The police suicide problem

Being a cop is a dangerous job -- and not just for the obvious reasons. Suicide kills more officers every year than homicides or accidents at work. But what does society owe the families of those for whom this high-stress job is too much to take? One widow answers: respect.

The whole family Trooper Paul McCarthy with his wife, Janice, and their children. In police culture, says trooper-turned-academic John Violanti, suicide is considered a "coward's way out," and line-of-duty benefits are only for "heroic" deaths. (Photograph from the McCarthy family)

By Julia Dahl

January 24, 2010

http://www.boston.com/bostonglobe/magazine/articles/2010/01/24/the_police_suicide_problem/

Early on the afternoon of July 28, 2006, Captain Paul McCarthy of the Massachusetts State Police put on his blue trooper uniform, holstered his gun, and got into the driver’s seat of his police cruiser. McCarthy was despondent, exhausted from 13 years of physical and emotional pain. It all began on an overtime shift back in 1993: a snowy March midnight when a man driving a stolen MBTA bus bulldozed his cruiser, crushing his legs and trapping him inside the vehicle. After that came the surgeries and months spent learning to walk again. He fought hard and, defying doctors’ predictions, after a year and a half made it back to active duty in the only job he’d ever wanted.

But things hadn’t worked out as he’d hoped. First there were nightmares and flashbacks. Then constant, grating agitation and anxiety, sensitivity to noise, and bursts of temper that left his wife, Janice, and their three small children frightened and confused.

Paul McCarthy began stuttering and picking fights at work. He was diagnosed in 1994 with post-traumatic stress disorder, and for years, Janice says, she begged her husband to quit. She nursed him through three more on-the-job injuries and shouldered most of the work of raising their children while he kept passing promotion exams and sinking deeper into mental illness. His supervisors made a record of his “bizarre” behavior, and in 2001 Paul was suspended, Janice says, and had his gun confiscated while he underwent yet another psychiatric evaluation. A department doctor wrote then that while Paul was “technically fit” for duty, “it is more likely than not that he will deteriorate when he returns to his former setting.” Still, he was cleared for duty, given his gun, and sent back to work.

In 2005, Paul lost the kids’ college money -- half of the settlement from his accident -- in the stock market, Janice says, and for her that was the last straw. At Christmas, they separated.

Paul McCarthy loved his wife, he confided in a friend, but the independent, fun-loving girl he had met in 1982 didn’t seem to be on his side anymore. He moved to a small condo near the family’s Andover home. Things at work were deteriorating, too. In June 2006, he poured his frustrations into a rambling eight-page letter of complaint to the state Equal Employment Opportunity Commission, writing: “The Massachusetts State police do not recognize Post Traumatic Stress Disorder as an issue that affects the employees of the Mass State Police.”

It was all too much. On the last Friday of July, Janice and the kids were visiting family in Saratoga Springs, New York, when McCarthy stepped out of his apartment and got into his cruiser. At 6:30 p.m., he pulled up to a construction site in Canton at the junction of Route 128 and Interstate 95. A surveillance camera caught the last hour of his life: A passing thunderstorm roared through, then Paul got out of his cruiser and paced. At 7:30 p.m., he pulled out his gun and shot two rounds into a mound of dirt. Moments later, he turned the barrel around and fired a single shot into his chest. He was 41 years old.

* * *

Janice and the children learned of Paul’s death two days later when his body was found. They had watched Paul deteriorate for years, but his suicide was a shock. After the funeral, Janice says, her devastation turned to anger. “I have three children who need validation from someone other than their mother that this had nothing to do with them,” she said early last month when I visited her at her home in Andover. “This wasn’t because Chris didn’t stay with him that weekend, and it wasn’t because Shannon left her toys on the floor. I need someone else to stand up and say, ‘This goes way back.’ ”

Janice took her case to the state retirement board, and in June 2007 her husband’s death was ruled “accidental.” The decision meant she would collect 72 percent of his pension (an “in the line of duty” death would have meant 100 percent and an additional one-time payment of nearly $100,000), but more important, it drew a line connecting his on-the-job injuries to his suicide, opening the door for what Janice McCarthy really wants -- her husband’s death to be ruled “line of duty” and his name added to the National Law Enforcement Officers Memorial in Washington, D.C.

The retirement board’s decision in Paul McCarthy’s case reflects a national shift toward recognizing the physical and emotional toll of police work. In 2003, Congress passed a law expanding federal line-of-duty benefits to include the families of police officers and other first responders who die due to heart attacks or strokes. The new law, called the Hometown Heroes Survivors Benefits Act, went into effect on September 11, 2006, and essentially acknowledges that the stress of policing can kill. Janice McCarthy wants lawmakers to take that logic one step further and say that if police work can cause enough internal turmoil to make your heart give out, it can also drive you to suicide.

But it won’t be easy. The legal precedent linking suicide directly to on-the-job trauma is thin, at best. Back in 1978, the Massachusetts Industrial Accident Board found a causal connection between a work-related incident and the subsequent suicide of an officer at the Billerica House of Correction. More recently, Pamela Yanco, the widow of a Wellesley police officer who killed himself in 1992, tried to get the same recognition Janice wants for her husband. In 2001, the state Appeals Court rejected Yanco’s argument that her husband’s death was the result of an on-the-job personal injury -- namely, a false accusation of improper conduct -- ruling that the law “prohibits the payment of benefits to the dependents of an officer who intentionally brings about his or her own death.”

Workers’ compensation law, says Susan Stefan, an attorney with the Center for Public Representation in Newton and an expert in mental disability law, generally doesn’t compensate people for emotional harm that isn’t accompanied by physical injury. But in 2008, she says, an amendment to the Americans with Disability Act broadened the definition of “disability” to include mental impairment. Still, Stefan points out that American society is struggling with how to treat psychological injuries suffered by those in public service: “This is a culture where the president of the United States has to spend time trying to decide whether families of soldiers who commit suicide get condolence notes.”

Janice McCarthy has strong allies, however. State Representative Christopher Fallon learned of the case two years ago through Janice’s uncle, Ken Coye, who recently retired as chief of police in Malden. Moved by her story, Fallon helped her prepare her case to present to the state retirement board, and has since introduced a bill that would make it easier for an officer to receive disability benefits for a psychological illness. In May of 2009, news of McCarthy’s quest reached Andy O’Hara, a former California highway patrolman and the founder of Badge of Life, a national advocacy group devoted to improving mental health training for law enforcement officers. The two began talking, and in December O’Hara and his colleagues established a working definition of line-of-duty suicide: “any police officer suicide in which work-related psychological trauma is a precipitant or significant contributor to the act of suicide.” To determine whether an officer suicide fits this definition, O’Hara suggests that outside mental health professionals conduct what’s called a “psychological autopsy,” collecting information through interviews with family and friends of the deceased and a review of his or her medical and job history.

O’Hara’s group is one of several like-minded organizations advocating for police mental health services. The National Police Suicide Foundation was begun in 1997 by a former Baltimore police officer and chaplain who lost a co-worker to suicide. In 1995, Teresa Tate of Cape Coral, Florida -- whose officer husband had taken his life in 1989 -- formed Survivors of Law Enforcement Suicide. Both groups are working to persuade departments across the country to add suicide prevention programs and awareness training for officers and to adopt more compassionate protocols for how to treat surviving families.

* * *

One of the biggest problems these organizations face is a lack of data about officer suicide. No federal office counts or keeps track of officer suicides, but according to an academic study published in the International Journal of Emergency Mental Health last year, at least 141 US police officers committed suicide in 2008, more than three times the number killed in homicides and twice the number who died in on-the-job accidents. The National Police Suicide Foundation, which also counts retired and corrections officers as well as police from some Native American forces, puts the number higher, at 300 to 400 per year. John Violanti, a former New York trooper who is now a professor of social and preventative medicine at the State University of New York at Buffalo, coauthored the journal study with Badge of Life’s O’Hara. Violanti has been researching officer suicide since 1986, when he and a group of colleagues examined the deaths of Buffalo law enforcement officers between 1950 and 1980 and found that the suicide rate among police officers was three times that of other municipal workers. “That raised our eyebrows,” he says.

Other academics have made similar discoveries. In 1999, a study published in the Archives of General Psychiatry found that male police officers are more than twice as likely as the general population to suffer from depression, and that nearly a quarter of male and female officers have thoughts of suicide, compared with just 13 percent of the general population.

“Cops don’t lead a healthy life,” says Kevin Gilmartin, a retired police officer and clinical psychologist in Portland, Oregon, who studies and consults on law enforcement. Gilmartin points out that the constant vigilance and repeated exposure to bodily harm that are hallmarks of a police career don’t just impact physical health, but mental and emotional health as well. In his 2002 book Emotional Survival for Law Enforcement, Gilmartin was damning, writing that police departments “appear to be fatally losing the battle of emotional survival.”

There is evidence, however, that departments take the problem seriously. The International Association of Chiefs of Police recently produced a CD-ROM to help members around the globe create suicide prevention programs. And Mike Haley, who heads the Fraternal Order of Police’s Critical Incident Program, travels the country to teach peer counseling and encourage departments to add more training programs, especially to prepare rookie officers for the traumas they’ll face. “Even a short period of time in this profession will change your life,” says Haley. Every day, he explains, officers witness the carnage of car accidents, domestic violence, homicides, rapes, overdoses. No one calls the police with good news; officers are screamed at, threatened, and insulted constantly. Most officers don’t talk about the pain this causes, he says, “and it just begins to fester like a sore.”

But can police work cause suicide? Perhaps.

Most of the police mental health workers I spoke with thought the idea of a “line-of-duty suicide” was intriguing, but they weren’t exactly ready to sign on to a new classification. Gilmartin says he think it could create a victim mentality, and Dr. Audrey Honig, who is a former chair of the international chiefs’ association’s Psychological Services Section, says she thinks the better tack would be to lobby for recognition of some suicides within existing line-of-duty classifications. Bill Genet, a former New York City police officer who created a confidential peer counseling program, sighs wistfully at the notion: “If they can do it, God bless ’em.”

Almost no one seems to think that there is much chance of getting the federal government to alter line-of-duty qualification rules any time soon. Partly, it’s a financial issue; more line-of-duty deaths would mean bigger payouts to surviving families. And then there’s the stigma of suicide. Violanti says that in police culture it’s considered a “coward’s way out,” and line-of-duty benefits are reserved for “heroic” deaths.

* * *

After Paul’s death, Janice McCarthy and her children moved out of the big house they’d built with some of the settlement from the 1993 accident. Paul’s life insurance did pay out in the case of suicide, so when the McCarthys downsized, they were able to remain quite comfortable in a two-story Colonial with a cozy side porch and a three-car garage, still in Andover, which is where I visited them last month.

Janice is a vibrant woman of 46. She has short blond hair and an athletic body. Part of the way she copes with the grief is by creating routines that she thinks are healthy. She gets up before dawn and has her coffee, and four days a week she runs 10 miles. On the other days, she goes to the gym. She says that exercising is when she does her best thinking. And over these last 16 years, Janice has had a lot to think about. She brought Paul home from the hospital just before her 30th birthday. “I remember thinking, ‘Wow, I wonder what most people do on their 30th birthdays? Not this.’ ” After the troopers helped him out of the car, someone offered to build a ramp so Paul could get his wheelchair into the house. Her husband said there was no need, he’d be walking soon enough.

But it wasn’t that soon. For months he relied on a walker. They moved the bed downstairs, and for a while Janice slept with him. But he was in so much pain, every time she moved, he felt it -- not that he was sleeping much, anyway.

In the hours, days, and months after the accident, Janice says that her husband’s colleagues were organized and compassionate. She could call and they’d be there with a car to drive them to the hospital. Officers and their wives brought food over, and she still has hundreds of get-well cards from Paul’s co-workers. But when his physical injuries healed, when he surprised everyone and walked again, a new, more nebulous group of problems set in, problems a ride or a hot meal couldn’t help.

Retired State Police sergeant Edward Lee, who counseled Paul informally for years, says that the prevailing thinking about mental illness among State Police brass is that “if we give you psychological counseling, then we think you have a psychological problem, and if you have a psychological problem, maybe you shouldn’t be working.” (The department declined to comment on the case and would not permit an interview with the man who was McCarthy’s supervisor at the time of his death.)

On the day of my visit, as we sit chatting, Janice orders pizza, and her two younger children -- Chris,12, and Shannon, 17 -- make their way into the kitchen. The oldest, Paul Jr., 19, is studying classical languages at the University of Chicago. Chris has red hair and freckles, and Shannon is tall and pretty, with a shy smile. She’s still wearing her plaid school skirt, and tonight she’s got her hair in a side ponytail.

When the pizza arrives, Chris sits down and digs in while Shannon leans against the counter and picks at a salad. She says that last summer she took a course in neurobiology and learned about what happens to the brain when mental illnesses, like post-traumatic stress disorder, take hold.

“I think that really helped validate what was going on with your dad, right?” nudges her mother. Shannon smiles and opens her mouth to say something, then stops. “Am I putting words in your mouth?” asks Janice. Shannon nods and makes a gesture with her thumb and forefinger, indicating “a little bit.” Janice leans over and puts her arm around her daughter.

When I ask Shannon if it’s hard to talk about her dad, she nods her head. “A little bit,” she says.

“It’s hard, but we have to talk about it,” says Janice. “If we don’t talk about it, nothing changes.”

I don’t see any pictures of Paul hanging in the main living area of the McCarthy home. What I do see is a kitchen table piled high with binders and folders and notebooks; more than 800 pages of meticulously organized documents pertaining to Paul’s injuries, diagnosis, and death. Janice has photocopies of everything: psychological evaluations discussing his “severe, chronic PTSD”; depositions from the 1993 accident; photographs of him in the hospital; internal memos that show State Police officers were concerned about Paul’s “non-rational, delusional behavior.” Everything is labeled, with section titles “Correspondence” and “Demotion” and, finally, “Suicide.”

“This has become my full-time endeavor,” Janice says. “This is how I make sense of it. This is how I make it better.” (She also volunteers twice a month doing suicide-prevention training with police in Connecticut.)

Fortunately, thanks to the partial pension from the state and Paul’s life and disability insurance, Janice doesn’t have to work on anything but the case. She is candid about the fact that she doesn’t need the extra money the line-of-duty designation would bring. She thinks the fight is important for her family, and she wants Paul remembered for how he lived -- for the twin babies whose lives he saved by getting their mother to the hospital, for what a great cop he was -- not how he died. She also hopes that if she wins, if she gets federal benefits and Paul’s name on the wall, she’ll have won for future survivors who aren’t as financially lucky as she’s been.

When I tell Janice that Fallon doubts his bill will pass this year, she is quick to point out that she’s attacking the issue on two fronts: Fallon’s bill represents one path, and her upcoming hearing before the state Division of Administrative Law Appeals represents the other. Janice has hired a Boston law firm and hopes to present her case this summer, but when I spoke with Ralph White, one of the members of the state retirement board that approved the “accidental death” pension for Paul but rejected the line-of-duty claim, he said he would be surprised if the division would go out on a limb and create such a precedent.

“The line-of-duty designation is sacred territory,” says White.

Janice doesn’t disagree. “The line-of-duty designation should be sacred,” she tells me when I read her White’s response. “For an officer to give his life is the ultimate sacrifice, but for a suicide to be categorically eliminated from consideration is unjust. Paul’s legs healed, but his brain did not. Instead, he suffered for 13 more years. His memory deserves to be honored for that struggle, and his children deserve to see their father’s name in its rightful place on that wall.”

And so his widow will continue her fight.

Julia Dahl is a writer in New York.