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Table 6 How infrastructure, knowledge and skills can impact on detainee safety

From: Contextualising health screening risk assessments in police custody suites – qualitative evaluation from the HELP-PC study in London, UK

FIELD OBSERVATIONS

“The Sergeant… had seen a detainee over the weekend who had been caught removing items from a supermarket. I also saw the man who clearly had some form of cognitive impairment. He gave the man a verbal warning and contacted his sister to see if she could get him to see the GP. Earlier this morning, [the Sergeant] had tried to contact the sister again to see if she had managed to make any progress. It transpires that the sister had a stroke and died the previous day. The Sergeant and I had a discussion about this as he was clearly quite shocked. We talked about a number of things but the conversation culminated with us talking about how occasionally he sees people in custody who have real needs and that they can make a difference. He allowed me to use his exact words ‘We see so much s**t in here; we forget how to deal with the nice people’.”

(Field note paras 1&2: 25 July 2012)

STAFF INTERVIEWS

“There is a custody course, about the people we deal with. But I think you learn so much by doing it rather than any course. We’ve had a death in custody and unfortunately it takes a death, sometimes for [serious issues] to come to the limelight.”

(Male CO3)

“The organisation takes a massive risk unless you have got someone trained sitting in a busy custody suite. But what Police Officers get in training is very minimal when it comes to mental health and why people behave in certain ways.”

(Female CO1)

“On some occasions, the police officer straight away says ‘Oh, and we’ve brought their insulin in with them,’ but that tends to be a very on the ball police officer [who] knows the nurse is going to ask for certain medications: the first thing they say to [the arrested person] is ‘Is there any medications you would like to bring in with you?’ Risk assessment should start way before they even get to the custody suite.”

(Female nurse 1)

“Not very many [custody nurses] have had mental health training. Most of them are from [emergency departments] and [medical admissions wards] and things like that.”

(Female nurse 1)

“I think that you learn to identify certain medications when people tell you they are on them. You learn to identify that certain medications are for certain ailments.”

(Female CO1)

“Given my experience, it was quite clear he was Asperger’s. I said to the [detention officers], ‘When you deal with him you’re going to have to give clear explanations.’ They said ‘… he was really odd with the fingerprint machine. He couldn’t cope with that at all’.”

(Female nurse 1)

DETAINEE COMMENTS

“I told the police I’ve got asthma, I’d left [the inhaler) at home. They didn’t ask how severe the asthma was just how often do I get it. They did not offer to get me my pump or to get a pump for me.”

(Male Detainee 34)