Police Violence As a Cause of Mental Health Symptoms: A Conceptual MODEL

Background

Police violence is recognized as a public health concern in the United States, and recently cumulating evidence has shown police violence exposure to be linked to a broad range of mental health outcomes. These associations extend beyond the associations between other types of violence exposure and mental health, and to be independent of the effects of co-occurring forms of trauma and violence exposure, such as adverse childhood events or intimate partner violence. However, there is no existing theoretical framework within which we may understand the unique effects of police violence on mental health and illness.

Methods

In this conceptual review, we explore the construct of police violence as a potential etiological factor for mental health symptoms and conditions, based on the assumptions that (1) violence and trauma are, generally speaking, associated with elevated risk for a broad range of mental health symptoms, and (2) the contribution to risk may vary not only by severity of exposure, but also by type of exposure. Specifically, we examine the theoretical and public health literature on police violence within a life events framework in order to identify potentially unique characteristics that distinguish it from other forms of violence exposure in its association with mental health symptoms.

Results

We identified eight factors that could potentially alter the public mental health impact of police violence, such that police violence may be considered a conceptually distinct form of violence exposure. Identified factors included those that (1) increase the likelihood of overall exposure (e.g., impact of police culture on internal accountability); (2) increase the psychological impact of police violence (e.g., power inequities inherent in state-sanctioned violence); and (3) impede the possibility of coping or recovery from such exposures (e.g., pervasive community and national presence of the police). Based on these factors, we propose a theoretical framework for the further study of police violence from a public mental health perspective.

Implications

We highlighted eight potentially influential factors that distinguish police violence as a unique form of violence from a public health perspective. This conceptual framework provides a valuable starting point from which the construct from police violence can be further explored from a public health standpoint. The assumption that police violence is a violence like any other would require that the net effect of all of these eight factors would sum to 0, and this assumption is highly unlikely, particularly since some of these pathways are now supported by epidemiological evidence (e.g., stress of police avoidance has been recently linked to depressive symptoms). In order to test the proposed model, subsequent studies will need to examine the mechanisms underlying this risk and map those mechanisms onto these proposed features of police violence.