Police custody health care: a review of health morbidity, models of care and innovations within police custody in the UK, with international comparisons

Abstract

This paper is a scoping review of the available evidence regarding health care issues in police custody. It describes the types and prevalence of health disorders encountered in custody and provides an overview of current practice and recent innovations in police custody health care. In contrast to the health of prisoners, the health of police custody detainees has, until recently, received little academic or clinical attention. Studies on health care in police custody identified for this review are limited to a few geographical jurisdictions, including the UK, continental Europe, North America, and Australia. There are significant health concerns among police detainees including acute injury, chronic physical health problems, mental and cognitive disorders, and the risks associated with drug and alcohol intoxication or withdrawal. There is some evidence that deaths in police custody have reduced where attention has been paid to the latter issue. Police personnel continue to experience difficulties identifying detainees with health issues relevant to their safe detention, but research shows that the use of evidence-based screening tools improves detection of such morbidities. Innovations in police custody health care mainly relate to detainees with mental disorders, including improved identification of illness, timely access to mental health services, the protection of the rights of mentally disordered detainees, and the diversion of mentally disordered persons from the criminal justice system into appropriate health and social care interventions. There is a lack of rigorous research relating to interventions for physical health problems, protecting those at risk of substance withdrawal, and detainees with preexisting or peri-arrest injures. Research to improve the health of police custody detainees requires greater priority, focusing on case identification and service redesign to address high levels of morbidity and to facilitate health promotion and prevention activities.

The crime, mental health, and economic impacts of prearrest diversion of people with mental health problems: A systematic review

“…People with mental health problems are more likely to become victims of crime compared with the general population (Pettitt et al, ) and more likely to be arrested for minor offences (Charette, Crocker, & Billette, ). Within police custody, small‐scale studies suggest that up to 39% of individuals have some kind of mental illness (McKinnon, Thomas, Noga, & Senior, : 218). Some have even suggested that the intersections between police and people with mental disorder are indicative of the criminalisation of mental illness (Butler, ; Reuland, Schwarzfeld, & Draper, ; Teplin, ).…”

Integrated responses for people with cognitive disability and complex support needs: Factors and principles

“…Interagency collaboration was further enhanced by secure information-sharing systems (Barbabella et al, 2017 Bruns et al, 2015;Morton, 2017), shared practice guidelines and formal protocols (Duffy et al, 2016;Mason et al, 2018;McIntyre et al, 2017), streamlining of administrative processes (Davidson et al, 2014;McKinnon et al, 2016) and allowing sufficient time to collaborate and for team-building (Keesler, 2014;Lee et al, 2013)-all of which required adequate funding (Kerman et al, 2017;Landsdell, 2018;Till et al, 2015). Co-location of services to provide a single point of access and a gateway to a variety of services (Dooris et al, 2013;Dyer and Briddle, 2016;Hardwick, 2015;Whiteford et al, 2013) was identified as effective in facilitating improved information sharing between service users and services and between services and partner agencies (Petch et al, 2013).…”

“…The facilitation of better information sharing allowed improved assessments of risk and need as a more complete picture of clients was achieved through coordinated, accurate and timely intelligence from a wider range of services (Home Office, 2014). Important, too, were transparent decision-making processes with clear referral pathways (Henning, 2016;Mason et al, 2018;McKinnon et al, 2016) and an identified liaison person to act as a champion for and coordinate effective interagency collaboration (Brown et al, 2016;van Duijn et al, 2018;Padwa et al, 2016;Whittle et al, 2017). This collaboration resulted in increased client understanding of the services available and enhanced appropriateness of the services provided (Gibson et al, 2016;Home Office, 2014).…”

Containment and care? A qualitative interview study exploring police custody staff views about delivering brief alcohol interventions to heavy drinking arrestees

“…Amidst the evolving alcohol treatment system and wider health care within the custody suite, an increasing emphasis has been placed upon the role of police custody staff in responding to the wider health and social care needs of arrestees (Chariot & Heide, 2018; Her Majesty's Inspectorate of Constabulary (HMIC), 2015; HM Government, 2009). There has been a call for accurate health screening, followed by appropriate interventions within the custody suite (McKinnon, Thomas, Noga, & Senior, 2016), fuelled by a persistently high number of deaths (2009-2018) during or following police contact, many of which are self-inflicted (Independent Office for Police Conduct, 2018;Kinner et al, 2015). At the same time, there has been an on-going delivery model of diversionary approaches that aim to reduce future reoffending throughout the criminal justice system (HM Government, 2009).…”