Depressive Disorders: Duty Status and Work Restrictions
Following the initial episode of any depressive disorder (e.g., major depressive disorder, depression not otherwise specified) with no history of suicide attempt or psychosis – the criteria below apply for return to work without restrictions.
The following conditions must be met:
- full remission as defined by DSM-5 (“During the past two months, no significant signs or symptoms of the disturbance were present”)
- absence of impairing symptoms in the past 2 months
- if requested by the police physician, an evaluation by a doctoral-level mental health provider acceptable to the police physician, who understands the functions and demands of police work
- adherence to treatment and ongoing evaluations
- no disqualifying adverse effects from treatments such as medication, electroconvulsive therapy, etc. (see LEO Medications chapter)
- unimpaired judgment and attention
- appropriate inter-personal interaction
- treatment of comorbidities (including substance abuse and sleep disorders)
- no imminent risk of harm to self or others
LEOs with current or past psychotic symptoms, suicidal ideation or attempt, or personality disorders will require additional evaluation. It is the consensus of the LEO Task Group that follow-up evaluations* should be undertaken as follows:
- regular evaluations over a period of at least 6 months
- regular evaluations on a monthly basis or more frequently when the anti-depressant is tapered
- regular evaluations on a monthly basis or more frequently after dis-continuing anti-depressant, for at least 3 months, and at 6 and 12 months after discontinuing anti-depressant
*Evaluations by a health care provider knowledgeable about mental health disorders and management acceptable to the police physician.
Recurrent Depressive Disorder:
With recurrence of any depressive disorder (e.g., major depressive disorder, depression not otherwise specified, uncomplicated by suicide attempt or psychosis) – criteria for return to work without restrictions are the same as above. Treatment recommendations are also the same as for an initial episode, but careful consideration must be given to whether the LEO requires work restrictions if anti-depressant medication is discontinued or changed. The police physician may also require ongoing follow-up to monitor for recurrence.