Physical and mental health issues in police recruit training: a critical review

Abstract

Police recruit training is widely regarded as a high-risk period for physical injury and psychological strain, but much of the literature commonly cited to support this claim is drawn from serving officers, military recruits, athletes and other occupational groups rather than from police recruits themselves. Objective of the study was to critically appraise the evidence on physical and mental health problems during police recruit and cadet training, explicitly separating recruit-specific findings from evidence drawn from analogous populations, and to summarise contributing factors and prevention strategies. A critical review following the Grant and Booth typology of review types, rather than a systematic or scoping review; searches and synthesis were undertaken by a single reviewer, a limitation discussed in the text. PubMed, Scopus, PsycINFO, CINAHL and Web of Science were searched for English-language, peer-reviewed literature reporting physical or mental health outcomes in individuals undergoing structured police, cadet or law-enforcement-recruit training, from January 2005 to December 2024. A small number of foundational mechanistic sources predating this window were hand-searched and are explicitly identified as such rather than presented as part of the systematically searched evidence base. The synthesis draws on 24 sources, of which 8 report data directly from police recruits, cadets or trainees; the remainder derive from military recruits, serving police officers, paramedics, war veterans, athletes and university students, and are discussed as indirect, contextual evidence. Recruit-specific studies indicate a substantial musculoskeletal injury burden (approximately 27--41% of recruits injured during initial training, depending on definition and setting), sleep and circadian disruption during field-training phases, and measurable occupational stress, anxiety and depressive symptoms, with a small but growing intervention literature. The small number of recruit-specific studies, single-reviewer screening, English-language restriction, and heterogeneous outcome definitions and exposure measures preclude quantitative pooling and limit the certainty of conclusions. Available evidence, although still limited in volume and methodological strength, indicates a meaningful physical and mental health burden during police recruit training and supports further recruit-specific research together with integrated, evidence-informed prevention strategies.