Abstract
People with severe mental illness and intellectual disabilities are overrepresented in the criminal justice system worldwide and this is also the case in Ireland. Following Ireland's ratification of the United Nations' Convention on the Rights of People with Disabilities in 2018, there has been an increasing emphasis on ensuring access to justice for people with disabilities as in Article 13. For people with mental health and intellectual disabilities, this requires a multi-agency approach and a useful point of intervention may be at the police custody stage. Medicine has a key role to play both in advocacy and in practice. We suggest a functional approach to assessment, in practice, and list key considerations for doctors attending police custody suites. Improved training opportunities and greater resources are needed for general practitioners and psychiatrists who attend police custody suites to help fulfill this role.
Highlights
People with severe mental illness and intellectual disabilities are overrepresented in the criminal justice system worldwide (Bradley, 2009; Fazel & Seewald, 2012)
This is the case in Ireland, where the prevalence of severe mental illness in prisons is at least four times that of the general population with studies suggesting that the proportion of those with intellectual disabilities is substantially higher (Gulati et al 2018, 2019)
The Policing and Crime Act 2017 in England and associated guidance for ss. 135 and 136 of the Mental Health Act 1983, which came into effect in 2017, placed an onus on police constables to consult with an allied health professional prior to compulsorily removing a person to a ‘place of safety’pursuant to the sections of the Mental Health Act 1983
Summary
What is the role of doctors in respect of suspects with mental health and intellectual disabilities in police custody?. People with severe mental illness and intellectual disabilities are overrepresented in the criminal justice system worldwide and this is the case in Ireland. For people with mental health and intellectual disabilities, this requires a multi-agency approach and a useful point of intervention may be at the police custody stage. Medicine has a key role to play both in advocacy and in practice. We suggest a functional approach to assessment, in practice, and list key considerations for doctors attending police custody suites. Improved training opportunities and greater resources are needed for general practitioners and psychiatrists who attend police custody suites to help fulfill this role
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