Most vulnerable people are not identified as needing an appropriate adult
Estimates on the number of people who are 'PACE vulnerable' have varied.
Clinical research (McKinnon and Grubin, 2013) has shown that of detentions of adults by the Metropolitan Police Service 39% involved a person with a mental disorder* and 25.6% involved a person with psychosis, major depression, intellectual disabilities, or who researchers felt lacked capacity to consent to a questionnaire.
*In this context 'mental disorder' includes psychosocial disabilities (mental illness), learning disabilities, personality disorders, and autism, as per the Mental Health Act 1983 Code of Practice.
However, our There to Help research shows these prevalence rates are not reflected in police recorded need for an appropriate adult. For every 100 adult detentions in England and Wales in 2021, only 7 were recorded by police as needing an appropriate adult. This has increased since - but only slightly.
McKinnon and Grubin found that without access to specialist evidence-based tools, police (and unsurprisingly) significantly under-identified mental disorders amongst adults in custody.
Identification rates vary greatly between forces
Our There to Help research has also found that recorded need for appropriate adults in adult detentions varies hugely across police forces.
In 2021, we obtained data from police forces in England and Wales. The average rates ranged from 22% down to just 0.3% of adult detentions.
Even allowing for local population differences, this indicates that many people are not being identified.
Identification is only part of the challenge
Liaison and Diversion (L&D) services identify vulnerability in police custody, and give advice to police decision-makers. Data from NHS England indicates that, in 2018/19:
- 68,581 adults engaged with L&D due to mental ill health, learning disabilities and other vulnerabilities.
- Of these people, police had secured an AA for only 1 in 5 (19.4%)
- There were large local variations between areas
Identification varies by condition
Data from NHS England's Liaison and Diverson services show that expert identification of conditions does not always mean that police will secure an appropriate adult.
It also shows that certain conditions are much more closely associated with people getting an appropriate adult.
Some of the conditions most likely to get an AA are ones that are rarely recorded, such as dementia. While some more common conditions, such as depression, are unlikley to result in an AA.
Identification is lower if there is no AA scheme
The challenge of identification (or at least recording) is llinked to the availabiilty of approrpiate adult support.
There to Help 2 (2019) evidence that, in relation to custody, police are half as likely to record the need for an AA where there is no organised AA scheme for adults.
Though the requirement on police is the same, local authorities have a statutory duty to provide an appropriate adult when needed for a child, but not for a vulnerable person.
Identification is lower in voluntary interviews
There are clear benefits for children and vulnerable adults attending voluntary interviews, wherever detention is not necessary. However, there are also increased risks that the process will not be fair.
Compared to custody officers, investigating officers may be less familiar with how to identify vulnerable people, and the relevant safeguards.
Our There to Help research indicates that adults who attend voluntary interviews are much less likely to be recorded as needing an appropriate adult.
Identification is improving...slowly
There is still a long way to go but things are improving.
Since we began raising awareness through our first There to Help report in 2015, recorded need for appropriate adults has been improving.
In 2012/13, police forces recorded the need for an AA in only 2.7% of adult detentions. By 2021 this had risen to 7.3%.
But that is still far below the best available evidence on how many people meet the criteria for support.
With the launch of our new tracker and training videos (below), we're looking forward to accelerating that change.
Change is uneven
Although the national average is increasing, that progress is uneven across England and Wales.
Some forces have increased slowly but consistently.
Others have seen very significant increases over short periods of time.
While others have remained consistently low (or high).
For more detail, see the tracker below.
We've been researching the identification of vulnerable people in police custody and voluntary interviews since 2015.
To find out more take a look at our There to Help research series or select an individual report.
Wondering how well your force is doing?
Thanks to the kind support of digital transformation company UBDS, we've created the vulnerability identification tracker.
Based on the data from the There to Help research series, the tracker lets you see how well each force is doing on vulnerability identification, month by month.
Users can compare:
- individual forces over time,
- other local or similar forces, or
- England and Wales with Northern Ireland.
How can we improve identification?
We've developed three training videos aimed at professionals involved in identifying PACE vulnerability, for example:
- police officers
- detention officers
- custody healthcare (forensic nurses and physicians)
- NHS England liaison and diversion
