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Health Screening of People in Police Custody (HELP-PC) Phase 4. Evaluation of the HELP-PC police risk assessment screen in the North of England

Lookup NU author(s): Dr Iain McKinnonORCiD



This is the final published version of a conference proceedings (inc. abstract) that has been published in its final definitive form by Royal College of Psychiatrists, 2023.

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Aims and hypothesis To ascertain the efficacy of health screening/risk assessment procedures for health disorders in police custody detainees. Background A growing body of research shows excess morbidity among people detained in police custody. Between 2009-2012, the HELP-PC study culminated in the development and piloting of a new custody risk assessment/health screen which improved the efficacy of police screening procedures in London. This fourth phase of HELP-PC evaluates the effectiveness of the new screening procedures embedded in one police force in the North of England. Methods Using validated structured clinical interviews, research psychiatrists assessed detainees in custody from October 2021. These interviews assessed psychiatric, neurodevelopmental, alcohol and substance use disorders, relevant physical health issues,, and an assessment of mental vulnerability. We analysed the ability of the HELP-PC risk assessment screen to detect these clinically important conditions, and whether or not police custody officers referred detainees for an Appropriate Adult. We calculated prevalence rates for health disorders, and report on the predictive validity of the screen using 2x2 contingency tables. This study received a favourable ethical opinion. Results To date we have interviewed over 110 custody detainees. 64% (95%CI:54-73%) of detainees presented with a diagnosable mental disorder, and 12% (6-19%) had a Serious Mental Illness (SMI). Based on the RAPID screening tool for intellectual disability (ID), 40% (30-49%) reached the threshold for further assessment for Intellectual Disability, although there was clinical suspicion in 5% (2-11%). 18% (12-27%) scored above threshold on the AQ-10, and 19% (12-27%) scored above threshold on the ASRS ADHD screen. 31% (23-41%) had an AUDIT score above threshold for alcohol dependence. The HELP-PC risk assessment screen detected all (95%-lower-bound 79%) of the detainees with SMI, and 76% (64-85%) of people with “any mental disorder”. It detected 77% (62-89%) of detainees who had a positive RAPID score, and all of those where ID was clinically suspected. 76% of detainees at risk of alcohol withdrawal were detected. Appropriate Adults were only considered for 3.5% of all detainees. Conclusions The HELP-PC risk assessment screen shows promise in the detection of significant health concerns when embedded into a police risk assessment system. Despite high rates of detection of mental vulnerability, appropriate adult use remains below that expected. We will continue to gather data until May 2023 at which point we will be in a position to make recommendations about any necessary alterations. We have no conflicts of interest to disclose.

Publication metadata

Author(s): Moore J, Evans E, Rauf S, Groom F, Whitehouse E, McKinnon I

Publication type: Conference Proceedings (inc. Abstract)

Publication status: Published

Conference Name: RCPsych Faculty of Forensic Psychiatry Conference 2023

Year of Conference: 2023

Online publication date: 01/03/2023

Acceptance date: 12/12/2022

Date deposited: 06/03/2023

Publisher: Royal College of Psychiatrists

ePrints DOI: 10.57711/zef0-0e24