General Psychiatric Problems

When a psychiatric disorder is suspected, an assessment involving background information, full psychiatric history (if known), observation of the detainee, and mental state examination (Table 6) should be performed by the doctor to assess whether there is any evidence of mental illness.

The doctor should then consider whether diversion from the criminal justice system is appropriate. If the detainee has committed a minor offense and there is only evidence of minor to moderate mental illness, treatment may be arranged in the community, in outpatients, or in the day hospital. However, if the detainee has an acute major mental illness but has only committed a minor or moderate offense, then admission to the hospital for further assess ment and treatment is required either informally or if necessary formally. When the offense is more serious and there is evidence of probable mental illness needing further assessment, then the detainee may need to go before the court for such an assessment to be ordered.

Chronic stable mental health problems usually pose no specific problems for police detention but may require specific safeguards when the detainee is to be interviewed by the police (see Subheading 9). Long-term medication should be continued.

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