What is 'Equivalence' in Police Custody Healthcare?

什么是警察拘留医疗保健中的“等效”？

• 批准号: ES/V009982/1
• 负责人: Gethin Rees
• 金额: $ 73.75万
• 依托单位: Newcastle University
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2021
• 资助国家: 英国
• 起止时间: 2021 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=ES%2FV009982%2F1
• 关键词: What; Equivalence; Police; Custody; Healthcare

ContextAt present, there is no clear standard for healthcare provision in police station custody suites governing the level of care expected by those detained. Healthcare providers are expected to work within the standards outlined by their own professional bodies; however, these are vague, and no clear standard exists for detention staff, who perform most custody healthcare. This is troubling due to the high rate of persons in police custody with mental health and substance abuse concerns and the rate of deaths in custody; both these rates are unequally distributed along ethnicity lines. It also stands in contrast to other parts of the criminal justice system (for instance prisons), where an equivalence standard, i.e. an expectation that persons detained in prison will receive healthcare equivalent to those at liberty, is the norm.There are two common explanations the absence of such a standard: police custody is a law enforcement space; and persons are only detained for a few hours, meaning that they can access traditional healthcare upon release. Traditionally, healthcare in police custody is understood as resolving emergencies (including sending those that cannot be treated in custody to hospital) and ensuring that detainees are fit to be interviewed. However, the high rate of persons who are detained during a mental health crisis, as well as the 'chaotic lifestyles' of those detained, means that the healthcare needs of detainees in police custody spaces are increasingly important.Aims and ObjectivesAs a result of these changes, this project aims to develop knowledge about the healthcare practices of police custody staff (police officers, detention officers, and healthcare providers) in order to inform an equivalence standard and provide guidance for its implementation into custody work. The project will ask four key questions:1) How do custody staff (police and healthcare) interact with detainees, and how do these interactions impact detainees' experiences of health and wellbeing in police custody? How do detainees' observable characteristics (age, body size, skin colour, gender) influence these interactions?2) How do police and healthcare staff in custody interact with each other, and what is needed to achieve optimal multiagency working and deliver equivalence in healthcare?3) What role does the age and space of police custody environments play in the delivery of healthcare?4) What health information about detainees is accessed, recorded, managed, and shared within police custody; how is this done, and how is the information secured?To answer these questions, we will carry out the following social science research methods:- Up to 500 hours of observations in four police custody suites- Semi-structured interviews with 60 custody staff and 40 detainees- Audits of 1,600 police custody risk assessment files and interviews with 20 police custody desk sergeants about their risk assessment proceduresPotential BenefitsThe chief outcome of the research will be a policy brief outlining what an equivalence standard in police custody would include and how it could be implemented. We expect that this will include advice on the interactions between detainees and staff (police, civilian, and healthcare), the forms of information that detainees receive and the ways in which they receive it. In addition, we also expect to comment on the interactions between staff in custody, especially as they discuss detainees across professional boundaries. For instance, the transfer of personal information about a detainee between staff should be highly confidential, and so we would introduce guidance on the handling of such information in order to maintain patient confidentiality. It is expected that the production of an equivalence standard that works with current custody suite practice will improve healthcare outcomes for those who attend police custody, while also reducing the potential for deaths in custody.

目前，警察局拘留室的医疗保健服务没有明确的标准来管理被拘留者所期望的护理水平。医疗保健提供者应在其专业机构规定的标准范围内工作;然而，这些标准很模糊，对拘留所工作人员没有明确的标准，而拘留所工作人员承担着大部分拘留保健工作。这一情况令人不安，因为在警方拘留中有精神健康和药物滥用问题的人比例很高，而且拘留中死亡的比例也很高;这两个比例在沿着族裔中分布不均衡。它也与刑事司法系统的其他部分形成鲜明对比（例如监狱），在这些地方，一个等同标准，即被拘留在监狱中的人将获得与自由时等同的医疗保健，是一种规范。而且这些人只被拘留几个小时，这意味着他们在获释后可以获得传统的医疗保健。传统上，警方拘留期间的医疗保健被理解为解决紧急情况（包括将那些无法在拘留期间接受治疗的人送往医院），并确保被拘留者适合接受采访。然而，在精神健康危机期间被拘留的人的比例很高，以及被拘留者的“混乱的生活方式”，意味着警察拘留场所的被拘留者的医疗保健需求越来越重要。（警察、拘留官员和医疗保健提供者），以便制定等效标准并为其在拘留工作中的实施提供指导。该项目将提出四个关键问题：1）拘留工作人员（警察和医疗保健）如何与被拘留者互动，这些互动如何影响被拘留者在警察拘留期间的健康和福祉体验？被拘留者的明显特征（年龄、体型、肤色、性别）如何影响这些互动？2)被拘留的警察和医疗保健人员如何相互作用，以及需要什么来实现最佳的多机构工作和提供医疗保健的等效性？3)警察拘留环境的年龄和空间在提供医疗保健方面发挥什么作用？4)在警察拘留所内获得、记录、管理和分享了哪些关于被拘留者的健康信息;如何做到这一点，如何保护这些信息？为了回答这些问题，我们将采用以下社会科学研究方法：-在四个警察拘留室进行长达500小时的观察-与60名拘留工作人员和40名被拘留者进行半结构化访谈-对1，600份警察拘留风险评估文件进行审计，并与20名警察拘留台警长就其风险评估程序进行访谈潜在的好处研究的主要成果将是一份政策简报，概述警察拘留中的等同标准包括哪些内容以及如何实施。我们希望这将包括关于被拘留者与工作人员（警察、平民和医疗保健）之间的互动、被拘留者获得信息的形式和方式的建议。此外，我们还希望对在押工作人员之间的互动，特别是当他们跨越专业界限讨论被拘留者时，进行评论。例如，工作人员之间传递被拘留者的个人信息应高度保密，因此，我们会就处理这些信息提供指引，以确保病人的保密性。预计制定一个与目前拘留室做法相适应的等效标准将改善那些被警察拘留的人的医疗保健结果，同时也减少拘留期间死亡的可能性。