Silent Struggles: Traumatic Brain Injuries and Mental Health in Law Enforcement

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Abstract

Objective: To determine the prevalence of head injuries (HIs), posttraumatic stress disorder (PTSD), and depressive symptoms in law enforcement officers (LEOs) and (2) the association between HIs and psychological health conditions. Setting: County-level survey administered via Research Electronic Data Capture. Participants: A total of 381 LEOs completed the survey (age = 43 ± 11 years; 40 [11%] females; time as LEO = 1-50 years, median = 15 years). Design: Cross-sectional study. Main Measures: We examined the prevalence of HIs (the Ohio State University Traumatic Brain Injury Identification Method), PTSD (PTSD Checklist - Civilian [PCL-C]), and depressive symptoms (Patient Health Questionnaire-9 [PHQ-9]). We used Mann-Whitney U and chi-square analyses to compare PTSD and depressive symptoms between those with and without a HI history. Results: There were 282 (74%) participants who reported a lifetime history of 1 or more HIs; 116 (30%) sustained 1 or more HIs on the job. PCL-C scores ranged 17 to 85 (median = 27); 33 (10%) participants met or exceeded the clinical cutoff score of 50 to indicate a positive PTSD screening. Participants with a HI history (median = 29) had higher PCL-C scores than those with no HI history (median = 24; P

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Caccese, J. B., Smith, C. R., Edwards, N. A., Emerson, A. M., Le Flao, E., Wing, J. J., … Onate, J. A. (2025). Silent Struggles: Traumatic Brain Injuries and Mental Health in Law Enforcement. Journal of Head Trauma Rehabilitation, 40(3), E185–E195. https://doi.org/10.1097/HTR.0000000000000986

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