CMHRA

Question 1

What is ‘Custodial Management’

Answer 1

Custodial Management covers the process of detention not simply the place of custody
eg. police car, the cells

Question 2

Where does Custodial Management begin

Answer 2

when persons detained or arrested

Question 3

When does Custodial Management end

Answer 3

when the perosn is released or transferred into the care of another agency, individual or family member

Question 4

Unlawful detention exists when…

Answer 4

Police officer detained the person and the detention is not under an enactment

Question 5

Do’s of Custodial Management

Answer 5

Follow safe practices
- restraints
- transport
- interview rooms
- holding cell and charge room
- police and court cells

Do follow police instructions

Question 6

Health and Safety Evaluation - CMHRA
Crimes Act 1961, Section 51

Answer 6

everyone who has actual care or charge of a person who is a vulnerable adult and who is unable to provide himself or herself with necessaries is under a legal duty -
a) to provide that person with necessaries; and
b) to take reasonable steps to prevent that person from injury

Question 7

Health and Safety Duty of Care - CMHRA

Answer 7

• police have a legal ‘duty of care’ to take reasonable care of all people arrested, detained or placed in their custody
• this duty begins from the moment the person is detained and applied until the person is released from custody or transferred into the care of another agency

Question 8

NIA Safety Alert - CMRHA

Answer 8

a self-harm/suicidal tendency safety alert must be entered into NIA when a police officer becomes aware through any reliable means that:

• a person is reasonably likely to commit suicide
• has a history of suicide attempts
• has attempted suicide (whether in custody or not)

Question 9

Police actions that keep detainees safe

Answer 9

M
remove the means

O
reduce the opportunity

A
reduce the anxiety

H
manage the health and safety

Question 10

When would you do the initial risk assessment?

Answer 10

Carry out an initial assessment of risk of the detainee at the time of arrest or detention

Question 11

Who is responsible for the safety of a detainee?

Answer 11

The arresting or detaining officer is responsible for the detainee’s safety and security until responsibility is formally transferred to custody staff, another officer or agency

Question 12

What is more important, transporting the detainee to the custody unit or seeking medical attention?

Answer 12

Where a person is arrested or detained and a decision has been made to continue that detention, then they should be transported to a custody unit at the earliest opportunity. Consideration must always be given to any immediate medical needs or mental health assessments required

Question 13

When a detainee is examined at the scene by ambulance staff, what do you do with that information?

Answer 13

Where ambulance staff have examined a detainee at the scene of an apprehension and deem that the detainee does not require medical attention, arresting officers should obtain the details of the ambulance staff and their opinion of the detainee’s medical condition. This information must then be accurately communicated to the Custody Supervisor on arrival at the custody unit and recorded in the ECM

Question 14

What must occur if the transporting officer differs from the arresting officer?

Answer 14

If the arresting officers differ from transporting officers, a comprehensive handover briefing must be conducted regarding the circumstances of arrest, highlighting any care or welfare concerns, and outlining any searches that have or have not been undertaken

Question 15

What information needs to be disclosed during handover for entering into the ECM?

Answer 15

All information relevant to the observed and/or disclosed physical and mental state of the detainee, and any significant events that have occurred which may impact on the continued physical and/or mental state of the detainee, must be entered into the ECM on handover of responsibility to custody staff and conveyed to the Custody Supervisor

Question 16

What are the three ECM monitoring levels?

Answer 16

Not in Need of Specific Care

In Need of Care and Frequent Monitoring

In Need of Care and Constant Monitoring

Question 18

How often are detainees checked, in the hours after being received into Custody?

Answer 18

Irrespective of the detainee’s assigned monitoring level, for the first 3 hours after being received into custody, the detainee must be verbally or physically roused at least once per hour, and a clear verbal response obtained

Question 19

When would you arrange proper medical attention?

Answer 19

Detainee:
- requests medical attention or advice
- appears to be or is suffering from the effects of any illness, disease, drugs, or poison
- appears to be suffering from or complains of having a head injury/concussion
- is unconscious or lapsing into and out of consciousness
- shows signs of recent injury
- fails to respond to stimuli
- is depressed or disturbed, or is showing signs of any other mental condition
- is seriously ill
- presents in a manner that raises any doubt about their health
- has been subject to a tactical option such as O/C Spray, a Dog Bite, or TASER

Question 20

What do you do with the medical information
pertaining to a detainee and acquired by officers (through observation, professional assessment or voluntarily disclosed by the detainee)?

Answer 20

All medical information pertaining to a detainee and acquired by officers (through observation, professional assessment or voluntarily disclosed by the detainee must be recorded in the ECM (or by way of notebook if the ECM is not available) to inform officers who later assume custody responsibilities

Question 21

What must you ensure if the detainee has prescribed medication?

Answer 21

• the medication is held in a clearly labelled bag
• they get verbal confirmation of the detainee’s name (from the detainee, and ensure this matches the name on the prescribed medication, before supplying
• a visual examination of the medication does not raise concerns about its legitimacy
• advice is sought from a Health Professional to determine if a detainee’s medication should be administered by a Health Professional or if it can be self-administered.
• the detainee is observed to take the medication in accordance with the prescription information
• injectable medications, such as insulin, must only be administered under the supervision of, or by, a Health Professional
• where prescribed medication is not held with the detainee, it is obtained from the detainee’s home or through a new prescription
• administration of medication, including dosage and timing, is recorded in the ECM, and communicated to any person to whole custody transfers

Question 22

In relation to monitoring and re-assessment, what do you need to be mindful of with detainees who are violent or dangerous?

Answer 22

Monitor and re-assess the detainee’s health regularly. Violent or dangerous detainees may become suicidal or unwell due to drug or alcohol consumption as their detention continues. Be mindful of the risks of excited delirium and positional asphyxia

Question 23

What are the four levels of consciousness?

Answer 23

• Alert - able to engage in a coherent conversation
• Voice/Drowsy or Confused - responds to voice and able to reply. May need some assistance to walk.
• Pain/Partially Responsive - responds to pain only (e.g., nail bed pressure)
• Unresponsive - does not respond to any stimuli.

Question 24

What action must you take for a detainee who is Pain/Partially responsive - responds to pain

Answer 24

Treat this as a medical emergency. Immediately arrange for an ambulance to attend the custody unit and take appropriate action to provide medical assistance. If an ambulance is delayed, or the person’s condition calls for immediate action, consider using a Police vehicle to transport the detainee to the nearest appropriate medical facility

Question 25

What action must you take for a detainee who is **unresponsive, does not respond to any stimuli**?

Answer 25

When a detainee is unresponsive, treat this as a medical emergency. Immediately arrange for an ambulance to attend the custody unit and take appropriate action to provide medical assistance. If an ambulance is delayed, or the person's condition calls for immediate action, consider using a Police vehicle to transport the detainee to the nearest appropriate medical facility

Question 26

What is a particular risk for intoxicated people?

Answer 26

Intoxication can mask underlying medical conditions and/or injuries which, when undetected and untreated, can lead to serious injury or death. Officers must take reasonable steps to identify any potential medical conditions by way of observation, detainee medical history, and/or disclosure from the detainee. Officers must not assume a detainee only requires detoxification until it has been reasonably determined the detainee has no historic or current medical conditions or injuries that may be confused with or exacerbated by intoxication. **NOTE: Loud snoring is a sign that the person is deeply unconscious**

Question 27

What are the three types of checks the custody staff might do?

Answer 27

**Observation Check** Observe through a cell view port to confirm the detainee's well **Verbal Check** Verbally rouse the detainee to establish well-being **Physical Check** Enter the cell and confirm well-being

Question 28

Can CCTV cameras sometimes be used for monitoring checks?

Answer 28

**CCTV is not an authorised means of monitoring or carrying out checks** of detainees. CCTV does not replace observation, verbal, and physical checks and must not be used as a substitute for these. Note: Some custody units are equipped with CCTV that is specifically designed and approved for constant monitoring within a padded cell. This is the only exception to direct observation of a detainee. There must be a CCTV camera in the cell with an approved specific viewing monitor mounted on the wall beside the cell door. The quality of viewing on the monitor must provide the same or better coverage than the view through the cell window and it must be constantly viewed.

Question 29

What are the time intervals for monitoring checks in custody?

Answer 29

**Not in Need of Specific Care** - checked a minimum of once per hour **In Need of Care and Frequent Monitoring** - checked a minimum of 5 times per hour at irregular intervals **In Need of Care and Constant Monitoring** - directly observed without interruption

Question 30

What is the preferred location for a mental health assessment?

Answer 30

Where a person has been detained, pursuant to the Mental Health (CAT) Act 992, officers must first consider taking them to a hospital or other appropriate lace before detaining them at a police station or custody unit. Unless the person ; violent or poses an obvious and immediate threat to the safety of others, all racticable steps should be taken to avoid detaining people in Police cells solely or the purpose of receiving a mental health assessment

Question 31

What is the maximum period of detention under the Mental Health (CAT) Act 1992?

Answer 31

Detention under the Act **must not exceed 6 hours** from the time of initial apprehension at the scene

Question 32

Who must assess the person in custody within 6 hours?

Answer 32

Mental health assessments must be conducted by a Health Professional within 6 hours. It is not sufficient for the detainee to be examined only by a DAO within this time

Question 33

What is the time limit for assessment if you have picked up a person who you believe is both mentally disordered (s109 (1) CAT 1992) and intoxicated in a public place (s 36 Policing Act 2008)

Answer 33

Where a person is detained and is also intoxicated, detention must not exceed 6 hours, and an assessment must still be conducted by a Health Professional within this time. Detoxification powers, pursuant to Section 36 of the Policing Act 2008, do not supersede the detention limit

Question 34

Who must assess the person in custody within 6 hours?

Answer 34

Mental health assessments must be conducted by a Health Professional within 6 hours. It is not sufficient for the detainee to be examined only by a DAO within this time

Question 35

What should you do if the assessment will not be carried out within the 6-hour timeframe?

Answer 35

Where a person is detained and is also intoxicated, detention must not excood 6 hours, and an assessment must still be conducted by a Health Professional within this time. Detoxification powers, pursuant to Section 36 of the Policing Act 2008, do not supersede the detention limit

Question 36

What levels of care are available for those persons detained for a mental health assessment?

Answer 36

Where a person is detained for a mental health assessment, they should be subject to care and monitoring at the level of 'frequent' or 'higher' until both the mental health and risk assessments are completed. Where officers are not satisfied with the recommended level of care and monitoring generated by the ECM, or the level advised by the Health Professional who undertook the mental health assessment, a higher level of monitoring should be applied

Question 37

Under Section 41 of the Crimes Act 1961 what is the police responsibility around preventing suicides?

Answer 37

Officers must take all practical and reasonable steps to prevent the suicide of tainees. Section 41 of the Crimes Act 1961 provides that everyone is justified using such force as may be reasonably necessary in order to prevent the mmission of suicide, or the commission of an offence which would be likely ) cause immediate and serious injury to that person

Question 38

What is the first action you should take when you find a detainee attempting suicide?

Answer 38

Call for help from other staff and ensure medical assistance is immediately sought

Question 39

After calling for medical assistance, after you find a detainee attempting suicide, what should your next steps be?

Answer 39

- Stop the attempt - Ensure safe practices are used and carry out immediate first aid if necessary.

Question 40

Do you need to change the level of monitoring for a detainee who attempts suicide?

Answer 40

A detainee who has attempted suicide must be constantly monitored and the circumstances are to be brought to the attention of the Custody Supervisor and a Health Professional for assessment of the detainee's immediate needs

Question 41

What must officers do where a detainee is identified as being at risk of suicide or self-harm?

Answer 41

- Ensure a detailed handover to custodial officers is completed - Ensure the detainee is subject to care and monitoring at the level of ‘constant' - Seek advice from a Health Professional and/or Mental Health Crisis Team Ensure a NIA alert is entered when it is identified that the detainee is known to have suicidal tendencies

Question 42

Can medical conditions be confused with intoxication?

Answer 42

Officers dealing with a detainee who appears to be intoxicated should be aware of, and consider that, they may be exhibiting the symptoms of a genuine medical condition. Where doubt exists as to whether a detainee is intoxicated or exhibiting symptoms of a medical condition, or both, officers must immediately seek medical treatment for them