The determinants of health and health status of individuals in police custody in Australia: A scoping review

Abstract

Background In Australia, the health of people in police custody facilities and the conditions of their detention have been the focus of repeated scrutiny and investigations since the Royal Commission into Aboriginal Deaths in Custody was published in 1991. However, there remains a lack of comprehensive, consolidated evidence on the health needs of this population. To address this gap, we conducted a scoping review to identify and describe the available information on their health status and determinants of health. Methods We followed the JBI methodology for scoping reviews, including searching databases of academic and grey literature, and hand searching websites, citations and review articles published since 2000. Final searches were completed on February 3, 2025. Study characteristics, determinants of health, and health conditions were extracted from included sources, and analyzed by jurisdiction, date, and document type. Results We identified 172 relevant information sources, including 141 grey literature documents and 31 academic publications, published between 2000 and 2024 from every state and territory in Australia. Sources most frequently used data from New South Wales, Western Australia, and Queensland. More than half (57%) of sources used data from the Drug Use Monitoring in Australia (DUMA) program. Individual (age, gender, Indigenous status) and mental health and drug use characteristics were the most frequently reported data. Other important health determinants such as tobacco use, diet, exercise, stress, exposure to violence, and environmental conditions of police custody were largely underreported. No general health status or burden of illness studies were identified. Conclusions Available information on the health of people in police custody in Australia is fragmented, mostly drawn from a single program, and focused primarily on mental health and substance use, while data on physical health and broader health determinants are limited. Enhancing systems that routinely monitor and transparently report health priorities for police custody are needed to improve health service provision and support environments that promote detainee health.