“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 of officers with PTSD had ever accessed mental health care. As Kaliebe notes, part of this is due to occupational culture: Police work prizes toughness, and officers worry that seeking help could signal a lack of fitness for duty or could trigger removal from active service. Concerns about confidentiality and stigma are all major barriers to their seeking treatment.
Why Many Police Officers Don’t Trust Therapists
While these reasons are all important, Kaliebe homes in on another: the fact that many officers don’t trust therapists because they have good reasons not to. The uncomfortable truth is that mental health institutions have grown rife with anti-police rhetoric. Social work academics have described police as tools of “social control and White supremacy.” An entire subfield within social work is dedicated to police abolition. The American Psychological Association adopted a 2022 resolution endorsing several claims of anti-police activists. When officers scan the mental health landscape, it’s no wonder they’re skeptical. Why would they seek care from people who don’t respect them, or worse, think they’re the problem?
This dynamic threatens to damage any would-be “therapeutic alliance” between therapists and their police clients. Decades of research have demonstrated that forming this alliance is one of the strongest predictors of outcome—often more important than any technique a therapist uses. By definition, this alliance depends on the client’s belief that the therapist understands them, respects them, and is working in their interest. If an officer walks in already primed to expect hostility, or if a therapist starts a session ready to deliver it, the therapeutic relationship is compromised before the first question is ever asked.
Need for Cultural Competence With Police Populations
Kaliebe proposes several evidence-based interventions for police officers (motivational interviewing, mentalization, cognitive behavioral therapy, family counseling), but none of them work if the officer doesn’t voluntarily walk through a therapist’s door. Thus, the onus falls on therapists, who need to be trained in genuine cultural competence with police populations: understanding their organizational structure, knowing their lingo, appreciating all the unique stresses of their job, and, frankly, being willing to express respect for the important work they do. He even recommends therapists go on ride-alongs with current or former officers as part of their preparation.
There is a bitter irony here: Many of the behaviors that activists most criticize in police officers—excessive aggression, impaired judgment, lack of empathy, etc.—are exactly the kinds of outcomes associated with untreated PTSD, depression, and chronic stress. Likewise, research has linked psychological distress in officers to restricted attention, reduced self-regulation, increased anger, and difficulty bringing empathic, nondiscriminatory responses to the communities they serve. In other words, when the mental health field alienates police officers, it doesn’t just fail those officers; it may be worsening the very problems it claims to care about.
If you or someone you love is contemplating suicide, seek help immediately. For help 24/7, dial 988 for the 988 Suicide & Crisis Lifeline, or reach out to the Crisis Text Line by texting TALK to 741741. To find a therapist near you, visit the Psychology Today Therapy Directory.