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Lookup NU author(s): Dr Gethin ReesORCiD, Stephanie Mulrine, Dr Mwenza BlellORCiD, Dr Iain McKinnonORCiD
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The dynamics of care delivery (including healthcare), in police custody suites has radically altered in the past twenty years. Previously doctors (referred to as Forensic Medical Examiners (FME)) would need to be called into a police custody suite and so would only visit these spaces in the case of an emergency or a medical need that was outside the skills of the custody team. Following greater public awareness of the frequency of deaths in custody (Angiolini 2017, Baker 2018) and an acceptance that the medical needs of detained persons were greater than what could be dealt with by a visiting FME, Healthcare Providers (HCPs) became embedded within police custody, providing 24 hour medical support, seven days a week. Having embedded, professional HCPs in custody has only served to bring to light that the medical needs of detained persons is even greater than was appreciated and has resulted in significant changes to the working practices of both the HCPs (i.e. in having to work within a carceral environment), but also for the police and civilian detention staff. This text, based upon an Economic and Social Research Council Standard Grant, is the first project of its kind to take a holistic approach to understanding the delivery of care in police custody and to identify the practices of care as well as the interpersonal (predominantly detainee and staff) and interprofessional dynamics that result from the delivery (or denial) of care in police custody. Based upon case studies of the custody suites of two English police forces, the text will explore themes, for instance the impact of police commissioning of healthcare and the ways this produces a “postcode lottery” of care in different suites. The development of interprofessional teamworking and the impact of embedding on Custody Officer decision-making and what happens when HCPs are not actually embedded? At the same time, we will also explore how risk-mitigation plays a key role in the practices of all custody staff (healthcare, police and detention officers) and will explore the ways that risk is identified and managed in custody, which sometimes can result in a denial of care. Mental illness constitutes an overwhelming presence in police custody and alongside exploring its impact on the collection of evidence in terms of fitness to interview decisions, we will explore the significant difficulties all staff in custody have in identifying, managing and processing persons with significant mental health needs. Exploring how resource limitations with other stakeholders (for instance mental health crisis, hospitals and the Criminal Justice Liaison and Diversion teams), place additional pressure on the skills of the custody team to deal with some of the most vulnerable. We aim to show that while the custody suite teams are trying to make the best of a bad situation, there is a significant gulf in what can be done for persons detained (sometimes after being sectioned under a Mental Health Assessment) due to wholesale lack of resources across the health and social care sector, especially related to mental health. We will conclude with a discussion of how custody healthcare is presently far from an equivalence standard (as is recommended in the prison estate), but that there are some ways that the standard of care could be improved (and certainly can resolve the “postcode lottery”). Much of the focus of these improvements will concern the drain of resources that custody healthcare, in its current form, is taking from the NHS and this will lead us, finally, into a critique of the proposed “Right Care, Right Person” policy, in particular in the ways that it places additional responsibility on struggling NHS services (especially those services related to mental health) and while it might save police resources, these are then not being transferred to health services that are desperately short of cash. As a result, we will conclude by taking what we have learned about care in police custody and extend it to the larger questions and debates around mental healthcare and policing, while at the same time actively critiquing the discourses of care (and healthcare) mobilised within the police custody infrastructure..
Author(s): Rees G, Mulrine S, Blell M, Addison M, McKinnon I
Series Editor(s): Fleming, J
Publication type: Authored Book
Publication status: In Press
Series Title: Routledge Studies in Policing and Society
Year: 2027
Acceptance date: 13/07/2026
Publisher: Routledge
Notes: Funding has been received from ESRC to pay for open-access publishing.
