Improving the detection of detainees with suspected intellectual disability in police custody
| DOI | https://doi.org/10.1108/AMHID-04-2015-0015 |
| Pages | 174-185 |
| Published date | 06 July 2015 |
| Date | 06 July 2015 |
| Author | Iain McKinnon,Julie Thorp,Don Grubin |
| Subject Matter | Health & social care,Learning & intellectual disabilities |
Improving the detection of detainees with
suspected intellectual disability in
police custody
Iain McKinnon, Julie Thorp and Don Grubin
Dr Iain McKinnon is Honorary
Senior Clinical Lecturer/
Consultant Psychiatrist at the
Institute of Health and Society,
Newcastle University, Campus
for Ageing and Vitality,
Newcastle upon Tyne, UK and
Forensic Services,
Northumberland Tyne and
Wear NHS Foundation Trust,
Northgate Hospital, Morpeth,
Newcastle upon Tyne, UK.
Dr Julie Thorp is Consultant
Forensic Psychiatrist at
Forensic Services,
Northumberland Tyne and
Wear NHS Foundation Trust,
Northgate Hospital, Morpeth,
Newcastle upon Tyne, UK.
Don Grubin is Professor of
Forensic Psychiatry at the
Institute of Neuroscience,
Newcastle University,
Newcastle upon Tyne, UK and
Forensic Services,
Northumberland Tyne and
Wear NHS Foundation Trust,
Bamburgh Clinic, St Nicholas
Hospital, Newcastle upon
Tyne, UK.
Abstract
Purpose –The purpose of this paper is twofold. First to ascertain the efficacy of current police reception
screening to detect detainees with intellectual disability (ID). Second to assess the validity of a short targeted
screen for ID among police custody detainees.
Design/methodology/approach –The study comprised three stages. First, 248 police custody detainees
were assessed for a range of health morbidities, including a pragmatic clinical evaluation of ID. For those with
suspected ID, the police custody screens were scrutinised for evidencethat this had been detected. Second,
a new police health screen, incorporating a short screen for ID, was piloted. Totally, 351 detainees were
assessed in the same way as in part 1 with the new screens being scrutinised for evidence that ID had been
detected where relevant. Third, the new police screen for ID was validated among a sample of 64 inpatients,
some with ID and some without, from forensic inpatient services. Parts 1 and 2 were carried out in the
Metropolitan Police Service, London. Part 3 took place in one NHS Trust.
Findings –In parts 1 and 2, the rate of detainees with suspected ID was 2-3 per cent. The standard police
screen detected 25 per cent of these detainees in part 1. When the new screen was introduced in part 2, the
sensitivity for ID increased to 83 per cent. However, there was no requisite improvement in the proportion of
detainees with ID receiving an Appropriate Adult. In the inpatient study, the new screen showed a good level
of sensitivity (91 per cent) and reasonable specificity (63 per cent).
Practical implications –It is possible to improve the detection rate of detainees with suspected ID by
introducing a short ID screen into the police custody officers’reception health screen.
Originality/value –The HealthScreening of People in Police Custody(HELP-PC) study is a project evaluating
screeningfor health morbidity amongpolice custody detainees.Other data from this study havebeen reported
elsewhere, but thisis the first time the data pertaining to ID screening has been reported in detail.
Keywords Intellectual disability, Screening, Appropriate adults, PACE, Police custody,
Vulnerable detainees
Paper type Research paper
Introduction
1. Intellectual disability in the police station
People with intellectual disability (ID) in policecustody are among a group of detainees considered
“mentally vulnerable”under the Police and Criminal Evidence Act (PACE) (1984). Mental
vulnerability also covers other mental disorders such as mental illness and other causes of cognitive
impairment. Nevertheless, most of the published literature has focused on intellectual disability.
Early work in the UK observed that only one of 196 police custody detainees had evidence of a
low intelligence quotient (IQ) or mental handicap (Irving, 1980; Irving and McKenzie, 1989).
Hampered by methodological constraints, these studies nonetheless paved the way for further
Received 2 April 2015
Revised 2 April 2015
Accepted 19 April 2015
PAG E 17 4
j
ADVANCESIN MENTAL HEALTH AND INTELLECTUAL DISABILITIES
j
VOL. 9 NO. 4 2015, pp. 174-185, © Emerald Group Publishing Limited, ISSN 2044-1282 DOI 10.1108/AMHID-04-2015-0015
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