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

by Dave Campbell
Chair | Metropolitan Police Service Disability Staff Association

Accessible toilets: why do we have them and why do we need them?

The provision of accessible toilet facilities is fundamental in the modern workforce as well as being a crucial part of being an inclusive organisation. It is also a legal requirement and is covered under both the Equality Act and Building Regulations.

The Equality Act 2010, states that all organisations have a duty to provide accessible goods and services to their disabled workforce. The provision of accessible toilet facilities is a fundamental and crucial part of inclusive service delivery, therefore their design and management warrant careful attention.

According to the Government’ s data capture body (Office for National Statistics – ONS) approximately 18-23% of the adult UK workforce will have a disability. This equates to about 8,000 people in our organisation that are likely to have some form of disability, in a workforce of 46,000.

Accessible toilets are useful for a broad range of people who are either permanently or temporarily disabled – they provide an important provision for disabled persons to use the facility independently and as safely as possible. The guidance in Building Regulations was a result based on many years of campaigning by disability rights groups and research into the broad church of issues that disabled persons face in the workplace and public areas; and so the design, positioning and exclusivity of use of accessible toilets should be followed exactly as intended, because all of the requirements contained within are essentially important to someone.

What may appear to be a small and insignificant detail to some may pose a real element of difficulty or even danger to a disabled person. On many accessible toilets in the workplace as well as in public areas, we may see signs that look similar to the one presented above, which make us think that its use is confined to wheelchair users only.

Notably 70% of all disability is hidden, which means that it is difficult to assess if a person using the facility really needs to, so there has to be an element of widespread trust, consideration and common sense. If you don’t really need to use the facility of an accessible toilet, then simply put: don’t!

Most significantly, the working age of our organisation is changing and likely to get older in the future due to changes in our pensions, compulsory retirement and retirement age. Many people are working beyond anticipated retirement age. The UK has an ageing population with over 40% of the population aged over 45 years – the age at which the incidence of disability begins to increase significantly. As we live longer and in comparison to previous generations, age brings an increasing chance of disability or impairment.

So what is the difference between an accessible toilet and a regular toilet? Both may be used by differently abled people, but the fundamental differences are in the design and layout, the available space, cubicle layout, the flooring, the hand-grip equipment, the lighting, the alarm system, height of amenities such as wash basin, toilet paper, and so on. The toilet, above all else, removes the disabling barriers and limitations that exist for people with disabilities in regular toilets.

The accessible facility’s wider access doors and bigger room/cubicle area provides adequate space to manoeuvre safely with or without walking aids, wheelchairs or assistance dogs. Toilets seats are raised higher to make it easier to stand up and sit down. By raising the seat of an accessible toilet, transfers to/from a wheelchair are also safer as the seat height is more equal between the two. Wash basins are equally set at a height to aid ease of use. Taps are different so they are operable by people with limited strength or manual dexterity – they should be operable either by automatic sensor or lever action (capable of being operated using a closed fist). The surface finish of sanitary fittings and grab bars generally contrast visually with background wall and floor finishes. Specific heights are specified for placements of full and half-length mirrors, which are useful to persons changing stomas. Such attention to detail also applies to placement on soap dispensers, paper and toilet paper dispenser, and hand dryers.

An accessible toilet is designed to meet the majority of needs of independent wheelchair users and people with mobility impairments, as well as the additional requirements of people with bowel and bladder conditions. It also helps people with impaired dexterity, grip or balance, and other conditions where physical support from grab rails and the presence of an emergency alarm is helpful. It may also be a place where someone can have privacy to change a colostomy bag or stoma, and to self-medicate such as administering injections, e.g. insulin. In terms of health and safety, should someone fall or slip there will be an alarm cord sited within the unit to alert the need for assistance.

In most buildings you will find more regular toilets available than accessible toilets: for example in many buildings there may be female/male or gender neutral toilets on all or several floors, as opposed to generally one accessible toilet in a number of our buildings which are usually situated on the ground floor and on a main exit/entry route. In our larger buildings there are of course a higher number of accessible facilities. Non-disabled colleagues have to a degree a choice of where to go; the choice for disabled persons are more limited.

Where accessible toilets are generally used because of ease of use rather than necessity, facilities can often became unusable or placed out of action due to lack of care in hygiene, lack of consideration (people not leaving the facility in a clean state), carelessness or misuse (blocked toilets). This could mean that no other facility is available for use, or overused so often by the general workforce that a person who needs to use them are unable to due to over-occupancy. This can also mean that these toilets are less safe for someone with mobility issues: they may be unable to change due to fear of slipping, have nowhere to place items to change, or be unable to administer medication or change a stoma dressing.

Lack of availability can be critical for colleagues that need to use facilities because of mobility and dexterity issues, irritable bowel disease, syndromes such as ulcerative colitis and Crohn’s disease, coeliac disease, fibromyalgia, and many other conditions requiring them to be located near to an accessible toilet.

Believe it or not, I get a number of complaints from our disabled colleagues across the MPS around the misuse of accessible toilets. Some have recounted experiences where due to facilities being out of service or left in an unusable state, staff have soiled themselves as they cannot access them. Often these services are out of use because they require the service of a plumbing specialist, or specialist cleaning due to the mess left. Many people are unable to manoeuvre in a regular toilet and may struggle to get to an accessible facility elsewhere in the building in time. This is not just confined to policing – many say this is a regular occurrence in shops, malls and other public areas where there is an accessible facility.

Furthermore, people often believe it is OK not to report a fault, or to leave an unhealthy mess left that poses a risk. This can impact on whether someone can come to work and stay at work – people have often expressed how degrading this can be. Where locks and a RADAR key locking mechanism are fitted, these have been damaged to gain access, which makes facilities unusable as they become insecure and less private, allowing someone to enter whilst they are in use. Facilities that suffer from these issues are often left out of action for days if the problem is more extensive.

These things do happen! Is it really acceptable in 2022? How would you feel if your loved one retuned from work distressed because of the lack of consideration from their colleagues?

There are no laws that state that non-disabled persons can’t use accessible toilets, and we’ve all been caught short at some point in our lives with the nearest useable toilet being the only option. Because much of disability can be hidden, it is not appropriate to challenge everyone who comes out of the cubicle as to whether they have as a legitimate reason to use the facility. It is important that people understand why accessible toilets exist and act with consideration, maintaining a disabled person’s right to common decency and dignity. ∎

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

This article was kindly provided to us by the Metropolitan Police Service Disability Staff Association and first appeared on the MPS intranet

March 26^th was Epilepsy Purple Day. Purple Day is an international grassroots effort dedicated to increasing awareness about epilepsy worldwide. On March 26^th annually, people in countries around the world are invited to wear purple and host events in support of epilepsy awareness. Last year, people in more than 85 countries on all continents participated in Purple Day. The origins of Purple Day go back to 2008 when Cassidy Megan created the idea of Purple Day in 2008, motivated by her own struggles with epilepsy. Cassidy’s goal was to get people talking about epilepsy in an effort to dispel myths and inform those with seizures that they are not alone.

So what is epilepsy? It is defined as a neurological disorder marked by sudden recurrent episodes of sensory disturbance, loss of consciousness, or convulsions, associated with abnormal electrical activity in the brain. The brain controls the way we function, Inside the brain, millions of nerve cells (neurones) pass messages via electrical signals to each other. During a seizure these electrical signals are disrupted and this affects how you feel or what you do while the seizure is happening. Epilepsy is usually only diagnosed after a person has had more than one seizure and not all seizures are due to epilepsy.

Epilepsy can happen to anyone, of all ages, races and social classes. UK statistics suggest that epilepsy affects around one in every 100 people in the UK. Every day, 87 people are diagnosed. One in every four people newly diagnosed with epilepsy are over the age of 65. One in every 220 children will have a diagnosis of epilepsy. That’s an average of one child with epilepsy in every primary school and 5 in every secondary school. There are around 60 different types of seizure and a person may have more than one type. Seizures vary depending on where in the brain they are happening. Some people remain aware throughout, while others can lose consciousness.

Photosensitive epilepsy affects 3% of people with epilepsy. In this type of epilepsy, seizures are triggered by flashing or flickering lights, or some patterns.

The consequences of an epilepsy diagnosis are severe and wide-reaching, It can also affect someone’s education and employment prospects, and lead to an increased degree of social isolation. For more information please see the links below.

One of the networks within the DSA is the Epilepsy Support Network who provide Peer to Peer support, sign posting and a listening place for those living with Epilepsy. Stephen Lewis Is Lead of the Network and has written about his journey.

A different kind of brainstorm

It was the week before Christmas 2011 and I had collapsed in my kitchen. I woke up in the Intensive Care Unit and spent six hours being checked over by doctors who said they thought I may have had a seizure. I was 36, and the idea of having had a seizure seemed a universe away from where I was at that time. I remember my New Year’s Resolution was ‘To Take Every Opportunity That Came My Way’, so when the London Marathon ballot came out as it does every year at work, I sent in my email entry fully happy that I had stuck to my resolution.

Only trouble was they picked my name out, so now I had to run a marathon, and the farthest I’d ever ran before that was about three miles at Hendon back in 2002!

During the next four months I was sent to professionals and neurologists, examined and probed more than an alien abductee. In between this I had more seizures and they put me on a course of medication that made me very sick. I couldn’t believe medication to help you with seizures would give you nosebleeds, stomach cramps, acne and make your hair fall out!

I remember one appointment with my neurologist – he was telling me that they had found a shadow on my MRI scan and an abnormality on my brain. It was called Cortical Dysplasia and this occurs when the top layer of the brain does not form properly. Technically I’d had it my whole life and on that day in 2011 my brain went to send a signal from one part of my brain to another and the fuse broke. That’s how I explained it to my children, who were so young at the time. They came up with a really great name for it, they called it a ‘glitch’ and when I showed them the MRI scans they thought it was brilliant.

But I wasn’t always so open – I did hide a lot of things from my family. Both my Mum and Nan were alive back then and I didn’t tell them that dysplasia is a lesion on the brain, a growth that once discovered has to be checked and measured to make sure it isn’t growing; or that my neurologist did have initial concerns as to why a perfectly fit 36 year old male with no hereditary illness or previous condition should suddenly start having seizures. My Mum and Nan were upset enough to know I was unwell, and there was no way I was going to worry them further.

So in between all of this I was trying to navigate my personal life: work out how to get around without a car, get to see my kids at the weekend using buses and trains. And figure out what the rest of my life was going to look like in amongst all the tests, seizures and medication side effects.

Then came work, which started off with very supportive and line managers and Occupational Health worked to help me be able to still have a meaningful role. But as with all units, people move and the replacement line managers were not so caring or at all supportive. I tried many times to explain my condition to them, but no matter how or what I tried to do to get their help, I can only describe my time working with them as a horrible experience, when all I had done was become ‘very ill’.

During this time I started the Epilepsy Support Network as a way to focus my energies, to help any others who may find themselves with my condition and need help and also as a place to keep all my information in one place. That was when I became involved in the Disability Staff Association and realised that there was a lot of support for officers who were also suffering from similar situations as I was, including a great deal of information on a lot of other subjects.

Since then I have been fortunate to work with some very kind and amazing people, who have who have helped me to grow stronger and utilise my skills so that I can work to the very best of my abilities. I am involved with the Blue Light Champions Network, I am a Mental Health First Aider and assist a number of other staff associations within the Disability Networking strand. I also work on the local Wellbeing Team and I am extremely fortunate to work for a very supportive Senior Leadership Team who have the health and welfare of their officers and staff at the forefront of their minds.

A lot has changed in nine years and I am very proud to have been a small part of that change.

Oh, and just in case you were wondering – I did run the Marathon in 2012 and finished it in 6 hours, 9 minutes, 12 seconds.

Take care. ∎

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epilepsy.org.uk
epilepsysociety.org.uk
purpleday.org