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Care of Detainees

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Clinical Forensic Medicine

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Abstract

Healthcare professionals (HCPs) may be asked by the police to assess the fitness for detention in police custody of adults and juveniles arrested in connection with an offense; those detained by immigration; individuals requiring a place of safety (children and the mentally ill); remanded or sentenced (convicted) prisoners; or those detained under terrorism legislation. A person in police custody is referred to as a detainee in this chapter. Detainees may have to be interviewed regarding their involvement in an offense and possibly further detained overnight for court; guidance may therefore have to be given to the custodians regarding their care.

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Author information

Authors and Affiliations

  1. Faculty of Forensic and Legal Medicine, London, UK

    Margaret M. Stark (Founding Academic Dean)

  2. Faculty of Forensic and Legal Medicine, Bristol, UK

    Guy A. Norfolk (Founding President)

Authors
  1. Margaret M. Stark
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  2. Guy A. Norfolk
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Corresponding author

Correspondence to Margaret M. Stark .

Editor information

Editors and Affiliations

  1. Willunga Place 8, Sydney, 2125, New South Wales, Australia

    Margaret M. Stark

Appendices

Appendix 1: Glasgow Coma Scale

Glasgow Coma Scale

Score

Eye opening

Spontaneous

 4

To speech

 3

To painful stimulus

 2

None

 1

Best motor response

Obeys commands

 6

Localizes painful stimulus

5

Withdraws (normal flexion)

4

Flexes abnormally (spastic flexion)

3

Extension

2

No response

1

Best verbal response

Orientated

5

Confused

4

Says inappropriate words

3

Makes incomprehensible sounds

2

No verbal response

1

Maximum

15

  1. From Jennett and Teasdale [35]

Detained Person: Observation List

  1. 1.

    If any detainee fails to meet any of the following criteria, an appropriate healthcare professional or ambulance must be called.

  2. 2.

    When assessing the level of rousability consider:

    • Rousability – can they be woken?

      • Go into the cell

      • Call their name

      • Shake gently

    • Response to questions – can they give appropriate answers to questions such as:

      • What’s your name?

      • Where do you live?

      • Where do you think you are?

    • Response to commands – can they respond appropriately to commands such as:

      • Open your eyes!

      • Lift one arm, now the other arm!

    • Remember – take into account the possibility or presence of other illnesses, injury, or mental condition, a person who is drowsy and smells of alcohol may also have the following:

      • Diabetes

      • Epilepsy

      • Head Injury

      • Drug intoxication or overdose

      • Stroke

From: Home Office. Code C. Annex H [1]

Appendix 2: The Mini-Mental State Examination

 

Score

Orientation

What is the (year) (season) (date) (day) (month)

…./5

Where are we: (country) (state) (county) (town) (police station)

…./5

Registration

Examiner names three objects (e.g., orange, key, ball)

 

Patient asked to repeat the three names

 

Score one for each correct answer

…./3

Then ask the patient to repeat all three names three times

 

Attention

Serial 7’s. Stop after 5 correct answers

 

Alternatively, if patient makes errors on serial subtraction: spell

 

“world” backwards: D L R O W

 

Score best performance on either task

…./5

Recall

Ask for the names of the objects learnt earlier

…./3

Language

Show and ask the patient to name a pencil and a watch

…./2

Repeat the phrase “No ifs, and, or buts”

…./1

Give a three-stage command. Score one for each stage (e.g., “Take this piece of paper in your right hand, fold it in half, and place it on the chair next to you”)

…./3

Ask patient to read and obey a written command on a piece of paper stating: “Close your eyes”

…./1

Ask the patient to write a sentence. Score correct if it has a subject and a verb

…./1

Copying

Ask patient to copy intersecting pentagons. Score as correct if they overlap and if each has five sides

…./1

Total score

…./30

  1. From Folstein et al. [69]

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Stark, M.M., Norfolk, G.A. (2011). Care of Detainees. In: Stark, M. (eds) Clinical Forensic Medicine. Humana Press. https://doi.org/10.1007/978-1-61779-258-8_9

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