Health care in police watch‐houses: a challenge and an opportunity

Crilly, Julia; Brandenburg, Caitlin; Kinner, Stuart A; Heffernan, Ed; Byrnes, Joshua; Lincoln, C. Eric; Gardiner, Paul A.; Davidson, Peter; Somerville, Annabel; Wilson, Daniel J.; Thomas, Stuart

doi:10.5694/mja2.51688

Cited by 3 publications

(6 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…detainees), might be under arrest awaiting charges or court outcome (remand or bail), or temporarily transferred from prison for a court appearance. 2 Detainees may experience acute health problems that require transfer to an ED, especially related to alcohol or other drugs, injury, chest pain, mental health problems, altered level of consciousness, diabetes, or seizures. 3,4 Equitable healthcare for detainees is a requirement in the UN Mandela Rules, 5 but there are many challenges to healthcare provision in custodial settings.…”

Section: Introductionmentioning

confidence: 99%

“…Of the limited research that does exist, it is evident that watch-houses have varying structures and processes underpinning healthcare approaches, and transfer to the ED is common. 2,[10][11][12] Although it has been estimated that people brought in by police (inclusive of watch-house transfers) account for less than 1% of Australian ED presentations, 3,13 this population warrants attention as it is highly vulnerable, complex, and reliant on police services for access to care. 2,4 Some research on the provision of healthcare in short-term custody settings has been completed internationally, 11,12,14,15 but there is a paucity of information about the management of detainees once transferred to the ED.…”

Section: Introductionmentioning

confidence: 99%

“…2,[10][11][12] Although it has been estimated that people brought in by police (inclusive of watch-house transfers) account for less than 1% of Australian ED presentations, 3,13 this population warrants attention as it is highly vulnerable, complex, and reliant on police services for access to care. 2,4 Some research on the provision of healthcare in short-term custody settings has been completed internationally, 11,12,14,15 but there is a paucity of information about the management of detainees once transferred to the ED. 4,16 The present study aimed to understand ED doctors' perceptions of the appropriateness of detainee transfers from police watch-houses to the ED, and to explore their experiences and perceptions of management of detainees in the ED.…”

Section: Introductionmentioning

confidence: 99%

“…People detained in watch‐houses (i.e. detainees), might be under arrest awaiting charges or court outcome (remand or bail), or temporarily transferred from prison for a court appearance 2 . Detainees may experience acute health problems that require transfer to an ED, especially related to alcohol or other drugs, injury, chest pain, mental health problems, altered level of consciousness, diabetes, or seizures 3,4 …”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Supporting equitable care of patients transferred from police watch‐houses to the emergency department: A qualitative study of the perspectives of emergency doctors

Brandenburg,

Thomas,

Lincoln

et al. 2024

Emerg Medicine Australasia

Self Cite

View full text Add to dashboard Cite

ObjectivePeople detained in short‐term police custody often have complex health conditions that may necessitate emergency care, yet little is known about their management in EDs. The present study aimed to understand ED doctors' experiences and perceptions regarding the appropriateness and management of detainee transfers from police watch‐houses to the EDs.MethodsA qualitative descriptive study, using semi‐structured interviews undertaken with ED doctors working in five purposively sampled EDs across Queensland, Australia. Data were analysed using inductive content analysis.ResultsFifteen ED specialists and trainees participated. Participants reported that their overarching approach was to provide equitable care for watch‐house detainees, as they would for any patient. This equitable approach needed to be responsive to complicating factors common to this population, including presence of police guards; restraints; complexity (physical/mental/social) of presentation; reliance on police to transport; ED doctors' often limited understanding of the watch‐house environment; justice processes and uncertain legal disposition; communication with the watch‐house; and detainees misreporting symptoms. Thresholds for assessment and treatment of detainees were contextualised to the needs of the patient, ED environment, and imperatives of other relevant agencies (e.g. police). Participants often relied on existing strategies to deliver quality care despite challenges, but also identified a need for additional strategies, including education for ED staff; improved communication with watch‐houses; standardised paperwork; extended models of watch‐house healthcare; and integrated medical records.ConclusionsProviding equitable healthcare to patients transported from watch‐houses to the EDs is challenging but essential. Numerous opportunities exist to enhance the delivery of optimal care for this underserved population.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Supporting equitable care of patients transferred from police watch‐houses to the emergency department: A qualitative study of the perspectives of emergency doctors

Brandenburg,

Thomas,

Lincoln

et al. 2024

Emerg Medicine Australasia

Self Cite

View full text Add to dashboard Cite

show abstract

“…The provision of healthcare in the watch-house setting is particularly challenging as detainees are often detained for brief periods of time, have complex health needs relative to the general population, 6,7 and are in a setting with multiple barriers to healthcare provision. [8][9][10] These factors challenge the ability to provide equitable and cost-effective healthcare. However, appropriate and timely health care also has significant potential for great social return relative to cost for this often hard-to-reach and vulnerable population.…”

Section: Introductionmentioning

confidence: 99%

Police perspectives on the economic considerations of providing healthcare in short-term custodial settings in Australia

Brandenburg,

Crilly,

Thomas

et al. 2023

Med Sci Law

Self Cite

View full text Add to dashboard Cite

Providing appropriate healthcare to people in short-term police custody settings (i.e. watch-houses) is challenging due to the complexity of detainee health needs and the limitations of the custodial environment. However, little is known about how detainee healthcare is managed in Australia, including economic considerations. This study had two aims: (1) to understand police perspectives on the costs associated with the delivery of healthcare to watch-house detainees in Queensland, Australia and (2) to scope the applicability of the Prison Healthcare Expenditure Reporting Checklist (PHERC) tool for the Australian watch-house context. The study employed an exploratory qualitative descriptive approach. A purposive sample comprised 16 watch-house staff from six regions in Queensland, Australia, interviewed between April and November 2021. A key finding was that police viewed healthcare expenditure as a major, but largely unavoidable cost for Australian watch-houses. Participants reported that direct expenditure comprised mostly of in-house healthcare services (of which there were a variety of models), but also costs of medication and health-related consumables. Indirect costs included costs of escorting and guarding detainees requiring transfer to hospital for health assessment and treatment. Participants reported that the PHERC was not applicable to the Australian watch-house context. Future research should explore the cost-effectiveness of different watch-house healthcare delivery models and how best to measure this.

show abstract

National consensus statement on opioid agonist treatment in custodial settings

Chan,

Cook,

Curtis

et al. 2024

Preprint

View full text Add to dashboard Cite

IntroductionOpioid use and dependence are prevalent among incarcerated people, contributing to elevated rates of overdose and other harms in this population. Opioid agonist treatment (OAT) has been demonstrated as an effective intervention to mitigate these risks. However, challenges to health care implementation in the custodial sector result in suboptimal and variable access to OAT in prisons nationally.Main recommendationsAmong a national multi-disciplinary expert panel, we conducted a modified Delphi study which yielded 19 recommendations to government, relevant health authorities and custodial health services. These recommendations cover five core domains: induction or continuation of OAT, OAT options and administration, transition of care to the community, special populations, organisational support. Key recommendations include prompt recognition and treatment of opioid withdrawal, active linkage to community-based OAT providers upon release, and ensuring appropriate organisational support through local protocols, adequate funding, and monitoring of key program indicators.Changes in management as a result of this statementThis consensus statement addresses a significant gap in national policy on OAT in Australian prisons. The recommendations set forth best practice standards grounded in evidence and expert consensus. We expect that implementing these recommendations will enhance the quality, consistency, and continuity of OAT both within prison and upon release. Optimizing OAT provision is crucial for improving health outcomes and addressing overdose, which is the leading cause of death among people released from prison.

show abstract

Health care in police watch‐houses: a challenge and an opportunity

Cited by 3 publications

References 15 publications

Supporting equitable care of patients transferred from police watch‐houses to the emergency department: A qualitative study of the perspectives of emergency doctors

Supporting equitable care of patients transferred from police watch‐houses to the emergency department: A qualitative study of the perspectives of emergency doctors

Police perspectives on the economic considerations of providing healthcare in short-term custodial settings in Australia

National consensus statement on opioid agonist treatment in custodial settings

Contact Info

Product

Resources

About