Screening for psychiatric morbidity in police custody: results from the HELP-PC project

Aims and method To ascertain the efficacy of custody health screening for mental disorders. We assessed a sample of detainees for the presence of mental disorders and the need for an appropriate adult. The assessments were carried out using pragmatic interviews and examinations supported by structured tools. Where possible, we attributed a probable clinical diagnosis based on the information available to us. The need for an appropriate adult was judged based on this information and capacity assessments. Results Existing screening procedures missed a quarter of cases of severe mental illness and moderate depression; they also failed to detect about a half of those at risk of alcohol withdrawal and 70% of those at risk of withdrawal from crack cocaine. The need for an appropriate adult was not recognised in more than half of cases. Clinical implications Consideration should be given to modifying police screening procedures for mental and associated disorders so that detainees receive the appropriate attention.