The Psychological Fitness for Duty Exam

One chilly morning last Spring I crawled out of bed the same time I do every workday, showered, downed my morning coffee, and dressed for work–only this time forgoing my usual combo of dark blue cotton/poly blend, ballistic vest, boots and duty belt in favor of a more “business casual” look.

Pulling out of the driveway and heading north as usual, I continued past my normal turn toward the PD and instead went straight for my morning “happy place”–Caribou Coffee!!–to grab another unit of caffeine before doubling back to the train station and buying a round trip ticket to downtown Chicago. I had an appointment to make. It was with a clinical psychologist and I would be going through a full battery of tests and an interview as part of a psychological assessment.  

I wasn’t in trouble, or suspected of having any issues affecting my emotional wellness or ability to do my job. On the contrary, I had just been selected by my department as a Crisis/Hostage Negotiator, pending approval of the psychologist. The evaluation was merely a routine and final part of the selection process, and one I should pass easily enough. Right? 

Besides, I’d been through psych evaluations before and obviously passed.  I went through social work school and have a sound working knowledge of psychology and psychopathology, and I even provided a little therapy to others in my grad school days. And my wife’s a psychotherapist; she’d surely let me know if I had anything to worry about!

So why was I nervous?

Not terribly nervous, really, just … well, you know. Sixteen years of police work can change one’s perspective, after all, and sometimes in ways that non-cops might not understand.  For example, I had deliberately left my house almost two hours sooner than necessary just to make sure I arrived on time because … well, there had been a recent spate of suicides in the Chicago area. Figuring it would look bad showing up late to a shrink’s office, I wanted time to find alternative transportation should some sad soul decide to delay my trip by cashing out their chips beneath the wheels of my commuter train.  

Now, who in hell factors THAT contingency into their travel plans?!?  

As it turned out, I guess I needn’t have worried. I took the psychologist’s tests and answered her questions and obviously passed (even despite revealing to her the morbid reasoning behind my very early start that morning), since she forwarded her assessment to the department and they saw fit to move forward with me as a new negotiator.  

I had voluntarily waived any rights or expectation of privacy in the greater interest of earning a spot I coveted.     

What I went through that day was essentially a form of “Pre-Employment Psychological Exam” in the sense that the tests and interview were designed and conducted to gauge my compatibility with the duties of a Crisis Negotiator and how well I could be expected to hold up to the stresses of the job. 

It was a position I really wanted, the department had a clear and reasonable interest in making sure that I was well-suited for the job, and one of the ways for them to measure my suitability was to require I not only undergo a psychological assessment but also permit the assessor to share her findings with the department. Such is the nature of “Fitness for Duty” exams, but with a very important distinction we’ll soon get into.

We decided to bring up the issue of fitness for duty–and specifically psychological fitness for duty–in the context of this series we’ve been working on delving into employee assistance programs, counseling, and confidentiality. There seems to be some confusion about how seeing a mental health professional as part of a fitness for duty assessment might differ from seeing one for counseling, especially with regard to your confidentiality and what you can or should expect.  

A fitness for duty exam is actually very different from counseling–apples and kumquats, really–and the two should never be confused by officers, supervisors, or administrators.  Unfortunately, they often are and, when this happens, LEOs can feel blindsided if they think they are being sent for counseling when they are really being assessed for fitness, and are surprised to find there is no associated ethical or legal expectation of privacy attached.

Fitness for duty (FFD) exams are, in the strictest sense, supposed to be used to determine if employees are psychologically fit–or unfit–to continue on in the performance of their job duties when their emotional soundness has somehow come into question. 

According to psychologist Gary L Fischler, a fitness for duty exam “initially seeks to answer two questions.

First, does an employee have a psychological problem; and second, can he or she perform his or her job in a safe and effective manner? Both conditions must exist for an employee to be found unfit for duty. That is, if an employee has a psychological problem but no work problems (or clear potential for work problems) then he or she may be referred to mental health treatment, but could continue to work without restriction. In this case, the employee would not be compelled to such treatment and it would be at his or her discretion.

Conversely, if there are work related problems, but no psychological problems, the issues should be handled through remedial or disciplinary channels.”  (Fischler, 2001)    

This, of course, is the ideal and how it usually works in most workplaces. 

It should be said, as Althea often notes out from her experience and practice (she does not do FFD exams herself, but commonly assists in referrals and frequently provides concurrent therapy to employees undergoing FFD assessment), that when an agency or company sends an employee for a true fitness for duty exam the motivation is almost always to help the employee. The organization has recognized an employee is failing to fulfill essential duties in some fashion, sees that it may be a result not of incompetence or insubordination but rather an underlying psychosocial issue, and is committed to helping the employee. 

And while it’s true FFD exams are often a source of stress for the employee, and may be perceived as an act of punishment (instead of an intermediary component of progressive discipline designed to help the employee avoid more severe punishments)–and this can be especially true for cops–refusal to submit to one can be much worse.  Restoring the employee to full functionality and good standing is almost always the goal.

As the employer has a strong stake in the fitness of its employee’s psychological soundness as it relates to the workplace, and as compliance with the FFD exam is often a prerequisite to continued employment (or, at least, avoidance of harsher discipline), it follows that the employee’s expectation of confidentiality is lessened.

The mental health professional conducting the FFD will be working for the benefit of both the employer as well as the employee, will be sharing certain findings, and will ultimately make a recommendation to the employer regarding the employee’s fitness for duty and recommended follow-up. 

For these reasons FFDs should never be taken lightly by the employer; they can be quite intrusive and should only be used when there are very real concerns about both the psychological fitness of the employee and that his or her continued employment is jeopardized.    

The term “fitness for duty” has, in some ways, been bastardized or misused to represent other types of employment-related assessments. This is very true in our field of law enforcement.  In our view, the need for FFD assessments for cops is evident; it is an extremely stressful profession that can wear on officers’ emotions and psyches and may, in extreme cases, impair officers’ ability to safely, effectively, and fairly do the job. When that happens, for the sake of the officer, department, and community, identifying troubled cops and either restoring them to effectiveness or, in the worst cases, removing them, is critical.  

Unfortunately, “fitness for duty” has, to a great extent, become a catch-all phrase generally applied to the post-critical incident assessment and mandatory counseling some police departments implement with poorly planned (if planned at all) and poorly executed good intentions. 

Take, for instance, an officer involved shooting (OIS).  Most police departments will have some form of paid administrative leave for the officer(s) directly involved; besides the need to conduct a thorough investigation of the facts, an OIS is, by its very nature, a traumatic event that can have a tremendous emotional, psychological, and even physical impact on involved officers. Many departments may require their involved officers undergo a psychological assessment, or recommend or even mandate counseling, before the officer(s) is/are allowed to return to full duty. These mandated exams or sessions are often referred to as fitness for duty assessments.

Attorney Laura Scarry, a former police officer and current writer, trainer, and lawyer who dedicates her practice to represent police officers, doubts the appropriateness of using the “fit for duty” term post-incident, as it “implies that something is awry” when the officer has done nothing wrong and acted in accordance with training and procedure. 

Part of the problem, according to Scarry, is that “management and officers are often reactionary” and only learn what to do in response to an OIS or other critical incident after it has already occurred. Officers may or may not be required to go for a FFD exam or be referred to an EAP for counseling, and both management and their officers may not even know the difference or the proper terminology.

Often, Scarry says, management “just tells the officers, post-incident, to ‘go for counseling’” (which implies confidentiality) when what they mean is for the officer to undergo a FFD exam (with its necessarily lessened confidentiality). She urges agencies and officers to have a plan in place before an incident occurs, to understand the implications of that plan, and for officers to “never assume anything.”  

And that is one of the clearest pieces of advice we offer, as well.  If it’s clear you are being mandated before a mental health professional, ask “is this a fit for duty exam?” of both your administration when you are referred, and again when you meet the professional you’ll be working with. Be clear about the purpose of your meetings, and what, if anything, will be released to the department or other parties.  

And if you do, in fact, find yourself in a FFD exam, do not treat it as therapy. It’s not. Follow the lead of the examiner and trust their intentions to help you. Read carefully and understand the releases you will be asked to sign.

Clarify, without being adversarial, the goals and end product of the exam and also what you can expect to be confidential and what will be released to third parties.

Next month we will continue with this series, returning to our study of EAPs and confidentiality, but we thought it necessary to devote time to clarifying any confusion about the differences between counseling and a fitness for duty exam.  The reality is we all have a strong likelihood of someday undergoing what our department calls an FFD, so understanding them is critical.  

“Psychological Fitness-For-Duty Examinations:  Practical Considerations for Public Safety Departments” by Gary L Fischler, PhD.  Illinois Law Enforcement Executive Forum.  2001.

Laura L Scarry, JD. DeAno and Scarry, LLC, Chicago, IL & Wheaton, IL

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