Police officers face high rates of PTSD, depression, and suicide.

Many officers distrust therapists and avoid seeking mental health care.

Therapists need police cultural competence to build trust and improve outcomes.

"Therapists are not your friend and really could care less about you as a person. Never ever talk to them."

"Therapists are not your friend and really could care less about you as a person. Never ever talk to them."

That’s a real quote from a real police officer, cited by psychiatrist Kristopher Kaliebe in a recent article in Open Inquiry in Mental Health. It's an overgeneralization to be sure, but Kaliebe argues it reflects something the mental health field needs to address: the significant trust gap between law enforcement officers and the therapists who are supposed to help them.

The numbers make this need clear. Police officers face elevated rates of posttraumatic stress disorder (PTSD), depression, anxiety, and substance use compared to the general population. For instance, in a single big-city department, 26 percent of officers screened positive for at least one serious mental health condition (such as depression, anxiety, PTSD, or suicidal ideation). Police officers are routinely exposed to traumatic events, whether it be violence, death, child abuse, or the like—all while managing organizational stress, regular shift work, sleep disruption, and relentless public scrutiny. The result is that more officers die by suicide each year than in the line of duty.

Yet, despite these numbers, remarkably few officers ever seek treatment. For example, Jetelina and colleagues found that only about 10 percent........

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