Evaluation of Specific Mental Health Disorders in LEOs
Specific diagnoses most relevant to the police physician are discussed below. In its Cautionary Statement for Forensic Use of DSM-5 (in Section 1 of DSM-5), the American Psychiatric Association notes: “It is important to note that the definition of mental disorder included in DSM-5 was developed to meet the needs of clinicians, public health professionals, and research investigators rather than all of the technical needs of the courts and legal professionals.”
The focus of the assessment should be on those behaviors and deficits of capacity that impair performance of essential job tasks. The diagnosis is a common frame of reference for conducting the inquiry. When considering the LEO’s fitness for duty, all relevant data should be carefully reviewed. Sum-mary information concerning specific diagnoses is provided in Appendix A to facilitate thorough case-by-case analyses.
The recommendations which follow pertain to the LEO’s return to usual work. Return to limited duty may occur sooner. The appropriateness of limited duty is in part determined by:
- the residual work capacities of the LEO while in treatment
- the degree to which work activities may interfere with treatment and recovery
- specific workplace stressors which may impact the LEO
- the availability of work that does not pose a risk to the LEO or others while the LEO is symptomatic.
The police physician may consult with the LEO, representatives of the agency, and evaluating and treating providers in considering work restrictions. It is also appropriate for the police physician to be available to the employer to discuss the appropriateness of a proposed modified-duty assignment. Each case requires an individual review of all relevant factors. These include the impaired LEO’s risk to collaterals and the department’s duty to protect others from a LEO’s known impairment.
Ongoing modified work will need regular progress reports to the police physician by the treating providers and re-evaluation of the LEO at frequent intervals. If the LEO’s fitness for duty depends on treatment, the return-to-work plan must include a mechanism for monitoring adherence to treatment going forward, with an emphasis on behavioral indicators not limited to mere attendance at appointments, medication compliance or development of insights.