Structures, processes and outcomes of health care for people detained in short-term police custody settings: A scoping review.

Abstract

BACKGROUND\nPeople detained in short-term custodial settings can require health care that may necessitate transfer to an Emergency Department (ED). What and how health care is delivered to detainees in short-term custodial settings may influence their health outcomes.\n\n\nOBJECTIVE\nThe aim of this scoping review was to synthesise and critically appraise the evidence on health care delivered to detainees in short-term custody settings.\n\n\nDESIGN\nA scoping review was undertaken. Five online databases (CINAHL, PubMed, Medline, Embase and Criminal Justice Database) were searched from January 2010 to May 2020. Data extracted pertained to the structures, processes and outcomes of health care delivery. The Mixed Methods Assessment Tool was used to quality appraise the studies. Deductive analysis was used to sort the findings into structures, processes and outcomes of health care delivery and then thematic analysis was undertaken to synthesise these findings.\n\n\nRESULTS\nIn total, 37 studies with varied designs were included in this review; 3 randomised control trials, 4 quantitative comparative studies, 21 quantitative descriptive studies, 8 qualitative studies and 1 mixed methods study. Studies were mainly from westernised countries. The quality of evidence varied across studies. Health care delivery structures had a strong focus on the identification of mental illness, with processes predominantly comprising health assessment screening on arrival to the short-term custodial setting. Outcomes (at the detainee and organisation level) included increased identification of substance misuse issues and improvement of health conditions, alongside inadequate assessment/identification of physical and mental health issues for detainees.\n\n\nCONCLUSION\nGaps in evidence identified limited international perspectives as most studies originated from the US, a focus on detainee conditions/symptoms and limited long-term research within the area of health care in short-term custodial settings. Literature regarding health care delivery in short-term custodial settings focused predominantly on mental illness identification. Understanding the nature of health care delivery in short-term custodial settings further through research into specific roles such as the custody nurse is required to develop targeted interventions that address the needs of the detainee on a comprehensive level.