From Hard Charging to Human: Cumulative Trauma, Career Stress, and the Promise of the Co-Response Model in Policing

Police officers often enter the profession as hard-charging, highly motivated men and women determined to prove themselves. Many leave the police academies reborn with a warriors persona. Especially in the academy and field training phases, no one wants to be perceived as weak or unreliable. Recruits are socialized into a culture that values decisiveness, composure, and resilience under pressure. For many, this early mindset becomes foundational to their professional identity.

Yet over the span of a career, the accumulation of traumatic exposure, organizational stressors, and life transitions can take a measurable psychological toll. For this and other reasons officers are running on fumes and unwilling to take first steps toward wellness. Enter peer support and co-responders.

Early Exposure and the Culture of Performance

Law enforcement officers experience repeated exposure to traumatic events at rates significantly higher than the general population (Violanti et al., 2017). These exposures often begin after academy graduation and often during field training. While most agencies now provide supervisory support, peer debriefings, and crisis intervention access—consistent with recommendations from organizations such as the International Association of Chiefs of Police—the prevailing occupational culture still prizes emotional control and strength

Research has consistently shown that officers may under-report stress reactions due to fear of stigma and concerns about fitness for duty (Fox et al., 2012). The pressure to perform can delay help-seeking behaviors, even when departments offer resources. Many organizations started mandatory defusing or debriefing for all officers who rolled on a high stress call.

Cumulative Stress Across the Career Span

Although critical incidents are central to public perceptions of police stress, research indicates that organizational stressors may be equally or more impactful. Administrative burden, mandatory overtime, court appearances, policy changes, and promotional competition all contribute to career strain (Shane, 2010). These sometimes add to officer burden as they move through their careers.

Simultaneously, officers navigate common life transitions: marriage, parenting, mortgages, childcare demands, and financial pressures. These parallel stressors compound occupational trauma exposure and should be carefully managed.

Over time, repeated exposure to violence, death, and human suffering can contribute to:

Emotional numbing
Hypervigilance outside of work
Irritability and relationship strain
Compassion fatigue
Substance abuse
Burnout
Symptoms consistent with post-traumatic stress disorder (PTSD)

A meta-analysis of police officers found PTSD prevalence estimates ranging from 7% to 19%, notably higher than in the general population (Jetelina et al., 2020). Moreover, chronic stress has been linked to increased cardiovascular risk and sleep disruption among officers (Violanti et al., 2018). Some believe it is well above the 25 % prevalence level according to NIH.

Mid-career officers may be particularly vulnerable. As cynicism increases and promotional ceilings become apparent, some experience what scholars describe as “moral injury”—a psychological response to repeated exposure to ethically challenging or morally distressing situations (Papazoglou & Chopko, 2017). Mid career officers tend to run even higher than 25 % prevalence of PTSD.

A Cultural Shift Toward Normalization

In response to mounting evidence, many departments have begun reframing stress reactions as normal physiological responses to abnormal situations and they are treated as an injured on duty.

Organizations like the National Alliance on Mental Illness have partnered with law enforcement agencies to promote Crisis Intervention Team (CIT) training, increasing officers’ understanding of mental health—both in the community and within themselves.

Peer support programs, embedded clinicians, and mandatory wellness check-ins are increasingly common. These initiatives reflect a broader recognition that resilience requires structured support, not silent endurance.

The Co-Response Model: Evidence and Impact

Effective crisis stabilization in modern law enforcement requires more than rapid response—it demands structured decision-making, behavioral insight, and the ability to de-escalate complex human situations in real time. Integrating the ROAR-360 model (Respond, Observe, Assess, React) into crisis intervention practices provides officers with a practical, field-tested framework that aligns closely with Crisis Intervention Team (CIT) principles.

At its core, ROAR-360 enhances crisis stabilization by giving officers a cognitive roadmap during high-stress encounters.

In the “Respond” phase, officers focus on safe, controlled arrival while beginning to regulate the pace of the interaction. “Observe” emphasizes situational awareness, encouraging officers to identify both stabilizing and destabilizing factors—behavioral cues, environmental risks, and emotional dynamics. During “Assess,” officers synthesize this information, incorporating communication, risk evaluation, and behavioral health considerations. Finally, “React” prioritizes proportional, informed action, with de-escalation, voluntary compliance, and resource coordination as primary goals.

This structured approach directly reinforces the foundational goals of CIT programs: slowing situations down, reducing use of force, and improving outcomes for individuals experiencing behavioral health crises. Rather than relying solely on instinct, ROAR-360 operationalizes decision-making, helping officers remain deliberate, consistent, and adaptive in unpredictable environments.

The development of ROAR-360 is closely associated with the work of Pietro D’Ingillo, Psy.D., a law enforcement psychologist who has played a significant role in advancing CIT-based training within the Los Angeles County Sheriff’s Department and partner agencies. His work reflects a career spent embedding behavioral science into frontline policing, including collaboration with law enforcement, corrections, and county mental health systems.

Dr. D’Ingillo’s contributions to CIT programs emphasize a multidisciplinary, co-response approach—recognizing that effective crisis stabilization often requires both law enforcement authority and clinical expertise. Through the development of ROAR and related CIT training models, he has helped formalize a competency-based framework that translates de-escalation theory into actionable steps officers can apply in the field.

A key principle underlying his work is that crisis encounters are dynamic and person-centered. Some individuals respond to command presence, while others respond to empathy and clinical engagement. ROAR-360 supports this flexibility by guiding officers to continuously reassess and adapt their approach based on real-time observations and behavioral cues.

Integrating ROAR-360 into crisis stabilization efforts strengthens the overall effectiveness of CIT programs by bridging the gap between policy and practice. It equips officers not only to respond, but to think—critically, calmly, and strategically—under pressure. In doing so, it advances a model of policing that prioritizes safety, communication, and the preservation of life in every encounter. One of the most promising structural reforms addressing both officer stress and community mental health outcomes is the co-response model.

Co-response programs pair law enforcement officers with licensed mental health clinicians to respond jointly to calls involving behavioral health crises. Rather than defaulting to arrest or emergency detention, teams can conduct on-scene assessments, de-escalate situations, and connect individuals to services.

Research supports this approach:

A study of the Crisis Assistance Helping Out On The Streets (CAHOOTS) program in Eugene, OR found that approximately 17% of police calls were diverted to the co-response team, with only a small fraction requiring police backup (Watson et al., 2019).
Evaluations of co-responder models have demonstrated reductions in arrests, emergency department transports, and use-of-force incidents (Shapiro et al., 2015).
Officers participating in co-response programs report decreased role strain and increased confidence when managing behavioral health calls (Compton et al., 2014).

By shifting appropriate calls to clinician-led engagement, co-response models reduce officers’ exposure to repeated high-intensity encounters that may not require a strictly law enforcement solution. This redistribution of responsibility can decrease cumulative stress while improving outcomes for individuals in crisis.

Importantly, co-response models also mitigate moral injury by aligning response strategies with community-oriented and trauma-informed principles. Officers are no longer forced into binary arrest-or-release decisions in complex mental health situations and a continuum of care is developing here in Massachusetts, although not yet as fluid as it might be.

Toward Long-Term Sustainability

Law enforcement will always involve exposure to trauma. However, sustainability requires systemic adaptation. Research suggests several protective factors:

Leadership that models appropriate vulnerability
Routine, confidential mental health check-ins
Sleep and fatigue mitigation strategies
Strong peer support structures
Clear pathways for behavioral health referral
Integrated response models such as co-response teams

The evolution of policing culture—from hard charging to human-centered professionalism—does not signal weakness. It reflects maturity in understanding occupational health.

Supporting officers through cumulative trauma exposure is not merely a wellness initiative; it is a public safety imperative. Evidence increasingly shows that when officers are supported psychologically and structurally, communities benefit as well.

References

Compton, M. T., Bahora, M., Watson, A. C., & Oliva, J. R. (2014). A comprehensive review of extant research on Crisis Intervention Team (CIT) programs. The Journal of the American Academy of Psychiatry and the Law, 36(1), 47–55.

Fox, J., Desai, M. M., Britten, K., Lucas, G., Luneau, R., & Rosenthal, M. S. (2012). Mental-health conditions, barriers to care, and productivity loss among officers. Journal of Occupational and Environmental Medicine, 54(7), 861–866.

Jetelina, K. K., Molsberry, R. J., Gonzalez, J. R., Beauchamp, A. M., Hall, T., & Violanti, J. M. (2020). Prevalence of mental illness and mental health care use among police officers. JAMA Network Open, 3(10), e2019658.

Papazoglou, K., & Chopko, B. (2017). The role of moral injury in PTSD among law enforcement officers. Frontiers in Psychology, 8, 798.

Shane, J. M. (2010). Organizational stressors and police performance. Journal of Criminal Justice, 38(4), 807–818.

Shapiro, G. K., Cusi, A., Kirst, M., O’Campo, P., Nakhost, A., & Stergiopoulos, V. (2015). Co-responding police–mental health programs: A review. Administration and Policy in Mental Health and Mental Health Services Research, 42(5), 606–620.

Violanti, J. M., Owens, S. L., Fekedulegn, D., Ma, C. C., & Charles, L. E. (2018). An exploration of shift work, fatigue, and cardiovascular disease in police officers. American Journal of Industrial Medicine, 61(5), 414–420.

Violanti, J. M., et al. (2017). Police stressors and health: A state-of-the-art review. Policing: An International Journal, 40(4), 642–656.

Watson, A. C., et al. (2019). Crisis response services and diversion outcomes: Evidence from CAHOOTS. Psychiatric Services, 70(11), 1049–1055.*