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Brandenburg C, Crilly J, Thomas S, Gardiner P, Kinner SA, Heffernan E, Lincoln C, Somerville A, Davidson P, Wilson D, Green D, Byrnes J. Police perspectives on the economic considerations of providing healthcare in short-term custodial settings in Australia. MEDICINE, SCIENCE, AND THE LAW 2024; 64:217-223. [PMID: 37691343 DOI: 10.1177/00258024231198915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
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.
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Affiliation(s)
- Caitlin Brandenburg
- Department of Emergency Medicine, Gold Coast Hospital and Health Service, Southport, Queensland, Australia
- Menzies Health Institute Queensland, Griffith University, Southport, Queensland, Australia
| | - Julia Crilly
- Department of Emergency Medicine, Gold Coast Hospital and Health Service, Southport, Queensland, Australia
- Menzies Health Institute Queensland, Griffith University, Southport, Queensland, Australia
- School of Nursing and Midwifery, Griffith University, Southport, Queensland, Australia
| | - Stuart Thomas
- Social and Global Studies Centre, RMIT University, Melbourne, Victoria, Australia
| | - Paul Gardiner
- Cairns Watch-house, Far North District, Queensland Police Service, Cairns, Queensland, Australia
| | - Stuart A Kinner
- Justice Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- School of Population Health, Curtin University, Perth, Western Australia, Australia
- Griffith Criminology Institute, Griffith University, Brisbane, Queensland, Australia
| | - Ed Heffernan
- Forensic Mental Health Group, Queensland Centre for Mental Health Research, Brisbane, Queensland, Australia
- Faculty of Medicine, The University of Queensland, Brisbane, Australia
- Queensland Forensic Mental Health Service, Queensland Health, Brisbane, Queensland, Australia
| | - Cathy Lincoln
- Forensic Medicine, Gold Coast Hospital and Health Service, Southport, Queensland, Australia
| | - Annabel Somerville
- Department of Emergency Medicine, Cairns and Hinterland Hospital and Health Service, Cairns, Queensland, Australia
| | - Peter Davidson
- Department of Medicine, Division Global Public Health, University of California, San Diego, CA, USA
| | - Daniel Wilson
- Office of the Medical Director, Queensland Ambulance Service, Kedron, Queensland, Australia
| | - David Green
- Department of Emergency Medicine, Gold Coast Hospital and Health Service, Southport, Queensland, Australia
| | - Joshua Byrnes
- Centre for Applied Health Economics, School of Medicine, Griffith University, Brisbane, Queensland, Australia
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Kroll MW, Wolf DA, Cobb JC, Greenberg TZ, Kunz SN, Brewer JE, Williams HE. Homicide Manner-of-Death Classification in Arrest-Related Death. Am J Forensic Med Pathol 2024; 45:103-110. [PMID: 38411190 DOI: 10.1097/paf.0000000000000921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Abstract
ABSTRACT Multiple studies have documented various factors that influence or determine forensic pathologist classification of manner of death. There do not appear to be any published studies on manner of death classification specifically regarding arrest-related deaths (ARDs). The goal of this study was to consider a large body of cases of nonfirearm ARDs to analyze the homicide classification with regards to numerous decedent and practitioner (medical examiner/coroner [ME/C]) variables. We analyzed 1145 US autopsy reports from the years 2006-2020, inclusive, and considered decedent variables of age, ethnicity, height, weight, body mass index, toxicology, and mention of a conducted electrical weapon and ME/C influence variables of gender, country region, and year. We found that the homicide classification likelihood increased by a factor of 1.04-1.05 per year, 1.34-1.37 for a female medical examiner, and 1.4-1.5 going from Southern states to Western states. There is an increasing trend for ME/C to label nonfirearm ARDs as homicides in the United States. The homicide classification is more common in Western states and less common in Southern states, and it was more common with a female ME/C.
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Affiliation(s)
- Mark W Kroll
- From the Biomedical Engineering, California Polytechnical Institute, San Luis Obispo, CA
| | | | - J Celia Cobb
- Office of the Chief Medical Examiner, Oklahoma City, OK
| | | | | | | | - Howard E Williams
- School of Criminal Justice and Criminology, Texas State University, San Marcos, TX
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Heide S, Birngruber CG. Todesfälle in staatlichem Gewahrsam und psychiatrischen Einrichtungen. Rechtsmedizin (Berl) 2022. [DOI: 10.1007/s00194-022-00570-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Todesfälle im Polizeigewahrsam. Rechtsmedizin (Berl) 2022. [DOI: 10.1007/s00194-022-00555-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Gewahrsamsfähigkeitsuntersuchungen in der Notaufnahme. Notf Rett Med 2022. [DOI: 10.1007/s10049-021-00971-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Wardrop R, Ranse J, Chaboyer W, Crilly J. Structures, processes and outcomes of health care for people detained in short-term police custody settings: A scoping review. J Forensic Leg Med 2021; 81:102198. [PMID: 34147830 DOI: 10.1016/j.jflm.2021.102198] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 05/19/2021] [Accepted: 05/26/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND People detained in short-term custodial settings can require health care that may necessitate transfer to an Emergency Department (ED). What and how health care is delivered to detainees in short-term custodial settings may influence their health outcomes. OBJECTIVE The aim of this scoping review was to synthesise and critically appraise the evidence on health care delivered to detainees in short-term custody settings. DESIGN A scoping review was undertaken. Five online databases (CINAHL, PubMed, Medline, Embase and Criminal Justice Database) were searched from January 2010 to May 2020. Data extracted pertained to the structures, processes and outcomes of health care delivery. The Mixed Methods Assessment Tool was used to quality appraise the studies. Deductive analysis was used to sort the findings into structures, processes and outcomes of health care delivery and then thematic analysis was undertaken to synthesise these findings. RESULTS In total, 37 studies with varied designs were included in this review; 3 randomised control trials, 4 quantitative comparative studies, 21 quantitative descriptive studies, 8 qualitative studies and 1 mixed methods study. Studies were mainly from westernised countries. The quality of evidence varied across studies. Health care delivery structures had a strong focus on the identification of mental illness, with processes predominantly comprising health assessment screening on arrival to the short-term custodial setting. Outcomes (at the detainee and organisation level) included increased identification of substance misuse issues and improvement of health conditions, alongside inadequate assessment/identification of physical and mental health issues for detainees. CONCLUSION Gaps in evidence identified limited international perspectives as most studies originated from the US, a focus on detainee conditions/symptoms and limited long-term research within the area of health care in short-term custodial settings. Literature regarding health care delivery in short-term custodial settings focused predominantly on mental illness identification. Understanding the nature of health care delivery in short-term custodial settings further through research into specific roles such as the custody nurse is required to develop targeted interventions that address the needs of the detainee on a comprehensive level.
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Affiliation(s)
- Rachel Wardrop
- School of Nursing and Midwifery, Griffith University, Parklands Dr, Southport, QLD, 4222, Australia.
| | - Jamie Ranse
- School of Nursing and Midwifery, Griffith University, Parklands Dr, Southport, QLD, 4222, Australia; Menzies Health Institute Queensland, Griffith University, Parklands Dr, Southport, QLD, 4222, Australia; Department of Emergency Medicine, Gold Coast Hospital and Health Service, 1 Hospital Blvd, Southport, QLD, 4215, Australia.
| | - Wendy Chaboyer
- School of Nursing and Midwifery, Griffith University, Parklands Dr, Southport, QLD, 4222, Australia; Menzies Health Institute Queensland, Griffith University, Parklands Dr, Southport, QLD, 4222, Australia.
| | - Julia Crilly
- School of Nursing and Midwifery, Griffith University, Parklands Dr, Southport, QLD, 4222, Australia; Menzies Health Institute Queensland, Griffith University, Parklands Dr, Southport, QLD, 4222, Australia; Department of Emergency Medicine, Gold Coast Hospital and Health Service, 1 Hospital Blvd, Southport, QLD, 4215, Australia.
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Identifying vulnerability in police custody: Making sense of information provided to custody officers. J Forensic Leg Med 2021; 80:102169. [PMID: 33901738 DOI: 10.1016/j.jflm.2021.102169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 03/26/2021] [Accepted: 04/04/2021] [Indexed: 11/23/2022]
Abstract
Vulnerable individuals frequently come into contact with the criminal justice system with those with mental health disorders over-represented in custody. Therefore, it is crucial to identify vulnerability in order to ensure the appropriate safeguards can be put in place. Research has documented that this is problematic and can be influenced by a number of factors. The current study, therefore, aimed to understand how custody officers in England and Wales made sense of different types of information presented to them, the impact that it had on their initial disposal option and whether there was a difference in police force area. Six case scenario vignettes containing different types of vulnerability were developed and disseminated. A total of 237 custody officers from 25 police forces participated. Results highlighted that custody officers were more likely to obtain a mental health assessment in all case scenarios, except if the individual displayed comprehension difficulties - custody officers would instead seek to implement the services of an Appropriate Adult. In addition, differences between police force areas were observed. Police forces in the North of England were the least likely to obtain the assistance of an Appropriate Adult when presented with a vulnerable suspect compared to other police force areas. This suggests fundamental differences in the disposal options preferred between police force areas and has implications for the treatment of vulnerable individuals in police custody.
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Houcinat M, Arcani R, Jouve E, Poinso F, Piercecchi MD, Guivarch J. Views of Medical Examiners and Psychiatrists on the Compatibility of the Mental State with Detention in Police Custody in Marseille University Hospital. J Forensic Sci 2020; 65:1669-1675. [PMID: 33104307 DOI: 10.1111/1556-4029.14484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 05/17/2020] [Accepted: 05/21/2020] [Indexed: 11/29/2022]
Abstract
Police custody is detention in response to a suspicion of crime. A person in custody has the right to be examined by a physician, who is responsible for determining whether the person's medical condition allows him/her to continue to be held in detention. However, there is no consensus on the definition of compatibility of the mental state with custody. Our objective was to determine the relevant criteria for compatibility and incompatibility of the mental state with detention in police custody according to medical examiners and psychiatrists. A descriptive study using a semi-structured questionnaire was conducted from November 2016 to May 2017 with medical examiners and psychiatrists who examined detainees in police custody in Marseille. We recruited 17 medical examiners and 43 psychiatrists. We identified three sets of criteria used to determine a mental state compatible with custody: care, pathology/disorder, and the context of police custody. The primary determinant of incompatibility was a need for immediate hospitalization, followed by a high suicide risk, psychiatric dangerousness, delusional symptomatology, an inability to understand questions, and an inability for the detainee to defend him-/herself. The psychiatrists and medical examiners differed significantly in their views of suicide risk, delusional symptomatology, and psychiatric diagnosis. Our work has permitted identification of the main determinants of incompatibility of the mental state with custody according to psychiatrists and medical examiners in Marseille. It offers preliminary results to reach a consensus and provide an inventory for physicians to use regarding police custody.
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Affiliation(s)
- Mouna Houcinat
- Department of Psychiatry, Assistance Publique Hôpitaux de Marseille (AP-HM), La Conception University Hospital, 147 Boulevard Baille, Marseille, 13005, France
| | - Robin Arcani
- Department of Internal Medicine and Therapeutics, Assistance Publique Hôpitaux de Marseille (AP-HM), Timone University Hospital, 264 Rue St Pierre, Marseille, 13005, France.,INSERM, INRA, C2VN, Aix Marseille University, Marseille, 13005, France
| | - Elisabeth Jouve
- Department of Medical Evaluation and Public Health, Assistance Publique Hôpitaux de Marseille (AP-HM), La Conception University Hospital, 147 Boulevard Baille, Marseille, 13005, France
| | - François Poinso
- Faculty of Medicine of Marseille, Aix-Marseille University, 27 Boulevard Jean Moulin, Marseille, 13385, France.,Department of Child Psychiatry, Assistance Publique Hôpitaux de Marseille (AP-HM), Sainte Marguerite University Hospital, 270 Boulevard de Sainte-Marguerite, Marseille, 13009, France
| | - Marie-Dominique Piercecchi
- Department of Forensic Sciences and Health Rights, Assistance Publique Hôpitaux de Marseille (AP-HM), Timone University Hospital, 264 Rue St Pierre, Marseille, 13005, France.,CNRS, EFS, ADES, Aix Marseille University, 51 Boulevard Pierre Dramard, Marseille, 13015, France
| | - Jokthan Guivarch
- Faculty of Medicine of Marseille, Aix-Marseille University, 27 Boulevard Jean Moulin, Marseille, 13385, France.,Department of Child Psychiatry, Assistance Publique Hôpitaux de Marseille (AP-HM), Sainte Marguerite University Hospital, 270 Boulevard de Sainte-Marguerite, Marseille, 13009, France.,ISC-EPRED, EA 1228, Institute for Criminal Sciences, 43 place Charles de Gaulle, Poitiers, 86073, France
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McKinnon I, Finch T. Contextualising health screening risk assessments in police custody suites - qualitative evaluation from the HELP-PC study in London, UK. BMC Public Health 2018; 18:393. [PMID: 29566649 PMCID: PMC5863839 DOI: 10.1186/s12889-018-5271-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 03/08/2018] [Indexed: 12/05/2022] Open
Abstract
Background In the UK, police custody officers have a responsibility to screen for health morbidity and vulnerability among detainees. This study aimed to develop an understanding of the barriers to performing effective health screening in police custody suites, understand the impact of screening tools on practice within the custody suite, and to identify factors that could hinder or facilitate the future implementation of a new screening intervention in this environment. Methods A qualitative study was conducted alongside a quantitative evaluation of a novel screening tool. Qualitative methods included observation of the custody environment, semi-structured interviews with police staff, and elicitation of comments from detainees about their experiences of screening. Data were analysed inductively using thematic analysis. Normalization Process Theory (NPT) was used to inform data collection and as a framework for higher level analysis of findings. Results Five overall constructs were identified that develop understanding of the integration of health screening within custody: the workability of risk assessment screening tools; the effect of the custody environment and the people therein; shifts in professional roles and interrelationships amongst staff; cultural responses to risk and liability in police work; how infrastructure, knowledge and skills can impact on detainee safety. Conclusions Health and risk assessment screening in police custody is a complex and demanding activity which extends beyond the delivery of a screening tool. Professional roles, the demanding environment and police culture impact on the overall process. Recommendations for improved integration of health and risk assessment screening in wider police custody practice are proposed. Electronic supplementary material The online version of this article (10.1186/s12889-018-5271-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Iain McKinnon
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, NE4 5PT, UK. .,Northumberland Tyne and Wear NHS Foundation Trust, Morpeth, NE61 3BP, UK.
| | - Tracy Finch
- Department of Nursing, Midwifery and Health, Northumbria University, Coach Lane Campus West, Newcastle upon Tyne, NE7 7XA, UK
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11
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Affiliation(s)
- Patrick Chariot
- Department of Forensic and Social Medicine, AP-HP, Hôpital Jean-Verdier, 93140 Bondy, France; Institut de recherche interdisciplinaire sur les enjeux sociaux (IRIS), UMR 8156-997, Sorbonne Paris Cité, Université Paris 13, UFR SMBH, 93000 Bobigny, France.
| | - Steffen Heide
- Institute of Legal Medicine, University Hospital, Halle/S., Germany.
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12
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Verdier E, Denis C, Bourokba N, Chauvin P, Chariot P. Social vulnerabilities and health conditions of arrestees in the Greater Paris area, France, in 2013: a multicentre cross-sectional study. Int J Legal Med 2017; 132:897-905. [PMID: 29090334 DOI: 10.1007/s00414-017-1727-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 10/25/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The aim of this study was to describe the health and social conditions of arrestees, as compared to the general population. METHODS We studied a sample of 600 adult arrestees in three locations in the Greater Paris area, prospectively included (February-May 2013). A descriptive analysis has been performed, then prevalence was estimated using an indirect standardisation according to age, based on data from a population-based, representative survey in the same area. RESULTS Arrestees had a median age of 31 years; 92% were males. As compared to the general population, arrestees had a lower level of education (8.6 vs. 7.6%, p < 0.001), were more frequently unemployed (42.0 vs. 11.9%, p < 0.001) and in a difficult financial situation (43 vs. 11%, p < 0.001) and had less significant social support (48.1 vs. 87.9%, p < 0.001). They reported also more frequently a chronic health condition (54 vs. 36%, p < 0.001) and a limited health insurance coverage (36 vs. 15%, p < 0.001). CONCLUSION Comparative analysis of male arrestees and males from the general population showed that the former had worse social and health conditions. These results argue for widespread medical interventions on all arrestees. Medical examination during detention could act as a gateway to health care and social support.
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Affiliation(s)
- Emilie Verdier
- AP-HP, Department of Forensic Medicine, Hôpital Hôtel-Dieu, 75004, Paris, France
| | - Céline Denis
- AP-HP, Department of Forensic Medicine (Service de Médecine Légale et de Médecine Sociale), Hôpital Jean-Verdier, 93140, Bondy, France
| | - Nacer Bourokba
- AP-HP, Department of Forensic Medicine, Hôpital Raymond-Poincaré, 92160, Garches, France
| | - Pierre Chauvin
- Sorbonne Universités, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Department of Social Epidemiology, UPMC Univ Paris 06, 75012, Paris, France
| | - Patrick Chariot
- AP-HP, Department of Forensic Medicine (Service de Médecine Légale et de Médecine Sociale), Hôpital Jean-Verdier, 93140, Bondy, France. .,Sorbonne Paris Cité, Institut de Recherche Interdisciplinaire sur les Enjeux Sociaux (IRIS), UMR 8156-997, UFR SMBH, Université Paris 13, 93000, Bobigny, France.
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Gérardin M, Guigand G, Wainstein L, Jolliet P, Victorri-Vigneau C, Clément R. Evaluation of problematic psychoactive substances use in people placed in police custody. J Forensic Leg Med 2017; 49:24-32. [DOI: 10.1016/j.jflm.2017.05.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 03/02/2017] [Accepted: 05/01/2017] [Indexed: 11/28/2022]
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McKinnon IG, Thomas SDM, Noga HL, Senior J. Police custody health care: a review of health morbidity, models of care and innovations within police custody in the UK, with international comparisons. Risk Manag Healthc Policy 2016; 9:213-226. [PMID: 27695373 PMCID: PMC5028165 DOI: 10.2147/rmhp.s61536] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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.
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Affiliation(s)
- Iain G McKinnon
- Institute of Health and Society, Newcastle University, Academic Psychiatry, Campus for Ageing and Vitality
- Northumberland Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Stuart DM Thomas
- School of Global, Urban and Social Studies, RMIT University, Melbourne, VIC
- Legal Intersections Research Centre, University of Wollongong, Wollongong, NSW
- Southern Clinical School, Monash University, Clayton, VIC, Australia
| | - Heather L Noga
- School of Criminology, Simon Fraser University, Burnaby, BC, Canada
| | - Jane Senior
- Offender Health Research Network, University of Manchester, Manchester, UK
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