Bedfordshire Police Cultural Intelligence Lead & DPA Executive Committee member Samantha Alexander writes about sickle cell disorder (SCD) – a condition affecting an estimated 7.7 million people globally – and looks at how it can be treated and accommodated in the workplace

During National Sickle Cell Awareness Month in September and all year round, hard work is being done to continuously raise the awareness of the importance of blood donation and the calls on all eligible donors to ensure the local blood supply reflects the community. Come and take a read with me as to why.

What is sickle cell disorder?
Sickle cell (also termed sickle cell anaemia) is an inherited blood disorder that causes anaemia (a reduced ability of the blood to carry oxygen) and chronic pain.

One component of the red blood cells, haemoglobin – which carries oxygen – is defective. This results in the usually doughnut-shaped cells becoming sickle-shaped. These are unable to squeeze through small blood vessels, causing blockages that deprive organs and tissues of blood.

People who inherit the disorder have two copies of the sickle cell gene, one from each parent. If both parents are carriers, having just one copy each, there is a one in four chance of the child picking up two copies of the gene. Those who carry just one copy have the sickle cell trait but may have no symptoms.

Sickle cell crisis
There are four types of sickle cell crises (Diggs, 1965). These are: vaso-occlusive, aplastic, splenic sequestration, and hyperhemolytic. The most common is the vaso-occlusive (‘painful’) crisis which people who have sickle cell may experience.

Sickle cell trait
Sickle cell trait means you carry one copy of the sickle cell gene (HbS) and one copy of the normal haemoglobin gene (HbA).

If you have the trait, it means your body produces a very small amount of sickle haemoglobin, which means that under certain circumstances, your red blood cells can ‘sickle’.

Because most of the haemoglobin in your body is normal, the majority of people with the trait do not have any symptoms at all, and might not even think to get themselves tested.

Who can be a sickle cell carrier?
Due to the movement of people across the diasporas, contrary to a known myth, anyone can be a carrier of sickle cell, but it is much more common in people from certain ethnic backgrounds. In the UK, most people who carry the sickle cell trait have an African or Caribbean family background, but it is not exclusive to this group and can occur in White British people.

Extrapolating from 16^th century census data, leading geneticist Dr Steve Jones, of University College London, has calculated that one in five Britons, 11 million people, have a Black ancestor: “Increasing numbers of White babies are born each year carrying the sickle cell anaemia trait because of hidden Black ancestry…” “People who think of themselves as White but have the sickle cell trait almost certainly had a Black ancestor” he said. (Source: The Independent – ‘Hidden Black Ancestry Linked to Rise in Sickle Cell Disorder’)

What about testing?
Everyone should get tested because if you are a carrier (have the trait), your children could have sickle cell disease, should the other parent also be a carrier.

Being tested is also important if you are having surgery: there is a slightly higher rate of complications during surgery if you have the trait. However, if your anaesthetist is aware, they can make sure you have extra oxygen, which reduces the chances of complications.

Why oxygen?
Lack of oxygen is one of the known causes of complications in people with sickle cell trait. So be careful if you’re at a high altitude (e.g. at the top of a mountain, long-haul flights).

Many people with sickle cell trait can and do lead normal lives and can even excel. People with ‘trait’ are often told they cannot do sport or travel to high altitudes, but this is not true – they just need to take a little extra care.

Another common myth suggests that sickle cell trait rarely carries any symptoms. However, it is gradually seen that it can cause pain in a number of individuals. For those with a sickle cell trait, 20-40% of the haemoglobin is HbS (in comparison to 80-100% in patients with a sickle cell disorder), suggesting that some sickling and the associated joint/crisis pain can occur.

Sickle cell and the Equality Act 2010
Sickle cell symptoms like pain, fatigue, stress and depression resulting from normal activities meet the criteria for disability, and the majority of people with SCD are deemed to be disabled. Even if your condition is controlled, you may still be considered disabled in the eyes of the law.

The Access to Work and Disability Confident Employer schemes are available for employees and employers including those who live with SCD and also those who have sickle cell trait. Click on the links for more information on these schemes.

June 19^th is World Sickle Cell Day, a United Nations recognised day to raise awareness of sickle cell disorder across the world, and September is Sickle Cell Awareness Month.

You can help! Read more about giving blood. ∎

This blog was originally published on the Bedfordshire Police intranet – it is reproduced here with kind permission of the author

She’s passionate about making Essex Police and policing in general more diverse and inclusive to reflect the communities we serve. So Inspector Tracy Betts was a perfect fit when the Disabled Policing Association was seeking a new president. And she’s hoping to inspire change nationally.

“I feel privileged that people have trusted me with such an important role. It’s given me the opportunity to influence people for the good of my policing colleagues nationally and to have a positive impact on policing.”

And this Purple Light Up Day – December 3 which is also International Day for Persons with Disabilities – Tracy says it’s all about celebrating difference.

“That’s the biggest message. Particularly cognitive difference, so, the way we think and learn. It’s not just about supporting people with a disability or a difference or a difficulty, it’s about celebrating the diversity they can bring to our Forces.

“People think you have to be registered disabled or you have to have a physical disability but it is anything which impacts on your day-to-day life. And it doesn’t have to be permanent. You may be disabled and not realise you are disabled. So it’s about understanding what disability really means and then being able to help yourself, work colleagues, friends and family to be the best you and they can be.”

And it’s in the area of police recruitment and retention of officers and staff which Tracy feels the Disabled Police Association can play a major part, alongside other national staff associations such as the National LGBT+ Police Network and the National Black Police Association.

“As a police service, we need to be able to move forward and we need to be able to change policing in the light of the way our communities think and rebuild those relationships that have been damaged in the past few years.

“For example, we’ve got a lot of young people coming into Essex Police who are much more open in talking about difference. People may come into the Force with assessments for autism and dyslexia or they are neurodivergent in another way, such as ADHD, OCD or Tourette’s. These are things we are understanding about more all the time.

“And that’s just ‘invisible disability’, the disabilities people don’t see. There are visible disabilities, and sensory impairment as well. But we have people with lived experience throughout the force who are here to help them.

“As a Force, we don’t get it right all the time, but we are committed to being able to change. And that’s the wonderful thing – to be able to change and evolve. This is reflected in the fact that the Essex Police is a Disability Confident Leader organisation.”

The DPA represents disability networks in the 43 police forces of England and Wales. It is consulted at the highest national level – including the Home Office and the National Police Chiefs’ Council – helping to change the way forces recruit, retain and develop their police officers and staff.

And it has been heavily involved in the Police Uplift Programme. This set out to recruit 20,000 police officers between summer 2019 and March 2023 – about 15% of the national workforce.

“The DPA has been pivotal, communicating the lived experiences of police officers and staff to the decision-makers, in a practical way. It’s made a massive amount of change in the past three years and I want that to continue.

“We’ve never had such a good opportunity to change the face of policing nationally.”

Tracy says it’s not just about supporting people with disabilities with reasonable adjustments, it’s about understanding what disability means. And all the national policing staff associations have worked with the College of Policing to ensure recruitment criteria mean we get the most diverse candidates coming forward.

“Record numbers of women, Black, Asian and minority ethnicities and people with disabilities have applied to join police forces over the past year. So it’s been effective. This is so important because we need to represent the communities we serve. If we don’t, they aren’t going to recognise themselves in the police.

Unfortunately, the police service has lost the trust and confidence of some communities and we need to rebuild it.”

A career detective for much of her 27 years in policing, Tracy joined Bedfordshire Police in 1995, transferring to Essex three years later.

Her ‘day job’ is now managing our Professional Assessment Team, helping to ensure every sergeant and inspector who is promoted into the role is supported and assessed during their first year in their new job.

She has also chaired the Essex Police Disability and Carers’ Network. Tracy is diagnosed with dyslexia and has other neurodivergent traits. She also has some physical health conditions, which fit into the definition of disability.

But she doesn’t fit into just one category.

“There are lots of parts of me. I’m not just a female police officer, I’m a female menopausal disabled police officer. I’m a mother and a grandmother and I also follow a faith so I have protected characteristics.

“So when we are looking at our policies and procedures to be able to recruit people, develop them and retain talent, the skills and knowledge we need as a service, we’ve got to make sure that we appeal to every part of them not just one aspect.

“We need to look at the whole.”

For more information on police recruitment and the support offered by the DPA, visit the police recruitment hub at joiningthepolice.co.uk ∎

This article originally appeared on the Essex Police website – it is reproduced here with kind permission of the author

In this blog produced for the Metropolitan Police Service Disability Staff Association, PC Erin Evans looks at how music can be used to promote recovery from brain and psychological injuries such as traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD)

What do you think of when you hear the term ‘Music Therapy’? Does just listening to music pop into your head? There is so much more to music therapy than purely listening to music. Let me explain…

Music Therapy is an established psychological clinical intervention which helps people whose lives have been affected by injury, illness or disability through supporting their psychological, emotional, cognitive, physical, communicative and social needs.

The Bonny Method of Guided Imagery and Music (GIM) has been effective in addressing symptoms of PTSD such as flashbacks, nightmares, anxiety, insomnia and difficulty concentrating. The GIM process allows access to the subconscious feelings, images and memories, which provides empowerment and reconnection through self-understanding with the therapist.

Another technique taught by music therapists is ‘Music Breathing’: this is taught by deep breathing to the rhythm of a song of the client’s choosing. Breathing in this way is seen to help relieve stress and anxiety. When the client has a flashback, music breathing teaches them to breathe along to the rhythm of the song, which makes them focus on the breathing rather than the flashback. Breathing exercises can have other benefits such as a reduction in blood pressure. This is a tool to use for receptive music therapy containment.

A study found that there were greater improvements in symptoms of PTSD with music therapy than for people who were receiving cognitive behavioural therapy (CBT). Symptoms of PTSD include:

• Avoiding places and people
• Trouble sleeping
• Trouble concentrating
• Irritability, anger outbursts or aggression
• Reliving the experience through flashbacks, intrusive memories, or nightmares
• Overwhelming emotions with the flashbacks, memories, or nightmares

Following a group Music Therapy for PTSD study, it was discovered that the therapy was helping relieve certain symptoms of PTSD. The social element of the group addresses the symptom of avoidance as the participants must be aware of those around them.
Music Therapy helps people with poor concentration as they must engage with their sounds as well as others. Instruments such as drums can be used to help with aggression and irritability: playing the drums loudly is a way of expressing anger, giving the participants a sense of empowerment.

Music therapy has been used to help police officers affected by PTSD in Seoul, South Korea, and the project run there has been very effective. The project was aimed to help manage stress, negativity and to build up the inner strength to cope with the officers’ job more effectively.

Following a research paper on ‘How can music therapy help in the rehabilitation of Police Officers from forces across the South East of England suffering from PTSD’, it was found that in 2016-17 there were 971 officers who took time off work for mental health related illnesses, with an increase of 19.7% in Kent Police, whilst the national average of officers who take time off for mental health reasons being 10.4%. Hampshire Constabulary also said that mental health was the main cause of sickness. Primary research conducted on this paper found that that overall consensus is that Music Therapy is not quite understood, and that needs to be done to improve awareness of the technique.

The research also found that there are a large number of officers who have previously suffered or suffer from a mental health related illness. It also found that being a police officer is an authoritative role, and thus there is potential stigma attached to admitting to having a mental health related illness. The research highlighted that there is a high rate of trauma and PTSD within the police, and currently a lack of psychological support. The majority of officers felt that Music Therapy should be trialled, as many felt that it could be an alternative way of helping with trauma.

Current support is offered through occupational health with services such as CBT. However, unlike CBT, Music Therapy is not a manualised approach – it is client-led, evidenced-based, and qualitative rather than quantitative. Whereas other therapies such as CBT are short-term fixes, Music Therapy is a long-term treatment. ∎

This blog was originally published on the MPS intranet – it is reproduced here with kind permission of the author