“It’s the worst I’ve seen in my career,” said Beyer, co-founder and CEO of Harbor of Grace Enhanced Recovery Center, a private mental health and substance use treatment and recovery center for first responders in the coastal Maryland city. Havre de Grace. Established in 2015, Harbor of Grace is one of only six treatment centers in the US approved by the Fraternal Order of Police, the world’s largest law enforcement organization.
Public safety is a profession plagued with high rates of mental health and addiction problems. Considering the relentless pressures on first responders, Beyer said, treatment centers can’t keep up with demand.
Specialized recovery facilities like Harbor of Grace focus on treating law enforcement officers, firefighters, EMTs, and dispatchers—people who regularly face violence and death on the job. In the past two years, Beyer said, the number of police officers admitted for treatment at his facility alone has more than tripled. “And we always have up to 20 police officers in line,” she said. Other first responder treatment centers reported a similar increase in patients.
Anger at police and policing practices spiked after a Minneapolis officer killed George Floyd in 2020, putting additional pressure on the mental health of officers, said Brian Lerner, a psychiatrist and chief medical officer at Harbor of Grace. . “Officers feel undervalued by the public and often don’t feel supported by their agencies either,” he said.
That’s part of the reason “we’re seeing a significant rate of burnout among police officers,” said Jennifer Prohaska, a clinical psychologist in Kansas City, Kan., who focuses on helping law enforcement personnel.
The poor mental health of many officers, combined with low morale, has contributed to a police exodus across the country that has left departments understaffed and remaining officers overworked and exhausted. Atlanta, Seattle, Phoenix and Dallas have been particularly hard hit by officer shortages. “That is creating a huge strain on the system,” Prohaska said. “It’s a perfect storm.”
Even before the most recent stressors, rates of burnout and depression increased among first responders. Post-traumatic stress disorder rates are five times higher in police officers than in the civilian population. Some studies estimate that up to 30% of police officers have a substance use problem. Alcohol dependence is at the top of the list. Last year alone, 138 law enforcement officers committed suicide, more than 129 killed in the line of duty, according to the FBI. A recent report from the Ruderman Family Foundation suggests that police suicides are often underestimated due to stigma.
Harbor of Grace has a small campus of eight single-story brick buildings with pale blue and yellow accents and is more like a seaside inn than a clinical setting. The center can treat 47 patients at a time. It has seven intensive care beds, mostly for detoxification.
Offers help for a wide range of mental health conditions, including addiction, sleep disorders, anxiety, depression, suicidal ideation, and PTSD.
To date, more than 500 law enforcement agencies (federal, state, and local) have posted employees to Harbor of Grace. The center has 45 full-time clinical staff, including an emergency physician and several psychiatrists, nurses, and counselors. Many have previously worked as first responders, from army medics and firefighters to police officers.
On a recent morning in the Harbor of Grace, the sun was blazing over the Chesapeake Bay. A group of patients, mostly men and a few women in their 30s, gathered in the small courtyard. Some sat alone, while others stood in small groups chatting.
“We get all kinds, from all backgrounds and at all stages of brokenness,” said Beyer, 66, a former firefighter and EMT who overcame an alcohol problem decades ago. “All of our patients and most of our staff know what it’s like to hold a dead or dying child,” he said.
Sergeant Ryan Close has held several dead children. The 37-year-old police officer works as a patrol supervisor for a small New England law enforcement agency that he declined to identify to protect the identity of his colleagues. He has been a police officer for 15 years and has worked for various departments. When he started, he said, officers received no psychological training or access to designated peer support programs.
He said that almost every time he was involved in a critical incident, such as a shooting or an accident involving burned and disfigured bodies, “my supervisor ordered me to go to the bar afterward.” One incident in particular has stuck in his memory: when a boy shot himself in the head with a rifle. Washing down the horror with alcohol “was the culture back then,” he said.
But Close didn’t drink much at the time and was teased by his peers for ordering only small beers. It wasn’t until years later, when memories of his experiences at work and having trouble sleeping resurfaced, that he began self-medicating with alcohol. He developed social anxiety and his marriage suffered.
His department pressured him to seek help and he entered Harbor of Grace in April 2021 for a 28-day course of treatment. There, he learned to let go of his hardened veneer and his drive to always be in control. He also saw many other police officers struggle with it when they arrived at the center. “I saw adult men have a seizure as a 6-year-old because a staff member wouldn’t let them use their cell phone.”
Many first responders develop strong defense mechanisms and are “insecure, distrustful and controlling,” Beyer said. They often wait too long before seeking help, she added.
Police officers tend to be “very closed, very reluctant to be vulnerable,” Lerner said. But he finds that most first responders become model patients after taking their first steps. “At that point, they’re all inside,” she said. “They don’t do anything halfway.”
At Harbor of Grace, the communication style mirrors the tone of a police station or fire station, Beyer said. “We don’t waste time on feel-good stuff,” she said. “We are frank. We call people if necessary.”
Psychologist Prohaska said it is important that there are specialized behavioral treatment centers for first responders. But, he said, there also needs to be better investment on the front lines, for practical initiatives that teach public safety employees resiliency, like the one he developed for the Kansas City Police Department.
Strong mental health training should be part of the academy’s curriculum and embedded in police culture, he added. “Just like we teach officers safety, we need to teach them resilience,” he said. “A two-hour PowerPoint course is not enough.”
Beyer expects the situation to get worse before it gets better. In the past two years, she has seen more police officers quit while undergoing treatment. Previously, most returned to work. “Now, once they get clarity, a lot of them say, ‘I want to stay healthy, and the way to stay healthy is to leave police work,’” she said.
Close decided to go back to work in law enforcement. He has become an advocate for peer support at his agency and beyond. He said his own mental health journey has made him a better police officer, with more empathy and better communication skills.
His advice to fellow officers is to learn about the possible effects of trauma before they develop a serious problem. Also, he said, “establish a good dialogue with your family, your supervisors, your colleagues. Know what your limitations are. And learn healthy coping skills. Alcohol is not one.
This article was produced by Kaiser Health Newsa program of the Kaiser Family Foundation, an endowed nonprofit organization that provides health information to the nation.
