Role of wider culture

As with all patients, what a police officer brings to the doctor is shaped by wider culture. A big feature of 20th century Western culture has been the rise in the authority assigned to medicotherapeutic ways of understanding the trials of life. Arguably, the contemporary concept of a person emphasises not resilience, as it once did, but vulnerability.1 A widening range of everyday experiences, including work, have come to be viewed as capable of inducing illness. “Stress,” until recently a folk category, has now gained the medical imprimatur of a real ailment: “work stress” is the number one cause of sickness absence in the United Kingdom.2

The number of people of employable age receiving incapacity benefit for longer than six months quadrupled to two million between 1981 and 2002. The Department of Work and Pensions states that 70% of patients receiving long term disability benefits have medically unexplained symptoms.3 Certification on mental health grounds is the leading cause of sickness absence in most high income countries, accounting for around 40% of lost time, with average time off sick for …