HARTFORD - A US Justice Department and National Alliance on Mental Illness (NAMI) report prompted by 12/14 and other high casualty events urges police chiefs around the country to put mental health programs in place to help officers cope with on-the-job trauma, including the aftermath of mass shootings., Preparing for the Unimaginable: How chiefs can safeguard officer mental health before and after mass casualty eventsreleased on May 25, is offered as a best practices guide. It was prepared with help from officials including retired Newtown Police Chief Michael Kehoe, who led the response for the Sandy Hook Elementary School shooting and reportedly worried during the following weeks that some of his officers might kill themselves.Preparing for the Unimaginable is the result of NAMI's work with Newtown's police chief," Mr Davis wrote in his Letter from the Director, which appears in the early pages of the report.Preparing for the Unimaginable is organized chronologically, and divided into four main segments. Part One explains why mental wellness matters to a chief and their agency, followed by Part Two, preparing for a mass casualty event. Part Three, "Managing a Mass Casualty Event and Its Aftermath," concerns immediate incident response, the first weeks, the first months and "the long haul," beginning with the pre-incident preparation the chiefs suggest in their collaborative foreword and concluding with long-term aftercare. The fourth section is a collection of personal stories and resources designed for educational purposes.'It Affects The Family'Preparing for the Unimaginable also includes input representing another group affected by mass shootings: family members of the police officers.Associated Press content was used in the creation of this story.

The report,

Oak Creek (Wis.) Chief of Police John Edwards, Manchester (Conn.) Chief of Police Marc Montminy, and Miami Beach (Fla.) Chief of Police Daniel Oates also collaborated on the report. The lead authors were Laura Usher, Stefanie Friedhoff, Sam Cochran and Anand Pandya, MD.

In the report's foreword, called "Mental Wellness Needs New Focus," the team of police chiefs writes, "The overwhelming probability is that you will not need this guide." The likelihood of a casualty incidents, they say, is "so low that no law enforcement agency has been able to develop expertise in dealing with such incidents, let alone the traumatic psychological aftermath they have on first responders.

"But when these events do occur," they continue, "they can have a wide-ranging impact on your agency and your officers."

The police chiefs suggest planning in advance for officer support, before an incident happens. Take action to prepare, they urge.

"The goal of this guide is to provide law enforcement executives with best practices regarding first responder mental health - best practices learned from colleagues unfortunate enough to have experienced a mass casualty event," the foreword continues.

NAMI brought together the police chiefs, mental health professionals, trauma and media experts, and others with first-hand knowledge to provide readers with a concise compendium of what worked and what did not. Melissa Glaser, LPC, community outreach coordinator for the former Newtown Recovery and Resiliency Team, and Newtown Police Sergeant Scott Ruszczyk, who also serves as president of Newtown Police Union, are among those listed as contributors.

According to Ronald L. Davis, director of Community Oriented Policing Services (COPS), his organization reached out to NAMI to provide guidance to the Newtown Police Department following 12/14.

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In his foreword, "Leadership When the Unimaginable Occurs," former Chief Kehoe, who retired from his post in January 2016, tells readers that as events were unfolding on the morning of 12/14, and in the hours following, "police officers throughout the state of Connecticut were already busy handling a multitude of important responsibilities required when a tragedy befalls a community."

Law enforcement must respond to catastrophic events, "to mitigate the dangers inherent in the crisis," he wrote. "Then they must successfully navigate the aftermath, including daily intrusions and reminders of the tragedy from the media and offers of assistance from hundreds of well-intentioned community members, and visitors arriving with stuffed animals, flowers, food, and other gifts.

"In addition to responding to traumatic events, dealing with the scope and duration of the aftermath of tragedies is one of the most important concerns of police chiefs and sheriffs throughout the country," he continued. "Ensuring the mental wellness and health of first responders has long been an underappreciated task for the heads of police agencies."

While law enforcement officers have learned from past events, and now train to respond to threats with "the best equipment and practices known today," Chief Kehoe wrote, "many chiefs are not prepared to deal effectively with the intense scope and unanticipated duration of the aftermath of these events, and many chiefs are unaware of the impact such events will have on their communities and the officers in their agencies."

The 140-page report emphasizes how to prepare for mass shootings, but it says taking steps such as choosing trusted mental health service providers, creating peer support programs and designating mental health incident commanders also will help officers cope with more common events such as car crashes, suicides and domestic violence.

Law enforcement experts say it has been a struggle to create conditions in which officers feel comfortable coming forward for help.

"Are we there yet? No. That's why this report is so significant because it raises awareness," said Jim Baker, director of advocacy for the International Association of Chiefs of Police in Alexandria, Va. Mr Baker also contributed to the report.

Lori Kehoe, RN, a former hospice nurse and the wife of retired Chief Michael Kehoe, said that a few weeks after 12/14, her normally cool, calm and collected husband became unnerved worrying that some of his officers would kill themselves.

The suicide rate for police officers is higher than the general public's, according to The Badge of Life, a group of current and retired officers working to prevent police suicides. Studies show there are about 125 to 150 officer suicides a year, and more than 200,000 officers are suffering from posttraumatic stress disorder or some other form of emotional stress, the group says. None of Newtown's police officers took their own life following 12/14, but that did not stop their chief from worrying that it might happen.

Ms Kehoe's personal recollections, "Lori Kehoe's story: The impact of trauma on law enforcement spouses," shares both personal and professional thoughts about her husband and some of the men and women under his command

"After 20 years as a hospice nurse, I understand grief and crisis," Ms Kehoe wrote in part. Her early concerns were for her husband. "I was able to identify a little anger this week, depression the next, bargaining, denial. Recognizing those stages allowed me to give Mike all the room he needed and understand the changes that were happening."

While her husband was doing well, Ms Kehoe said it took nearly a year after the SHES shootings before she realized something about herself.

"I was mentally and emotionally not functioning, almost to the point of not getting out of bed," she wrote. "And even though I'm a nurse, I didn't know about trauma - I didn't know what trauma could do to a person or that there was such as thing as PTSD by association.

"I was so angry. I was mad at everyone and everything. I was depressed beyond belief, alone, and isolated," she wrote.

Ms Kehoe called the first anniversary of 12/14 a turning point. She sought, and received, help for her anger through a weeklong program designed for the spouses of police officers.

"The treatment was necessary, and it changed my life," she wrote. Education is important, she says. "If an incident like this affects the officer, it affects the family.

"They may never talk about it, but it's still happening. And in some ways, I was lucky. Many people react to trauma with alcohol abuse and out of control behavior that creates chaos. That did not happen to my officer."

There is treatment, for everyone, Ms Kehoe pointed out. "You can and must do something about it."