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Intellectual and developmental disability in police custody. Results from the Health Screening of People in Police Custody project

Lookup NU author(s): Dr Iain McKinnonORCiD, Professor Donald Grubin


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Introduction and AimDetainees with Intellectual and Developmental Disabilities (IDD) are among a group of “mentally vulnerable” detainees in police custody. Previously we demonstrated that standard screening by custody officers (COs) missed most detainees with IDD. Our work also supports other studies suggesting that three questions within the COs’ “risk assessment screen” could assist in identifying these detainees.As part of a larger study, we aimed to evaluate the efficacy of a short screen for IDD compared to the clinical opinion of research psychiatrists. We also aimed to evaluate the same short screening tool delivered to forensic inpatients with established diagnoses.MethodsPart 1: 351 police custody detainees underwent a clinical research evaluation inone London police station. Part of this evaluation assessed for the presence ofIDD by means of a pragmatic clinical evaluation. At the same time, a novelhealth screening tool was piloted in that police custody suite; alongside otherscreening questions, it included the short screen for IDD. We evaluated itsefficacy in detecting the detainees who were judged by researchers to have likelyIDD.Part 2: Meanwhile, the screening questions were tested in the forensic services ofthe NTW NHS Trust. Patients’ responses to the screening questions werecompared to (1) whether they were diagnosed with ID, (2) whether they werediagnosed with “developmental disorder”, and (3) whether or not they were inthe Trust’s Learning Disability services.ResultsPart 1: The IDD part of the new police risk assessment screen detected 83% of those with suspected IDD. The true negative rate was 88%. There were a number of false positives as a result of CO user errors. Although impossible to make a definitive diagnosis of IDD among custody detainees in a short time window, inter-rater reliability between senior forensic LD clinicians and researchers’ judgments was good.Part 2: Cross tabulating the IDD screen results against the three criteriadescribed above showed true positive and true negative rates above 87% for allthree criteria.ConclusionsIn police custody there was an improvement in the detection of detainees withIDD compared to the standard screening procedures, although larger studies arerequired. The inpatient study within NTW Trust also supported the validity of thequestions, albeit in a very different environment. Training for COs will be key tosuccessful implementation. Police forces are now keen to implement the healthscreen to improve identification of IDD and other relevant health problems.

Publication metadata

Author(s): McKinnon I, Grubin D

Publication type: Conference Proceedings (inc. Abstract)

Publication status: Published

Conference Name: Royal College of Psychiatrist Faculty Psychiatry of Intellectual Disability Annual Conference 2014

Year of Conference: 2014

Pages: 50-51