Mental Health Correlates of Police Violence Exposure in Baltimore and New York City

Background and Purpose: Following the widespread adaptation of smartphone technology and consequent rapid dissemination of real-time footage of encounters between police and civilians, police violence has increasingly been recognized as a public health concern in the United States. However, there has been minimal empirical research examining the health and mental health correlates of police violence among exposed civilians. Data from the first Survey of Police-Public Encounters (SPPE I) revealed notably high lifetime prevalence rates of physical, sexual, and psychological violence exposure, which was associated with mental health symptoms including depression, distress, suicidal behavior, and sub-clinical psychosis. However, this survey had notable methodological limitations including the use of lifetime rather than 12-month police violence exposure data and limited adjustments for potential confounding factors. The present study reexamines the mental health correlates of police violence in the second Survey of Police Public Encounters (SPPE II).                                                      

Methods: One thousand adult residents of New York City and Baltimore provided data on exposure to police violence and self-reported experiences of mental health symptoms. Past-year police violence exposure was assessed using the Police Practices Inventory, a validated measure of police violence exposure based on the World Health Organization (WHO) conceptualization of violence. Specifically, separate variables indicated 12-month exposure to (1) physical violence, (2) physical violence with a weapon, (3) sexual violence, (4) psychological violence, and (5) police neglect. Validated measures were used to assess mental health outcomes, including psychological distress (K-6 scale), suicidal behavior (WHO suicide assessment), and sub-clinical psychotic experiences (WHO psychosis screen). Logistic regression analyses were used to test the associations between each police violence exposure and each mental health outcome, adjusted for intimate partner violence, adverse childhood experiences, and involvement in criminal activities and substance use.

Results: Police violence was more commonly reported among racial/ethnic minorities, male or transgender respondents, and those with less income or education. Each domain of police violence exposure was significantly associated with each mental health outcome in unadjusted analyses. Following adjustment for potential confounding factors, physical violence was associated with suicidal ideation (OR_adj=2.45) and psychotic experiences (OR_adj=2.24). Physical violence with a weapon was associated with suicidal ideation (OR_adj=2.72), suicide attempts (OR_adj=7.30), and psychotic experiences (OR_adj=4.34). Sexual violence was also associated with suicidal ideation (OR_adj=3.76), suicide attempts (OR_adj=6.63), and psychosis (OR_adj=6.61). Psychological victimization was associated with psychotic experiences (OR_adj=1.65), and neglectful policing was associated with both suicide ideation (OR_adj=2.15) and psychotic experiences (OR_adj=2.45).

Conclusions and Implications: Findings from the SPPE I study were largely confirmed in the SPPE II data, using more rigorous methodology that is less susceptible to biases or the influence of confounding factors. Specifically, police violence is experienced by a notable minority of the population, is disproportionately reported by racial/ethnic minorities, and is associated with greater severity of a range of clinically notable mental health symptoms. The pattern of stronger associations with more assaultive forms of police violence is consistent with causal explanations in which violence exposure contributes to risk for mental health symptoms, although this cross-sectional finding should be further examined in future longitudinal studies.