Abstract
BackgroundIn 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.MethodsA 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.ResultsFive 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.ConclusionsHealth 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.
Highlights
In the UK, police custody officers have a responsibility to screen for health morbidity and vulnerability among detainees
Context of the present study This qualitative study was conducted alongside phase 3 of the Health Screening of People in Police Custody (HELP-PC) quantitative evaluation which studied the sensitivity and specificity of a new health screening risk assessment conducted by Custody Officer (CO) in London, UK
There are complex issues related to the people, processes, environment and cultural factors that exist in police custody settings, which impact on the conduct of health screening
Summary
In the UK, police custody officers have a responsibility to screen for health morbidity and vulnerability among detainees. There is evidence of shortcomings in routine screening (known by the police as “risk assessment”), especially for detainees with serious injuries, chronic physical health problems, mental disorders and vulnerability and those at risk of alcohol withdrawal [9, 11] with calls for the introduction of evidence based structured screening [12]. International studies show similar patterns of excess health morbidity, but the arrangements for the provision of healthcare in police settings, the process for how detainees are screened and access care, and the reporting of health outcomes vary substantially between nations [13]
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