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Sleep Difficulties of Corrections Professionals: Nothing to Yawn At

November 7th, 2014

“I sleep a lot and have had bouts with insomnia and did not sleep for days.”

“Too much mandatory overtime has affected my sleep patterns.”

These are quotes from anonymous corrections officers. Their comments are not at all unusual. We have also heard many a time of staff bringing six “high-energy” (that is, high-caffeine) drinks to work, to consume during their shift—to force their brain to stay awake and alert while on duty, when in fact it is trying to shut down and go to sleep.

Of DWCO’s national 2011 sample of N=3599 corrections professionals of multiple job types and agency types, 43.3% indicated that they were experiencing sleep problems, with 45.8% of the men reporting sleep problems, and 40.2% of the women. Of those who reported having been exposed to one or more incident of violence, injury or death, 45.7% reported sleep problems, as opposed to 26.8% of those who did not report exposure to such incidents. Of those comorbid-positive (that is, meeting criteria for PTSD and also scoring as moderate or higher on depression symptom severity) 72.1% reported sleep problems, as opposed to 37.3% those who were not comorbid-positive.

Sleep disturbances include difficulty falling asleep, difficulty staying asleep, nightmares, obstructive sleep apnea, and Restless Leg Syndrome.

What are some of the consequences of sleep deprivation/insufficient sleep? According to the Centers for Disease Con-trol and Prevention (CDC), 23.2% of US adults 20 years and older reported difficulty concentrating on things in relation to sleep insufficiency (less than 7 hours of sleep in a 24-hour period), and 18.2% reported difficulty remembering things in relation to sleep insufficiency. In corrections work environments, difficulty concentrating or remembering can have life-threatening consequences.

Also according to CDC, insufficient sleep is associated with high-risk behaviors such nodding off or falling asleep while driving, and unintentionally falling asleep during the day. And insufficient sleep is associated with low energy and feel-ing tired during the day.

Sleep insufficiency undermines health by increasing the risk of chronic illnesses such as hypertension, diabetes, depression, and obesity, as well as cancer, increased mortality, and reduced quality of life and productivity [1].

Moreover, a study of employees in the transport industry and in the army found that even moderate sleep depriva-tion produced impairments in processing and motor performance. These impairments were be equivalent to those of alcohol intoxication [2]. After 17-19 hours without sleep, speed and accuracy on some tests were equivalent to or worse than speed and accuracy at a Blood Alcohol Content (BAC) of 0.05%. After longer periods without sleep (up to 28 hours), performance reached levels equivalent to performance following the maximum alcohol dose given to subjects (BAC of 0.1%). In the US, drivers with BAC of .08% or higher are considered to be legally intoxicated—Driving Under the Influence (DUI).

Given the inescapable consequences of sleep deprivation on health and functioning, it seems safe to conclude that every effort must be made to ensure that corrections professionals, and in particular shift workers, are presented with work conditions that allow them to get on at least 7 hours of sleep per 24-hour period.

Here are some tips from the National Sleep Foundation that may help promote sufficient and good quality sleep.

  • Establish and adhere to a regular routine regarding what time you go to bed to sleep and what time you wake up. This helps regulate your body’s biological clock which controls your circadian rhythms to help you go to sleep and to stay awake. Of course, working over-time throws your biological clock off. And changing shift schedule confuses your body even further as to when is should be secreting chemicals to help you go sleep and when it should be working on helping you wake up and stay awake. Whenever shift schedules change, staff experience the equivalent of jet lag.

  • Avoid exposure to bright lights, loud sounds, activities or information that may cause you to get “wound up,” excited or otherwise stressed just before bedtime. Avoid watching the news on television, playing video games, or working on your laptop in bed before going to sleep.
  • Instead, help your brain wind down and shift from wakefulness to sleep mode. If your mind is on things you have to do the next day, write them down and tell yourself that you are going to sleep now and you will be dealing with these matters the next day.
  • Make sure that the room where you sleep is dark and quiet, and that your mattress and pillow are comfortable.
  • Routinely engage in a relaxing ritual just before bedtime. That could involve drinking a warm non-alcoholic and non-caffeinated beverage, reading, stretching, taking a shower or engaging in sexual activity with your partner.
  • If napping during your day interferes with sleeping at your regular bedtime, avoid taking naps, especially later in your day.
  • Get physical exercise, daily if possible, to help yourself unwind.
  • Avoid consuming alcoholic drinks, tobacco products, caffeine, or heavy or spicy meals prior to going to sleep.
  • If you find yourself unable to sleep, get up and do something relaxing, such as reading, until you feel tired and ready to go to sleep.
  • If you continue having difficulty sleeping in spite of your efforts to do so, consult with your physician about it.
  • Like needing water, oxygen and food, our body, including our brain, NEEDS sleep. Sufficient and good quality sleep is a non-negotiable prerequisite for our health and functioning, and even for our very survival.

References

[1] Institute of Medicine. Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem. Washington, DC: The National Academies Press; 2006.
[2] Williamson, A. & Feyer, A. (2000). Moderate sleep deprivation produces impairments in cognitive and motor performance equiv-alent to legally prescribed levels of alcohol intoxication. Occupational Environmental Medicine, 57, 649–655.

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A Marathon, not a Sprint: Systematic Action Is Essential to Reduce the High Costs of Corrections Fatigue

September 8th, 2014

Corrections employees of all ranks and disciplines are repeatedly exposed to a multitude of occupational stressors throughout the course of their careers, including operational stressors, organizational stressors and traumatic stressors. The large number of stressors corrections workers face are formidable and their effects dire for individuals and groups immersed in unhealthy corrections workplace cultures. Well-documented consequences include pervasive and contagious negativity, hostile work environments, abusive behavior among staff and toward offenders, high sick leave and health benefits use, high turnover, and off-duty law-breaking behaviors. In addition, corrections staff often suffer serious physical and psychological health issues, and potentially shortened life expectancy.

During the past few days we were informed of two more corrections officer suicides that occurred. We also recently read news reports of expensive lawsuit settlements—into the millions—due to physical abuse or neglect of offenders by corrections personnel. Results of nationwide research conducted by Desert Waters Correctional Outreach estimate that 27% of corrections professionals meet criteria for Post-traumatic Stress Disorder, and 26% demonstrate moderate to severe depression symptom severity. Using a data-driven and research-supported assessment tool, the Corrections Fatigue Status Assessment (CFSA-v5), it has been estimated that 20% of corrections staff typically demonstrate a high level of Corrections Fatigue, accounting for 36% of reported sick days. These figures, together with other corrections research, consistently indicate that corrections workers’ health and functioning is seriously affected by occupational stressors, with significant negative outcomes.

Desert Waters’ research-supported Corrections Fatigue Model illustrates the causal factors, process, and consequences defining Corrections Fatigue. The model helps us understand the mix of circum-stances that tend to produce dysfunction in corrections workplace cultures, and sometimes severe health and functioning consequences for individuals.

Countering the trajectory of Corrections Fatigue’s development is a difficult yet critically needed undertaking. Effective interventions require a customized, comprehensive and data-driven approach that addresses the needs of each agency while considering its specific issues and characteristics. One size does not fit all. Taking into account the unique nature of Corrections Fatigue and corrections workplace environments, a six-stage approach for addressing Corrections Fatigue systemically was recently published.

The recommended six-stage approach to improving corrections workplace health and functioning includes the following component stages: (1) Inform (i.e., educate on the nature of Corrections Fatigue, (2) Assess (i.e., measure the extent that Corrections Fatigue permeates the workplace culture using validated workplace health assessment tools), (3) Evaluate (i.e., compare identified problem areas to the content of existing programs, structures, and resources for promoting staff health and functioning), (4) Plan (i.e., prepare for implementation of new or modified programs, structures, and resources), (5) Implement (i.e., roll out planned changes or improvements), and (6) Re-Assess (i.e., periodically and systemically re-assess workplace health and functioning using validated assessment tools).

Desert Waters Correctional Outreach offers a variety of data-driven and research-supported assessment tools designed specifically for addressing Corrections Fatigue (i.e., the CFSA-v5) and additional critical areas such as corrections staff suicide risk (i.e., the DDS), and average exposure to life-threatening events or critical incidents (i.e., the VIDES). A Corrections Staff Resilience Inventory (CSR-I), currently in beta, allows for identification of resilience-promoting behaviors that staff are effectively using (or not using sufficiently). Results from the CSR-I provide highly specific and concrete recommendations of behaviors to be increased through workplace culture improvement efforts for the purpose of raising the resilience of the workforce against Corrections Fatigue.

The aim of interventions for staff health and functioning is to educate staff of all ranks and disciplines on healthy adaptations to work-related challenges, ways to increase resilience to stress, and ways to reduce preventable and avoidable stressors, such as staff conflicts or staff-offender clashes.

It cannot be emphasized enough that enduring change of ingrained negative or dysfunctional patterns requires systematic, ongoing, culture-wide efforts within organizations. Over the decades, dysfunctional behaviors become self-sustaining and self-reinforcing patterns in corrections environments, where new recruits are vulnerable to “contamination” through unhealthy indoctrination as they assimilate into the affected workplace culture. Interventions involve gradually “deprogramming” and “reprogramming” staff’s thinking, beliefs, and behaviors in response to challenging corrections workplace experiences, situations, and circumstances, and learning to adapt successfully to occupational stressors. Culture improvement is a slow, laborious, but deeply critical process. It is a marathon, not a sprint.

While a good program offered once can help to temporarily modify individual responses to occupational stressors, unless other resources are applied as well, and repeatedly over time, that one-time program is unlikely to produce sustained cultural changes. The continuous stressors impinging on corrections staff, if not offset by continuous countermeasures, will most likely wash away the effects of sparsely offered positive countermeasures, and fairly quickly.

Desert Waters’ signature course, From Corrections Fatigue to Fulfillment™ (CF2F), represents an ideal starting point for initiating a program of sustainable change and deterrence of Corrections Fatigue. It helps increase staff awareness of how and why occupational stressors can shape staff’s emotions, thoughts, and behaviors, while also validating staff’s struggles. The course provides participants with information about self-care skills, cognitive repairs to damaged core beliefs, and strategies to impact the work environment constructively. The programming also helps staff identify ways in which THEY can make a positive difference in areas where they have influence.

In seeking organizational culture improvement, staff’s habitual ways of responding—both en masse and one staff member at a time, must be constrained to health-promoting parameters through targeted skill-building and repetition, repetition, repetition. To use a couple of analogies, one does not become a sharp shooter by firing their gun once in a while. Nor does a body-builder achieve and maintain success by working out only a few times. Corrections staff also require ongoing instruction and role modeling from higher-level staff in order to continue honing their self-management, interpersonal, and resilience-boosting skills. Continual reminders of effective strategies and structured opportunities to practice them are needed. Corrections organizations as a whole need to be genuinely invested in this pursuit for improvement to take root and grow.
Several questions can be asked about motivations that drive improvement efforts. “Is it to simply check a box to confirm or substantiate that a certain training has been provided?” “Is it to maintain the status quo while biding one’s time to retire?” Or, “Is the goal to breathe new life into staff by bringing enduring and sustainable solutions to corrections workplace problems?”

It is helpful to bear in mind that improving workplace culture health and functioning also requires defining goals that reach to the heart of problems, which is critical in the formulation of effective solutions. At times, what may be perceived as a problem may actually be a consequence of a cause that is more deeply rooted or embedded in a broader context. For example, high sick leave use may be the outcome of a hostile work environment or of staff’s fears for their physical safety. For this reason, effective and validated assessment tools, such as the CFSA-v5, can be seen as particularly advantageous. The CFSA-v5 results allow organizations to objectively pinpoint critical areas of need and facilitate optimal and efficient channeling of improvement efforts.

Other useful questions for corrections administrators to consider include: “How big will a problem become if systematic steps are not taken to counter the negative effects of ongoing occupational stressors?” and “What is it costing an agency in the long term to ignore Corrections Fatigue within their organization?” What is the actual price of turnover, sick leave days, overtime, substandard job performance due to low morale, and lawsuits for staff misconduct—to name a few of the consequences of corrections work malaise? What is the impact on the workforce of another staff suicide?

Given tight budgets, administrators may hesitate to embrace the idea of investing in staff well-being in a focused, systematic and long-term fashion. Yet the actual price tag of avoidance may be extremely high. In fact, empirical evidence is in hand that supports the high costs. Click here to obtain a no-charge estimate of the costs of just one component of Corrections Fatigue—use of sick leave, using Desert Waters’ online Corrections Fatigue Annual Costs Calculator.

In summary, significant and enduring positive improvements in the quality of corrections workplace culture require serious, long-term and ongoing commitment to change, including routine and periodic scientific assessments, monitoring of scores, and programming and training adjustments.

A road map that is in-depth and solutions-oriented needs to be drawn up and permanently installed, becoming “the way we do corrections” from now on, while also incorporating data-driven, evidence-supported modifications over time. This includes planning ahead for ways to deal with obstacles and bumps on the road that inevitably crop up during the journey toward healthier staff and healthier workplace cultures.
An approach that emphasizes prevention steps and proactive game-planning is invaluable, as it reduces risk, loss and liability, and it increases the likelihood of safety and security.

We at Desert Waters bring a data-driven, comprehensive umbrella approach to counter corrections agencies’ personnel problems and address their legitimate needs. We desire to take the journey with you and your agency, and to design the best-fitting road maps for you, and with customized solutions to match the unique needs of your particular organization—while also engaging the unique strengths of your organization.

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Communicating Safely in the Midst of Disagreement

July 23rd, 2014

Working in corrections takes a toll on staff’s personal relationships. Relationships with significant others are difficult enough under the best circumstances, let alone when people repeatedly come home after work seriously stressed. This article examines ways to communicate and problem-solve when tension builds due to a disagreement.

In healthy relationships, the purpose of communicating regarding a disagreement has several facets: (1) to understand each other’s perspective, needs and wants about the subject of concern; (2) to brainstorm for possible solutions to deal with the current differences; and (3) to agree to a mutually acceptable and viable solution to the problem at hand.

Ideally, before any such major disagreement emerges, a couple needs to spell out and agree to certain ground rules for managing their differences. Effective ways to communicate safely and constructively on such occasions need to be identified and agreed upon ahead of time. No one would think of playing sports or any other game before first presenting and agreeing upon how the players are to conduct themselves throughout the event. If we do that for a game, how much more should we do something similar for activities that may affect the safety and future of what may well be our most important relationship? (I remember in the 1990’s hearing John Bradshaw say that we get more training for driving a car than we do for being married and for raising a child.) Often-times, however, we do not know what safe and effective communication looks like. We may have not seen it take place or experienced it directly. That is where a few premarital counseling sessions (or even a good book on the subject) may prove to be a very wise investment.

Here are some thoughts on the matter, in a nutshell, to help you communicate safely and sanely with your partner when you have to discuss an area of disagreement:

  1. Agree to limit your discussion to one issue at a time– and exercise the self-control required to honor that.

  2. Listen attentively to what your partner is saying.
  3. Repeat back what you hear them saying so they know that you are listening and they have the opportunity to correct you if you misunderstood them.
  4. Ask for clarification when not sure about the meaning of something your partner said.
  5. Ask open-ended questions to try to gather more information that will help you improve your understanding of your partner’s perspective. Open ended questions do not have Yes or No answers. They start with How, What, When, Where.
  6. Do not interrupt while your partner is talking.
  7. Maintain an open and respectful body posture and facial expression. That is, monitor your body language. No glaring, frowning, rolling of the eyes. No folded arms. No torso or face turned away from your partner. Maintain eye contact while keeping your arms at your sides or resting in front of you. Remember to smile every once in a while in a friendly way.
  8. When it is your turn to speak, talk about your own perspective and your own experience using “I” messages (“I feel __,” “I think __,” “I want __,” “I need __”).
  9. Avoid mind-reading— that is, assuming that you know what your partner thinks, feels or intends to do, or what their motives are.
  10. Avoid verbally attacking your partner through “You” messages (such as through expressions of contempt, disrespect, sarcasm, ridicule, accusation, criticism or blame).
  11. Avoid “I” messages that are in reality critical “You” messages, such as, “I feel that you are being unfair” or “I think that you are all wrong.”
  12. Avoid all-inclusive critical or accusatory generalizations (e.g., “You always __,” “You never __.”)
  13. Let your partner know when you think that they have made a good point, or when you agree with what they said.
  14. Avoid power-plays (blackmail, intimidation or manipulation) through threats of escalation or revenge.
  15. If your partner begins to violate the ground rules, point that out to them and ask them to regroup and respect the rules.
  16. Absolutely avoid aggressive physical contact with your partner when angry.
  17. Remind each other periodically that you are on the same team, that you are not each other’s enemy, that you love, cherish and appreciate one another.
  18. Dialogue until both parties have said all they want to say about the issue.

Stop the discussion and agree to revisit the matter at a future time if:

  1. At least one party is consistently violating the communication ground rules and tempers are escalating, that is, when at least one party has become too emotional to be capable of calm and logical. Aim to agree to meet again at a later time when “cooler” minds prevail.

  2. Either party fears they may lose control physically or verbally— doing or saying something destructive.
  3. Either party needs more time to think things through.
  4. There is a significant number of interruptions and you cannot stay focused on the topic.
  5. The timing for the discussion turns out to be inappropriate for any other reason.

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P.A.V.E. Your Road to Wellness

July 23rd, 2014

Revised and reprinted from the March 2009 issue of the Correctional Oasis.

There are four areas that are pillars of wellness for corrections staff. These include:

  • (a) Processing the emotional impact of the job;
  • (b) Identifying and using Antidotes to neutralize negative consequences of work-related stressors;
  • (c) Having a positive Vision for their professionals and personal life; and
  • (d) Offering words of Encouragement to oneself and also to others.

(a) Processing: Emotional processing refers to the “digesting” of the fallout of stressful life events in order to be able to continue to move past them and to even grow as a result of them. Like milk is processed into cheese and peanuts to peanut butter, processing converts the emotional impact of events to constructive lessons learned and distressing memories that get “filed” so they are no longer acutely disturbing. Such processing can reduce negative mood and thoughts, and related acting out behaviors (such as going on a drinking binge or an overeating binge).

Processing requires willingness and determination to examine our inner life, to become aware of our thoughts, emotions, intentions and urges. Processing is not for the faint of heart, as being honest with ourselves requires courage. (Someone once said, “The truth will set you free, but first it will make you miserable.”) It is much easier to try to escape emotional discomfort through addictive behaviors or through attempts to take our frustrations out on others, instead of facing our inner reality and taking responsibility for our well-being.

Common methods of processing involve talking to trusted others about the issue, writing, or pursuing specialized psychological treatment.

(b) Antidotes: An antidote is a counter-dose, a chemical that negates the effects of a poison. If bitten by a rattle snake, you need the antidote of rattle snake anti-venom to neutralize the venom in your body. At work, you may have some emotionally painful interactions and experiences. These negative experiences need to be countered, and their “venom” neutralized, in order for you to regain your peace of mind. Telling yourself the truth is fundamental. Having someone you can confide in is also essential. Getting enough sleep and having a meaningful and love-filled life outside of work are key basic antidotes for corrections workers. Being outdoors in the beauty of nature refreshes your spirit. Working out on a regular basis de-stresses your body. Engaging in enjoyable hobbies and other activities, such as volunteering, refuels your soul. Make a list of the antidotes that work for you. Then put them to practice.

(c) Vision: Research shows that having a vision to pursue—a purpose to get out of bed every day—boosts health. Vision guides how you invest your life, what you do to impact others, and what legacy you want to leave behind. Vision helps you see yourself as part of something bigger than yourself. It propels you beyond your solitary existence as an individual to a person who sees and embraces the big picture, a person who invests in the welfare of others, both now and in the future.

How do you come up with a vision for your life? Start by asking yourself what principles you value dearly, what causes you are passionate about—what makes you feel the most alive, what you sense your natural talents are, and what brings you joy. Then start thinking of ways to uphold these principles and to promote those causes through the use of your talents and by doing what brings you joy.

(d) Encouragement: This practice is about “speaking words of life” to yourself and to others. The word “encouragement” is composed of two words: “in” and “courage.” So encouraging someone is like injecting a dose of courage into them! Think about that!! It’s no wonder that encouragement can be so energizing and empowering.

In order to encourage yourself to persevere or to do the right thing, treat yourself like a good parent or a good coach would treat you. Identify your abilities and strong points. Acknowledge any progress you make. Point out to yourself a job well done. Remind yourself that mistakes are learning opportunities. Figure out ways to work on areas where you need to improve. Speak similar words of life to others as well. Identify their abilities and strong points. Acknowledge any progress they make. Point out to them a job well done. Remind them that mistakes are learning opportunities. Support them as they figure out ways to work on areas that need improvement.

Encouragement can bring out the best in us—both for the recipients and the givers of courage “injections.” An added bonus is that as you encourage others you tend to attract to yourself positive people. So you end up enjoying the supportive community that gets built up around you. This of course contributes both to your well-being and to theirs.

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New DWCO Data Collection Initiative

December 31st, 2013

We are inviting willing corrections professionals to complete assessment questions to help with an initiative to collect and analyze important information on the occupation-specific challenges and impact of corrections work.  Assessment completion is voluntary and it is to be done on staff’s own time and from their personal computers. Data are ultimately used to promote the health, well-being, functioning, and fulfillment of corrections professionals.

Read more…

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ctudor Research

Another Pink Elephant?

December 20th, 2013

Some subjects are very hard to talk about. These are usually topics that involve addressing painful emotions, struggles and failures, or our personal fragile mortality. These matters are particularly hard to talk about by people who make a living out of projecting an aura of invincibility, power and control. Fragile is the last thing they want to be or appear to be. Of all these difficult subjects perhaps the hardest to address is that of suicide by “one of us.” And of all the professions that may have a difficult time talking about the suicide of “one of us,” corrections professionals are close to the top of the list—especially the security/custody staff.

After all, aren’t corrections professionals the ones who keep everybody in their care safe? Aren’t they the ones who have life and death duties, every day of the week, 24/7? Aren’t they the ones who often intervene in the case of inmate suicide attempts and save offender lives? Aren’t they the ones who keep whole communities safe through their supervision and management of society’s most dangerous?

In the 1980’s, when the literature seemed to explode on the subject of alcohol abuse and other types of family “dysfunctions,” helping professionals fervently highlighted the fact that the substance abusing individual and their family members often denied the issue or tried to rationalize it away. Helping professionals likened this minimizing or denying to having a pink elephant sprawled in the middle of the living room floor, with no one in the family acknowledging the presence of the beast. Instead of exclaiming, “What’s going on here? There’s this huge pink elephant in our living room!!!” they would figuratively continue to gingerly step around the animal, perhaps for years, acting like it did not exist. Not mentioning it, not commenting on it, not confronting it.

In some correctional settings a similar situation seems to be happening. In this case the pink elephant is staff suicide. The numbers indicate that there is truly an epidemic of suicides among corrections professionals, but very, very few are talking about this, and even fewer are doing something to proactively address the issue.

There are probably many reasons for this silence. It is hard for this tough group of “in control” individuals to admit that they have limits and that they too can break when pressures get bad enough. Many of them may also not know how to even begin to fix the problem, and so they opt to avoid it altogether. (It is easier to attribute the staff suicide to “weakness,” and move on, without exploring possible underlying issues.) And some may think that staff suicide has been going on for so long, that there is nothing that can be done about it anyway. For all these reasons, and probably many more, we continue to silently step around the pink elephant in the corrections living room.

Addressing the subject of corrections staff suicide involves facing and acknowledging some hard realities regarding corrections work. This requires tremendous integrity and courage.

In the general population the average suicide rate for the year 2010—the latest year for which national statistics are available—was 12.4 completed suicides per 100,000 persons (American Society of Suicidology, 2012). (Suicide rates are reported in terms of number of occurrences per 100,000, as—thankfully—suicide is a very rare event.) When examined by State, the highest reported rate was 23.2 per 100,000, for the State of Wyoming, and this is considered to be alarmingly high—almost twice the national rate.

A New Jersey study of active duty law enforcement professionals found that for male police officers the suicide rate was 15.1 per 100,000, and for adult males of the same age range (25 to 64 years old) in the general population the suicide rate was 14.0 per 100,000. For male Corrections Officers, however, the suicide rate was 34.8 per 100,000, more than twice that of the police officers and two-and-a-half times higher than that of the general population!

When an agency reports that they have a certain number of staff suicides per year, that number may appear small and negligible, as it is usually less than 5 staff suicides annually (unless the agency’s workforce is very large.) However, when the proportion is considered—the number of completed staff suicides com-pared to the total number of employees of that agency—the real impact and risk for suicide for that population becomes apparent.

For example, when a Department of Corrections with a workforce of 5,200 employees has five suicides in one year (which is an actual case), this translates to 96.2 suicides per 100,000. Yes, 96.2 per 100,000, compared to the average of 12.4 per 100,000 for the U.S. general population. This is the stuff of nightmares for behavioral scientists and behavioral health providers. Even three corrections staff suicides in one year out of 5,200 corrections employees translates to 57.7 suicides per 100,000—again frighteningly high compared to the general population.

Moreover, these numbers do not reflect suicide rates of retired staff for that agency. It has been our experience over the years that these rates are high as well, as we periodically receive information about retiree suicides.

What might contribute to these horrific suicide rates in the corrections profession? Could it be that corrections agencies inadvertently or selectively hire individuals predisposed to mental health struggles that may culminate in suicide? Upon reflection, this possibility does not seem very logical or likely.

Or might it be that the corrections work environment causes or contributes to a gradual erosion of staff’s well-being to the point that suicide becomes an acceptable option to them?

The latter seems to be a much more probable alternative, and there is substantial research evidence that supports this notion.

One recent study (Bierie, 2012) reported that a prison work environment of noise, clutter, dilapidation, lack of inmate privacy and lack of cleanliness contributed to increased substance use, increased sick days, and physical symptoms (e.g., recurring headaches, poor sleep, digestive problems) and psychological symptoms (e.g., feelings of anger, depression, worry) in corrections staff.

In an Australian study, corrections officers serving in high-stress and social-isolation posts were found to have increased negative emotions and outlook the longer they worked at these posts (Dollard and Winefield, 1998).

A Canadian study reported a 26% Post-traumatic Stress Disorder (PTSD) rate for corrections officers (Stadnyk, 2003).

A French study (David et al., 1996) determined that 24.0% of corrections staff of several disciplines met criteria for depression.

DWCO’s 2011 Initiative found that, for a nationwide U.S. sample of corrections professionals, 27% met criteria for PTSD (Spinaris, Denhof & Kellaway, 2012), and 26% met criteria for Depression (Denhof & Spinaris, 2013)—both of which are very high compared to other high-risk professions and the general population (Perrin, et al., 2007; US Centers for Disease Control and Prevention, 2010). Occurrence of both of these conditions increased with workplace exposure to incidents of violence, injury or death. Even more disturbingly, 17% of the DWCO Initiative sample was found to suffer from both PTSD and Depression at the same time. This is a highly significant finding in relation to staff suicide concerns, because the co-occurrence of PTSD and Depression has been repeatedly found to significantly increase suicide risk (Pietzrack, et al., 2011; Sareen, et al., 2007).

Could it be, therefore, that the high suicide rate among corrections professionals is fueled by undiagnosed and untreated occupationally-related PTSD and Depression, often coupled with substance abuse? These, and perhaps other disorders as well, may arise for the first time as a result of employment or they may have existed prior to corrections work and made worse due to high-trauma and other high-stress work conditions.

The evidence suggests that this is a likely explanation of the suicide epidemic among corrections staff.

So what should our response be to these realities?

As with every tough occupational subject, we need to start by acknowledging the problem at the highest executive levels. This must be followed with long-term committed conversations and studies that seek to explore causes and solutions for the issue. Engaging in this endeavor requires inspired leadership vision for the future of corrections as a profession. It takes courage and the tenacity to go against the status quo (a resigned stance that says, “This is the way it’s always been in corrections, and we can’t change it”). It also takes the courage, caring and tenacity to go against the system-wide denial that oftentimes characterizes corrections professionals of all ranks. In other words, it takes no longer tolerating or ignoring realities and conditions that would be deemed intolerable to most other professions and populations.

Courageous leaders acknowledge, without judgment, that the challenges they themselves and their executive colleagues may have faced (and apparently overcome) during the course of their careers are still present in the work environment for others.

Leaders are taught to believe that the health of the working environment is their duty to maintain, as it’s “on their watch,” as the saying goes. Therefore, when evidence indicates that the environment still contains chal-lenges which prove to be too much for some to overcome, some leaders might take this as a criticism of their lead-ership effectiveness, when in fact it is not.

The reality is that the profession’s numerous challenges constitute inescapable occupational hazards. It is the unsuccessful or unhealthy individual and collective adaptation to those unavoidable and recurring challenges that create corrections staff’s funerals and memorial services. Acknowledging the inherent difficulties, without pointing fingers, by noting that they are real and impactful and “the nature of the beast,” helps leadership to validate and maintain the committed conversations that follow: “It’s not just you. It’s not just our agency, office or facility. It’s the job. And we’re all in it together. So let’s do our best to try to make it better and safer for us all.” Those conversations can then focus on training on, instituting and providing for healthy adaptations to these challenges at both the individual and the organizational levels. In other words, the aim needs to become one of identifying and making possible the implementation of healthy tools for overcoming the challenges in a way that keeps body, mind, spirit, work teams and families together.

Appearances can be deceiving, and the appearance by “macho” corrections professionals of adapting successfully to difficult work environments may be the most deceiving of all. Corrections staff make their living by convincing others that they are in control at all times, which is a necessary part of the job if those around them are to remain safe. Corrections staff also know that their employers have their retirement and their family’s finances in their hands. And so the last thing they would want to show to their supervisors or administrators is the depth of the difficulty they may be experiencing adapting well to the challenges of the job. Appearing to be in control at all times allows them to continue to come to work day after day without drawing negative attention to themselves. In actuality though, they may be one of the walking wounded.

They may be grinding along on the power of unhealthy and even toxic coping strategies until, for whatever reason, they sadly decide that life just got to be too much and they opt to end it suddenly (hopefully without harming someone else first).

We at Desert Waters believe that the corrections profession now has enough information and tools on hand to begin implementing changes and providing training and relevant resources to corrections employees regarding the maintenance of their well-being and the health of the organization.

In the case of an actual staff suicide, the subject needs to be addressed with the surviving coworkers respectfully, compassionately and non-judgmentally—but also head-on, without being vague or indirect. We need to acknowledge the fact that even the toughest of the tough can break when their load gets heavy enough and/or when a staff member’s constitution gets undermined to the point where even a relatively light load causes their knees to buckle. The proverbial last straw that breaks the camel’s back accurately illustrates this concept. It has been our experience over the years that corrections staff relate to that metaphor only too well—hence our proposed term “Corrections Fatigue” and its analogy to the phenomenon of metal fatigue.

Regarding corrections staff suicide, we need to start somewhere and we need to start NOW. We need to continue designing data-driven methods to “vaccinate” staff against the suicide “virus” and whatever feeds it through the teaching of effective coping strategies and through effective workplace climate interventions— coupled with the provision of ample and affordable resources. More specifically, the impact of repeated exposure of corrections staff to psychological trauma on the job, whether directly or indirectly, must be at the forefront of discussions and interventions, as we know that it contributes to staff’s psychological undoing (Denhof & Spinaris, 2013).

We also need to train staff to handle and intervene safely and compassionately in the case of distraught coworkers. And we need to have appropriate protocols in place regarding postvention—handling the issue of a completed staff suicide and communicating to staff about it. Doing so effectively can provide healing closure to coworkers as well as an opportunity for a powerful pitch for the importance of staff wellness and the promotion of mental health. Staff are usually listening at that point. A coworker’s suicide allows for a breach in their walls of denial, even if briefly, as staff’s defenses go temporarily down when they are faced with the undeniable reality of the frailty of one of their own.

Not doing anything significant to target staff wellness from an occupational standpoint, in spite of the mounting evidence of the dire need for such interventions, could be perceived as deliberate indifference—which is certainly not the intent.

So let’s acknowledge the pink elephant in the corrections living room and begin to take the necessary steps to get it safely transported out of the house.

As C.P. Sennett has said, “If nothing changes, then nothing changes.”

And we are in desperate need for POSITIVE and PROACTIVE CHANGE regarding corrections staff wellness, including suicide prevention.

References

American Society of Suicidology (2012). U.S.A. Suicide: Official Final 2010 Data. Available at: http://www.suicidology.org/c/document_library/get_file?folderId=262&name=DLFE-636.pdf.

David, S., Landre, M.F., Goldberg, M., Dassa, S., & Fuhrer, R. (1996). Work Conditions and Mental Health among Prison Staff in France. Scandinavian Journal of Work Environmental Health, 22, 45-54.

Denhof, M.D., & Spinaris, C.G. (2013a). Depression, PTSD, and Comorbidity in United States Corrections Professionals: Impact on Health and Functioning. Available at: http://desertwaters.com/wp-content/uploads/2013/06/Comorbidity_Study_6-18-13.pdf

Dollard, M.F. & Winefield, A. H. (1998). A test of the demand-control/support model of work stress in corrections officers. Journal of Occupational Health Psychology, 3, 243-264.

New Jersey Police Suicide Task Force Report. (2009). Available at: http://www.state.nj.us/lps/library/NJPoliceSuicideTaskForceReport-January-30-2009-Final(r2.3.09).pdf.

Perrin, M.A., DiGrande, L., Wheeler, K., Thorpe, L., Farfel, M. & Brackbill, R. (2007). Differences in PTSD prevalence and associated risk factors among World Trade Center disaster rescue and recovery workers. American Journal of Psychiatry, 164, 1385-1394.

Pietrzak, R.H., Goldstein, R.B., Southwick, S.M., & Grant, B.F. (2011). Prevalence and Axis I Comorbidity of Full and Partial Posttraumatic Stress Disorder in the United States: Results from Wave 2 of the National Epidemiologic Survey on Alcohol and Re-lated Conditions. Journal of Anxiety Disorders, 25, 456-465.

Sareen, J., Cox, B. J., Stein, M. B., Afifi, T .O, Fleet, C., & Asmundson, G. J. G. (2007). Physical and Mental Comorbidity, Disability, and Suicidal Behavior Associated with Posttraumatic Stress Disorder in a Large Community Sample. Psychosomatic Medicine, 69, 242–248.

Spinaris, C.G., Denhof, M.D., & Kellaway, J.A. (2012). Posttraumatic Stress Disorder in United States Corrections Professionals: Prevalence and Impact on Health and Functioning. Available at: http://desertwaters.com/wp-content/uploads/2013/09/PTSD_Prev_in_Corrections_09-03-131.pdf.

Stadnyk, B.L. (2003). PTSD in corrections employees in Saskatchewan. Available at: http://rpnascom.jumpstartdev.com/sites/default/files/PTSDInCorrections.pdf.

United States Centers for Disease Control and Prevention (US-CDC). (2010). Current Depression Among Adults—United States, 2006 and 2008 Morbidity and Mortality Weekly Report, October 1, 2010 Erratum. Available at: http://www.cdc.gov/features/dsdepression/revised_table_estimates_for_depression_mmwr_erratum_feb-2011.pdf.

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Exposing the Hook

October 28th, 2013

From what I’ve heard repeatedly over the years, there is one type of incident that has a profoundly demoralizing effect on corrections staff and even entire corrections agencies. This type of incident can shatter trust, respect and pride in the profession like no other. What I am referring to is the disillusionment that follows after staff find out that someone they looked up to in the profession came up short—significantly short. Examples are when employees discover that staff they considered to be exemplary professionals, role models and even mentors, are found to have violated policies ranging from employee harassment to inappropriate relationships with employees to inappropriate interactions with offenders. Such behavior is experienced by employees like a personal betrayal, and many of them have difficulty trusting or respecting fellow staff again. Not wanting to be “burned” twice, they build up walls around themselves to guard against the possibility of experiencing such a letdown and betrayal again.

All of us have heard the stories. Sometimes it is staff in enviable positions, staff who were shining stars and who were going places in the profession. On other occasions it is staff who have performed reliably and honorably for years. Then, seemingly suddenly, they make a choice that is against professional ethics, against wisdom, against common sense, even against the law at times.

Staff that self-destruct in such ways may throw away years of commendable performance in one swift move, one act of poor judgment. These choices invariably involve the violation of policy and of professional boundaries. Lamentable choices might be the romantic pursuit of a subordinate, often in spite of the fact that both parties may be involved in other long-term relationships. They can even be about being romantically or financially involved with offenders, and actions that are associated with that, such as transmitting messages from offenders to others, and bringing messages and/or contraband in to them.

What is at the root of such destructive choice-making?

I’ve pondered this question many a time, taking seriously the saying, “There but for the grace of God go I.” (If we are honest with ourselves we will acknowledge that we also have made some impulsive, unwise decisions in our lives, perhaps not of the magnitude described above and perhaps not in the professional arena, but foolish decisions nevertheless. No one is immune to foolishness, from those at the top to the foot soldiers, so to speak.)

The best answer I came up with to the question of what drives such behavior is what the Big Book of Alcoholics Anonymous calls “self-will run riot.” That is, more often than not, the root of misconduct and unethical professional behavior is the pursuit of self-gratification outside what is allowable in our current circumstances. (Some people would say that such behavior is motivated by greed or lust.) This happens when the dictates of our basic “wiring,” which drive us to need satisfaction, collide with higher-order professional boundaries and ethics.

Civilization requires the spelling out of what constitutes legal, ethical, and acceptable behavior. To co-exist in society relatively peacefully, we need to know and follow the parameters within which we can operate legally, ethically and safely. Many of these expectations are immutable, written in stone. Others fall in the grey zone, perhaps to be evaluated on a case-by-case basis. For example, in the present corrections environment, personal involvement with offenders is never acceptable and sexual involvement can be grounds for prosecution through PREA. Additionally, in some jurisdictions flings with subordinates may be grounds for dismissal or a strongly urged resignation or early retirement, whereas in other workplace cultures they may be considered acceptable behavior and even be common practice.

To convince ourselves to cross a professional boundary line, we generate a multitude of rationalizations regarding why the behavior is permissible. Remember, our visceral, gut-level wiring drives us to get our needs and even our wants met (“the lust of the eye”). So, when under its influence, we may try to talk ourselves into excusing infractions or boundary violations. If the temptation is seductive enough, we may tell ourselves that the existing rules are too rigid, that they do not truly apply to our situation, that our case is a very special exception to the rule, that if it were wrong it would not feel so right, that we are being unfairly deprived of a good thing, that this is a once in a lifetime opportunity we don’t want to miss, etc., etc. At that point we are so mesmerized by the prospect of having “it,” that we downplay or ignore potential costs of boundary and policy violations, because we are certain that “it” will ensure our happiness and satisfaction.

The hook, the root of such disastrous choices, is talking ourselves into believing the lie that there is something outside the proscribed boundaries which is wildly desirable and much better than what we have or what we are allowed in our circumstances. We get hooked when we start feeling unjustly deprived—that good things are being unfairly withheld from us by “life,” by our administration, by society, or by whomever. When that happens, it is only a matter of time before the next step is taken, that of violating rules to meet personal wants or needs in a professional setting. So the concealed hook is the falsehood that the “forbidden fruit” is much superior to what we already have, that we are being “done wrong” by having it withheld from us, and that breaking some rules to get our hands on it is justifiable.

Professional safety from such self-deception comes from acceptance of professional boundaries without arguing about their legitimacy and appropriateness. Professional safety (and sanity) are found in unques-tioning acceptance of the fact that policies and ethical guidelines are there for a good reason—even if that reason is obscure to us at this time. Professional safety is based on the fact that professional boundaries exist for the protection of our reputation, our self-respect and our peace of mind, and for the protection of social interactions and relationships. Moreover, in corrections, professional boundaries are intrinsically tied into safety and security of operations. To stay safe and to keep the workplace safe, we need to stay vigilant and on our toes, ready to reject ego strokes and other seductive lures designed to take us outside the safety of proscribed boundaries. We need to remind ourselves periodically that, truly, all that glitters is not gold.

It may sound overly simplistic or even condescending to some, but protection from boundary violations is found in our willingness to accept “No” in the same way that we want toddlers to accept that they are not allowed to touch a hot stove or to sprint suddenly across the road. The key is acceptance of limits and respect for rules without grumbling and arguing, and without trying to find loopholes to “beat the system.” Wisdom involves acceptance of the fact that the workplace is not the proper venue to meet intimate personal needs or to satisfy any type of greed or lust. We are at work to serve, not to be served. Character maturity can be measured partly by the ability to forego inappropriate gratification, no matter how alluring.

Yes, we know of cases where staff were ostracized by coworkers and “cut off from the herd.” Isolated from their own, their professional needs for connection and respect left unmet, they may become vulnerable to the pull of temptation presented to them through offenders. Still we need to remind ourselves of the obvious—two wrongs don’t make a right. Getting personally involved with offenders will only lead to more woe.

So professional safety is found in respecting professional rules and limits, and staying away from what is expressly prohibited or even frowned upon (grey-zone items) in corrections organizations. This requires self-discipline and resolve to separate personal needs for love, affection, admiration, and companionship from workplace activities. Applying emergency preparedness tactics at a personal level, we need to remind ourselves regularly of the importance of professional boundaries, and that they are there for good reason. We must also regularly practice telling ourselves “No” as soon as we detect that our personal needs and wants are trying to crop up inappropriately in the workplace.

The only way to avoid getting hooked is to not play with the bait.

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Weaving Positive Meaning

June 2nd, 2013

Many of us tend to be meaning-seekers, wanting to be a positive influence in our world. Meaning is the fuel that keeps us going, what gives our life flavor, richness and purpose—what makes ourlife worth living.

What we pursue, how we invest our waking hours, what fills our dreams, even whether we have dreams at all, makes a critical difference in our quality of life and even our health.

And for many, many reasons (I am sure you can name a few!), corrections is the type of work that challenges staff deep and hard regarding the creation and maintenance of positive meaning. In the field of corrections, positive meaning does not grow freely on trees all on its own while you are sleeping. Rather, it requires persistent breaking of fallow ground, digging rocks out of the soil, fertilizing and watering, and pulling stubborn weeds that make a comeback seemingly overnight.  It also requires coming back and doing this again and again after periods of drought, heat waves, storms and freezing cold.

Creating positive meaning in corrections, and hanging on to it day after day and year after year, is nothing less than heroic. It requires learning to see courageously with new eyes. It requires to relentlessly keep sifting, looking for grains of gold in the mud of a river bed. For they are there, waiting to be found.

For many years now I have seen that staff flourish when they learn to infuse even routine or menial work with positive significance. These workers learn to not take themselves too seriously, to not fall in love with their image or power or what others think of them, and to do their job to the best of their ability on any given day.

The ones I’ve seen doing gloriously are those who have learned to find goodness and beauty, and to be thankful (and even grateful) for little things and big things and everything in between — even for things that do not look good and that are hard to be thankful for at first.  These are the ones who have also learned to forgive and to keep going after hard times.

So, how do you go about creating positive meaning for yourself?

Here are some suggestions.

  • Look for the beauty in the gift of every moment.
  • Tap into what inspires you to be the best you can be.
  • Remember the ones you are providing for by doing this work.
  • Actively contribute to the welfare of others and the common good.
  • Remember that you are afforded the opportunity to influence people’s lives, communities, and even generations to come through your work, choices and actions.
  • Relish the pursuit of acts of courage, civility and integrity.
  • Celebrate every shred of progress in yourself and others. (Ban Perfectionism!)
  • Aim to influence coworkers and offenders positively through your professionalism, integrity and ethics.
  • Model behaviors you want to see in others.
  • Seek input from others who have what you want.
  • Seek honest feedback from colleagues with whom you interact frequently.
  • Highlight success stories and share with others.
  • Point out to others the skillfulness required of corrections professionals of all disciplines. During the workday you and your colleagues may employ skills related to psychology, social work, public health, education, cheer-leading, motivational interviewing, mentoring, law enforcement and warfare.
  • Whenever you get discouraged at work, think of how far you’ve come in terms of your skill development regarding managing yourself and managing others.
  • Whenever you face your fears and stand your ground and do the right thing, give yourself credit for being courageous.
  • Whenever you persevere in the pursuit of your goals in spite of disappointments, you demonstrate your courage, grit and gumption.
  • Whenever you assist offenders within policy, you impact them positively.
  • Whenever you exercise self-control in the face of provocation, you are commendable, acting truly as a mature, wise adult.
  • Whenever you choose to see the silver lining in the cloud, you are winning the battle of the mind, remaining optimistic and in control of your attitude.
  • Whenever you support colleagues and help them do a better job, you offer them gifts of teamwork and caring, and you reinforce why you are an asset to your profession.
  • Whenever you choose to inspire, mentor, or otherwise encourage your colleagues, you contribute to the creation of a positive workplace climate, and you inject positive meaning in others’ lives.
  • Whenever you choose to take the high road after you encounter injustice—choosing to not return evil for evil, but to do the right thing —you win what may be the most important battle of all, the spiritual one.

So ask yourself:

  1. What do I want to accomplish through my life and influence, including my family life and my corrections employment?
  2. What do I want to be my predominant mood and attitude, the mood and attitude I am best known by?
  3. How can I impact people positively in my family and at my workplace on a daily basis?
  4. How can I create positive ripple effects in my community through my day-to-day actions?
  5. How might my work and my actions have a positive impact for generations to come?
  6. How can I best respond when I accomplish something that to me is significant and noteworthy, yet nobody commends me for it or nobody even notices?
  7. How do I “bounce back” from disappointment and bitterness when confronted with what, to me, seems to be injustice towards me or others?
  8. How can I “refuel”—go from becoming discouraged to being encouraged again (in-courage)? What can I tell myself to accomplish that? What actions can I take?
  9. How do I move past and even grow from my failures, my poor judgment and my mistakes, so that I can continue living out my most precious convictions, principles and values?
  10. What kind of life do I need to be pursuing intentionally today to feel like I am fully alive?

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Desert Waters’ PTSD Costs Estimator™

December 15th, 2012

Desert Waters’ PTSD (Posttraumatic Stress Disorder) Costs EstimatorTM currently provides an estimate of costs to a corrections facility due to PTSD-related absenteeism, based on quantitative findings from the nationwide study of PTSD and health-related factors conducted by Desert Waters Correctional Outreach (DWCO). http://www.correctionsfatigue.com/images/PTSD_Prev_in_Corrections_2012.pdf Read more…

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Desert Waters Study–PTSD in US Corrections Professionals

December 15th, 2012

Here is the link to the write-up of Desert Waters’ national study of PTSD in US Corrections Professionals. 

The results raise grave concerns about corrections professionals’ health and functioning in relation to workplace exposure to violence, injury and death, and the costs of PTSD to staff, families, administrators and the profession. 

http://www.correctionsfatigue.com/images/PTSD_Prev_in_Corrections_2012.pdf

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