Wellness Risk Management: The Below 100 Approach to Mental Health
Back in 2010, I helped launch a law enforcement risk management initiative called Below 100. The reason behind the name was simple: We sought to reduce the number of law enforcement line-of-duty deaths (LODDs) in a calendar year to fewer than 100. By analyzing Officer Down Memorial Page data, we arrived at simple, direct tenets—just five in total—that could increase survival on the streets.
- Wear your belt
- Wear you vest
- Watch your speed
- WIN—What’s important now?
- Remember: Complacency kills
It proved incredibly effective. When we launched, there were 177 LODDs in the U.S. By 2013, that number had fallen to 105—the lowest it had been since 1943.
One of the reasons for Below 100’s success was an early and enthusiastic endorsement by risk manager Gordon Graham. A former California Highway Patrol officer and co-founder of Lexipol, Graham sometimes describes himself as a student of human tragedy. A major reason things go wrong, according to his research, is because we tend to deal with proximate causes rather than root causes. This is the difference between explaining what happened vs. why it happened. Speed, for example, contributes to a crash; it does not, however, explain why the vehicle was travelling too fast.
Below 100 deals in both proximate causes and root causes: Wear your belt; wear your vest; watch your speed. These are proximate. But don’t get complacent and remember what’s important now—these address root challenges of public safety. There is furthermore a root cause undergirding Below 100 that I think is sometimes underappreciated. It’s overarching message is: We—the collective We—care about you and wish you well.
That’s a powerful and motivating message for first responders who don’t often hear it.
Wellness Risk Management
When it comes to wellness and Below 100, the psychological concept of learned helplessness is important. Basically, people behave in manners that would suggest they have no agency in their own wellbeing—even when this is, from the outside, obviously untrue. As a first responder you’ve seen it: The spouse who calls 911 but never presses charges or the addict who swears they will get clean but never does. Below 100 reminds first responders that we care and then offers simple steps to increase the likelihood of survival.
Mental health is obviously a complex issue. But if I were to venture a risk-management-informed approach to improving it, addressing both proximate and root issues, here are my candidates for core tenets:
Watch what you eat. I was shocked to speak with a former chief of police who told me that in her career, eating well never once occurred to her. “It was get what you can get when you can get it,” she said. “This usually meant fast food and lots of coffee. For 20 years.” I’m no nutrition expert, but it does seem that whole, low-glycemic foods, such as fruits, vegetables, and proteins are better options than Hamburger Hut grease and Sugary Drink fizz.
Watch what you imbibe. There are various means of relaxation and for some this means an occasional adult drink or cigar. For someone with acute pain or insomnia, for example, this might mean a medically prescribed pill (or, in some states, marijuana). Unfortunately, far too many first responders are “unwinding” a little too literally. If this describes you or someone you know, there are resources standing by to help. At the very least, be informed and aware about potential harms.
Get good rest. Easier said than done in your line of work, especially for those of you on third shift. But respect the role rest and recovery play. Appreciate that sleeping is one of the most productive things you can do and essential to your health. Invest in some black-out blinds or curtains, turn off the phone and limit screen time before bed.
Remember: Be grateful. Gratitude is key to happiness. Professor Robert A. Emmons of U.C. Davis has made a career of studying its power and the results are astounding: more confidence and awareness, lower blood pressure, increased immunity, better physical health and more. Give thanks!
Take care of yourself, and each other. As a first responder, you’re in the helping business. Being physically fit is essential to your work. So take care of yourself. And, while you’re at it, have a look around. Who else can you help out? How’s you spouse or shift partner doing?
As Graham says, bogging down in proximate causes often prevents us from seeing what’s at the root. At the same time, without proper fuel, relaxation and rest, what kind of condition are we in to assess what’s really going on? Beyond that, let’s be grateful for what we’ve got and take care of each other.
Five tenets won’t solve all the behavioral and mental health challenges first responders face. But just like Below 100 did for reducing LODDs, focusing on these five core steps can get you and your colleagues moving in the right direction. It might even have profound effect on health and happiness.