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Developing, Implementing and Evaluating a Mental Health Training Program for Police Officers Open Access


Other title
Mental Health
Law Enforcement
Type of item
Degree grantor
University of Alberta
Author or creator
Krameddine, Yasmeen I
Supervisor and department
Reay, Patricia (Strategic Management and Organization)
Silverstone, Peter (Psychiatry)
Examining committee member and department
Reay, Patricia (Strategic Management and Organization)
Ogloff, James (Forensic Behavioural Science)
Silverstone, Peter (Psychiatry)
Balachandra, Krishna (Psychiatry)
Greenshaw, Andrew (Psychiatry)
Department of Psychiatry

Date accepted
Graduation date
Doctor of Philosophy
Degree level
Interactions between police and individuals suffering from mental illness are very frequent. Police forces are regularly first responders to those with mental illness. Unfortunately, on occasion interactions are violent and sometimes fatal. Despite this, training police how to best interact with individuals who have a mental illness is poorly studied. The research in this thesis primarily examines a newly developed training program, which used professional actors in a role-play based training approach. Training was a one-day, 8-hour session, with feedback from senior officers, mental health specialists and actors. Latter feedback enforced how the officer can best approach and speak to individuals when they interact. Explicit goals were to improve officer empathy, communication skills, and ability to de-escalate stressful situations. This unique training program led to improvements in police officer behaviour which were still present 6-months after completion. More specifically, after training officers had (1) more confidence (23%) in interacting with those suffering from mental illness; (2) demonstrated behavioural improvements in empathy, communication and de-escalation strategies (determined by their supervising sergeant); (3) increased their ability to recognize mental illness, shown through increases in mental health call numbers as well as (4) increased efficiency in the time it required officers to begin and finish a mental health call. These changes led to cost savings of over $80,000 over 6 months. In contrast to changes in behaviour, attitudes did not change 6-months after training. We then conducted a 2.5 year follow up of police attitudes in officers who took training and found that officer confidence continued to increase up to 2.5 years after training (32%), however, longitudinal changes in attitudes were mixed with the majority of attitudes not changing. These findings illustrate that the link between attitudes and behaviours is complex, and one that requires further research to fully explain. Another topic of study was how demographic factors affected police attitudes. Initially older officers had increased stigma towards the mentally ill, but after training this changed with younger officers exhibiting higher levels of stigma. In keeping with studies from a range of other areas, female officers were found to show decreases in authoritarian attitudes, and increases in compassion and empathy towards those with mental illness when compared to their male colleagues. In regards to officer location, officers in high crime areas, namely North and Downtown Division were found to have increases in social distance towards individuals with depression compared to Southeast Division (lower crime area). Of importance, North Division officers who received the mental health training had stronger attitudes of compassion and empathy towards individuals suffering from mental illness compared to those that did not take part in the mental health training. This latter finding is supportive of the overall success of this training program, and implies the existence of subtle factors that influence attitudes. The final research piece examined attitudes of the homeless community in Edmonton, since they have frequent interactions with police. Homeless members were surveyed to determine how police interactions affected their attitudes towards police. Interestingly, individuals arrested or handcuffed had significantly greater negative views towards police than if they were not arrested or handcuffed. This novel finding may allow police policy to change in this population. Additionally, it was clear that many individuals in the homeless population do not believe police treat them with an appropriate level of fairness and respect. These findings allow us to conclude that more training is necessary for police officers in this area. Key findings for future police training relate to the benefits of training utilizing realistic “hands-on” scenarios, focusing primarily on verbal and non-verbal communication, increasing empathy, and de-escalation strategies. We recommend organizations provide training that is properly measured for effectiveness and urge training to focus on changing behaviours and not attitudes, because there is little evidence to demonstrate that changing attitudes relates directly to positive behavioural changes. Lastly, we believe that mental health training programs need to be implemented on a repeated basis over the longer-term to maximize its impacts. It is likely that a training program given on a single occasion is not sufficient to improve interactions over the career of a police officer. Future police training needs to address these issues.
This thesis is made available by the University of Alberta Libraries with permission of the copyright owner solely for the purpose of private, scholarly or scientific research. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.
Citation for previous publication
Krameddine, Y. I., Demarco, D., Hassel, R., & Silverstone, P. H. (2013). A Novel Training Program for Police Officers that Improves Interactions with Mentally Ill Individuals and is Cost-Effective. Frontiers in Psychiatry, 4, 9.Krameddine, Y. I., & Silverstone, P. H. (2014). How to improve interactions between police and the mentally ill. Frontiers in Psychiatry, 5, 186.Krameddine, Y. I., & Silverstone, P. H. (2014b). Police use of handcuffs in the homeless population leads to long-term negative attitudes within this group. Submitted for publication June 2014 to International Journal of Law and Psychiatry.Silverstone, P. H., Krameddine, Y. I., DeMarco, D., & Hassel, R. (2013). A novel approach to training police officers to interact with individuals who may have a psychiatric disorder. The journal of the American Academy of Psychiatry and the Law, 41, 344-355.

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