Repetitive Head Impacts (RHI), Head Impact and Trauma (HIT), & Blast Overpressure (BOP)
The Brain Keeps Score®
Introduction
For decades, we’ve addressed the psychological wounds of law enforcement and first responders without asking a critical question: Are there underlying neurological factors?
I created this RHI, HIT & BOP Self-Assessment to confront what has long been ignored.This assessment captures three critical types of brain trauma exposure that can alter brain function and mental health:
- RHI (Repetitive Head Impacts): Cumulative impacts from sports, training, defensive tactics, and arrests, even subconcussive/nonconcussive impacts that don’t cause immediate symptoms but accumulate over time
- HIT (Head Impact and Trauma): Significant single-event head injuries, diagnose concussions, and traumatic impacts that cause immediate symptoms
- BOP (Blast Overpressure): Exposure to explosive blast waves from breaching, flashbangs, IEDs, heavy weapons fire, and other explosive events that create pressure waves affecting the brain
These exposures aren’t limited to combat injuries. They include the cumulative trauma faced by military, law enforcement, and other first responders simply by doing their jobs.
It is my belief that the presence of neurological comorbidities is the missing piece in suicide prevention. If you’ve experienced symptoms of PTSD, depression, anxiety, or impulsivity and you’ve worn a badge, served in the military, or trained others in high-impact environments, you need to take this assessment.
We cannot treat what we do not understand. It starts with the brain.
Respectfully,
Stephanie Samuels, MA, MSW, LCSW
Clinician Specializing in Law Enforcement Mental Health Since 1989
Founder, CopLine, Inc.
Why This Matters
Many first responders, military members, and civilians experience head impacts, blasts, or repeated jolts to the body or brain through their work or life experiences, even without losing consciousness. These injuries may not seem serious at the time but can build up and affect memory, emotions, sleep, and behavior later in life.
This assessment helps document those exposures so your care team can better understand what might be affecting you.
Important Notice
This assessment is not a diagnostic tool. It is designed to help you document your exposure history and symptoms to share with qualified healthcare providers. Only a licensed medical professional can provide a diagnosis.
Time to Complete: Approximately 15-20 minutes
Privacy: Your responses are confidential and protected
Copyright notice: RHI/HIT/BOP Self-Assessment Tool was created by Stephanie Samuels, MA, MSW, LCSW, and is given freely to the first responder community. It belongs to you. While this tool is yours to use, share, and benefit from without restriction, it remains under copyright to preserve its integrity. It may not be reproduced for commercial purposes, repackaged, or distributed in modified form without the express written permission of the author.
Completing This Assessment
Consider having someone who knows you well assist you. Brain injuries can affect memory, making it difficult to recall all incidents accurately. A spouse, partner, close friend, or family member may remember events you’ve forgotten or provide helpful context about changes they’ve observed in you over time.
You can complete this assessment alone, but involving someone who knows your history may result in a more complete and accurate picture.
