Mental Health

Schizophrenia Spectrum and Other Psychotic Disorders

Schizophrenia

An individual with a confirmed diagnosis of schizophrenia is unable to perform the essential job functions of an LEO.

Schizoaffective Disorder

An individual with a confirmed diagnosis of schizoaffective disorder is unable to perform LEO essential job functions.

Other Psychotic Disorders: Recommendations Regarding Duty Status and Work Restrictions

• An individual with delusional disorder is unable to perform LEO essential job functions.
• For LEOs with a single brief psychotic disorder or schizophreniform disorder** the following required conditions must be met prior to return to full duty:
• no psychotic symptoms for 6 months after completion of treatment (off medication)
• 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 under-stands 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 Medications chapter)
• unimpaired judgment and attention
• appropriate inter-personal interaction
• treatment of comorbidities (including substance abuse and sleep disorders)

LEOs suicidal ideation or attempt, or personality disorders will require additional evaluation.

Follow-up evaluations: regular evaluations for at least 12 months.

For LEOs with secondary psychosis the following required conditions must be met prior to return to full duty:

• the cause of the psychotic disorder has been successfully treated and managed
• the psychotic symptoms have resolved for at least 6 months
• off antipsychotic medication for 6 months
• evaluation by a psychiatrist or by a licensed doctoral-level psychologist

Post-Traumatic Stress Disorder: Recommendations Regarding Duty Status and Work Restrictions

The following conditions must be met prior to return to full duty:

• Absence of impairing symptoms in the past 2 months, including, but not limited to:
  • significant dissociative episodes (flashbacks)
  • recklessness, self-destructive or avoidant behavior which could interfere with work performance
• If requested by the police physician, an evaluation by a doctoral-level mental health provider acceptable to the police physician, who under-stands 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)
• Appropriate inter-personal interaction
• Treatment of comorbidities (including other mental health issues, substance abuse, and sleep disorders)

LEOs with current or past psychotic symptoms, suicidal ideation or attempt, or personality disorders will require additional evaluation.

Follow-up evaluations:

• Regular evaluations for at least 6 months (or longer depending on comorbidities)
• Four instruments for evaluating PTSD are included in Appendix E:
• primary care PTSD screen, PC-PTSD, is a 4-item screening tool
• Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5) is a 20-item instrument which has high sensitivity and specificity for diagnosis, it is also useful for following LEOs over time
• Structured Interview for PTSD (SI-PTSD) is a longer test which requires 20-30 minutes to administer
• a still longer interview, the Clinician-Administered PTSD Scale (CAPS-5) has not been included, but is on the U.S. Veterans Administration website

**These two diagnoses can only be made after secondary psychoses have been excluded.