A rash of suicides by police officers has shaken the New York Police Department, leading the commissioner to declare a mental health emergency and highlighting the problem of untreated depression among law enforcement officers nationwide.
On Wednesday, Robert Echeverría, 56, became the ninth NYPD officer to take his own life this year. His death came a day after another officer, Johnny Rios, 35, killed himself.
The deaths have come despite the department's mounting efforts to encourage officers to seek help for depression and other mental health problems. After two officers killed themselves on back-to-back days in June, Police Commissioner James O'Neill sent a note reminding the more than 36,000 officers and 19,000 civilians in the NYPD that help is available if they're feeling depressed, hopeless or contemplating self-harm.
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But the deaths continued.
"It's extraordinarily painful," Mayor Bill de Blasio said Thursday. "We have lost officers in the past, but this concentration is devastating. We're going to do everything conceivable to help officers and to stop this."
The suicides have been a recurring nightmare for the nation's largest police force and have driven a discussion about the psychological toll of police work, a profession in which discussing mental health was long seen as taboo.
"This was something that no one ever spoke about," O'Neill said.
Law enforcement leaders around the country say they are hoping to change that mindset.
President Donald Trump recently signed a bill authorizing up to $7.5 million in grant funding a year for police suicide prevention efforts, mental health screenings and training to identify officers at risk.
"It is receiving much more visibility than ever," said Chuck Wexler, executive director of the Police Executive Research Forum. "The nature and extent of this issue is not well known, and the numbers we have are probably underreported."
Suicide claims more officers' lives annually than violence in the line of duty.
Prior to this week, there have been at least 122 law enforcement suicides in the United States this year, according to Blue H.E.L.P., a Massachusetts nonprofit dedicated to helping officers with PTSD, depression and other mental health struggles. That figure, which includes retired officers, puts the country on pace for the highest toll in at least the past four years.
"This is an epidemic," said Randy L. Sutton, a former Las Vegas police lieutenant who founded The Wounded Blue, another law enforcement advocacy group.
The suicide rate among police officers is about 16 per 100,000, according to 2013 figures, the latest available from a Centers for Disease Control and Prevention database.
The suicide rate among the general population has climbed to about 14 per 100,000, according to the CDC, its highest point since World War II.
John Violanti, a University of Buffalo professor and expert on police stress, said officers might be less likely to seek mental health treatment than the average person because of the nature of their job.
"The essence of the police culture is that you don't ever show weakness," he said. "That bleeds over into your personality, and cops develop this sort of hard shell."
All nine of the officers who killed themselves this year shot themselves, and they didn't have to go far to find a gun. Suicide rates are generally higher in states where a greater percentage of households contain firearms, studies have shown.
"That availability of the firearm of 24/7 makes them particularly at risk," Wexler said.
New York City police officials say the department usually has about four or five officers kill themselves each year.
Spates of suicides among law enforcement officers have gotten attention in places other than New York this year.
The Chicago Police Department, following the deaths of six officers by suicide in an eight-month stretch, posted a video in April featuring officers who reached out for help. A federal consent decree requires the department to increase the number of counselors in its employee assistance program.
"It's just a matter of cleansing yourself of whatever burden you're carrying around," Chicago Police Superintendent Eddie Johnson says in the video, likening the stresses of police work to a volcano. "That top is going to come off at some point."
Many agencies offer employee assistance programs, but departments are fighting the perception that whatever officers say will get back to their supervisors — or that they'll be ruled unfit for duty.
"If a cop breaks his leg, everybody's going to sign his or her cast and say, 'I wish you good luck,'" said Mark DiBona, a retired patrol sergeant in Florida who once contemplated suicide. "Nobody's going to sign your forehead when you say, 'I'm struggling.'"
In New York, police brass are encouraging officers to make use of an array of confidential help options, including peer support groups and a 24/7 text line.
In many departments, the last thing supervisors want to hear is that a gun-toting officer is showing signs of instability. That was the mindset several years ago in Phoenix, when Officer Craig Tiger fell into a spiral of self-destruction after fatally shooting a man who had been threatening people with a bat.
It took a drunken driving arrest a year after the 2012 shooting for Tiger finally to be admitted to a behavioral health center, where he was diagnosed with PTSD, said his ex-wife, Rebecca Tiger. In group sessions, Tiger realized he had many of the same symptoms as combat veterans.
He had witnessed death firsthand and, for years, self-medicated with alcohol.
"I think very often police officers don't want to admit to others that they are suffering," said Rebecca Tiger, herself a former Phoenix police officer. "The department never talked about PTSD. It was never brought up in training."
The police chief at the time fired Craig Tiger following his arrest. Tiger killed himself a little more than a year later.
The pain of her ex-husband's death was compounded by the police department's reaction, Rebecca Tiger said, adding some officers on her own squad did not even attend the funeral.
"If a citizen called up the Police Department and said, 'I'm suicidal,' we'd rush over there and help him," she said. "Craig told me for months that he was suicidal, and I couldn't get any help for him."
Arizona enacted a law last year known as the Craig Tiger Act, which compensates officers for treatment of PTSD. It affords them up to 36 counseling visits after being involved in traumatic on-the job incidents, such as witnessing a death.
"Now if you're diagnosed with PTSD and you need time away to heal and recover, you're not without pay," Rebecca Tiger said. "I think the stigma around this is changing."
Editor's note: The National Suicide Prevention Lifeline is 1-800-273-TALK (8255). Crisis Text Line provides free, 24/7 crisis support by text. Text HELLO to 741741 to be connected to a trained counselor.