Health needs and co-morbidity among detainees in contact with healthcare professionals within police custody across the London Metropolitan Police Service area

Aims
Detainees requiring access to healthcare services in police custody have been shown to suffer from poor physical and mental health, often exacerbated by substance misuse. This study examines the extent and nature of health needs in police custody across the Metropolitan Police Service (MPS), London.

Methods
A survey (n = 1657) was administered by Healthcare Professionals (HCP) for one month in 2015 across all MPS custody suites representing a 73% response rate. A logistic regression model was created using four binary outcomes (whether a detainee was a drug user, had mental health issues including self-harm and had an alcohol use disorder) with ten prognostics to test for co-morbid associations. A multiple imputation method using chained equations was used to manage missing cases.

Findings
High rates of physical health conditions, drug use, problematic alcohol use were noted but are within the upper range of existing studies. Mental health, self-harm and overall substance misuse levels (illicit drug user and a current drinker) were shown to be higher than other published studies. The logistic regression model found statistically significant associations between drug use, alcohol consumption and mental health including self-harm. Age was also found to be a key confounding factor. Physical health was broadly negatively associated with the four main outcomes.

Discussion
Levels of need for health interventions among the detainee population in London are broadly consistent with other European centres. There is a need for police custody staff to consider detainees' dual diagnosis needs. The development of integrated interventions alongside the enhanced clinical management of alcohol, drug use and mental health was considered.