Services that Manage the Care Needs of Drunk - Scottish Government

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1.7 Recent concerns about deaths in police custody have further highlighted the need for, and possible benefits of, a network of sobering-up services, where an individual’s care needs can be closely monitored by appropriately-trained staff. 1.8 Although the main focus of this report will be on sobering-up services, the review also considers information about other types of interventions that are intended to meet the immediate care needs of people who drunk and incapable -- including free transportation services and the provision of medical care within police custody suites (eg, through custody nurses). Other review evidence 1.9 A review of the literature on the subject of sobering-up services was undertaken for the Scottish Association of Alcohol Action Teams (SAAAT) by Macdonald towards the end of 2004. 1 This previous review found little literature which specifically evaluated sobering-up services, although it did identify sufficient material to be able to provide a general description of these services. 1.10 The review by Macdonald highlighted a number of issues which need to be taken into account when setting up a sobering-up service. These included: • Potential location and opening hours of the facility • The need for community and stakeholder support • Target population and admission criteria • Staff qualifications and management arrangements • The way in which the service links to other services (either through receiving referrals, or making referrals) • Policies and procedures related to the operation of the service – especially in relation to client monitoring • The source(s) of funding. 1.11 This current review was initially intended as a simple update to the SAAAT review, with a focus on the literature from 2004-2008. However, in undertaking a search of the literature, a substantial number of new evaluations and other relevant reports were identified. Therefore, this report includes considerable detail about the operation of these services which would not have been available for the SAAAT review, and there is a greater focus on some of the lessons that can be learned from the implementation of sobering-up services around the world. 1 Macdonald R (2005), Care approaches to drunk and incapable people. Designated places, drunk tanks and sobering facilities across the world. A literature review. Prepared for the Scottish Association of Alcohol Action Teams (SAAAT), January. 2
Methodology 1.12 This was a review of the international, English-language literature on the provision of sobering-up services and other similar services. The main focus was on services that aim to meet the immediate (rather than long-term) care needs of people who are identified as drunk and incapable, and which divert these individuals from the criminal justice system. Since there was very little literature identified on this subject, the review was expanded to include literature on the provision of medical care within police custody suites. The focus has mainly been on nurse custody schemes, but evidence was also identified on the role of forensic medical examiners in meeting the needs of alcohol-related detainees. It is important to note, however, that the provision of medical care to drunk and incapable people in police custody does not result in the diversion of these individuals from police custody. 1.13 Bibliographic databases including EMBASE, MEDLINE, PsycINFO were searched using the following search terms, among others: • Sobering(-up) services / facilities / centres • Drunk tanks • Detoxification centres • Nurse + custody • Drunk and incapable • Inebriate / chronic public inebriate 1.14 Initially the intention was to include only literature published between 2004- 2008 (to update the Macdonald review). However, when an initial search identified almost no literature in this period, the date limits were removed, and every effort was made to identify as many published papers as possible by changing search teams and searching on different combinations of search terms. 1.15 In addition, an internet search (using Google) was also undertaken using the same, or similar search terms. This resulted in a greater number of ‘hits,’ including recent evaluations and audits of sobering-up services and other types of services for drunk and incapable people. Moreover, several government reports were identified (particularly from Australia) which – while not directly related to the subject of services for drunk and incapable people – nevertheless provided detailed information about these services that was highly relevant for the purposes of this review. 1.16 The collected material was a combination of published journal articles, government reports, unpublished research reports, news articles and descriptions of services taken from local government or local health authority websites from around the world. 1.17 Most of the literature concerns the subject of sobering-up services, and the best of this literature comes from Australia. Fewer reports were identified from North America (USA and Canada), and the quality of this material was 3
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Page 51 and 52: Rhodes M (2004) Outdoor drunk tank

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