In 30 years as a Miami-Dade cop, he’d seen things he could not shake from his mind — a disemboweled body, a man bleeding out from a self-inflicted bullet to the brain. He’d been shot at, and shot back. He still hears the scream of a father learning his daughter had been killed in a car crash.
In all that time, only once did a supervisor ask how he was holding up — and that was long ago after Hurricane Andrew. So he kept his emotional turmoil to himself.
“I didn’t want to be seen as weak. I came on to this department as a pretty happy-go-lucky guy. I know now, I’m not that guy anymore.”
Stress and fear haunted the nights of another cop — dark dreams of drowned children and bullets striking him. He thrashed in bed, heart pounding and mind reeling, fighting thoughts of suicide.
“I can tell you I know what my gun barrel tastes like.”
The two officers are far from alone in struggling to cope with the traumas and pressures of the job. In a ground-breaking assessment, Miami-Dade is surveying its police and fire departments to get a better grasp of how many first responders might be dealing with post-traumatic stress disorder. More than 1,000 cops and firefighters have already filled out questionnaires and the results are expected to be made public as early as December.
The first-of-its-kind survey for Miami-Dade is part of a growing shift in law enforcement to openly acknowledge psychological challenges and help cops and firefighters deal with them.
“We are not doing enough to provide mental health services that are accessible to law enforcement,” said Habsi Kaba, director of Miami-Dade’s Crisis Intervention Team, which works with first responders who often feel that toughing things out is a job requirement. “You are supposed to put on that armor and just deal with it and if you are feeling emotional, then maybe you are not cut out for this job.”
There are already plenty of national statistics that suggest a mental health epidemic for first responders, particularly cops, whose daily roles also have come under increasing public scrutiny and criticism in recent years after a string of controversial shootings and arrests, mostly of black men and women, that have been caught on video or body cameras.
More police officers die by suicide than in the line of duty and, compared to the general population, they have significantly higher rates of anxiety and other mental health illnesses. About nine out of ten first responders will be exposed to a traumatic event in their career, and around one in three of them will develop post-traumatic stress disorder. In late October, the International Association of Chiefs of Police hosted a special forum to confront the mental health crisis in departments nationwide.
In Miami-Dade, calls for help are also rising, with a 62 percent increase in appointments with the department’s psychological services unit since 2014, said Lt. Melissa Barosela, who oversees the unit. The county also has beefed up its service, now employing six full-time psychologists working with as many as 100 officers and civilians each month.
The PTSD study in Miami-Dade was requested in May by Miami-Dade Commissioner Jose “Pepe” Diaz, who asked for it after reading a study about suicides among firefighters. His request came several months after Florida legislators passed a bill permitting first responders suffering from PTSD to qualify for workers’ compensation.
“They’re really going through some serious hard times,” said Diaz. “It’s kind of messed up that we don’t get them the help that they need.”
Still a stigma
Despite the progress, many cops and experts acknowledge there is still a social stigma attached to mental illnesses. And it’s arguably more pronounced among cops and emergency workers who are supposed to be trained to deal with trauma. That was reflected in interviews with three Miami-Dade officers who agreed to talk about their struggles. Though willing to discuss their difficulties, none wanted to be identified by their full names.
Psychological problems remain a sensitive issue for many rank-and-file officers, a perceived weakness in an occupation that puts a lot of pride in toughness and strength, both mental and physical.
“People out there want help,” said the third Miami-Dade officer, who was willing to go by his first name, Doug. “They’re just afraid to come ask.”
Doug is a fourth-generation cop who knew what he wanted to be since “the doctor slapped me in the ass” and always wanted to be on the street, never behind a desk.
“I’ve crashed cars, been hit by them, cut, stabbed, grazed twice [by bullets], gone through plate glass windows, tumbled down stairs, fallen off rooftops, been in more fights than I can remember. Broke bones, gotten hundreds of stitches and each time I came back for more.”
The decades on the force have left his body in “constant pain” and “at times, the depression is debilitating.” He’s lost count of the surgeries and procedures he’s undergone.
But his personal life was a far worse mess. His wife had an affair. His father died. His finances floundered. Doug, who rarely touched alcohol before joining the department, began to drink. Heavily. At first it was just a weekend thing. Then every day. He’d often wake up with a hangover and had to sweat it out at the gym before work.
Triggers, like the whiff from a garbage dumpster reminiscent of a corpse, spurred him to drink. So did the 2016 murder of King Carter, the 6-year-old Northwest Miami child who was killed by a stray bullet in a shootout while he was on the way to buy candy at a store. The investigation into the senseless death of an innocent child gutted Doug, opening wounds that had been scarred over. At one point he couldn’t fall asleep for a week. So he drank more.
“It was my normal life for years, many years,” he said. “There was a time when I was looking to drink myself into the grave.”
That had already almost happened on Memorial Day, 2015. He recalls barbecuing with friends, then waking up three days later in South Miami Hospital. He’d blacked out from drinking.
Barosela, the department’s psychologist, was at his bedside when he came to. He got help, but it didn’t hold up. For the next few years, Doug cycled in and out of rehabilitation and support groups. Then he finally decided he’d had enough and therapy stuck. Now, Doug shares his story with trainees at the police academy — offering guidance he never got as a rookie.
“There’s always going to be a King Carter, unfortunately,’’ he said. Every day, things he sees, hears and smells remind him of his worst cases. “The memories trigger the drinking and the drinking triggers the addiction.”
Taking out the trash
For many cops, it’s hard to recognize the early warning signs. PTSD in first responders often emerges through a slow buildup of events, said Dr. Deborah Beidel, a psychologist at the University of Central Florida and director of a clinical research lab known as UCF RESTORES.
She likened the mind to a trash can filled with memories. PTSD can occur when a person remains unable to fully process a traumatic event, Beidel said.
“We don’t like to take out our trash a lot and so we push it all down until finally it gets to the point where it is overflowing. And that’s where the problem starts.”
Ignoring the signs can impact the ability to perform a job at a high level, Beidel said. Almost anything can trigger anxiety. After the Pulse nightclub shooting in Orlando, where 49 people were killed and 53 wounded, many responders reported that one of their most difficult memories was the ringing of cellphones on bodies in the dark silence of the club. Years later, some still react when they hear a cellphone ring.
Beidel said officers are more likely to be overcome by events that connect to their personal lives, like responding to the death of a child similar in age to one of their own.
The Pulse shooting in 2016 changed the way UCF RESTORES operated. Before the incident, the facility dealt mainly with veterans. But now, as mass shootings become more frequent, it’s opened its doors free of charge and funded by the state, to law enforcement, firefighters and civilians who need help. Beidel said over the past three years the lab has treated nearly 250 first responders.
The program uses something called exposure therapy to help people work through situations and triggers that their brain has conditioned them to believe are dangerous. After three weeks of intensive care, three out of four first responders no longer meet the diagnostic criteria for PTSD, Beidel said.
She hopes that first responders can learn to accept that their feelings are normal human reactions to trauma, not an incurable crippling affliction that they should feel shame about.
“I don’t want robots protecting me,” Beidel said. “I want people with hearts, who will react with hearts. No person with a heart can view the things our first responders view and expect it’s not going to affect them in some way.”
The goal for mental health experts is threefold: Teach first responders how to recognize problems, remove the stigma associated with those problems and help people deal with them. Miami-Dade’s police department seems to be ahead of the curve on those issues, in part because officers deal with so many mentally ill people on the street themselves.
Since 2003, Habsi Kaba has taught a class designed to help officers to better recognize and handle those difficult encounters. But over time, the class morphed into teaching police about their own mental health and what they are likely to experience. Kaba estimates she’s held training sessions for more than 7,000 officers.
“No one was helping them. The class became the platform,” Kaba said. “We present it as we are going to talk about people with mental illnesses and little do they know, they begin to realize that we’re also talking about them. We’re talking about all human beings — there is no difference.”
At the end of every class, “without fail,” Kaba said some officers ask to talk. Kaba said it took years for officers to learn to trust her, but that she now receives regular calls from police considering some form of treatment or therapy.
Her clients have nicknamed her “The Hotline.”
“What I’m trying to do is remove all the barriers in their head to just reach out for help,” Kaba said. “It’s like a physical wound — if I’m bleeding, I need to stop the bleeding. What I try to teach officers is: It’s only going to get worse.”
Barosela, who runs the department’s psychological services unit, says many officers are worried about an impact on their careers. To help retain anonymity, psych services offices are located off-site and visits are strictly confidential — supervisors are not notified and no personal information is shared. Even appointments are staggered to try to avoid patients running into each other.
Barosela, who has worked on the unit for over a decade and served alongside people she has helped treat, says she also takes calls at any hour of the day.
“If it’s 3 a.m. and I’m sitting there with a gun at my head, I can call her and she will answer,” one officer, who has sought help from Barosela, told the Herald. “I know I can call her.”
Psychological Services provides support for substance abuse cases, bereavement, relationship counseling, crisis debriefing and post shooting trauma intervention. Other police departments in Miami-Dade can and do request to use its services.
Still, outside of South Florida, many departments with smaller budgets may not have the resources for first responders in need.
Geoff Bichler, an attorney who specializes in first responder lawsuits, said there aren’t enough good options for many police officers and firefighters. There is also a question of how many will be willing to step forward to pursue workers’ comp claims under the new state law because it requires openly acknowledging problems, which remains a major hurdle for many police officers.
“Most agencies are requiring people to come forward and seek help before they are offering it,” he said. “I think that is a regressive and unfortunate approach. We still have a very long way to go.”
On the Miami and Miami Beach forces, troubled officers can turn to fellow officers for help — peer support teams who listen to problems and can direct cops to outside help.
Since 2016, the Miami Beach department has had a 24-hour support group.
“When you have a peer team that is made up of officers, people can feel like you understand, you understand the stress, what you are going through at work,” said Miami Beach Lt. Elise Spina Taylor, a licensed psychologist.
Those selected as volunteer peer supporters take a 40 hour course on how to recognize mental health issues. During critical incidents, like an officer-involved shooting or the death of a child, volunteers will show up on scene, often handing out a pamphlet explaining symptoms and available resources.
“I can’t force someone to get help,” Spina Taylor said. “But at least I can let them know help is available.”
She said skepticism is eroding and that her department now averages between 50 and 100 hours of support time a month.
“We understand our job is to help the community,” Spina Taylor said of the police department. “But if you are not mentally and physically OK, you can only help other people so much. Sometimes we don’t help ourselves.”
The psychological toil of police work is getting new, if belated, attention. Top law enforcement officers gathered in Chicago earlier this week to address suicide rates of police around the country. So far this year, 188 officers have committed suicide, more than twice the number who have been killed in the line of duty. In New York City alone, the number stood at 10 through the end of October.
Miami-Dade police, one of the largest forces on the East Coast with nearly 3,000 sworn officers, hasn’t had a suicide of a working cop in almost five years. Police Director Juan Perez said the reasons are hard to quantify, but he likes to think it’s at least in part due to the department’s “robust interventions.” He also thinks the department’s interactions in the community play a part. He points to demonstrations that erupted throughout the country in 2016 after a sniper killed five Dallas police officers and injured nine others. Protests were at a minimum in Miami-Dade.
“In New York, police are ridiculed. There are protests and demonstrations. They undergo additional problems that we don’t,” Perez said. “Our relationship with the community here is different. Maybe it’s because we’re more of a melting pot.”
Holding it inside
Still, no matter how painful the job can be, it remains hard for some people to ask for help.
That once happy-go-lucky officer, who joined the force at 21, vividly recalls how the weight of the job crashed down on him one off-duty day as he sat in his car a decade into his career. He suddenly felt like he was going to black out and rushed to the hospital thinking it was a heart attack.
The doctor told him it was anxiety.
He realized he’d burned himself out, working lengthy midnight shifts while trying to spend time with his kids during the day. Like his colleague, and many people under stress, he began to self-medicate after a couple of years on the job. First, it was a few beers. He graduated to an entire bottle of whiskey. He would lash out at his wife and kids over minor things, once throwing a toaster against a wall. He drank through his whole career.
Two years before he retired, the officer said he received a call about a man in Cutler Ridge who was high on synthetic heroin and who had poured a pan of hot grease over his head. When the officer and his partner reached the man, he was jabbing his own throat with a 10-inch shard of glass, his entire body covered in blood. The man dropped the glass and moved toward the officers screaming “kill me mother------, kill me.”
At first, he reached for his gun but because the man was unarmed, he instead wrestled the man to the ground. Blood soaked his uniform and seeped into the officer’s shoes, squishing between his toes. He would have to wait weeks before learning the man didn’t have any transmittable disease.
When he got home afterward, he didn’t think about what happened. He was more worried about finding new shoes so he could go back to work the next day. Only later would he realize how it impacted him — he would replay the moment where the bloody man came at him over and over at night.
He told his wife what happened and they both broke down. It was the first time, the officer said, that he opened up to her about the toll the job was taking on him.
“It’s almost like everything that I had witnessed up to that point, like boom, here it is, it just blew up. I just had an overwhelming amount of emotion,” he said.
He has since retired, hoping that would ease his anxiety. Instead, his problems have worsened. Even at home he eats with his back to the wall, creating better sight lines to protect himself if someone is coming at him or his family. He sits in the last row of bleachers at his daughter’s volleyball games to afford a better view of the surroundings. He still wakes up suddenly, his heart racing.
“I’d like to get help,’ he said. “But I don’t know where to start.”