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Police and suicide prevention: why it is important

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Police and suicide prevention: why it is important

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Purpose: is to try and reduce risk of suicide by identifying where the key needs are and then directing them to the right area - triage - in less of a psychological approach
Important: do you feel that you are equipped enough to do this? Do you feel any weight of responsibility?
My interview: how well the purpose is working in practice how effectively are police officers using the tool, which is psychologically informed? What they're doing is evidence-based and compiled of previous research that the officers then use that
- need to evaluate intervention - not a focus on predicting risk but about how user friendly is it, does it do the job at the actual delivery of it - two needs: my own for my diss/research skills and providing the evidence for the user-friendliness of the tool = organisational stance
- Might end up recommended development for training
- compile questionnaire and email to Sally and Karen to see if there's anything extra
- Looking at experience = IPA

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Cummins, I. (2008). A place of safety? Self-harming behaviour in police custody. The journal of adult protection, 10(1), 36-47.

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Cummins, I. (2008). A place of safety? Self-harming behaviour in police custody. The journal of adult protection, 10(1), 36-47.

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- The custody environment is not designed nor can it hope to meet the needs of individuals who are experiencing acute mental distress. The article reports the findings of analysis of the recorded incidents of self-harm that occurred in the custody of one English police force during an eight-month period in 2006.
- There were 168 such incidents in this period. The ratio of male/female detained persons, who harmed themselves was 3:1. - The most common method used was a ligature either from the detained person’s own clothes or the paper suits that are used in custody. Alcohol or substance misuse was identified as a clear risk factor
- Police officers, in particular custody officers, are being placed in positions where they are assuming a quasi-mental health nursing role. This is a role for which, in the vast majority of cases, they have received little if any training.
- In addition, environmental, organisational and cultural factors mean that police officers often feel isolated from, or unsupported by community-based mental health services.
- There is a need for greater investment in the training of officers

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King, C., Senior, J., Webb, R. T., Millar, T., Piper, M., Pearsall, A., ... & Shaw, J. (2015). Suicide by people in a community justice pathway: Population-based nested case–control study. The British Journal of Psychiatry, 207(2), 175-176.

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King, C., Senior, J., Webb, R. T., Millar, T., Piper, M., Pearsall, A., ... & Shaw, J. (2015). Suicide by people in a community justice pathway: Population-based nested case–control study. The British Journal of Psychiatry, 207(2), 175-176.

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- Our findings provide new evidence highlighting elevated suicide risk among people in community justice pathways. We found that 13% of the national population dying by suicide were in contact with the criminal justice system in the year preceding death, a proportion greater than official sources suggest.
- Suicide risk associated with sexual offences is higher than previously reported. This may in part be as a result of the recency of the alleged sexual violence disclosure and the fear of real, or perceived outcome of prosecution.
- Elevated risk among suspects on police bail represents a newly identified association and is important as the majority of people passing through police custody are bailed and directed to appear at court. Further work should examine risk in this group, to help police, and community health professionals identify and manage this elevated risk.
- Our results suggest the need for prioritising effective ways to assess suicidality among those who pass through the justice system. These contact and release periods present an opportunity to recognise, signpost and deliver interventions to vulnerable people at elevated risk of suicide.

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McKinnon, I., & Grubin, D. (2014). Evidence-based risk assessment screening in police custody: the HELP-PC study in London, UK. Policing: A Journal of Policy and Practice, 8(2), 174-182.

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McKinnon, I., & Grubin, D. (2014). Evidence-based risk assessment screening in police custody: the HELP-PC study in London, UK. Policing: A Journal of Policy and Practice, 8(2), 174-182.

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- The welfare of detainees in UK police custody is the responsibility of Custody Officers (COs). COs need to identify detainees who have significant health problems and require the attention of a health care professional.
- We piloted a new risk assessment screen in 2012 in a police custody suite in London, UK. Data were compared with our evaluation of the standard National Strategy for Police Information Systems (NSPIS) risk assessment in 2009–10.
- We have demonstrated that a structured screen can improve the pickup rate of detainees with head injuries, physical and mental health problems, as well as those at risk of alcohol withdrawal syndrome.
- By consolidating health problems associated with elevated suicide risk, the detection of higher risk detainees was also significantly improved.
- The Metropolitan Police Service is planning to implement this risk assessment and we recommend a wide scale evaluation of its clinical impact and upon custody health services

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Noga, H. L., Walsh, E. C., Shaw, J. J., & Senior, J. (2014). The development of a mental health screening tool and referral pathway for police custody. The european journal of public health, 25(2), 237-242.

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Noga, H. L., Walsh, E. C., Shaw, J. J., & Senior, J. (2014). The development of a mental health screening tool and referral pathway for police custody. The european journal of public health, 25(2), 237-242.

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PolQuest is designed for use by police officers - this screening tool allows for a the identification of a range of mental health symptoms, some of which are identified as requiring urgent intervention, for example, risk of suicide and psychosis. The tool is designed to operate alongside a locally agreed management and service response plan that underpins a service level agreement between different agencies, outlining who should respond to identified need and within what time period, both daytime and nighttime.
-  It is accompanied by a referral pathway that outlines services' responsibilities, expected actions and response times.

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McKinnon, I. G., & Grubin, D. (2012). Health screening of people in police custody—evaluation of current police screening procedures in London, UK. The european journal of public health, 23(3), 399-405.

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McKinnon, I. G., & Grubin, D. (2012). Health screening of people in police custody—evaluation of current police screening procedures in London, UK. The european journal of public health, 23(3), 399-405.

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Method:  Prospective clinical interviews with custody detainees in London were conducted. Clinical findings were compared with those recorded in police health screening documentation.
- Mental disturbance was detected in 79% of the detainees with serious mental illness, one-third of the detainees with a risk history of suicide and one-half of the detainees with suicidal ideation were not documented as such on the police screen.

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Gould, C., McGeorge, T., & Slade, K. (2018). Suicide screening tools for use in incarcerated offenders: A systematic review. Archives of Suicide Research, 22(3), 345-364.

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Gould, C., McGeorge, T., & Slade, K. (2018). Suicide screening tools for use in incarcerated offenders: A systematic review. Archives of Suicide Research, 22(3), 345-364.

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Current screening processes for suicide risk in prisons,both in the UK and internationally have not been adequately validated. Furthermore, this review has demonstrated a distinct paucity of research into prison suicide screening tools across English-speaking countries with only fragmentary instruments in use within these jurisdictions. It is contended that many of these screening tools lack sufficient sensitivity to detect a high proportion of those at risk. As such the generalisability of these tools across multiple jurisdictions is unproven.
- Given the continued high rates of suicide in prisons in England and Wales, and internationally the development of an effective and practical prison suicide screening tool would be welcome indeed. An actuarial tool that enables reliable, accurate identification of risk with a high degree of sensitivity could enable the channelling of high-risk prisoners into appropriate healthcare pathways and facilitate the development of robust interventions to prevent avoidable loss of life

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Norfolk, G. A. (1998). Deaths in police custody during 1994: a retrospective analysis. Journal of clinical forensic medicine, 5(1), 49-54.

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Norfolk, G. A. (1998). Deaths in police custody during 1994: a retrospective analysis. Journal of clinical forensic medicine, 5(1), 49-54.

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- This paper presents the results of a retrospective analysis of deaths in police custody from 1 January to 31 December 1994. During that year, there were 32 such deaths in the UK. For purposes of analysis, the deaths were grouped into three principal categories based on the frequency of their occurrence: deaths by hanging (12); deaths among those arrested for drunkenness (11) and other deaths (9)
-  Despite the need for further research, certain recommendations can be made on the basis of this limited study and the literature review associated with it:
1. There is a need for improved suicide awareness training to be provided for both police surgeons and personnel.
2. Consideration should be given to introducing a simple screening proforma to be completed by custody staff for each detainee (when practical) that would seek to identify those at risk of suicide or otherwise in need of medical attention.
3. Introduction of video surveillance should be considered for use in cells of at-risk individuals.
4. Efforts to improve cell design and, in particular, the removal of all protruding objects suitable for self-suspension should continue.
5. An objective scale for assessing level of consciousness, such as the Glasgow Coma Scale, should be taught to custody staff and used to monitor all those arrested for being drunk and incapable or otherwise seemingly under the influence of drink or drugs.
6. Police surgeons should ensure that instructions regarding the care and supervision of prisoners are written down clearly for custody staff and not simply relayed verbally.

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Forrester, A., Samele, C., Slade, K., Craig, T., & Valmaggia, L. (2017). Demographic and clinical characteristics of 1092 consecutive police custody mental health referrals. The Journal of Forensic Psychiatry & Psychology, 28(3), 295-312.

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Forrester, A., Samele, C., Slade, K., Craig, T., & Valmaggia, L. (2017). Demographic and clinical characteristics of 1092 consecutive police custody mental health referrals. The Journal of Forensic Psychiatry & Psychology, 28(3), 295-312.

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- 43 police forces in England and Wales have made over 13 million arrests in the last decade. Yet despite this high volume criminal justice system activity, and evidence of substantial health morbidity across the criminal justice pathway, mental health services in police custody have so far only been developed in patches, and the literature in this area is limited.
- Referrals (n=1092) to a pilot mental health service operating across two police stations in a London borough were examined over an 18-month period in 2012/13.
- The referred group had high levels of mental health and substance misuse problems (including acute mental illness, intoxication and withdrawal), selfharm, suicide risk and vulnerability, with some important gender differences.
- Although this work has limitations, the findings are broadly consistent with the small existing literature and they confirm the need for services that are sufficiently resourced to meet the presenting needs.

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Forrester, A., Samele, C., Slade, K., Craig, T., & Valmaggia, L. (2016). Suicide ideation amongst people referred for mental health assessment in police custody. Journal of criminal psychology, 6(4), 146-156.

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Forrester, A., Samele, C., Slade, K., Craig, T., & Valmaggia, L. (2016). Suicide ideation amongst people referred for mental health assessment in police custody. Journal of criminal psychology, 6(4), 146-156.

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- In 2014, 23% (n = 111) of all deaths that took place in State custody (n = 479) were identified as having been self-inflicted (with natural causes identified as the largest single cause of deaths, in 67% of the total number).
- Meanwhile, a related national review of selfinflicted deaths in custody of people aged between 18 and 24 reported that during the seven-year period 2007 - 2014, there were 101 deaths in prison custody of people in this age group (Harris, 2015).
( Harris, T. (2015). Changing prisons, saving lives: report of the Independent Review into selfinflicted deaths in custody of 18-24 year olds. London: Ministry of Justice. )

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Marzano, L., Smith, M., Long, M., Kisby, C., & Hawton, K. (2016). Police and suicide prevention. Crisis.

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Marzano, L., Smith, M., Long, M., Kisby, C., & Hawton, K. (2016). Police and suicide prevention. Crisis.

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Aims: To investigate the impact of training on officers’ suicide prevention attitudes, confidence, and knowledge.
Method: Fifty-three participants completed a brief questionnaire before and after undertaking training. In addition, two focus groups were conducted with 10 officers to explore in greater depth their views and experiences of the training program and the perceived impact on practice.
Results: Baseline levels of suicide prevention attitudes, confidence, and knowledge were mixed but mostly positive and improved significantly after training. Such improvements were seemingly maintained over time, but there was insufficient power to test this statistically. Feedback on the course was generally excellent, notwithstanding some criticisms and suggestions for improvement. Conclusion: Training in suicide prevention appears to have been well received and to have had a beneficial impact on officers’ attitudes, confidence, and knowledge. Further research is needed to assess its longer-term effects on police attitudes, skills, and interactions with suicidal individuals, and to establish its relative effectiveness in the context of multilevel interventions.

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Linsley, K. R., Johnson, N., & Martin, J. (2007). Police contact within 3 months of suicide and associated health service contact. The British Journal of Psychiatry, 190(2), 170-171.

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Linsley, K. R., Johnson, N., & Martin, J. (2007). Police contact within 3 months of suicide and associated health service contact. The British Journal of Psychiatry, 190(2), 170-171.

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-  We evaluated police contact with individuals prior to suicide, using a systematic study of suicides within County Durham and Darlington over a 3-year period and analysis of police computer records covering the same area.
- A total of 205 cases of suicide were identified.
- A fifth of these (n=41) had a documented contact with police within 3 months prior to the suicide, there was an equal mixture of victims and alleged perpetrators of crime, and a significant number of those with police contact had also seen a health professional recently.
- As many people see a police officer in the 3 months prior to their suicide as see a mental health professional within 12 months prior to suicide