What is 'Equivalence' in Police Custody Healthcare?
Lead Research Organisation:
Newcastle University
Department Name: Sch of Geog, Politics and Sociology
Abstract
Context
At present, there is no clear standard for healthcare provision in police station custody suites governing the level of care expected by those detained. Healthcare providers are expected to work within the standards outlined by their own professional bodies; however, these are vague, and no clear standard exists for detention staff, who perform most custody healthcare. This is troubling due to the high rate of persons in police custody with mental health and substance abuse concerns and the rate of deaths in custody; both these rates are unequally distributed along ethnicity lines. It also stands in contrast to other parts of the criminal justice system (for instance prisons), where an equivalence standard, i.e. an expectation that persons detained in prison will receive healthcare equivalent to those at liberty, is the norm.
There are two common explanations the absence of such a standard: police custody is a law enforcement space; and persons are only detained for a few hours, meaning that they can access traditional healthcare upon release. Traditionally, healthcare in police custody is understood as resolving emergencies (including sending those that cannot be treated in custody to hospital) and ensuring that detainees are fit to be interviewed. However, the high rate of persons who are detained during a mental health crisis, as well as the 'chaotic lifestyles' of those detained, means that the healthcare needs of detainees in police custody spaces are increasingly important.
Aims and Objectives
As a result of these changes, this project aims to develop knowledge about the healthcare practices of police custody staff (police officers, detention officers, and healthcare providers) in order to inform an equivalence standard and provide guidance for its implementation into custody work. The project will ask four key questions:
1) How do custody staff (police and healthcare) interact with detainees, and how do these interactions impact detainees' experiences of health and wellbeing in police custody? How do detainees' observable characteristics (age, body size, skin colour, gender) influence these interactions?
2) How do police and healthcare staff in custody interact with each other, and what is needed to achieve optimal multiagency working and deliver equivalence in healthcare?
3) What role does the age and space of police custody environments play in the delivery of healthcare?
4) What health information about detainees is accessed, recorded, managed, and shared within police custody; how is this done, and how is the information secured?
To answer these questions, we will carry out the following social science research methods:
- Up to 500 hours of observations in four police custody suites
- Semi-structured interviews with 60 custody staff and 40 detainees
- Audits of 1,600 police custody risk assessment files and interviews with 20 police custody desk sergeants about their risk assessment procedures
Potential Benefits
The chief outcome of the research will be a policy brief outlining what an equivalence standard in police custody would include and how it could be implemented. We expect that this will include advice on the interactions between detainees and staff (police, civilian, and healthcare), the forms of information that detainees receive and the ways in which they receive it. In addition, we also expect to comment on the interactions between staff in custody, especially as they discuss detainees across professional boundaries. For instance, the transfer of personal information about a detainee between staff should be highly confidential, and so we would introduce guidance on the handling of such information in order to maintain patient confidentiality. It is expected that the production of an equivalence standard that works with current custody suite practice will improve healthcare outcomes for those who attend police custody, while also reducing the potential for deaths in custody.
At present, there is no clear standard for healthcare provision in police station custody suites governing the level of care expected by those detained. Healthcare providers are expected to work within the standards outlined by their own professional bodies; however, these are vague, and no clear standard exists for detention staff, who perform most custody healthcare. This is troubling due to the high rate of persons in police custody with mental health and substance abuse concerns and the rate of deaths in custody; both these rates are unequally distributed along ethnicity lines. It also stands in contrast to other parts of the criminal justice system (for instance prisons), where an equivalence standard, i.e. an expectation that persons detained in prison will receive healthcare equivalent to those at liberty, is the norm.
There are two common explanations the absence of such a standard: police custody is a law enforcement space; and persons are only detained for a few hours, meaning that they can access traditional healthcare upon release. Traditionally, healthcare in police custody is understood as resolving emergencies (including sending those that cannot be treated in custody to hospital) and ensuring that detainees are fit to be interviewed. However, the high rate of persons who are detained during a mental health crisis, as well as the 'chaotic lifestyles' of those detained, means that the healthcare needs of detainees in police custody spaces are increasingly important.
Aims and Objectives
As a result of these changes, this project aims to develop knowledge about the healthcare practices of police custody staff (police officers, detention officers, and healthcare providers) in order to inform an equivalence standard and provide guidance for its implementation into custody work. The project will ask four key questions:
1) How do custody staff (police and healthcare) interact with detainees, and how do these interactions impact detainees' experiences of health and wellbeing in police custody? How do detainees' observable characteristics (age, body size, skin colour, gender) influence these interactions?
2) How do police and healthcare staff in custody interact with each other, and what is needed to achieve optimal multiagency working and deliver equivalence in healthcare?
3) What role does the age and space of police custody environments play in the delivery of healthcare?
4) What health information about detainees is accessed, recorded, managed, and shared within police custody; how is this done, and how is the information secured?
To answer these questions, we will carry out the following social science research methods:
- Up to 500 hours of observations in four police custody suites
- Semi-structured interviews with 60 custody staff and 40 detainees
- Audits of 1,600 police custody risk assessment files and interviews with 20 police custody desk sergeants about their risk assessment procedures
Potential Benefits
The chief outcome of the research will be a policy brief outlining what an equivalence standard in police custody would include and how it could be implemented. We expect that this will include advice on the interactions between detainees and staff (police, civilian, and healthcare), the forms of information that detainees receive and the ways in which they receive it. In addition, we also expect to comment on the interactions between staff in custody, especially as they discuss detainees across professional boundaries. For instance, the transfer of personal information about a detainee between staff should be highly confidential, and so we would introduce guidance on the handling of such information in order to maintain patient confidentiality. It is expected that the production of an equivalence standard that works with current custody suite practice will improve healthcare outcomes for those who attend police custody, while also reducing the potential for deaths in custody.
