st. louis, which is my hometown. the other hat i've been wearing has been as a ferguson activist and working to make sure that the 20,000 young people that teach for america st. louis are

that disenfranchised people across this country their voices are heard making sure this is a process full of justice for them as well. look forward to the testimony here today and thank you all for coming. >> good morning. my name is tracy meers. i -- haven't had enough coffee. i have for the last 20 years, been a legal academic first at chicago law school and now at yale law school. my research focuses on criminal law and criminal procedure but i emphasize study of police and policing especially in urban communities, and like my co-task force members, i'm really interested in hearing more about officer safety and wellness. the written testimony has been fascinating. i'm also hopeful to hear about how officer safety and wellness affects the health and safety of the officers' families.

>> good morning i'm sue rohrere retired after 33 years from the seattle office in the metropolitan area. i've been training all the officers in the state of washington. i'm very much looking forward to today's testimony. we spent a lot of time talking about what police officers should do, and now i think it's time to really focus on the other side of the equation. i've had the privilege of dealing with police officers that come in on the beginning of their career, wanting to do good and save the world so i'm anxious for us to discover what we can do to keep that attitude alive in them. thank you. >> good morning. my name is shawn smoot. i'm director and chief counselor for the police benevolent protection association of illinois and the national police associations. i join my colleagues in welcoming all of you to the task force meeting today and i am very grateful for the

opportunity to serve on the task force with this esteemed group of experts, and very grateful to the president for convening this task force because i think it's something that needed to happen, and frankly, is overdue. i think it's very fitting that today we're going to have our last full day of public listening session on officer wellness and safety. and because we've heard so much over the past several weeks in terms of testimony with regard to the challenges facing law enforcement officers and communities around this country, i think it's very fitting that we have a day dedicated to officers' wellness and safety and the impact of officers' wellness on their families also. because those things really i

think, make the challenges even greater and i'm not sure there is a good public appreciation for that. so i very much look forward to the testimony of the witnesses today. we have several excellent panels, and i just want to thank the co-chairs for their leadership and director davis and his staff for their assistance in this process. thanks. >> good morning. my name is roberto signor i am chief of police for tucson, arizona. i grew up through that agency. i've been a police officer for 35 years, i've wenbeen a chief for six years. along the border we have a lot of unique issues dealing with immigration and dealing with the border and homeland security issues, so it's been just a wonderful experience for me to sit and listen to some of the brightest minds in the country when it comes to police work and talking about different ideas. this has been a growing and

learning experience for me so i'm very grateful for the opportunity to serve on the panel, and i'm also in awe of the panelists that we have had come before us and talk because i've taken away a lot of fantastic information i hope to use at my own agency. thank you for being here this morning. >> so thank you very much. just a couple reminders. as you can tell, this task force listening session is being televised live through our webcast. for those that are watching on line, there will be -- you can send your comments throughout the day. we will have a public comment period at the end of the day, which we'll talk about later, but i wanted to give you a heads-up on that. one thing i didn't say at the beginning, and if i may my background is 20 years of law enforcement including eight years as a police chief in alton, california. i'm very glad the task force has

taken to talking about this issue. i'm glad the chiefs recognize that i've had to make that phone call. i think some of those on the task force have had to make that phone call when an officer is killed in a line of duty. so anything we can do to keep our officers safe and healthy improves not only their service but the service to the community, and there is a very strong link, so this is a very good day to focus on the well-being of our outstanding men and women who serve so we don't have to make those phone calls, and many times injuries come in many ways, not just gunshots. we look forward to that testimony. at this point i think, madam co-chair, we are ready to proceed with the panel. >> commissioner ramsey will be starting off. >> thank you very much. panel 1 will focus on officer wellness. we have three panelists here with us and one that is joining us through skype. something we did not mention but i think it's very important the biographies of all of our panelists can be found on the

cops cops' website. so our introductions throughout the day will be very, very brief, but we appreciate all of them being here. we're going to begin this discussion with dr. lawrence miller, a clinical psychologist. doctor? >> esteemed task force members fellow panelists, and guests, good morning on a cold morning in washington, d.c. as i look around the room, i see we have at least a few brass with us today, so i'd like to begin with a question that applies to law enforcement leaders, and that is, as a law enforcement supervisor would you send one of your officers on patrol with an insufficiently maintained vehicle? would you send one of your officers into a crime scene with an unserviced duty weapon? what about a radio that didn't work? or just an ill-fitting utility belt or uncomfortable pair of shoes? and, of course, the answer is for liability reasons and safety reasons, of course not. yet we know the tools of law en

enforcement get banged bruised and worn out and they need continued assessment and repair. ironically, far less attention is often paid to the care and maintenance of what is arguably a police officer's most important resource and that is his or her brain. so to provide effective and science-based interventions for law enforcement stress syndromes, it's important to understand that stress is not one uniform thing there are different types of stresses that apply to policing, and that's how i want to begin this discussion today. i'm honored to have that opportunity to begin this discussion so we can understand what it is the average man and woman in policing faces on a daily or occasional basis. the daily stressors involve numerous interactions that police officers have with citizens in their patrol communities. we have to realize that 90% of what an officer does every day involves talking to people. and this ranges from casual

conversations to dangerous confrontations. so therefore, training in behavioral resilience communication skills, verbal de-escalation strategies can often help officers defuse potentially hostile situations and present that tipping point from turning it into a deadly force encounter. i believe dr. ramey will be elaborating more on officer wellness training. then there are the cumulative stressors that build up over time, and this can include not only work stressors but family stressors as well. we know that family can bump up work stress, and can sometimes off set the corrosive effects of a home life. but when both of these systems begin to fray some of these suppressed emotions can punch through in the form of alcohol abuse, domestic violence, overaggressive policing, and most tragically officer suicide

that dr. velonte will be expounding upon subsequently. critical incident stress refers to the acute life and death encounters such as officer-involved shootings hostage scenarios, injury or death of a fellow officer, and particularly disturbing homicide, child abuse or disaster scenarios. in these cases, it's important that officers receive a post-incident psychological check-up. and if necessary are provided access to specialized services to help them deal with the stresses of these traumatic events. post-traumatic stress disorder which we heavy a lot about, is actually a very simple clinical syndrome that could include heightened avoidance arousal and avoidance in functioning. fortunately, acute

post-traumatic stress syndrome is actually quite rare, and we can make it more uncommon if we allow our officers and colleagues to health and intervention strategies that i believe sergeant orr will be telling us more about ptsd in a few minutes. but if you ask most rank and file cops what stresses them out the most, they'll probably not tell you things like difficult civil encounters or even gun or car chases. they're going to tell you about stresses from within, the organizational stresses. what bugs these men and women are the messages they perceive as sometimes confusing or perhaps unsupportive from the very top brass that they expect to be on their side. so law enforcement leaders need to learn proper, constructive organizational management, discipline and communication skills. because the example of fair and honorable policing does begin at the top. so to summarize, recognizing the potential effects of mental health and organizational interventions in law enforcement

stress doesn't mean we should oversell this. not every police officer needs counseling. not every -- even the best stress management program is not going to guarantee that the stakes are not going to be made and bad policing is not going to occur by impulsive immature or corruptible cops. but the vast majority of police officers, if they believe they're being treated unfairly by their leaders, and if they feel that support as an indication for the brass and what they do these officers are like toll participate in their daily patrol efforts, these officers are less likely to take their stress out on the street, these officers are going to be more likely to turn to the chuckleheads who ruin it for everyone else and these officers will be able to exemplify what we all hope is the culture of honor we want to characterize our police agencies. thank you for the opportunity to

introduce this topic by opening this up today. >> thank you for your testimony doctor. next we'll hear from dr. john vialonte professor, sunni buffalo. >> good morning. thank you very much for inviting me this morning. it's been an honor to present here in this very important mission, looking at the other side of the equation as was mentioned before. i'm going to talk about something that no one else wants to talk about and that's suicide. unfortunately, this particular occupation of policing it's been suggested by research that there is a high number of police officers who kill themselves instead of being killed by others. in fact, in some estimates, suicide is twice that of officers who are killed feloniously in the field. this is a very staggering sort of statistic. we've done two national studies

on police suicide the first one in 2009. we found that there were 141 police suicide in the united states. in 2012 we counted 112 police suicide in the united states. both male and female officers suicide occurred at a similar rate in both years. suicide appeared to cluster in the 40 to 44-year group which is kind of almost at the end of a police career, close to the end of a police career. that kind of coincides with suicide rates in the united states with middle-aged individuals. a large increase of suicide was seen in officers with 15 and 19 years of service. firearms remain the most popular type of suicide, 90%. personal problems appear to be the largest reason officers committed suicide, followed by legal problems. approximately 11% of our suicide in policing were military

veterans indicating a possible influence of post-traumatic stress disorder and military combat. the second largest study we did was from the centers of disease control data, and we found that for three years -- three recent years, '99 '04 and '07 that there were 264 police suicides. that number of suicide represents a 69% increased risk for suicide among police officers compared to 1.46 million workers in america. detectives and criminal investigators had an 82% increased risk of suicide above the general working population, and corrections officers had a 41% increase of suicide above the general population. staggering figures from the centers of disease control. prevention strategies, the iacp,

international association of chiefs of police, has published a document and there are several points they made that i think are very important. number one, the leaders need to be recruited. leaders in police work need to be recruited that care about their people. one particular chief called it a duty of care. we need a duty of care. those -- of those people that work the street every day. institutions met the wellness of their officers. tracking is one way to do that. if you know of troubled officers, it's a good idea to pay attention to them and take care of them. out of existing psychological services, we need more police psychologists out there that understand the job, that understand policing. there are some that don't, and i think those who do need to be searched out. invest in training, especially at the recruit level. officers in the academy will start out on this kind of work

are unaware of what's going to happen to them in the next 20 to 25 years. and what they're going to see every day of their career, and sometimes it's not very pleasant. changing the police culture. there is a culture in police work that police don't have problems, we solve problems. police do have problems. i think that culture needs to be changed so police will -- officers will be willing to go for help if they need it, to stop the trauma and stop the stress before it gets too late and they make the ultimate move of suicide. education is a good way to do that. i think there are several programs out there that are gatekeepers' approach that work very well. they're very simple programs. more research. we're looking at psychological autopsies, for example to retrospectively look back at police suicides and find out how the officer got to that point where he or she decided that they wanted to kill themselves.

we're doing some experimental work as well trying to detect suicidal thoughts in officers prior to the point where it's too late. i think the united states air force has a great program for this and the key to their prevention efforts are involving the community. they involve the chaplain they involve leadership, they involve psychologists, they involve families to give them a better understanding of what suicide is all about. and i think that's very important. i think we can do that in policing, too. we need to look at idealogical studies, as i mentioned before and i think in my view police work is a fertile field for suicide. maybe police work itself doesn't lead to suicide, but there's certainly part of that equation that does. if you take personal problems

relationship problems and other problems and you put them in the context of being an officer, that's when you get into trouble. so departments have a duty and a moral obligation to care for their people and prevent these tragic deaths, these very unnecessary deaths. thank you. >> and thank you for your testimony, doctor. next we'll hear from david orr norwalk, connecticut police department. >> thank you, sir. good morning and thank you for allowing me to speak to you today about the topic of post-traumatic stress disorder as it relates to police officers. i bring to you the perspective of a union leader and front line supervisor from a working class community about 45 minutes outside of new york city. as a union leader with the american federation of state county and municipal employees, otherwise known as afscme, i represent my membership of collective bargaining, labor rights and discipline. however, i also find myself

performing the duties of a peer counselor to my colleagues during stressful times in their lives. this includes those stressful times following a critical incident at work where death has occurred. occasionally, these incidents can be so severe that they burn a lasting impression into the minds of the most seasoned veteran cops. i'm talking about real tragedies, the details of which you wouldn't talk about at the dinner table. as cops, we all know that people love to hear stories about what we do. this is evidenced by the countless number of tv shows and movies that glorify cop life and culture. people love to hear the story of the car chase, the big arrest or the life that you saved, but nobody wants to hear the story told by the newtown officers who responded to sandy hook elementary and entered a first grade classroom to find an entire class full of six-year-old children murdered by a deranged young man with an assault rifle. nobody wants to know about the scene inside of a home in

cheshire connecticut in 2007 where jennifer hawk petit and her daughters were raped doused with gasoline tied down and murdered. this is the part of our job that nobody wants to hear about. and that's understandable. unfortunately, the reality is that horrible tragedies will continue to happen and police officers will continue to respond to them. we as officers will continue to insert our bodies and minds directly into these tragedies in an effort to try and help in some way. most of us will emerge from it and find a way to cope with what we've experienced but some will not. some will be scarred so deeply that the course of their lives will change indefinitely. for these officers we must ensure that the necessary services and coverage are provided for the wounds inflicted on their minds just as if those wounds had been inflicted on their bodies. currently, only 32 states provide adequate ptsd mental

health coverage under workers' compensation. the state of connecticut is one of the 18 remaining states that does not recognize ptsd as a compensible nature under its workers' compensation laws. the only compensation for this is for police officers and firefighters who, in the line of duty recognized one of their own. after sandy hook elementary many of the officers who responded to the school and investigated the aftermath of that tragedy suffered from intense ptsd. had they suffered a physical injury they would be covered under workers' comp. but since their injuries were mental in nature and those who died were not police officers, there was no coverage. their claims under workers' comp were rejected, they were forced to go back to work or lose their jobs. many did not get the mental health care that they needed nor did they get sufficient time off to recover.

a police officer who is at work and suffering from ptsd raises serious public safety concerns. officers suffering from ptsd can present a danger to themselves or others or they may be rendered ineffective in performing their essential duties. without workers' compensation coverage for ptsd, and the protection that are offered under the workers' compensation act, officers might be unwilling to admit they have ptsd. this can have serious consequences for the officer both professionally and personally and can present a civic liability to their employer. in the weeks following sandy hook, i, along with hundreds of other police officers from around the state of connecticut, volunteered to work and cover shifts for newttown police department. it was clear us that our brother and sister officers in newtown were physically and, even more so emotionally exhausted. so i am now respectfully asking that you do the same for those officers who are suffering from ptsd and that you help them by

delivering to the president in your report to him on march 2nd the message that i have tried to convey to you today, that ptsd is a real problem in policing that it cannot be ignored and that it should be covered under workers' compensation in every state in this country. thank you for your time and for allowing me to speak to you on this topic. >> thank you, sir for your testimony. next joining us through skype is dr. sandra ramey professor, university of iowa. doctor? the audio, we don't have audio right now, so can we make an adjustment here? doctor, you may have us on mute.

well, we're trying to resolve whatever technical difficulty we have. we still can't hear you. >> is there something you can direct her to do at her end? >> still no sound, doctor.

>> until we resolve this technical difficulty we're going to begin with our questions. doctor, stand by. there is a group working to try to restore the audio so we can hear your testimony, which is very important to us all. so with that just as a reminder, the task force members will begin their round of questioning. they will be called in the order in which they've indicated to me that they have a question. so we will begin our questioning

with shawn smoot. >> thank you mr. chairman. i want to thank the panel for their very compelling testimony. all three of you did a very nice job framing the issues. i want to go back and talk -- ask a question of dr. miller. we've heard a lot of testimony with regard to procedural justice, both external procedural justice and internal procedural justice within departments. and i noted in your testimony that you indicated the greatest source of stress was organizational for police officers. i'm wondering if you could perhaps give us some insight to how procedural justice being instituted within departments might be helpful in that regard. >> i want to thank you for giving me the opportunity to discuss something that i didn't have room to fit into my five-minute presentation. you gave me the perfect opening.

this is a concept from organizational psychology the difference between what's called distribute distributeive justice and procedural justice. let's say we have a dispute. i want to get everything i want, you want to get everything you want, but typically what will happen is a compromise will be made. one of us is going to be less satisfied than oertthe other with that compromise. that's how the spoils of that conflict are distributed among the parties. but even if i'm on the so-called losing side, even if i don't get everything that i want if i believe that the process by which that decision was made was a fair and unbiased one, i'm more likely to abide by that decision, i may respect the process of the decision even if i don't like the results. what that means is the next time i have a dispute, i will be

willing to go to that arbitrator because i know that person or persons will behave in an honorable, fair way. this is very important in policing because, as i mentioned earlier, one of the big complaints the police officers have about their supervisors and managers is that they're told to do things, accused of doing things, instructed to do things and they don't get a say in it, and sometimes they don't perceive the process as being fair. we see this, of course in the real world where you have police-citizen encounters that turn violent. the citizens don't believe they're being treated fairly by the city by the police departments. so even if the outcome is favorable or unfavorable, the process is expected. by the same token, many police officers feel they're taking a beating for things that have nothing to do with them. you'll often hear this phrase over and over again we're just doing our jobs. why are you punishing us for doing our jobs? and the answer is you're not supposed to punish police officers for doing their jobs you're supposed to discipline them if they do their jobs

inappropriately, and here's the most important thing then train them how to do it the right way. we allocate lots of funds for all sorts of things in policing and government. training, which if you think about it is probably the least expensive option in terms of equipment, apparatus. experts out there exist. there are trainers out there doing training on a piecemeal basis. if we can put together perhaps a standard curriculum of behavioral sciences training for police officers, this will serve to professionalize police and law enforcement in a way that's only being done in isolating pockets. and i think that may be a very important message to bring back to the president. let's take what we already know what's already being done what's already proven to be successful and apply this. we don't have to reinvent the wheel, we simply have to do things on a much broader scale in a way we can reassess and re-evaluate as we continue. >> thank you. next we have sue rohrer followed

by tracy meers. >> dr. miller i'm going to give you more time to expound on your favorite topic but i want to delve a little differently. one of the things i've personally been involved with in the last couple years is looking at our approach in the basic law enforcement academy moving from a boot camp type model to more of a canvassing school type model. one of the reasons we made that change is we didn't want to sow the seeds early on in the officer's career that you are subject to this authority from above that is unkind, unlistening and that sort of thing. i'm wondering if you can comment a little bit about, is that a legitimate legitimate issue, having that power differential so far out of whack in the beginning? and as officers go through their career, is this inoculation at the beginning helpful or not? >> i don't think it has to be all or nothing. policing is, for better or worse, a paramilitary organization. you do need chain of command.

decisions have to be made and someone has to take responsibility for those decisions. the problem is the general public, and i think even many individuals in policing they categorize police officers in andy griff itith in mayberry on one hand and the show "cops." it doesn't show respect for authority with boot camp and we need officers to show authority, but we need that authority to be competent, we need that authority to be reliable and when you're screening for officer candidates -- ellen kirschner talks about screening out ask screening in. we know one of the differences of a patrol officer is one who can take orders necessarily collaborate with her peers but when the situation calls for it can act independently. so i think we need to emphasize

to police officers that our job is to make you stronger not weaker. by the same token, we need to broaden their experience and their knowledge of dealing with different types of people, different types of situation because that will, as you say, make them more professional, more of an officer candidate school. i'm all for increased education and increased training for police officers. every police officer should be a professional, a credentialed professional. it's not going to guarantee a few bad cops aren't going to abuse the system but it will guarantee that when officers go out there they won't overreact because they don't know what else to do. if you analyze a lot of situations that have gone on, whether in ferguson or anywhere else, you can see there's been a tipping point. at some point a person did something or said something that lit that fuse and the situation exploded. and although better training and behavioral intervention on the part of law enforcement is not going to eliminate all such incidents, and law enforcement officers have to know that when they need to make an arrest, when they need to engage in deadly force, then they're prepared to do so.

but unlike a soldier whose job is basically, it's been said, to kill people and break things, a police officer's job is to maintain the peace and avoid using force as much as possible. so if we can keep the strong, determined, resilient attitude of police officers but at the same time put them in a more nuanced approach to dealing with human beings, because police after all, i tell my classes you guys are the street psychologists. you're out there dealing with people, the same people i deal with in my nice, comfortable office, you're dealing with them out on the street every single day, so you need to be as prepared as possible just like a paramedic needs to be prepared to deal with medical emergencies, police officers need to be prepared to deal with behavioral emergencies. you'll find that the officers who are trained who feel competent are less likely to overreact and use force because they have more tools in their tool box to react to. so yes, i don't think we need to jet jettison the boot camp mentality but simply add to it or expand with a rider range of option-- wider

range of options. >> thank you. >> and panel, if you feel like jumping in feel free to do so. we move on to cedric alexander. >> good morning. i was struck by all your testimony, both oral and written. i jotted down some notes to myself just about the sort of composition of fatalities, at least in the data that we were given. it seemed like roughly half, maybe over half, was suicide, and then other officers who were killed in the line of duty, maybe some combination of, you know felonious shootings and then vehicle crashes seem to be, like, sort of three categories of fatalities. i want to focus though on the -- how do i want to put it? i think i want to focus on the suicide issue. and this question is probably

directed more to dr. vialonte and to you sergeant orr. when you read this testimony, you can't help but take away from it something like hurt people, hurt people including themselves. and i was struck by you know your testimony, sergeant orr, about the fact that there is 18 states that don't have coverage for ptsd and your testimony, dr. vialonte, that we should encourage officers to reach out. i was wondering whether we want to take a stronger stance. so my father was a judge. he's retired now and he began his career in the juvenile justice court. and when you're a judge in the juvenile justice court in chicago, you are mandated every six months to have a meeting with a counselor. it's not an option. you have to do it. and i was wondering if you all

had some ideas that you could share with us that were more mandatory in terms of taking care of officer health in this context. it's one thing to say that there should be workmen's compensation or just encouraging people to reach out. but if you could choose one or two things that you thought would address this issue very concretely, i wonder what you would say. >> well -- excuse me. first of all i think it's a very good question. i think it's important -- one of the suggestions that have come out over the past few years is that police officers should have a yearly mental health check. in other words, just like you go to the dentist or you go to the doctor to check your health you want to check your mental health as well. so every year an officer should go in to see a departmental

counselor or a peer support officer and talk about any problems that he or she has had over the past year. and it doesn't have to be a year, it could be any time they would like to, but mandatorily go in and talk to somebody about this. the idea being if you have small problems, they can be taken care of so they don't become big problems that can't be taken care of. i think the second thing i would like to say is that the police culture is tough. it's difficult to change. i think one researcher said it's like bending granite. it's the same kind of a thing. if you -- our recruits our young people that come into this work need to understand it's not a weak thing. you're not a weak person if you go for help. whether it be physical or emotional help. i think a lot of officers believe that that i will be

seen as weak, i won't get a promotion, my comrades are not going to have confidence in me, my leaders are not going to have confidence in me anymore. but it's a sign of strength to go for help. you don't know how difficult it is to pick up the phone and ask for psychological help. extremely difficult. it's twice as difficult for a police officer because they're not supposed to be someone who needs help. and that's the thing that we need to change. >> if i could address real quick. currently, from what i've seen the only mandates that we experience during our career are, one, in training in the inception of our career through the police academy where there is a small block of training towards officers' mental health and personal awareness and then in the recertification process in connecticut, it's every three years we go through a 60-hour

recertification process. it's updated periodically on new topics and i think there is a four-hour block every three years on officers' personal awareness and mental health. otherwise the only mandates we undergo are educational things for legal updates and firearms qualification and driver retraining and that kind of stuff. they're more requirements of us to stay up to date on what our requirements are for the job. there is no periodic mandate that requires us to go through any mental health screening. and the only time we're mandated to go through any mental health screening is when it comes from the administration and as a union guy, i've seen that numerous times where guys will be ordered into therapy for substance abuse or domestic violence or any other issue they're having in their personal life. anger management, something like

that. so the only time it's mandated is reactively after an incident. by that time it's already happened. if it's a suicide, then obviously be a mandate it's too late. so as the periodic mandate of some type of counseling, i think it's a great idea. i know from my time as a new york city police officer that there are some police departments that have mandates following a critical incident. where an officer-involved shooting or any other incident, it doesn't have to be use of force incident or any other tragic incident where officers are there while it's happening or immediately thereafter there is a policy -- there are policies that exist that mandate a cooling-off period where people are taken off the line, and i know some police departments in deadly use of force incidents have you know a minimum of three sessions with a counselor to try and process through what's happened there.

so that's also a great idea, if i could be on a more broad-based level. it's only happening in little pockets. >> comments on this, because i think this is a matter of great intentions, and we need more attention to the application. i think every panelist here agrees probably everybody in this rule agrees police officers need more access to mental health services. but in order for the rank and file as well as the top administrators to have buy-in in this project we have to work out a few details. for example, most officers believe that by asking for help and getting help this is going to put them at risk of being taken out of service, i guarantee you most police officers are not going to ask for it or go for it. by the same token, let's say they do ask and go for it police administrators have told me okay now i've got an officer who is doing the right thing they're trying to be pro-active they're in treatment, they're trying to address the problem, and they're still working the same way an officer with you

know, a physical injury that enables them to keep working still works. now let's say there's a use of forciblesy dent. something goes bad. i guarantee you you're going to have 100 people screaming look this agency let a psychologically damaged officer out there on patrol. we agree -- i don't pretend to have answers for the questions but this is something that needs to be very carefully addressed. how do we apply these conventions so they'll accepted by law enforcement, by the legal system and by the general public. if we can work this out then we will have an effective way of implementing this. and i think that where we need to get more buy-in from the people within law enforcement themselves, not just psychologists but the people who do this every day all day because they know what their people need and they know what their real needs and liabilities are. >> thank you very much. i'm told we resolved our technical issue. we're going to suspend the questions and turn to dr. sandra

ramey, university of iowa, as she completes her testimony and pick back up with our questions beginning with dr. cedric dan ter. dr. ramey? you need to turn up a little bit the volume. >> can you hear me? >> yes. >> okay. bear with me -- [ inaudible ] over the past two decades my research issues related to [ inaudible ] is there something i can do?

[ inaudible ] >> does that help this way? >> yes, it's better. >> okay. well it's not the most professional look, but let's try this. over the past two decades my research has primarily focused on issues related to risk and morbidity for cardiovascular disease with work conducted within approximately 17 departments. this work includes finding -- 70% more prevalent -- retirees compared to counterparts -- we also have studied officers daily physical activities at the fact

that work shifts and sleep quality and duration. can you guys hear me okay? can you hear me? >> there's interference on the line, unfortunately. not being a tech person -- [ inaudible ] >> muted? >> no, it's not.

[ audio problems ] >> can you hear me now? >> all right. let's try -- how it works. on your -- on your phone. >> on my phone? >> yes. >> how's that? >> that's pretty good. >> okay. there's a lot of feedback on my end but i'll do my best here. okay. so analysis of these and other studies resulted -- has resulted

in the culmination and decision to develop an intervention to build stress resilience in police. recently we conducted two pilot studies funded by the department of justice and nyosh the healthier workforce center for excellence at the university of iowa. the purpose of these studies was to test protocol for an intervention to build resilience. while an intervention to build resilience is not a magic bullet, it does, from my view, address many of the risk factors and health issues documented in law enforcement over the past three decades. especially -- stress. recent events have compounded the need for resilience training. currently there is a need in police agencies all over the country to improve community relationships. from the police view, police need -- from a public view, police need to make the best decisions possible and perform at their very best in every situation they encounter. and of course, most officers strive for this goal, as well. -- character of policing changing stressors within the environment is not a viable option. it is, however, possible to

teach officers to modify how they react to stress. this is referred to as resiliency or self-regulation. the problem is that presently, there is no consistent training within the profession to equip officers or their families with their skills to modify responses to stress. recent research suggests positive -- positive outcomes from stress resilience training in the military specifically the army and the navy, funded by the department of defense. this training has recently been expanded to the army wellness centers, and making it accessible to 200,000 soldiers and their families, which is extremely important. given similarities in exposure to stress, it is reasonable that these programs may also benefit sworn police personnel. improvement in performance including the ability to self-regular late and improve decision making are expected outcomes of resilience programs. results of our pilot studies further support the feasibility and effectiveness of this type of intervention, tested in four directs of the milwaukee police department.

our pilot and military projects utilized a program called the resilience advantage, it was developed at the hart mass research center a small nonprofit corporation in boulder creek, california. the program involves two to three-hour classes followed by four booster classes delivered weekly and use of an application or practice device to improve resilience to stress. outcome measures include improvements in psychological measures of stress, blood pressure and something called heart rate variability that is measured in this study by coherence level. simply stated hrv is the measurement between heartbeats and considers the contributions of the sympathetic and parasympathetic nervous systems. coherence is a state measure of heartrate ability. previously a regular heart rhythm was thought to be optimal. now we know some variation is optimal and is indicative of health. this is important because low hrv places officers at sudden risk for sudden cardiac death

and all cause mortality as with the rest of the population. hrv is highest when we're young and it decreases with age. however, it is possible to improve hrv through some types of training. our pilot studies reflect that -- reflect improvement onzx!í several psychological measures including the impact event scale which is a measure of ptsd, and significant improvement in diastolic blood pressure. the coherence percentage increased significantly, as well. a concerted finding in both of our studies was the high prevalence of low hrv in officers compared to age determined norms. however post intervention many of the hrv values improved which is exactly what we hoped to see. we reviewed the daily heartrate activity via heartrate monitors worn by officers during 24-hour cycles at work and on their off day. we found the mean heart rates for these officers to be alarmingly high. even during sleep. for example, one officer's heart rate was above 100 beats per minute. while promising this intervention still requires further testing for

effectiveness in larger sample sizes, -- can make to all agencies in the united states. applications are -- [ audio problems ] [ inaudible ] -- progress. the next step therefore is assess a larger group of officers -- apply the lessons learned in the pilot study evaluate a package called the mway software that is efficient way and a cost effective way to measure hrv beyond using heart rate monitoring and develop a tool kit accessible by all law enforcement agencies. now a caveat to all this is we must continue to look at the cost/benefit analysis for every new development and intervention. interventions like this one have the potential to save taxpayers

millions of health care dollars and money currently spent on stress related disability which is a whole other discussion. recent research suggests that teaching officer technical skills and practices that allow them to better self-regulate and modify their psychological responses in the moment stressful situations are taking place when stressful situations are taking place has significant benefits for both the individual officers and organizations. with proper support the department can expect reductions in health care utilization and costs, increased officer retention and job satisfaction, and improvements in quality of police encounters with citizens. this training could be offered at the academy and we're starting to pilot an iteration of this with the milwaukee police department with reinforcement provided to officers at in service sessions to maintain baseline health. in conclusion, i know it's the hope of the milwaukee police department and the university of iowa that this current effort to move towards intervention development will benefit

officers all over the nation by giving officers the tools to improve resiliency to stress work performance and improve the officer's quality of life. >> thank you very much. >> did you hear any of that? >> thank you very much. doctor, apologize for the difficulties that we had. we're going to return now for questioning, and dr. ramey feel free to jump in on any of these questions if you have something you want to add as we move through this questioning process. okay? >> okay. thank you. >> so we're going to go to cedric alexander followed by jose lopez. >> yes, good morning. this question is for dr. violanti, dr. orr and dr. ramey. if you would bear with me for one moment. if we look at the research you all have done over the years as it relates to ptsd heart disease and suicide, with older officers, i see here dr. violanti, you even mentioned that suicides appear to cluster in the 40, 44-year-old age group.

and you also further testified here, as well, too, that a large -- a rather large increase in suicide is seen in officers with 15 to 19 years of service. the question becomes there's a population of police officers that are going out, particularly those in my age group, okay. we're in the twilight of our careers. and much of what you're talking about, much of the research, i assume, has been validated pretty much on this population on my population, if you will. now, if we consider the fact that there's a younger population of young men and women that are coming on police departments today, entirely different generation, 21 22 years of age and they're much healthier, they grew up in a time where they've become more health conscious because their parents are more health conscious. they're less likely to drink, smoke, hang out, do the police glee club kind of thing if you will, that contribute to a lot of these illnesses that we're

very much familiar with. and -- but what's really striking is the fact that for many of these young people, they don't stay in the profession very long, as well either. so they're not looking to do 20 or 30 years where there's going to be this cumulative amount of stressors that they're going to endure over time that put them at risk. so ird like each of you, because of your research and your clinical work you've done over the years to expound a little bit on that. but in addition to that as well, too, you know, here's a real important question. when we send our military people to war, and we expose them to the type of ptsd which usually goes beyond the normal realm of anyone's exposure is what ptsd grows out of they're there for a certain amount of time. in policing you're exposed to those stressors on the street in this country for 20 or 35 years over the course of your career.

you're not in there for a tour, get the help you need and go on for the rest of your life. for police it could be much longer. if that is the case, would it be considerable -- i mean would it be reasonable to consider that in the profession, and because of the -- the stressors that are associated with policing on the streets of this country every day and everything that officer orr even spoke to as it relates to what officers have to deal with, would we be looking at a young officer that we need to bring on and expose him or her to a much smarter career in policing? where retirement becomes earlier than 20 years? and there are some other things that might be even helpful to keeping them healthy throughout the course of that career, considering that many of them are not going to stay 20 years today, anyway? you know, any significance to that whatsoever?

>> a point. i agree with you that younger officers are more conscious of their health today. and i've seen a change in that over the years. during my 23 years as a police officer, from the old school, you didn't see that. you know but now you do. you see that probably because of social media of more exposure to what -- bad health can do to you. i think also young officers are more apt to go for psychological help if they need it. again the old school probably not so much. but one of the sad things i've seen in my research in cardiovascular disease and ptsd is that when we look at the mortality studies of police officers police officers compared to the general population die at a younger age, some ten years younger on average, than those in the general population.

so we're seeing greater numbers of death from cardiovascular disease among younger officers, which is kind of surprising and kind of shocking. the thing you should understand about stress is that it's cumulative. that as you are continually exposed to trauma, day after day, and stress day after day, eventually it's going to wear your system down. some of our research show for example that the body becomes disregulated under chronic stress. there are certain hormones in the body like cortisol is an example, that become so disregulated that the body can't adjust anymore to the effect of that stress. and when that happens it opens the body up for disease. so we're seeing greater problems with disease, and that among officers. i think if you shorten the number of years for retirement that's a great idea. but, i don't know if it's economically feasible given the cost of training police officers

today. and given the cost of lost experience. i think 20 years is reasonable if you have resilient people. i think dr. ramey is very accurate in saying that we need to increase the resilience among officers. if we can do that we can cut down the effect of stress. so i think that's important. but i think most officers love to see retirement at 15 years instead of 20. but, again, it may be difficult task. >> i don't have the empirical research base that dr. violanti has so i'm going to fall back on my clinical experience working with officers. this raised a very intriguing point. a number of officers i see who are middle and late stages of their career who are undergoing psychological problems stress problems, family problems and so on, they sort of know on one hand that they're kind of getting burned out, but they don't want to quit. and there are a couple of reasons why they don't want to quit. one reason why they don't want

to quit is they don't want to be seen as a quitter, let their colleagues down, seen as knuckling under, folding under pressure and so on. other times the reason may be very practical. they've got ten years to go, five years to go two years to go. they want to get vested get their full pension, and then leave. what happens is you have officers who really are at best coasting and at worst underperforming on the job because they're just too burned out to function adequately. how they got that way is a whole different issue. what might be considered as opposed to an either/or retirement plan is perhaps a flexible type of retirement system whereas if you work your full 20, you get your full benefits. but perhaps there's a stepwise nonstigmatized way of retiring at 15, 10, so on in which you get some partial retirement benefit but you're not perceived as a burnout case. doesn't have to be done on the basis of a disability. and therefore, officers who really for whatever reason, god bless them cannot do the job anymore, they have face-saving

way of leaving law enforcement and not being out there and perhaps creating a liability for the agencies as a whole. the other end of the age spectrum i think what you're seeing is this is more of a fast-based world these young people live in. remember the culture has changed, too. years ago when you joined any company, whether it was a government agency or a private company, you sort of had a womb to tomb type of coverage and career. you started off early you worked your 20 or 30 years, at the end they gave you retirement, with your gold watch, and you considered having a good career. today, most companies hire people as independent contractors, very few people have full employment. and so how young people have responded is by turning this around saying, okay, well if there's no real consistency and loyalty among the organizations that hire us, then we're going to jump from one thing to another as the situation suits us. so you've got an interaction of age and personality with the economic culture. ironically, police agencies are one of the few places where, if somebody wants to and is able to, they can have 20 years of

full employment with a generous benefit package. i mean in fact many officers who go in to policing do it at least partly for that reason alone. so i think we need to do things to strengthen that system so that officers feel that they will, if they put their time in they will be able serve their time, and retire with honor and with all the practical benefits that go with it. but have a more flexible way of dealing with this because if an officer cannot do the job anymore, we ought to allow that officer who has otherwise faithfully served, a face-saving way out. >> just comment dr. miller reminded me of a plan i'd seen in some industries where they call it a phase-out retirement. in other words you would work full-time for 15 years, and then you would phase out your time for the next five years. perhaps work three quarters time for one year, then halftime the next year, and then a quarter time, and then out. this seems to work very well in industry. but, i don't know about policing. it's something that might be possible. >> thank you very much. jose lopez followed by brittany

packnett. >> thank you. some -- i think i have two questions. i wanted to return to the question that tracey had asked earlier on the panel and the discussion was a discussion around mandatory counseling of some sort for officers. and so i guess this, the first question is a two-part question. the first part for mr. orr, and i'm just wondering, as a union rep, and as someone who is actively engaged in discussion with rank and file officers is something like mandating counseling something that you think other union reps across the country could get behind and do you think that that is something that the rank and file officers across the country would want their union reps to push? and then the second question is

for -- or the second part of question one is for mr. mr. violanti, or anyone on the panel, i guess this part of the question has more to do with that piece around mandating. and you know anything that's mandatory in any agency or organization oftentimes is seen as, i don't need you to mandate anything else. and so what if the process was that maybe it wasn't mandatory. but every officer automatically got opted in, and had to create some form or fill out some form, some self-evaluation, in order to opt out. and so there is still an opportunity to make it feel as if it's not mandatory but it will take some significant work and some self-reflection to be able to kind of appeal and say this is something that i don't think that i'm in need of and something that i want to opt out of. >> thank you.

to address your question regarding mandated counseling and my perspective as a union leader. i -- counseling is a service. it's not an additional duty that's being imposed upon us to comply with or some new form we have to learn how to fill out or something coming from the courts regarding case law where we're exposed to some liability per the normal training we get. counseling is a service. so counseling in itself, i don't see how it could be a problem. my union perspective is that i would need to know what consequences could result from that. and whether or not there are opportunities for the officer to take that counselling in their own direction, rather than be mandated into a certain direction per the perspective of some administrator. and then, the obvious question

for me also, would be privacy and confidentiality would have to be requirement to that. and discipline could not result from anything that was exposed during counseling. so just to rehash, you know, counseling service i think is a great thing. i've seen some policies where it's mandated after a critical incident or, you know, but confidentiality has to be paramount, consequences have to be monitored by the employee and the union. discipline cannot result and the officer has to have some say in the course that that counseling takes if it is a long-term thing. >> i agree with sergeant orr. i think confidentiality is absolutely key. as far as mandatory, that does cause a problem.

i think when you force a police officer to do something that he or she doesn't want to do you're going to run into resistance from union and from the officers themselves. one of the suggestions i was thinking about was put a sort of a positive spin on this. in other words if you do go for let's say a mental health check, a voluntary mental health check and for some way you are rewarded for that, perhaps you know, incentive of some sort that might work. in other words, don't make it mandatory, make it voluntary, but do it positively. that's just an idea i was thinking about. i like the idea of seeing maybe not a psychologist but a peer support person. a police officer who is trained in peer support. officers would rather talk to another police officer than they would to someone else first. i mean, if psychologists are

needed certainly they can come after. but i think peer support is a very important key to getting officers to go for help. >> i had a comment. >> yes, go ahead, doctor. >> one thing that's worked in the pilot study -- can you hear me okay? >> yeah. >> is to present the opportunity to officers to have what's called a session that involves a confidential visit, can be as long as the officer wants it to be with a mental health professional that's outside of the organization. and what i found over the last couple of years of this is that if you can encourage an officer to participate in one of those sessions, i would say at least 50% of the time they come back and say, can we have more of those? are we limited to just one? so, doing some kind of incentive like john said to get people to see what it's like, that it's not as threatening as you might think, and it's actually help.

the other experience i've had over the years working with milwaukee and other departments is even sitting down and having the opportunity to tell your story to somebody is very powerful, and i even had a captain one time that said i feel like i should write you a check. this was the most therapeutic visit i've had with anybody for a long time. and it was just a simple conversation to talk about what was on his mind, and health and wellness and all those topics. so i guess my recommendation would be at least make things accessible, maybe try some of these programs that have some built-in telementoring counseling sessions, whatever you want to call it so officers can kind of test that and in a very confidential way see if that's something that they believe will help them. >> thank you. dr. miller? >> as with many of the topics here today the devil is in the details. the number of the agencies that i work with have a kind of bifurcated model. that is certain types of incidents, for example officer involved shootings, any officer

involved in an officer-involved shooting is mandatorily made to go for a critical incident follow-up which consists of a single session. there's no stigma attached to it. everybody goes so it's not like one person has been affected more than nick else and the way we conceptualize it just a general checkup. we're checking the points and plugs of your brain just to make sure everything works. overwhelming majority of cases the officers assuming the administrative aspect is handled psychologically the officer is cleared to go back to work. occasionally when that officer needs counseling it is then offered and made accessible but not necessarily mandated. there might be some other situations where this applies, such as hostage scenarios and so on. but for the vast majority of officers who are experiencing stresses again that relate to some combination of personal stresses, and work stressors the other way to do it is to make these services accessible. that is we have a panel of individuals within the community that if you wish to go see a mental health professional for

your own reason, that is between you and that mental health professional. just the same as any other patient who walks in to my office. the key is, whether or not the people within that department encourage that. so if somebody says you know, sarge, you know, lieutenant, i'm having some trouble dealing with something and the lieutenant slaps him on the back and says, come on, buck up. very little chance that person is going to seek out counseling. if the lieutenant looks that person in the eye and says, you know what? get the help you need. you need some time off we'll deal with it, do what you need to do. as long as that person comes into a mental health professional's office that information is as confidential as any other patient that would walk in. the only exceptions are the exceptions that would apply to anybody, if they're a threat to self or others, if they're engaging in child abuse. but that applies to everyone. again, mandatory and limited ice lated cases where you want to destigmatize the mental health process and make it universal. but voluntary but supported in cases where a well-meaning officer wants to get help for themselves.

>> thank you very much. brittany packnett followed by roberto villasenor. >> i don't -- >> we're tight on time. i can hold off. >> oh. well -- whatever. i mean, we had a little delay with the technology, so you want to -- you've got something, feel free. >> so i guess my second question, i mean the one piece that i did want to comment on on the confidentiality piece was that i think at a minimum one of the things that we've heard and that has been up for discussion is that when an officer is deemed unfit or unstable to work on a force that there has to be some flagging of that so that the officer can't just move to a different location and be picked up by a new department. so that's one thing. just to state for the record something that we've been

discussing as part of this, as part of the deliberations and we've heard on other panels, but i guess my question, my question question is around the role of the department when that actually does happen. and so when an officer is deemed unfit or unstable what is the role of the department now to continue to offer support to the officer who probably for a long time was a member of that family. and if not much, what should be the department's responsible in making sure that that officer has has a mental health support plan. >> i think there's a crucial question. this relates to the whole issue of fitness for duty in general. with the critical incident follow-up it's important to emphasize to the officer, and i tell all police agencies that i work with to tell the officer this and i tell them when they come in, when you come in for an officer-involved shooting where you've had an experience, you

may be having some aftereffects of it this is not a formal fitness for duty evaluation. this is not because somebody thought you did something wrong. somebody thought you underperformed. this is separate and apart from any i.a. investigation that may be going on. this is simply to assess your psychological state to see if you're okay. if for some reason you feel you cannot go back to work for i feel i cannot go back to work this will be dealt with as a clinical issue not as a performance issue. a formal fitness for duty evaluation is a specialized evaluation where the officer is misperforming or underperforming underperforming, and someone believes it's due to a psychological reason. but that has to be very carefully separated from a critical incident follow-up or any other kind of mental health treatment that occurs. and unfortunately, as some of our panelists said, you have a poorly trained psychologist who sometimes conflate the two. someone comes in for help, the officer gives them a bunch of symptoms and the psychologist or mental health practitioner isn't

familiar with that culture, they may jump to conclusions, next thing you know they write down, not fit for duty. that is a very important decision you're making about a man or woman's career in life when you make an assessment of fitness for duty and it should not be done lightly and should not be done unless a formal request for that assessment has been made. so, barring that i think it's important that officers realize that information is going to be confidential. because, again, you know we all know, we work with law enforcement, somebody once said any police agency is basically a class of fifth grade girls. and if somebody comes to me for any kind of psychological treatment i guarantee everybody in the department already knows they're going before i do. all right. so, we talk about confidentiality, we know that cops can be the worst blabbermouths in the business. but the confidentiality adheres upon us. we are the professionals. in other words we as the mental health professionals and you guys as the top brass as the supervisors need to keep things confidential. so if they want to talk about it, that's fine. but as far as we're concerned unless it involves a formal

mandated referral all right and that's important. a mandated referral means something that is a fitness for duty ee val use that is mandated by the department and therefore the results go to the department, not clean the clinician, and the officer. barring that that if an officer wants to seek help, the lieutenant, the sergeant says i don't want to know what went on in that session. i don't want to know what you told that guy. all i want you to do is get better. and if we can maintain that distinction and clarify this and that's what i mean about the devil in the details because you're going to have to get mental health people law enforcement people, legal people, union reps, pba people in here to hammer this thing out. this is going to be a tough thing to put together, but if you do it right, it's going to be a powerful force for getting police officers to seek help when they need it. and, to make sure that officers who cannot perform their job aren't out there doing so. >> thank you very much. brittany packnett followed by our final questioner roberto villasenor. >> thank you.

actually jose's second question was one of my questions so i just have two quick ones. one, is to any of you and i think a couple of times, both in your written and oral testimonies, there's been mention of issues of domestic violence, child abuse and other ways in which these stressors that law enforcement officers deal with can impact the home. and so my question is have you seen any models or do you have any concrete suggestions around the kind of counseling and mental health support that should be provided for partners and children and other intimates of law enforcement officers such that, i mean i think one of the statistics really talked about the impact of personal life stressors being one of the primary reasons for those unfortunate suicides that you counted. and so i'm wondering how we can ensure that families are supported and that those personal stressors are mitigated. >> i can address that real quick. the employee assistance program is in existence, it's pretty

vast. and officers can seek that out themself for any type of counseling, it can be anything from financial problems, where you can be networked with you know, financial advisers to help you get your finances in order. if you're going through that type of a crisis. marital crisis problem with children substance abuse, and officers can seek that out themselves, and i've seen that happen pretty good. i mean, guys will go for that on their own or maybe with a nudge from a friend. that can also be mandated through an administrator if there's a work performance related issue and they can be pushed in the direction of eap. i know that the first three sessions of eap are on the house, and then following that it falls under your insurance. and you're subject to the regular copays, whatever your policy is. but i know that in our region eap is very active, and they

come to roll calls a couple times a year there's monthly newsletters that are put out. people talk about it regularly. so it's not some type of phantom service. it's used pretty regularly and i think it's been pretty successful. >> just something very basic whichdy in the past was to police officers have a some difficulty communicating what they've experienced during the day when they get home. they kind of shut down. one of the things i did was to have a family police officer session, and we brought them all in together, and we taught communication skills. to azhóñ&ly face each other and talk to each other. and that seemed to help a lot. so i think that's one of the real problems we see. there's no communication on the family level, when officers get home. if we train them to do this properly, i think it will really improve the situation.

>> i can echo that. i would say at least 75% of the clinical cases that i see of law enforceness officers who come in for counseling the stresses that they're coming in for don't involve their work as much as they involve their family life. i think i mentioned earlier that, you know person has the way i conceptualize it to these guys and gals you have two legs you stand on your work leg and your family leg. and if both legs are strong you can withstand a hurricane. and if one is tottering you can lean on or hop around on the other. but if both start to go then you're going down. and a typical scenario is a police officer who may have been having difficulties at home family problems, and so on. but they've been doing a good job and work has been going well and now something happens at work and we all know police officers are very all or nothing kind of people you're only as good as your last screw-up and now they feel that work is going down, too, and this is that tipping point that can often precipitate them into a depression, even a suicidal

depression, and that's why it's very important that if that happens, they know there's somebody they can -- somewhere they can call, somewhere they can go to to sort of defuse that. i want to get back to the issue that one of the panelists mentioned about domestic violence, child abuse and so on. remember, child abuse is a reportable offense. it's a mandated reporter if i become aware that somebody is engaged in child abuse doesn't matter who they are i have to report it. what you want to do is get to the point that it hasn't reached that yet. domestic violence although it's not a reported -- a reportable offense, is something that is one of law enforcement's dirty little secrets because there is a high rate of domestic violence within law enforcement families. that would be a whole different panel that we don't have time to discuss here. but again, if you can get in there, in the beginning before these things reach the point of no return, often you can defuse or stave off the worst aspects. so it really boils down to three real concepts. access to mental health services. training both of law enforcement on how to access those services. and mental health professionals on how to provide proper specialized services to law

enforcement, and finally support. because, if it's not supported from the top, it ain't going to happen on the bottom. and i think if we can pull these things together again, working out all those pesky little details, we're going to have a powerful tool in helping law enforcement deal with stresses and that's going to prevent a lot of excessive force complaints, violence and other things that do mar what we've called this culture of honor of policing. >> thank you. >> thank you. and my final question something in particular to sergeant orr, so you talked about the crisis in sandy hook elementary, and volunteering time to relieve some of those officers and certainly, a great deal of the conversation in ferguson was about the length of the shift and the frequency with which officers had to be out there on the ground. and the kind of conflict that created between community and officer, and incredibly high stress situation. and so, as both an officer who has had this experience of

relieving officers in crisis and also as a union representative, what is your thinking around policies that would dictate only a certain number of hours actually be worked in these high crisis or mass demonstration situations? and i think to the question that was asked right before mine should that -- should those policies also extend to folks who may be having performance related mental health struggles? right? should they be kind of limited from participating in those kinds of activities. >> that's an interesting point. i think the current model that i've seen in our region is 16 hours is the max you can work. you know truck drivers on the highway have a maximum amount of hours that they can drive or they'll fall asleep. you know police work is similar to that in that you need to be awake and, you know sharp. so 16 hours is the current model model. i think mandating a reduction in that, if there's a performance related issue brings in an

economic element to it. where specifically in our region in suburban -- the suburban areas around new york city, where the cost of living is very high, police officers cannot live on their base salary and overtime is a requirement. if you want to live within a two-hour drive of where we work in fairfield county. so officers regularly work more than their eight hour shift, they welcome it. and if you're going to mandate a reduction in that you're going to put an added stressor on the person in the financial realm. so that needs to be considered there. in responding to sandy hook, and i imagine in other crises around the country like ferguson or what happened down staten island following that you know there's a maximum amount of time we can be out there but sometimes you can't leave. and sometimes that goes for days. and following 9/11 officers

were mandated 12-hour shifts every day, all days off canceled. that was because there was a national security issue and you just couldn't leave. nobody cared about what it did to your brain, and we're seeing that now. but, for public safety reasons, you couldn't leave. so that has to be considered also. in the regular course of policing, the eight-hour shift is enough, and you want to go home after that. and sometimes after seeing what you see, it's tough to go home and have dinner with your family. and as dr. violanti said in discussing what you've done in your workday, you have to relive it. so we're taught to compartmentalize some of the things that we deal with. but being able to open the doors of that compartment and let it out, and let some steam out of the valve before it bursts is really important. but, getting back to your question regarding shift time

maximums, i know the pushback from the guys would be on the economic and financial part, you know, our earning potential can't be limited in that way unless, you know, the performance issue is so great that we're now under a fitness for duty problem. >> i'd like to comment on shift work. i think most departments in the united states are going away from the eight-hour shift and moving to either a 10 or a 12-hour shift. this brings up the issue of fatigue. if you work 12 hours on a midnight shift you really can't make sense of thinking straight. and it's other -- it's very difficult to make decisions. it's very difficult not to get frustrated. and to get irritated by any little thing if you're up for 12 hours doing police work. additionally we found in our research that those who worked midnight shifts have a higher risk of cardiovascular disease and are more affected by stress. so you know that's an issue i

think, that's blossoming now in the united states policing. when you're on a special mission like sandy hook, or a flood, or a hurricane, those situations even get exacerbated worse. so, i don't know how to address this problem, but we do see we need more research on what the best shift is or the length of time that officers should work in a day. >> thank you. >> i was just going to say at least truckers have a national standard about how long they can work. we don't have anything like this in law enforcement. basically it's on the discretion of most departments or most jurisdictions. again, devil in the details. let's work something out that accommodates both the economic needs, the liability needs the health needs, and the realities of shift work and that's something to work towards. developing a national standard so that police officers don't feel that they have to fight for a certain shift level they can simply be told this is the standard, we need to follow it.

>> thank you. we're running short on time so our final question will come from roberto villasenor. >> this is for dr. violanti. i'd like to hear a little bit more about the term the psychological autopsy that you were mentioning. >> oh, sure. a psychological autopsy is basically a retrospective look at the police officer's life. one who performs this would go back and interview relatives friends, look at medical records, basically look at the life of the officer prior to his or her suicide. from that, through close relatives, for example we could ask questions about mental health. we could ask questions about standardized measures. like stress, for example. we could look at medical records. we could go through departments and talk to coworkers. it's a long involved process. but in the end result, we piece this together and we can essentially do a retrospective picture of what this officer was

like prior to his or her suicide. that's very helpful. because if we do many of these we can look for patterns that are prevalent in all police suicides. and psychological autopsies are performed quite frequently on suicide deaths. generally, in the legal profession, to determine whether or not a depth was a suicide, or not. we call them equivocal deaths. i think this would be very useful research to look at to tease out exactly what led the officer to this suicide. >> thank you very much, and thank all the panelists it's been very informative. please join me in thanking them for their testimony today. [ applause ] we're going to take a very brief break, five minutes. just to be able to transition between panels and then we'll resume. thank you.

>> doctor, thank you. appreciate. it was great.

>> now i can hear you perfectly. >> now you can hear me perfectly?

so we're at the one-minute warning. and before we get started let me thank everybody for their patience with our technological glitches. but you know what they say, when you fall off a horse you need to get back up right on it. so we're going to go ahead and straddle that horse again and this time we're going to start off with skype and i think we got it all fixed. so bear with us and i will now turn it over back to the co-chairs to lead us through the next panel. >> good morning, again. our second panel is dealing with the issue of officer safety. and we're going to start out

this panel with dr. alexander eastman, who is a lieutenant and deputy medical director with the dallas police department. and he's participating with us via skype. participating with us via skype. so, welcome dr. eastman and let's go to you via skype. >> thank you very much commissioner ramsey, director robinson, director davis. i want to tell you how much i appreciate the opportunity to present to you all the opportunity today. it's a unique opportunity because i'm coming to you from vacation here in parks city, utah and i have to thank the men and women of the police department for all their support in getting the tech lodgegical aspects sorted out. as its lead medical officer and tepty director for the entire dallas police department. this has been involved in a number of law enforcement operations from operational medicine so guiding chief brown

on our most recent response. in addition to our work with the dallas police department i serve a similar role with the university of texas police. but in addition, i'm a practicing trauma surgeon, board certified in critical care. i serve as the chief of trauma surgery and assistant at texas medical center. i perform direct patient care do research and lead the more than 1,000 employees who participate in the trauma service line at parkland memorial hospital. for the last decade, this has been a very personal and professional cause has been exploiting this unique interface of trauma surgery, public health and law enforcement and i intend to come to you from those three per perspectives this morning. my first recommendation, the stopping of bleeding has to be a core law enforcement skill across the united states. despite improvements in

equipment, tactics and trauma care, law enforcement remains one of our country's most dangerous occupations. over the last decade or so, there has been increasing interest in translating lessons learned from the battlefield into civilian law enforcement. now, it's obvious that we as law enforcement officers are not at war. we're not on the battle feed, but some of the techniques that have been pioneered in iraq and afghanistan can be easily apply applied to law enforcement officers. in fact, some of these techniques translate well into what has become to be known as save our aid programs. from a community policing perspective, there's no finer example of a police department engaging the community when a law enforcement officer aplies his equipment to save the life of a civilian. these kits contain a special operations forces tourniquet, a

modular bandage and a packet of quick combat gauze. in just 14 months police officers have saved 12 lives, including two of our own. in addition, these techniques have been shown to be safe in all police settings and in the campus setting, the university of texas has recently made a similar program mandatory. this is an inexpensive kit that's the ultimate insurance policy to save the life of one of our police officers who's been injured in the line of duty but it can be turned out ward. my second recommendation is is that the lessons learned and that described in a document known as the hartford consensus. it was developed and designed from a group drawn together by the american college of surgeons surgeons, federal bureau of investigations, dhs, fema, the attorney general of the united states emergency college of

emergency physicians and what this described was that these technique techniques are for community safety, so as we teach our police officers how to perform hemorrhage control, how to save each other, we enabled them to turn those skilled outward in the event after a mass casualty event. as a continuing participant, i was pleased to represent the major city chief association in its continuing and ongoing work in that group. in a late 2014 survey of the major city chief association member, 42 of 70 member agencies have implemented some sort of hemorrhage training program and equipped their officers. these 42 programs have trained and equipped nearly 200,000 law enforcement officers and now provide this hemorrhage control coverage to more than 65 million americans in their community. it is an awesome, awesome accomplishment over a very short

period of time and certainly commissioner ram cy is the outgoing president and darrell stevens giving credit to help that push forward. my third recommendation is probably my most important and that is the to develop the ability to track and study law enforcement officer injuries. as a trauma surgeon at a level i trauma center, part of my mission so to further the scientific study of improving the care of the injured patient. we review a vast amount of data in order to make our job better and to make us better at doing it every day. presently, there is no system in the united states to track law enforcement officer injuries. while many may point to the fbi database, the information contained is simply too focused on law enforcement. how far the suspect was from the assailant. was it day, night, were they wearing a bulletproof vest? the database lacks the granular detail we need to give the topic of law enforcement injuries some in depth study. a robust database of this nation

analyzed by medical providers and scientists involved in law enforcement would allow for reck documentations in tactics, training, equipment, medical care and policies and procedures grounded in that interface that i mentioned between scientific evidence, best medical practice and sound policing. our last recommendation involves the institution of a nationwide peer review system to help us when things don't go as planned. when errors are made in medicine the patients offten pay the ultimate price. yet, when this happens, doctor nurses residents sit together having this intensive study in a process known as peer review. the model has been applyied in commercial aviation and several other sectors with great success. in an essay i authored -- that appeared in the publication

american policing in 2022 we described the idea of fine peer review principles to the nation's law enforcement officer officers. arising from this, a national near miss database and reporting system is being deployed by the police foundation. this should help improve officer safety and will help us by fail tog improve our mistakes in a sound, protected fashion. we have to begin to take a hard look and learn from those times when things don't go exactly as planned. we do need some national protection because there needs to be protection from legal discovery on a nationwide level to allow this peer review process to continue. this is what happens in medicine and trust me, if you make a mistake, there's still plenty of malpractice claims that can be brought against you, but it allows for a frank and honest discussion. to summarize, my four recommendations. first, ensure hemorrhage control training and the provision of equipment is required at every

u.s. law enforcement agency. next, brace the recommendations of the hartford consensus as national policy to improve our community's safety from active shooter and intentional mass casualty events. third, develop and implement a database for law enforcement injuries and treatment and finally, facilitate legislative protections to develop a robust program in united states law enforcement. it is a pleasure and a calling to serve both as a law enforcement officer and care giver of law enforcement officers. i am humbled and honored to have been given this opportunity to represent both those groups today. the interface between medicine public health and law enforcement has great potential. not just as a source for many officer safety programs, but to harness those programs and transform them into policing resources. my thanks to commissioner

ramsey, chairwoman robinson and the peer group and for the opportunity to speak to you this morning. >> thank you, doctor. i hope you can stay with us for the question period. our next witness will be jane caster, who is the chief in tampa, florida. thanks for being with us. >> good morning. thank you, commissioner ramsey professor robinson director davis and members of the task force on 21st century policing for allowing me to be a part of this process. i'm the chief of police for the tampa police department. historically, when we talk about reducing the number of officer deaths, we begin with a focus on training, officer safety methods and the equipment we provide the our officers. all of those are necessary elements of safe policing, but i believe they just scrape the surface of the conversation that is needed to make our officers truly safe out on the streets. from where i stand, there are

three key points that as law enforcement leaders, we should focus upon. real time information for officers responding to in progress calls community relationships and officer wellness. with a proliferation of cell phones, information is moving at lightning speed. the effect is that officers are arriving on scene much quicker while the offense is in progress. while this increases the chances of apprehension it also places officers in increasingly dangerous situations. to enhance officer safety, we must put information in our officer's hands at comparative speeds. we've been able to do this at the tampa police department through a software solution we helped develop. it provides officers with real time data on suspects, zone activities, hot spots alerts and bulletins without delay. we also monitor social media for information that may assist responding officers in staying safe as they come upon scenes.