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Clinical Forensic Medicine pp 313–341Cite as

Care of Detainees

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Abstract

Healthcare professionals 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. 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.

Keywords

  • Asthma
  • Attention deficit hyperactivity disorder
  • Autistic spectrum disorder
  • Diabetes
  • Epilepsy
  • Heart disease
  • Intellectual disability
  • Mental health
  • Self-harm
  • Drug searches

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Fig. 9.1
Fig. 9.2

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Acknowledgment

Original co-author Dr. Guy Norfolk not involved in this edition.

Author information

Authors and Affiliations

  1. Faculty of Forensic and Legal Medicine, Royal College of Physicians, London, UK

    Margaret M. Stark & Alex J. Gorton

  2. Department of Forensic and Social Medicine, Hôpital Jean-Verdier (AP-HP), Bondy, France

    Patrick Chariot

  3. France Institut de Recherche Interdisciplinaire Sur Les Enjeux Sociaux (IRIS), UMR 8156-997, UFR SMBH, Sorbonne Paris Cité, Université Paris 13, Villetaneuse, France

    Patrick Chariot

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Correspondence to Alex J. Gorton .

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  1. Faculty of Forensic and Legal Medicine, Royal College of Physicians, London, UK

    Margaret M. Stark

Appendices

Appendix 1: Glasgow Coma Scale

Behaviour

Response

Score

Eye opening response

Spontaneous

4

To speech

3

To painful stimulus

2

None

1

Best verbal response

Orientated

5

Confused

4

Inappropriate words

3

Incomprehensible sounds

2

None

1

Best motor response

Obeys commands

6

Localises to painful stimulus

5

Withdraws from pain

4

Abnormal flexion (decorticate)

3

Abnormal extension (decerebrate)

2

None

1

  1. From Jennett and Teasdale [49]

Appendix 2: Detained Person: Observation List

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

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

  1. From: Home Office. Code C. Annex H [16]

Appendix 3: The Mini-Mental State Examination

Task

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. [97]

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Stark, M.M., Gorton, A.J., Chariot, P. (2020). Care of Detainees. In: Stark, M. (eds) Clinical Forensic Medicine. Springer, Cham. https://doi.org/10.1007/978-3-030-29462-5_9

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