Mental Health

Preliminary Assessment

Except in cases of psychiatric emergency, the police physician should conduct or review a medical evaluation of the LEO. If available, the following information should be requested:

• written job description containing a list of essential job functions
• performance evaluations of the last year (before and after injury or incident if relevant and available)
• any disciplinary write-ups or performance improvement plans
• discussion with or review of reports by collateral sources of information who have observed LEO behaviors of concern.

The history and physical should include the following:

• medical history
• psychiatric or psychological history including history of psychiatric hospitalizations, outpatient care, previous trials of psychotropic medications, and suicide attempts
• medications, including all supplements, non-prescription and prescription
• sleep history
• educational history, including academic performance and any academic disciplinary issues
• occupational history, including performance in prior work roles
• social history, review of psychosocial stressors associated with family life and personal finances, marital history, legal history, military history, including disability applications
• substance use/abuse history (including anabolic steroids), including any prior diagnosis, treatment, and social or legal consequences if there is reason to believe substance use/abuse contributes to the circumstances leading to evaluation (see LEO chapter on Substance Use Disorders)
• mental status evaluation: brief assessment of affect, mood, thought processes, abnormalities of thought (e.g., delusions) judgment, hallucination, speech, suicidal/homicidal ideation, if there are questions concerning cognition, brief screening instruments such as the Montreal Clinical Assessment, or the Mini Mental Status Examination can be administered (for evaluation of depression there are a variety of office screening tools available see Appendix E)
• physical exam focusing on neurological, endocrine, substance abuse and cognitive findings
• if appropriate, medication levels should be obtained (to evaluate adherence or diversion)