Abstract
BackgroundIntellectual Disabilities (ID) and Attention Deficit Hyperactivity Disorder (ADHD) are recognized psychological vulnerabilities in police interviews and court proceedings in England and Wales. The aims of this study were to investigate: (a) the prevalence of ID and/or ADHD among suspects detained at a large London metropolitan police station and their relationship with conduct disorder (CD), (b) the impact of their condition on police staff resources, (c) the effectiveness of current custody assessment tools in identifying psychological vulnerabilities, and (d) the use of ‘Appropriate Adults’ in interviews.MethodA total of 200 individuals in a police custody suite were interviewed and screened for ID, ADHD (current symptoms) and CD.ResultsThe screening rates for these three disorders were 6.7%, 23.5% and 76.3%, respectively. ADHD contributed significantly to increased requests being made of staff after controlling for CD and duration of time in custody. This is a novel finding. Reading and writing difficulties and mental health problems were often identified from the custody risk assessment tools, but they were not used effectively to inform on the need for the use of an Appropriate Adult. The frequency with which Appropriate Adults were provided to support detainees in police interviews (4.2%) remains almost identical to that found in a similar study conducted 20 years previously.ConclusionsThe current findings suggest that in spite of reforms recently made in custodial settings, procedures may not have had the anticipated impact of improving safeguards for vulnerable suspects. Detainees with ID and ADHD require an Appropriate Adult during police interviews and other formal custody procedures, which they commonly do not currently receive. The findings of the current study suggest this may be due, in large part, to the ineffective use of risk-assessment tools and healthcare professionals, which represent missed opportunities to identify such vulnerabilities.
Highlights
Intellectual Disabilities (ID) and Attention Deficit Hyperactivity Disorder (ADHD) are recognized psychological vulnerabilities in police interviews and court proceedings in England and Wales
A further four participants stopped half way through the Diagnostic Interview for ADHD in Adults (DIVA), they met criteria for predominantly inattentive type
The current study identified that 7 people screened positive for ID and 24 screened positive for current ADHD
Summary
Intellectual Disabilities (ID) and Attention Deficit Hyperactivity Disorder (ADHD) are recognized psychological vulnerabilities in police interviews and court proceedings in England and Wales. The widely publicized Bradley report [1] raised concerns about the inadequacy of the current provision of health services within the criminal justice system (CJS) in England and Wales. The Board devised a National Delivery Plan committed to improving the management of offenders with mental health problems, intellectual disability and personality disorder. The subsequent reforms led to considerable change in police services, with changes in screening for vulnerabilities and mental health facilities, and, importantly, healthcare provision and liaison by clinical practitioners (that is, doctors and nurses) who can access NHS records. The success of these changes has yet to be evaluated.
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