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#12 - Suicide et POLICIERS - 11 avril 2012

Nous les croisons à tous les jours, ces hommes et femmes en uniforme, patrouillant les rues de la ville ou les routes de campagne, intervenant pour résoudre des crises de toute sorte et de toute envergure, pour maintenir la paix ou pour appliquer la loi. Les policiers font partie de notre quotidien. Outre la perception populaire d’hommes et de femmes fortes, que savons-nous sur ce qu’ils vivent émotionnellement, sur leur culture organisationnelle, sur leurs façons de concilier leur travail avec leur famille, les situations de stress auxquelles ils font face comme premiers répondants et qui entraînent parfois au stress-post-traumatique et au suicide? Les policiers dans certaines villes sont plus à risque de suicide (ce qui n’est pas le cas à Montréal). Dans cette liste, nous avons les nouvelles recherches sur le suicide et les policiers, les facteurs de risque ainsi que les programmes de prévention. D’ailleurs, le Professeur Brian Mishara, directeur du CRISE, et le psychologue Normand Martin du Service de police de la Ville de Montréal viennent de publier un article sur l’évaluation d’un programme de prévention mis en place à la SPVM qui a eu un impact impressionnant de diminution des suicides des policiers.

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Mishara, Brian L., & Martin, Normand. (2012). Effects of a Comprehensive Police Suicide Prevention Program , Crisis. (disponible en-ligne / available online)
Résumé: Police suicides are an important problem, and many police forces have high rates. Montreal police suicide rates were slightly higher than other Quebec police rates in the 11 years before the program began (30.5/100,000 per year vs. 26.0/100,000). Aims: To evaluate Together for Life, a suicide prevention program for the Montreal police. Methods: All 4,178 members of the Montreal police participated. The program involved training for all officers, supervisors, and union representatives as well as establishing a volunteer helpline and a publicity campaign. Outcome measures included suicide rates, pre-post assessments of learning, focus groups, interviews, and follow-up of supervisors. Results: In the 12 years since the program began the suicide rate decreased by 79% (6.4/100,000), while other Quebec police rates had a nonsignificant (11%) increase (29.0/100,000). Also, knowledge increased, supervisors engaged in effective interventions, and the activities were highly appreciated. Limitations: Possibly some unidentified factors unrelated to the program could have influenced the observed changes. Conclusions: The decrease in suicides appears to be related to this program since suicide rates for comparable populations did not decrease and there were no major changes in functioning, training, or recruitment to explain the differences. Comprehensive suicide prevention programs tailored to the work environment may significantly impact suicide rates.

Descôteaux, J. (2010).
Programme de prévention du suicide du SPVM: Les policiers en crise outillés pour choisir la vie. Psychologie Québec, 27(1), 34-35.
Résumé: Entrevue avec le Dr Normand Martin, psychologue responsable du Programme d'aide pour les policiers et policières et du Programme de prévention du suicide au Service de police de la Ville de Montréal.
http://www.ordrepsy.qc.ca/pdf/Psy_Qc_vol_27_no1_Janvier2010.pdf

Commission de la santé et de la sécurité au travail (CSST). (2011) Prix innovation en santé et sécurité du travail: Service de police de la ville de Montréal. Podcast accessible à
http://www.csst.qc.ca/asp/innovation/2011/Montreal/SPVM.wmv.

Martin, Normand. (2011). Intervenir en milieu policier:  Enjeux et défis au niveau de l'intervention et de la prévention. Présentation faite au Colloque sur l’intervention et la prévention en dépendance et en santé mentale, Québec.
Résumé:Cette présentation a pour objectifs de cerner les enjeux de l’intervention psychologique en milieu policier, d'identifier les facteurs risques psychosociaux auprès d’une population en uniforme et de présenter un exemple d’une approche préventive qui a permis de réduire l’incidence des décès par suicide chez les policiers.
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Martin, M. (2010). Facteurs prévisionnels du développement de l'état de stress post-traumatique à la suite d'un événement traumatique chez les policiers. Université du Québec à Montréal, Montréal.
Résumé:Les événements traumatiques (ÉT) peuvent susciter des séquelles psychologiques importantes pour les individus qui en sont victimes, comme un état de stress post-traumatique (ÉSPT). Les policiers représentent une population à risque d'être exposée à des ÉT dans le cadre de leur travail et sont donc susceptibles de développer un ÉSPT. Ce trouble peut amener des répercussions considérables sur le fonctionnement psychosocial, la qualité de vie des individus qui en souffrent, entraîner une interférence marquée au niveau du travail et peut conduire à des coûts sociaux exorbitants. Ainsi, après l'exposition à un ÉT, il importe de pouvoir distinguer les facteurs qui influencent le développement et le maintien de réactions post-traumatiques (facteurs de risque) de ceux qui favorisent un retour plus rapide à une vie normale en prévenant l'apparition de symptômes post-traumatiques ou en atténuant leur intensité (facteurs de protection). L'identification des prédicteurs de l'ÉSPT chez une population policière s'avère primordiale et permettra de développer ultérieurement des stratégies de prévention et d'intervention efficaces. Le chapitre I présente une recension des principaux facteurs prévisionnels pouvant influencer l'ÉSPT dans la population générale et chez les policiers. Le chapitre II comprend un article empirique qui porte sur les facteurs de risque et de protection qui prédisent les réactions post-traumatiques chez une population de policiers. Le chapitre III dévoile les résultats d'un deuxième article empirique qui examine l'impact de l'exposition à un ÉT et l'impact d'un ÉSPT chez les policiers. Finalement, le chapitre IV présente une discussion générale et une analyse critique des résultats obtenus dans les deux articles empiriques tout en exposant des considérations méthodologiques, des pistes de recherche futures et des implications cliniques.
http://www.archipel.uqam.ca/3195/

Marchand, A., Boyer, R., Martin, M., & Nadeau, C. (2010). Facteurs prévisionnels du développement de l’état de stress post-traumatique à la suite d’un événement traumatique chez les policiers - Volet rétrospectif.
Résumé:Étant fréquemment exposés à des événements traumatisants, certains policiers sont sujets à développer un état de stress post-traumatique (ESPT). Cette étude évaluera les facteurs de risque ainsi que les facteurs de protection qui facilitent l'adaptation de ces travailleurs à la suite de leur implication dans de tels événements. Elle permettra de formuler des recommandations grâce auxquelles le milieu concerné pourra élaborer des stratégies de prévention, d'évaluation et d'intervention pour diminuer les effets négatifs des facteurs de risque et pour favoriser le développement de mécanismes de protection chez les policiers. Ces recommandations pourront ensuite avoir des retombées dans d'autres milieux où les travailleurs, notamment les soldats, les pompiers, les secouristes et les ambulanciers, sont également susceptibles d'être exposés à des événements traumatiques récurrents.
http://www.irsst.qc.ca/-publication-irsst-facteurs-previsionnels-du-developpement-de-l-etat-de-stress-post-traumatique-a-la-suite-d-un-evenement-traumatique-chez-les-policiers-volet-r-633.html

Marchand, A., Boyer, R., Nadeau, C., & Martin, M. (2011). Facteurs prévisionnels du développement de l’état de stress post-traumatique à la suite d’un événement traumatique chez les policiers : volet prospectif.
Résumé:  Quatre-vingt-trois policiers du Service de Police de la Ville de Montréal (SPVM) et d'autres corps policiers ont pris part, sur une base volontaire, à l'étude prospective à mesures répétées (devis quasi-expérimental). Ils ont tous été impliqués dans un événement majeur entre les mois de mai 2006 et mai 2010. Ils ont été évalués en moyenne entre 5 et 15 jours, 1 mois, 3 mois et 12 mois après l'événement
Les résultats de l'étude prospective démontrent que 3 % des policiers ont souffert d'un ÉSPT clinique, alors que 9 % ont vécu un ÉSTP partiel. Par contre, les données provenant de l'étude rétrospective montrent que 7,6 % des policiers de l'échantillon ont souffert d'un ÉSPT clinique, alors que 6,8 % ont éprouvé un ÉSPT partiel. Au niveau du volet prospectif, les résultats des analyses de régression indiquent que les facteurs de risque au niveau posttraumatique (c.-à-d., les symptômes d'état de stress aigu (ÉSA) et de la dépression) sont les prédicteurs les plus saillants. Les facteurs de risque pré-traumatiques (la stratégie de gestion du stress au niveau émotionnel) et péri-traumatiques (la détresse péri-traumatique et la dissociation) sont moins proéminents, mais demeurent néanmoins des facteurs de risque significatifs. Nous n'avons pas observé de facteurs de protection associés négativement avec les symptômes de l'ÉSPT. Les policiers conseillent à leurs confrères qui vivent un tel événement d'en parler, de consulter un psychologue et sont eux-mêmes ouverts en majorité à l'idée de recevoir un tel service si besoin est.
http://www.irsst.qc.ca/-publication-irsst-facteurs-previsionnels-developpement-etat-stress-post-traumatique-suite-evenement-traumatique-policiers-volet-prospectif-r-710.html

Violanti, J. M., O'hara, A. F., & Tate, T. T. (2011).
On the Edge: Recent Perspectives on Police Suicide. Springfield, Illinois, US: Charles C Thomas Publisher, Ltd.
 Résumé: In this book, the authors extend their academic research and knowledge on the subject to a national level. Two of the authors, who have personally dealt with the aftermath of suicide, add a realistic description of what it is like to be “on the edge.” Andy O'Hara, who survived his near suicide and describes the feelings and pain he felt during that crisis period, and Teresa Tate, whose husband died by suicide, will add immeasurably to the understanding of this problem. Chapter One discusses police suicide rates and the ongoing controversy that surrounds this area of research. In Chapter Two, the authors describe two in-depth analyses of national police suicide rates. Chapter Three is based on a conceptual model of the career span of a police officer and trauma within that span that may exacerbate conditions for suicide. Chapter Four presents a discussion of factors that may help to protect police officers from suicide. In Chapter Five, Andy O'Hara discusses his own journey to the edge and how such decisions may come about in police officers. In Chapter Six, Andy O'Hara presents a description of his newly developed program, “Badge of Life,” which seeks to “depower” police trauma and, instead, “empower” the officer. In doing so, they will be prepared not only for stress but for trauma before it occurs and know what to do when it does. In Chapter Seven, the aftereffects of suicide are explored and how police support can help to ameliorate psychological distress and trauma associated with an officer’s death. Teresa Tate, founder and leader of the survivor group S.O.L.E.S. (Survivors of Law Enforcement Suicide), presents actual cases of police survivors derived from her personal interviews with these survivors. In the final chapter, the authors conclude with a description and critical analysis of present programs for police suicide prevention. Law enforcement practitioners, researchers and therapists, as well as police organizational policymakers, will benefit from the discussions presented in this book.  [Tiré de la quatrième de couverture]
 Leenaars, A. A. (2010). Suicide and Homicide-Suicide Among Police. Amityville, NY, US: Baywood Publishing Company, Inc.
Résumé: This book, for the first time, investigates in evidence-based detail the probable epidemic, not approached since the great pandemic of the 1930s, of suicide and homicide-suicide among police.  The book answers many questions. Are the rates of suicide and homicide-suicide among police really high? Are suicide and homicide interwoven? What factors in a multidimensional array—such as emotional disorders, work-related trauma, domestic violence, and alcoholism—cause needless deaths? Many questions are answered, and the means of investigation, the "psychological autopsies," are outlined for the police officer and forensic researcher alike. The book examines more: Does the availability of a gun increase risk? What can be done to prevent the tragedies? What works? The whole book is, in fact, a treatise on prevention. Indeed, it is highly focused on intervention, but also on services for survivors, or "postvention." What help do fellow officers, family, and community need? Why are there barriers—"blue walls"—obstructing efforts at prevention? Why are investigations not allowed, or halted or dissembled? What policies and procedures have been proven, for about 100 years, to be effective, but rarely implemented? This book answers many questions and raises new ones. Rich in individual case investigations and general forensic research, the book attempts to be mindful of the needs of officers on the street, mental health providers, administrators of police services, forensic investigators, officers and specialists alike, and traumatized survivors of the horror. [Tiré du site web de l'éditeur]  

Violanti, J. M. (2010). Suicide or undetermined? A national assessment of police suicide death classification. International Journal of Emergency Mental Health, 12(2), 89-94.
Résumé: The validity of police suicide rates is questionable. The objective of this paper is to compare national police suicide rates with "undetermined" death rates and compare across occupations similar in exposure. An additional objective is to compare police suicide and undetermined rates in female and minority officers. Results indicated that male police officer deaths had a 17% increased risk of being misclassified as undetermined. The risk was higher than both firefighter and military occupations. A high risk of misclassification was also seen in female and African American officer deaths. The significantly higher ratio of police deaths classified as undetermined is interesting, given the high profile of law enforcement in society and the generally thorough investigations of police officer deaths. Also of interest is the suggestion that police misclassification risk is higher for police than other similar occupations. Future research should suggest possible ways to increase the validity of police suicide rates through methods such as post-suicide psychological autopsies.


Larned, J. G. (2010). Understanding police suicide. Forensic Examiner, 19(3), 64-71.
Résumé: The focus of this paper is to examine and help further the understanding of police suicide. The primary goal is to make law enforcement officers, their families, and the community they serve more cognizant of the stressors encountered on the job, from the patrolman on the streets to the executives in the offices. To that end, personal, community, and organizational issues involving law enforcement stress as it affects police officer suicide will be examined. Through this paper, you will be able to understand the body's reaction to stress, identify the mental and physical factors of stress, and recognize the external and internal stressors that could lead to suicide within law enforcement agencies and the communities they serve.
http://findarticles.com/p/articles/mi_go1613/is_3_19/ai_n56199663/?tag=mantle_skin;content
Kapusta, N. D., Voracek, M., Etzersdorfer, E., Niederkrotenthaler, T., Dervic, K., Plener, P. L., et al. (2010). Characteristics of police officer suicides in the Federal Austrian Police Corps. Crisis, 31(5), 265-271.
Résumé: Background: Suicide rates among police officers may be high because of strong occupational stressors. Aims: This study examined the suicide rate and suicide characteristics among police officers in the Federal Austrian Police Force. Methods: All suicides among policemen during the period 1996–2006 were analyzed retrospectively on the basis of personalized police record files from all Austrian police departments. Information on sex, age, marital status, children, region, method and place of suicide, suicide notes, position, and length of service was extracted from these files. The general Austrian population, adjusted for sex and age composition, served as the comparison group. Results: The suicide rate among male police officers was 30.2/100,000, which was comparable to the suicide rate in the adjusted general population (30.5/100,000). The female police officer suicide rate was 1.8/100,000, while the corresponding suicide rate of the adjusted female general population was 12.5/100,000. Firearms were the most frequent suicide method (77.8%), and the incidence of suicide notes was 30.8%. Conclusions: Suicide rates among police officers seem comparable to those of the age-adjusted general population. Given the healthy-worker effect, these results still suggest an increased risk of suicide among police officers. These findings should stimulate further research on stressors and risk factors for suicide among officers and should also encourage departments to increase awareness regarding suicidal signs among officers.
http://dx.doi.org/10.1027/0227-5910/a000033

Violanti, J. M. (2010). Police suicide: a national comparison with fire-fighter and military personnel. Policing: An International Journal of Police Strategies & Management, 33(2), 270-286.
Résumé: Purpose – The objectives of this paper are to examine national police suicide rates, to compare police suicides with fire-fighters and military personnel, and to examine suicide in women and minority officers.  Design/methodology/approach – The National Occupational Mortality Surveillance (NOMS) (1984-1998) was used as a data source. Descriptive statistics and proportionate mortality ratios (PMRs) were calculated.  Findings – Overall, the police suicide rate was four times that of fire-fighters. Minority officers had 4.5 times and police women 12 times the number of suicides than did fire-fighters. Police suicides outnumbered homicides by 2.36 times. Police had significantly higher than expected PMRs for suicide.  Research limitations/implications – NOMS data are presently available up to 1998, and data in the study are descriptive only. Although suggestive of risk, statistically significantly elevated PMRs cannot be interpreted directly as indicating a causal relationship between police work and suicide. Confounders are not recorded in NOMS and may lend considerable weight to suicide.  Practical implications – The paper reflects the need to look deeper into police suicides and their root causes. Police organizations are advised to initiate suicide awareness training and psychological assistance to officers.  Originality/value – The paper is among the first nationally to compare suicide among similar hazardous occupations, suggesting the need for prevention.
http://dx.doi.org/10.1108/13639511011044885

Koch, B. J. (2010). The psychological impact on police officers of being first responders to completed suicides. Journal of Police and Criminal Psychology, 25(2), 90-98.
Résumé: When a suicide is completed, police officers are often among the first responders. Little attention has been paid to the emotional and psychological impact on the police officer in this specific situation. This study examines the effects encounters with completed suicides have on the emotional and psychological well-being of the police officer. This is a qualitative study, which intends to bring alive the feelings, thoughts, actions, choices, and challenges of police officers who have encountered completed suicides as imparted through participants' stories. Interviews were done with eight police officers. In addition, interviews were done with a coroner, a police chaplain, and a police psychologist to add some unique perspectives to the police officers’ experiences of encountering completed suicides. Interviews were done in a semi-structured, focused format involving an ongoing fine-tuning of questions. The overarching finding reveals the central role played by police culture in shaping how police officers come to perceive this experience, and how they subsequently choose to mediate it. This study identifies ten strategies police officers use to mediate this experience, and discusses the possible psychological consequences of employing each strategy.
http://dx.doi.org/10.1007/s11896-010-9070-y

Levenson, R. L., Jr., O'Hara, A. F., & Clark, R., Sr. (2010). The Badge of Life Psychological Survival for Police Officers Program. International Journal of Emergency Mental Health, 12(2), 95-101.
Résumé: Worldwide, there is no more consistently stressful job than that of the police officer. In the United States, police officers are more likely to die by suicide than by any type of crime or criminal activity. This article discusses the Badge of Life Psychological Survival for Police Officers Program (BOL), founded in 2008, with the goal of developing an effective police officer suicide primary and secondary prevention program. Such a program is not a regular entity within the majority of accredited law enforcement agencies. Along with standard suicide prevention protocols typically used in other programs, an Emotional Self-Care Program (ESC) was designed to focus on the officer's ability and responsibility to care for his own emotional well-being. The model relies on teaching the factor of resilience as a significant component of stress-resistance. Selected for their credibility and trust level, peer support officers conduct the actual annual training workshops, set the example, and encourage involvement at all levels. A "cradle-to-the-grave" program (i.e., rookies to retirees), ESC calls upon departments to begin teaching their personnel about the effects of job-related stress and trauma while they are still in the academy, emphasizing the importance of voluntary, confidential "annual mental health checks. " Representatives of BOL now lecture regularly across the United States and Canada. All consultations, lectures, educational and training workshops, services, and referrals are free, as are original training materials developed and approved by the BOL Board of Directors.


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Les opinions exprimées dans ces documents sont celles des auteurs et elles ne représentent pas nécessairement celles des membres du CRISE. Ces titres sont fournis à titre informatif seulement et cette liste ne se veut pas être exhaustive. Le CRISE ne se tient aucunement responsable de l'utilisation de l'information contenue à l'intérieur de ces documents.

 
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