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Police must be monitored for brain injury, argue researchers

Twenty-one police officers out of the 54 who took part in their study, all from the same police constabulary, reported having a traumatic brain injury (TBI).

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“Most of the head injuries were from general life experience, such as contact or extreme sports, and some officers were ex-armed forces,” says Huw Williams, associate professor of clinical neuropsychology at the University of Exeter.

Those with TBI were more likely to have experienced post‐concussion symptoms, which was associated with greater severity of PTSD, depression and drinking to cope.

The research supports findings that head injury can compound PTSD, which almost one in five officers have, and exacerbate drinking as a coping strategy.

The study is the first of its kind, and came about when researchers saw there was no data on the relationship between brain injury in police officers and their mental health.

“We did a brief scoping exercise of the literature, and were fascinated to see there was no research on brain injury in police officers, particularly in connection with brain injury and adverse mental health,” says Nick Smith, graduate research assistant at the University of Exeter.

Williams and Smith were surprised how many officers reported having a brain injury, although they expected there to be a relationship between TBI and adverse mental health.

We found that, when officers have a mild brain injury, where they were assaulted or in a car accident, they could have PTSD. When they have this with head injury it can be long lasting, and they can exacerbate each other,” says Williams.

“Despite being a relatively small group, the findings were robust enough to say head injury, in the mix with PTSD, depression and drinking to cope, might lead to negative long-term outcomes,” says Williams.

The findings, the researchers argue, highlights a need to tackle TBI and the consequences of post-concussion syndrome, which can cause irritably, poor concentration and memory issues.

The paper states that exploring TBI in the police could, identify a major factor contributing towards ongoing mental health difficulties in a population where, based on previous research, the implications of TBI should not be overlooked.’

“If it’s not properly treated, it could lead to greater absence from work, so it’s reasonable for police forces to pick up on these issues to mitigate risk of long term sickness,” says Williams.

“Otherwise, I can see it snowballing – chronic stresses increase over time and the weight of negative experiences become harder to carry.

“This leads us to think we need a better system in place to identify TBI, an alert system to allow people come back into operations or situations in a way that’s healthy so they’re not exposed to more risk,” Williams says.

In sports, for example, the protocol following a concussion is much clearer, Williams says, and helps to lower a player’s risk of having a second concussion while recovering from the first.

“England Rugby does a great job with concussion management protocols, they identify the problem then do something about it, ensuring people are in the right mindset to be doing a very demanding job,” Williams says.

Increased awareness of TBI in the police would be a natural progression from being aware of prisoners with TBIs, says Williams.

“I’ve worked in prisons looking at how common head injury is in people who end up in prison, and various police forces became interested in working with us in a trauma-informed manner, taking on a more broad view of the vulnerabilities of people they’re working with.

“But working from this perspective involves understanding trauma of people who provide services as well,” he says. “Sixty, 70 percent of the time, police are trying to manage and look after vulnerable people. It’s important to recognise how they can become vulnerable themselves.”

There needs to be a system and trauma-informed principles in place for police officers to manage their own vulnerability, Williams says – and he’s hopeful this will happen in the future.

“Initial conversations with forces indicate a healthy attitude towards trying to improve how can improve psychological wellbeing,” he says.

But this isn’t just up to forces themselves. It’s also important, Smith adds, to lessen divide between police and public.

“Police need help like us – it’s important to understand how trauma might affect them.”

Williams says police are often portrayed negatively in the media, and it’s important that the public is aware of why they make the decisions they make and the laws they have that could lead to them suffering trauma. 

PTSD, he says, is more likely to occur when officers don’t feel like society is backing them and the public doesn’t understand why they do what they do.

“It’s important for police to be understood as operating as people for people,” Williams says.

This will also require efforts from across probation, healthcare and education, Williams says, to better understand people from different backgrounds and how to build up empathy across society and reduce violence, as well as educating on the importance of identifying brain injuries when they occur.

Ultimately, Williams is hopeful that police forces want to give officers better protection from the consequences of TBI.

“Police officers need to think about myriad factors at same time, and we want them to be optimum capacity to do that,” Williams says.

This study was a pilot, and Smith hopes to do a much larger study in other police forces across the UK that controls for PTSD and depression to see if increases in post-concussion syndrome are due to head injury and not any other factors.

The first step, Smith says, is finding out the rate of TBI in the police force, then developing a tool to measure and monitor brain injury over time. The research, he says, will be done to help rehabilitate people with TBI, with the aim to help police understand the people they’re meeting, and vice versa.

Williams argues that this work is very relevant to public protection, and it’s important it continues.

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Learn more about virtual reality in rehab

Event is an opportunity to hear from expert Dr Katherine Dawson, Consultant Clinical Neuropsychologist.

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An event later this month will give neuro-rehab professionals an opportunity to learn more about the use of virtual reality in the field. 

The virtual webinar, on 26th January at 1.20pm to 2.30pm, features an in-depth talk by Dr Katherine Dawson, Consultant Clinical Neuropsychologist.

A Guide to Virtual Reality, which can be booked by emailing training@thinktherapy1st.co.uk, will cover:

– Growth of digital health

– Virtual Reality(VR) / Telerehabilitation evidence base

– Virtual tour of the Brain Recovery Zone VR platform

– Where does the Brain Recovery Zone sit in a clinical pathway

– Clinical outcomes, case studies, and research trial

Dr. Katherine Dawson has over 15 years experience working in various rehabilitation settings (both within the NHS and private sector) with individuals who have a wide range of neurological conditions.

She has a particular interest in cognitive rehabilitation, and working with individuals and families to manage emotional and behavioural changes following Acquired Brain Injury (ABI).

She is currently involved in research with the NHS regarding ABI and telerehabilitation, and has recently published a book exploring adjustment to brain injury from the perspectives of clients, family members and clinicians. 

In December 2017, Katherine set up a local neuro-rehab service (Sphere Rehab) with her business partner, focusing on community integration post ABI. She also co-founded the Brain Recovery Zone neuro rehab Virtual Reality platform in the summer of 2019. The team are commissioned by several local CCGs and also work within the private sector.

Ahead of the event, she said: “I just wanted to say a massive thank you to Think Therapy 1st for inviting me to talk about VR and the Brain Recovery Zone. Virtual Reality has great potential in neuro rehab – both to ‘up’ the dosage of rehab, in addition to promoting ongoing engagement and self management.

“I am really looking forward to delivering this webinar and discussing some of the clinical outcomes including the work completed together with Think Therapy 1st and other clients.”

Helen Merfield, Managing Director, Think Therapy 1st, which is organising the event, said: “I am really excited about our VR event we have used Dr Dawson on a number of cases with amazing results and her VR really has changed lives.

“So much so that we are partnering with her company Sphere as a preferred provider for both VR through Brain Recovery Zone and Clinical and Neuro psychology. Close working ties can only improve outcomes which for both our companies are already impressive.”

To register for the event email training@thinktherapy1st.co.uk.

 

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Neuropsychology

Sport and exercise ‘have key role in mental health and wellbeing’

The Moving for Mental Health report highlights the role of physical activity in supporting mental resilience and recovery

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Physical activity and sport can play a key role in supporting mental health and wellbeing and helping people to recover from the ongoing impact of the COVID-19 pandemic, a new report has concluded. 

The Moving for Mental Health report includes better training for health professionals to prescribe movement as a means of effectively tackling the vast growth in people experiencing mental health issues. 

Produced following the onset of the pandemic, the report sets out evidence that developing a healthy relationship with physical activity and being involved in linked programmatic interventions and social networks is beneficial, can improve people’s mental health and wellbeing, and help tackle social isolation.

The project, by the Sport for Development Coalition and Mind, highlights how COVID-19 has exposed the weaknesses of single-sector responses to addressing complex mental health problems and tackling growing health inequalities. 

The report recommends physical activity and community sport be further embedded in health policy and integrated care systems while calling for an enhanced role for experts by experience and diverse communities leading in the design, implementation and evaluation of future strategy and programming.

Launched at an online meeting of the All-Party Parliamentary Group for Sport, it is also designed to support and inspire public bodies, funders, commissioners and policy-makers as well as community-based programme providers aiming to enhance the impact of movement for mental health.

Paul Farmer, chief executive of Mind, said: “While Mind’s research suggests that half of adults and young people have relied on physical activity to cope during the pandemic, we also know that physical activity levels for people with long-term health conditions, including mental health problems, have declined. 

“Considering how vital physical activity is for many people’s mental health, it is clear that we need a collective effort to reach those who need support the most.”

Andy Reed, chair of the Sport for Development Coalition, said: “This report is aimed at supporting and informing policy-makers about how we can maximise the contribution of targeted sport and physical activity-based interventions at this crucial time.”

The research was led by a team of academic researchers from Edge Hill University and Loughborough University, and draws on evidence and submissions from over 70 organisations including sport and mental health organisations, public bodies and Government departments.

Andy Smith, professor of sport and physical activity at Edge Hill University, said: “The impact of Covid-19 on people’s mental health and wellbeing cannot be overstated. 

“It has brought to light the significant mental health inequalities which existed prior to COVID-19, but which have since worsened further, especially among those living in under-served and low-income communities. 

“Our research is calling on the Government and other public bodies to invest in the provision of movement opportunities for mental health across multiple policy sectors, and to use the evidence presented as a basis for making more effective policy decisions which benefit everyone’s mental health and which tackle deep-seated inequalities.”

Moving for Mental Health is the first policy report in a series being published throughout 2022 by the Coalition and relevant partners. The reports are aimed at maximising the contribution of targeted sport-based interventions to helping ‘level up’ communities facing disadvantage and deprivation and tackling deep-seated health and societal inequalities which have been exacerbated by COVID-19.

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Calvert Trust announces new trustees

Louise Dunn, Judith Gate, Emily Flynn and Victoria Notman bring their expertise to the Trust, which also runs Calvert Reconnections

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The Lake District Calvert Trust (LDCT), which runs brain injury rehabilitation centre Calvert Reconnections, has started 2022 by announcing the appointment of four new trustees.

Louise Dunn, Judith Gate, Emily Flynn and Victoria Notman will bring their respective expertise to supporting the further development of the charity and its vital services.

Louise Dunn

Louise Dunn is a communications consultant and academic with over 25 years’ experience of management and leadership roles in the pharmaceutical industry and at Alder Hey Children’s NHS Foundation Trust and Charity.

Commenting on her appointment, Louise said: “As a Keswick resident, I’m delighted to be able to get involved with this extraordinary organisation, that has such a positive impact for people living with disabilities in our community and all over the UK.

“I am looking forward to learning more about how I can help the team and contributing to their exciting plans for the future.”

Judith Gate has extensive experience in the charity and public sectors including leading the volunteering and customer care functions for a national charity.

She currently leads a continuous improvement programme with a focus on delivering efficiency and improved customer experience through business process improvement and digital transformation.

Judith Gate

Judith said: “I applied to be trustee because I wanted to use my skills to deliver as much positive impact as possible. As an outdoor enthusiast I feel a genuine connection to the Calvert Trust‘s mission of making outdoor activity accessible to everyone

“I am really excited to join the board and look forward to using my knowledge and experience to help support the Trust achieve its ambitions over the coming years.”

Emily Flynn has over 21 years’ experience as a military officer and communications-electronics engineer across a wide spectrum of business areas including: senior leadership/board-level management; digital optimisation; resource planning; engineering, operations and risk management; trusteeship; and mountaineering leadership.

Commenting on her appointment, Emily said: “I am delighted to become a trustee of the Lake District Calvert Trust.

“The military introduced me to the benefits of outdoor education as a means of expanding personal confidence and stretching comfort zones in a controlled environment. It also led me to become a mountaineer.

“I hope to be able to bring my previous experience as a leader, mountaineer, engineer and trustee to help the Calvert Trust

Emily Flynn

continue to deliver amazing outdoor education to its participants and to help it grow over the next few years.”

Victoria Notman is legal director at the employment team at Burnetts Solicitors in Carlisle and has over 20 years’ experience as an employment lawyer.

She also has a first-class honours degree in physiotherapy and experience in the rehabilitation and development of adults and young people with mild to severe physical and mental impairments and learning needs.

Victoria said: “I am looking forward to applying my knowledge and skills to become integrated into the fabric of the Trust to such a degree that all the experience I have to offer can really make a difference to the lives and happiness of those accessing Calvert Lakes and Calvert Reconnections.”

Welcoming the charity’s new trustees, Giles Mounsey-Heysham, chairman of the LDCT Trustees, said: “After a detailed recruitment process, we are delighted to welcome our new Trustees.

Victoria Notman

“Together they bring a wealth of skills, experience and shared passion to the Lake District Calvert Trust. We welcome their contributions moving forward.”

The Lake District Calvert Trust has been supporting people with disabilities from its specialist Calvert Lakes residential centre and accessible riding centre near Keswick in the Lake District for almost 45 years.

Calvert Lakes has grown from being the UK’s first dedicated activity centre for people with disabilities, to welcoming around 3,500 visitors to stay each year.

These include individuals, family groups, specialist schools, accessible sports clubs, disability charity groups, supported living organisations and care homes across the UK.

Last year, the charity also opened Calvert Reconnections, the UK’s first residential brain injury rehabilitation programme combining traditional clinical therapies with physical activity in the outdoors.

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