Mental Health, Vulnerability & Risk in Police Custody

Purpose: The issue of mental health and policing is a subject that has been debated from a number of different perspectives. The purpose of this paper is to report on the findings of a case study that explored mental health difficulties and vulnerability within police custody. Design/Methodology/approach: The design of the study was qualitative, and it utilised telephone semi-structured interviews with all levels of the custody staff. This approach was taken because the aim of the study was to explore how people in different roles within the organisation, worked to safeguard vulnerable people in custody. Findings: The findings from this study identified a number of interesting themes that could be explored further in later studies. Overall the respondents expressed frustration that vulnerable people find themselves in police custody for low-level crime when it could have been avoided with improved mental health services in the community. Additionally, the findings demonstrated that despite the processes that are designed to safeguard the detainee, tensions still exist including, timely access to mental health assessments, appropriate training and support for staff, and the use of appropriate adults. Research limitations/implications: Although the study was small in scale, the custody facility delivered detainee facilities for about 5000 individuals per year. The research and information obtained supported the Force lead to identify opportunities for improving the customer journey as well as further research to identify how officers and staff relate to vulnerable individuals in contact with the police service Practical implications: Social implications: Originality/value: Despite the limitations of the study, the findings have captured interesting data from a range of professionals working in one police custody suite and therefore it presents a holistic overview of some key issues around mental health, vulnerability and safeguarding within the context of police custody

Blue remembered skills : mental health awareness training for police officers

The Bradley Report (Bradley, 2009) has raised a number of important questions regarding the treatment of individuals who are experiencing mental health problems and find themselves in the criminal justice system. One of the key recommendations is that professional staff working across criminal justice organisations should receive increased training in this area. This paper explores the experiences of two professionals, a mental health nurse and a social worker, involved in providing training for police officers. It goes on to consider the most effective models of training for police officers

UK policy on social networking sites and online health: from informed patient to informed consumer?

Background: Social networking sites offer new opportunities for communication between and amongst health care professionals, patients and members of the public. In doing so, they have the potential to facilitate public access to health care information, peer-support networks, health policy fora and online consultations. Government policies and guidance from professional organisations have begun to address the potential of these technologies in the domain of health care and the responsibilities they entail for their users. Objective: Adapting a discourse analytic framework for the analysis of policy documents, this review paper critically examines discussions of social networking sites in recent government and professional policy documents. It focuses particularly on who these organisations claim should use social media, for what purposes, and what the anticipated outcomes of use will be for patients and the organisations themselves. Conclusion: Recent policy documents have configured social media as a new means with which to harvest patient feedback on health care encounters and communicate health care service information with which patients and the general public can be ‘empowered’ to make responsible decisions. In orienting to social media as a vehicle for enabling consumer choice, these policies encourage the marketization of health information through a greater role for non-profit and commercial organisations in the eHealth domain. At the same time, current policy largely overlooks the role of social media in mediating ongoing support and self-management for patients with long-term conditions

Adult Social Work and High Risk Domestic Violence Cases

Summary This article focuses on adult social work’s response in England to high-risk domestic violence cases and the role of adult social workers in Multi-Agency Risk and Assessment Conferences. (MARACs). The research was undertaken between 2013-2014 and focused on one city in England and involved the research team attending MARACs, Interviews with 20 adult social workers, 24 MARAC attendees, 14 adult service users at time T1 (including follow up interviews after six months, T2), focus groups with IDVAs and Women’s Aid and an interview with a Women’s Aid service user. Findings The findings suggest that although adult social workers accept the need to be involved in domestic violence cases they are uncertain of what their role is and are confused with the need to operate a parallel domestic violence and adult safeguarding approach, which is further, complicated by issues of mental capacity. MARACS are identified as overburdened, under-represented meetings staffed by committed managers. However, they are in danger of becoming managerial processes neglecting the service users they are meant to protect. Applications The article argues for a re-engagement of adult social workers with domestic violence that has increasingly become over identified with child protection. It also raises the issue whether MARACS remain fit for purpose and whether they still represent the best possible response to multi-agency coordination and practice in domestic violence

Staff understandings of abuse and poor practice in residential settings for adults with intellectual disabilities

BackgroundA common factor in the abuse of people with intellectual disabilities in residential settings has been the failure of care staff and frontline managers to recognise poor practice at an early stage and prevent its development into a culture of abuse. In this context, staff understandings of abuse and poor practice in residential services for people with intellectual disabilities were explored.MethodSemi‐structured interviews (n = 56) were undertaken with care staff and frontline managers working across England. Interviews included the use of vignettes, based on real‐life experiences of people with intellectual disabilities, to prompt discussion.ResultsStaff struggled to define either “abuse” or “poor practice”, focussing more on individual acts or omissions than on institutional practices. When faced with vignettes, staff demonstrated a lack of agreement regarding what constitutes either abuse or poor practice.ConclusionsThe implications for practice in residential care settings and for safeguarding training are discussed

Keeping the focus on children: the challenges of safeguarding children affected by domestic abuse

Safeguarding children affected by domestic abuse is a key responsibility for all professionals working with children and families, but can be difficult to achieve in practice. Despite a policy emphasis on early intervention and child-centred work, limited attention has been paid to how professionals in universal and additional support services address this important area of work. This paper reports findings from qualitative research undertaken in one local authority area in the north of England during 2011 which examines the challenges facing professionals in safeguarding children affected by domestic abuse. Six mixed professional focus groups were held, attended by a total of 23 participants. Discussion focused upon participants’ awareness of domestic abuse, how they assessed and met children and young peoples’ needs, and their views about service provision and safeguarding processes. Data were transcribed and thematic analysis undertaken. The themes presented in this paper – embodied recognition, someone else's job, service gaps, skills deficits, and focusing upon children and young people – illustrate the scope and limitations of professionals’ work with children and young people affected by domestic abuse. Areas for practice improvement are discusse

Patient ethnicity and three psychiatric intensive care units compared: the Tompkins Acute Ward Study

Background: Psychiatric Care Units provide care to disturbed patients in a context of higher security and staffing levels. Although such units are numerous, few systematic comparisons have been made, and there are indications that ethnic minority groups may be over-represented. Aim: To compare the rates of adverse incidents and patterns of usage of three Psychiatric Intensive Care Units. Method: The study used a triangulation or multi-method design, bringing together data from official statistics, local audit and interviews conducted with staff. Results: Intensive care patients were more likely to be young, male, and suffering a psychotic disorder, as compared to general acute ward patients. Caribbean patients were twice as likely, and Asian patients half as likely, to receive intensive care (age, gender and diagnosis controlled). There were large differences in service levels, staffing, team functioning and adverse incidents between the three units. Various aspects of physical security were important in preventing absconds. Conclusions: More evaluative research is required in order to define effective service levels, and to explore the nature of the interaction between ethnicity and inpatient care provision during acute illness

Healthier prisons: The role of a prison visitors' centre

Since the inception of the prison as a ‘setting’ for health promotion, there has been a focus on how the health of those men and women who spend ‘time inside’ can at least be maintained and if possible, enhanced, during their prison sentence. This paper presents findings from a mainly qualitative evaluation of a prison visitors' centre in the UK. It reports experiences of prisoners' families, prisoners, prison staff, the local community and the ways in which the visitors' centre has contributed positively to their health and well-being. In addition, key stakeholders were interviewed to ascertain the role this visitors' centre has in policy frameworks related to re-offending. The findings from this evaluation underscore how the visitors' centre improved the quality of visits, and contributed towards the maintenance of family ties through the help and support it provides for families and prisoners. The paper concludes by suggesting that visitors' centres are an essential part of a modern prison service helping to address the government's health inequalities agenda

Perceived credibility and eyewitness testimony of children with intellectual disabilities

Background: Although children with intellectual disabilities (ID) often provide accurate witness testimony, jurors tend to perceive their witness statements to be inherently unreliable. Method: The current study explored the free recall transcripts of child witnesses with ID who had watched a video clip, relative to those of typically developing (TD) age-matched children, and assessed how mock jurors perceived these transcripts in the absence of knowledge of group (ID or TD) membership. A further aim of this research was to determine whether perceptions of credibility were associated with levels of free recall and witness characteristics (anxiety and mental age). Results: Mock jurors rated the testimony of children with ID as less credible than that of a TD age-matched comparison group. This was largely because of the transcripts of the children with ID containing fewer details than those of the TD children. Anxiety and mental age were found to have no effect on perceived levels of credibility. Conclusions: It appears that even in the absence of knowledge of whether a child does or does not have ID, this factor still affects perceptions of credibility among mock jurors. Our findings suggest that fundamental differences in the quality of the witness transcripts lead to lower perceptions of credibility for children with ID

Growing better brains? Pregnancy and neuroscience discourses in English social and welfare policies

In recent years, English welfare and health policy has started to include pregnancy within the foundation stage of child development. The foetus is also increasingly designated as ‘at risk’ from pregnant women. In this article, we draw on an analysis of a purposive sample of English social and welfare policies and closely related advocacy documents to trace the emergence of neuroscientific claims-making in relation to the family. In this article, we show that a specific deterministic understanding of the developing brain that only has a loose relationship with current scientific evidence is an important component in these changes. We examine the ways in which pregnancy is situated in these debates. In these debates, maternal stress is identified as a risk to the foetus; however, the selective concern with women living in disadvantage undermines biological claims. The policy claim of neurological ‘critical windows’ also seems to be influenced by social concerns. Hence, these emerging concerns over the foetus’ developing brain seem to be situated within the gendered history of policing women’s pregnant bodies rather than acting on new insights from scientific discoveries. By situating these developments within the broader framework of risk consciousness, we can link these changes to wider understandings of the ‘at risk’ child and intensified surveillance over family life