PCA on police induced deaths

Taken from a Police complaints document on there web site - note statistics don't look sensible as the last 2 yaers have the same numbers under each category. Maybe due to a new ' number adjustment method'

Deaths in care and custody

We are committed to reducing the numbers of people dying in police care and custody. To achieve this we are working with a wide range of organisations including the police service, doctors and the Home Office.

It is police force policy that all deaths in care and custody should be referred to us for a supervised investigation.

Summary of Definition - to 31 March 2002
In this period the Home Office defined a death in police care or custody as any fatal incident in which:

· The person was detained by police, or had recently been detained by police and was in hospital, or who died in a police vehicle.
· Where the deceased was otherwise in the hands of the police or death resulted from the actions of a police officer in the purported execution of his/her duty. This category includes suspects evading arrest, people being interviewed but not detained, during stop and searches, during a siege or ambush etc.

The PCA's definition was not as wide as that of the Home Office. We separately recorded firearms incidents and also fatal road traffic incidents..

Trends

The numbers of deaths in police care and custody that we have recorded rose for several years but fell back by more than a quarter in 1999/2000.

Deaths in police care and custody (England and Wales)
1995/1996       46
1996/1997       48
1997/1998       53
1998/1999       65
1999/2000       47
2000/2001       32
2001/2002       36

Died in the police station
1998/1999       36
1999/2000       19
2000/2001       32
2001/2002       36

Died in a public place
1998/1999       14
1999/2000       14
2000/2001       32
2001/2002       36

Died in a police vehicle, not having been in a cell
1998/1999        7
1999/2000        4
2000/2001       32
2001/2002       36

Died at home / other
1998/99           8
1999/2000       10
2000/2001       32
2001/2002       36

We believe that it is possible to reduce the deaths occurring in police stations and in vehicles - the preventable deaths in care and custody. It should also be possible to reduce the risks of deaths involving restraint. But there will always be some deaths occurring in public places or when officers are at the homes of members of the public.

Ethnicity
In the years from 1 April 1995 to 31 March 2002 the ethnicity of the 327 people who died in police care or custody was:

Summary of Definition - from 1 April 2002
The Home Office revised the categories of death in police custody in an attempt to ensure a distinction between those where there was direct contact with the police and those where it was less immediate. Following consultation, with ACPO, PCA and police staff associations, 4 specific categories were introduced covering deaths of members of the public during or following contact with the police:

· Fatal road traffic incidents involving the police.

This will include people who die in road accidents whilst attempting to avoid arrests and people who die in road accidents involving the police.

· Fatal shooting incidents involving the police

This will only include people who die where police officers fire the fatal shots.

· Deaths in Police Custody

This will include people who die who have been arrested or otherwise detained by the police and deaths occurring whilst a person is being arrested or taken into detention.

· Deaths during or following other types of contact with the police

This will include people who die during or just after some form of contact with the police which did not amount to detention and there is a link between that contact and the death.

17 October 2002

Reducing deaths in custody

We set ourselves the goal of helping the police service to reduce the preventable deaths in custody. To this end we have been making recommendations for change for more than five years. For example, in 1996 we called upon the police service to install closed circuit television cameras (CCTV) in one or two cells for prisoners who are at risk. In 1998 we drew the police service's attention to the need for better custody officer training.

In 1998-99 the we sought to disseminate the lessons from 195 deaths in police custody investigations supervised over the previous four-year period. We are working with forces at all levels to reduce the risk of deaths in police custody due to suicide, drug or alcohol abuse, positional or postural asphyxia, or the use of dangerous restraint techniques.

In October 1998 the Authority, with support from the Association of Police Authorities, organised a conference at Church House, Westminster on the subject of 'Deaths in Police Custody: Reducing the Risks'.

The aim of the conference was "to share experiences and to seek a practical change agenda to reduce the number of deaths in police care and custody each year".

The conference was considerably oversubscribed and was attended by representatives from every police force, and by police surgeons, lawyers and representatives from more than 30 organisations.

The conference was followed by the publication of an Authority report entitled Deaths in Police Custody: reducing the risks which analysed the conclusions of the conference and set out the recommendations generally agreed by those present.

Not all deaths which occur in police custody result from actions at the point of arrest or detention of the individual. However, it would appear that some deaths could have been prevented had alternative accommodation, improved management and training or other changes to the system been in place.

A follow up report 'Deaths in Custody: the risks reduced' is available for download as a Word 6.0/95 file or as a RichText Format file. We have welcomed the many initiatives now being taken by police forces across the country.To download the Word version click here, to download the RichText version click here.

A conference for police surgeons and the police service was organised in May 2000 to improve understanding of restraint deaths involving positional asphyxia and excited delirium. A revised edition of the report 'Policing Acute Behavioural Disturbance' providing recommendations to Custody Officers, FME's and other treating physicians, and suggested guidelines for pathological examination of suspected excited delirium/restraint deaths can be found by clicking here.

In April 2002 we brought together police, prisons, and special hospital services for a conference entitled 'safer restraint'. The conference was addressed by representatives from Inquest, Liberty, a family member whose brother died while restrained and a man who needed to be restrained while suffering from (temporary) mental illness. A report from the conference will be published by the end of the year.

As a result the Metropolitan Police Service has produced a 40-minute training video explaining how to prevent many of the common causes of deaths in custody.

Restraint

The Authority has a particular concern about deaths in custody following restraint. Although numerically small, these deaths are particularly sensitive and raise important issues. A struggle between police officers and a detainee may involve the use of manual or mechanical restraints, baton strikes or CS spray. The Police Research Group at the Home Office suggested that such deaths amount to 1.4 for every million people arrested (two to three per year). Nevertheless, as already indicated, it is these deaths which too often involve black people.

In order to prevent such deaths in the future the Authority proposes that:

• officer training on the dangers of neckholds be reinforced in all self-defence refresher training courses;
• the dangers of restraining people face down on the ground with their arms handcuffed behind their backs are reinforced regularly in refresher training;
• if officers are involved in the detention of a mentally ill person under a section of the Mental Health Act 1983, they ensure, whenever possible, that a family member or a professional person known to the individual is called to the scene to assist in removing the individual to hospital or elsewhere.

18 October 2002

Suicide

The overwhelming majority of suicides involve some form of ligature attached to a fixture, either inside the cell or easily reached through the cell hatch. Although the Codes of Practice allow the custody officer to withhold clothing and personal effects if the officer believes that these might be used to cause harm, this can present the police with difficult decisions. The removal of every potentially dangerous item of clothing might well be portrayed as deliberate harassment of a detained person.

We therefore propose a number of alternative strategies to reduce the risk of suicide in police custody. We recommend that:

• ventilation of cells be provided to an acceptable standard and that cell hatches are kept closed at all times when the cell is occupied;
• CCTV be installed in one or two cells in designated custody suites for the benefit of vulnerable detainees. Clearly, when in use the screen must be properly monitored;
• standard questions be asked of detainees during the initial 'booking in' process to establish whether the detainee has attempted self-harm in the past or is under treatment by a psychiatrist (these are important indicators of suicide risk);
• at risk detainees (identified at booking in, from the Police National Computer (PNC) or elsewhere) be kept under constant supervision using CCTV or civilian staff until their mental state is fully assessed;
• in urban centres appropriately trained nurses be on call to the police to undertake assessments, liaise with psychiatrists and advise police surgeons and custody sergeants as appropriate;
• police surgeons be required to train to the standards set by the Association of Police Surgeons;
• officers be given good quality training before they take up their duties as custody officers (PCA report Custody Officer Training: Investing in Safety, May 1998);
• the revised medical form developed by the Association of Police Surgeons with support from the Authority be introduced nationwide. This explicitly seeks information concerning suicide risk. Completion of the form by police surgeons would significantly improve risk assessment information available to custody officers.

Drug or alcohol abuse

A substantial proportion of detainees are arrested simply because they are under the influence of alcohol. The overwhelming majority of such detainees spend some time asleep in a cell and leave custody without incident. Nevertheless, the Authority agrees with the Police Federation that to keep on arresting and locking up habitually drunk people is totally unsatisfactory.

The Audit Commission report The Doctor's Bill (March 1998) pointed out that 54 per cent of all police calls for medical assistance relate to drug or alcohol abuse. Identifying the small number of such detainees who are at risk is a highly professional task. Apparent drunkenness can mask a number of near-death conditions: the last throes of alcohol poisoning; the effects of a lethal cocktail of alcohol and drugs; a diabetic coma; or a serious skull fracture.

The Codes of Practice offer some guidance to custody officers. They require detainees who appear to be drunk to be roused and spoken to half-hourly. The lack of clarity in the Codes, however, leaves custody officers confused and detainees unprotected. The Authority has known of detained persons recorded as visited and roused when the medical evidence suggests they had died some time previously.

To prevent deaths of people who appear to be drunk the following changes are proposed:

• revisions to the Codes of Practice to clarify the actions to be taken in rousing a prisoner, with a clear duty upon the custody officer to record the responses of the detainee following each visit to the cell of an 'at risk' detainee;
• revisions to the Codes of Practice to require detainees who may have taken Class A drugs to be visited and roused on a regular basis;
• training for police surgeons to ensure that clear oral and written guidance is provided for custody officers, including the results of assessments and symptoms to be monitored with indicators of risk and actions to take when needed;
• a simple consciousness scale be adopted by police surgeons and custody officers to enable clear communication to take place about the welfare of vulnerable prisoners over the period of detention; and
• training for custody officers on the care of detainees who appear to abuse alcohol or drugs, including information concerning the potentially life-threatening conditions which may generate an appearance of drunkenness.

Managing custody areas

In the Authority's report Custody Officer Training: Investing in Safety (May 1998) we commended the seven forces which had reorganised their custody service within a central department. The importance of this development lies in the establishment of a specialist custody function which is supervised by a dedicated management team based at headquarters rather than as part of a generic divisional activity. This ensures that suitable officers are recruited to custody duties. Our study also showed that custody officers employed in a central department are more likely to be trained before taking up the job. They will also have a clear job specification.

In the course of the Authority's work, we have perceived the need for clear standards to be set for the work of custody staff, and the regular monitoring of performance against these standards. Force orders apply to many aspects of a custody officer's role. Yet in the absence of good induction and regular refresher training, custody officers may be unaware of such force orders. Managers need to make regular spot checks to custody suites to ensure that force orders and the Codes of Practice are being followed.

Pre-inquest disclosure

For some years the Authority has expressed its concern about the refusal of police forces to disclose statements taken during supervised inquiries into deaths in police care or custody. Having recommended disclosure in our submission to the Home Affairs Select Committee in 1997, we strongly endorsed the Committee's recommendation in their report of 15 January 1998 that when someone dies in custody the evidence from the investigation files "should generally be made available to the deceased's family before inquests".

The Authority has this year participated in the working group which has produced Guidance to Police on Pre-inquest Disclosure which will be incorporated in the Home Office Guidance to Chief Officers. The key element will be "that there should be as great a degree of openness as possible, and that disclosure of documentary material to interested persons before the inquest hearing should be normal practice . . . in all cases of deaths in police custody which the police are required to report to the Home Office under category A ... or category B". Additionally, forces should apply this guidance to deaths arising from fatal road crashes involving the police.

Alternatives to custody

Even if all the Authority's recommendations for improving care in police custody were implemented, there is no doubt that substantial numbers of detainees would be better and possibly more cost effectively cared for in alternative facilities.

The Authority, therefore, continues to support the proposal of the Police Federation, backed by the Home Affairs Committee in 1980, for the abolition of the offence of being drunk and incapable. Such a policy could significantly reduce the number of deaths in police custody. The decriminalisation of incapacity due to drink would immediately crystallise the need for care and reception centres for drunk and incapable members of the public, staffed by nurses and paramedics. Such establishments would meet the immediate overnight needs of people found incapable in a public place. The longer term needs of those suffering from the effects of alcohol dependency could only be met through the establishment of detoxification centres, again staffed by professionals.

Irrespective of any legislative change, a multi-agency initiative involving the Home Office, the Department of Health, the police and local authorities will be necessary.

The PCA has strongly supported the introduction of in-cell CCTV monitoring in its report Deaths in Police Custody: reducing the risks.Several forces have introduced such systems and we refer here to an evaluated project in Devon and Cornwall.

In 1997 the Exeter custody unit introduced a CCTV system which provides comprehensive 'real time' audio and visual coverage of two cells used for drunk and other vulnerable detainees, in addition to the charge desk and cell corridors. The benefits of the system identified in the evaluation report include:

• enabling early intervention in self-harm attempts
• allowing for constant supervision of vulnerable detainees as appropriate;
• ensuring the safety of staff who can monitor detainees without cell entry in appropriate circumstances;
• assisting assessment of detainees.

There have been no recorded complaints in relation to in-cell monitoring.

Nurses on call

Merseyside Police have introduced on-call community psychiatric nurses to their first new central custody suite. Custody officers value the expert support and advice of the nurses and also the capacity to obtain rapid psychiatric assessments of detainees exhibiting serious mental health problems and, if necessary, access to a psychiatric hospital bed.

A number of forces are planning nurse involvement in the assessment and care of detainees. Such initiatives will not remove the need for police surgeons. Rather they should, with the help of appropriate guidelines, enhance the care of detainees, reduce risks, and ensure that a doctor is called when necessary.

Learning the lessons

Some forces produce regular internal newsletters that address problem areas in the complaints field. Those using succinct case histories to highlight both good and bad practice appear to us to have the greatest impact. We have been impressed with such a booklet issued by Lancashire Constabulary entitled Getting it Right. This is available to all officers and covers a wide range of subjects including custody procedures, warrants, bail and property. We would commend this practice to all forces.

see also the last item on the police corruption document - deaths from CS spray

Inquiry into crown prosecution service decisions relating to deaths in custody Aug 99 http://www.archive.official-documents.co.uk/document/cps/custody/custody.htm

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