The Critical Hand-Off: How Clear Medical Information from Law Enforcement Helps Prevent Arrestee Health and Suicide Risks

Law enforcement officers are often the first — and sometimes only — individuals to observe critical signs or receive important information from an arrestee about their health. If this information is not effectively transferred to jail staff, it creates a dangerous gap in care. The moment an individual is taken into custody marks a crucial transition — not only legally, but medically and psychologically. For law enforcement agencies, the responsibility extends beyond the arrest itself to ensuring the safety and well-being of the arrestee, particularly when it relates to their health and mental state.

The Importance of Notification

A key component of this responsibility is the accurate and thorough notification to jail staff regarding any known or observed suicide ideation, existing health conditions, or mental health concerns. Law enforcement officers should pay close attention to what family or friends say about an arrestee’s medication needs, physical and or mental health issues, or suicide risks. This information can be critical to the person’s safety and well-being while in custody.

Family and friends often have direct knowledge about medical conditions, mental health diagnoses, required medications, or recent behavioral changes that the individual may not disclose themselves — or may be unwilling to disclose due to fear or confusion. This information can be the difference between life and death, preventing medical crises, self-harm, and even tragic suicides within jails.

Refusals of Medical Care and the Need for Clearance

If an arrestee refuses to be seen by EMS or refuses medical attention on scene or at the hospital before being taken to jail, law enforcement should never accept the refusal at face value without further trained medical assessment and documentation. If the person is under the influence, disoriented, or has an altered mental status, their refusal may not be valid. Most jails require medical clearance for certain conditions — such as injuries, head trauma, severe intoxication, or pre-existing medical concerns — and the arrestee may not be accepted without medical clearance, regardless of the refusal. Officers should thoroughly document the circumstances, the nature of the medical issue, the refusal, and any consultation with EMS or hospital staff. Ideally, EMS should also document the refusal with a witnessed signature. This protects both the agency and the jail.

Even if an arrestee refuses care, officers should consult with EMS or hospital staff, follow agency and jail policies, document everything, and prioritize the individual’s health and safety before booking. 

Medical Clearance Protocols

In some jurisdictions, if an arrestee is in the custody of law enforcement, hospitals will not allow them to refuse medical clearance for jail. Medical clearance is an assessment — not necessarily treatment. The doctor will evaluate vital signs, injuries, illnesses and mental status to determine if they are stable for a correctional environment. A hospital can medically clear an arrestee for jail even if they refuse treatment, so long as the evaluating provider determines the individual is stable for incarceration and documents the refusal, the assessment and the rationale for clearance. However, if medical treatment is required for the person to be considered stable, the hospital cannot ethically or legally provide clearance without first administering that treatment. That refusal should never be used as a reason to skip care.

It is important for law enforcement agencies to consult with local hospitals to understand their protocols for handling these situations. Accepting a refusal without proper evaluation or documentation can place the arrestee at risk and expose both law enforcement and the jail to liability if the individual deteriorates while in custody.

At the Jail Sally Port

When an arresting officer arrives in the vehicle sally port, it is recommended for jail staff to meet the officer at the vehicle. Before removing the arrestee from the patrol car, staff should assess whether the individual was injured during the arrest, has a known serious medical condition, is unconscious, is unable to exit the vehicle on their own, or shows signs of distress or impairment. In those cases, jail staff and/or medical personnel should refuse to accept the arrestee and advise the arresting officer to immediately transport the individual to the hospital for medical clearance. This helps ensure the person receives proper care and helps prevent avoidable medical emergencies once in custody. It also ensures jail staff are not placed in a compromised position where they are asked to supervise someone who should never have been accepted into custody.

By receiving medical clearance, it protects the health of the individual, while ensuring that custody begins in a safe and responsible manner.

The Role of Communication at Intake

Any information shared by the arresting officer allows jail staff and medical professionals to assess risks, provide timely medical or mental health care, and implement appropriate precautions to prevent deterioration or potential self-harm. Clear communication at intake is a vital part of upholding both safety and legal responsibilities. Jails are not equipped to be emergency treatment facilities and failing to address injuries prior to booking can compromise the safety of the arrestee and place unnecessary liability on jail staff.

Pre-Booking Forms

To address this concern, agencies should implement a pre-booking form that must be completed before entering the vehicle sally port. If the form hasn’t been completed, jail staff should ask the arresting officer the required questions and document the responses at that time.

CIS has created a sample pre-booking form. Jail commanders are encouraged to work with their medical and mental health staff as well as their county or city leadership to tailor this form to their agency’s specific needs.

Risks and Liabilities for Jails

Jail medical claims continue to be the highest area of risk for jail/correctional facilities throughout Oregon. Jails with limited medical care and staffing face significant risk and challenges in meeting the health needs of individuals in custody. If the arresting officer fails to disclose medical, mental health, or suicide concerns, it can delay access to care, increase risk to both the Adults in Custody (AIC) and staff. It can also place additional burdens on correctional deputies/officers who may be required to respond to medical situations outside their scope of training. It is essential for jails to have clear protocols, effective communication with Law Enforcement agencies and outside medical providers, in order to maintain safety, manage risk, and uphold basic standards of care.

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How Jail Administrators Can Work with Arresting Agencies to Ensure Pre-Booking Forms Are Completed

• Establish clear policies and expectations. Develop and distribute a written policy requiring completion of pre-booking forms before entering the jail. Ensure all arresting agencies have copies and understand its importance for safety and risk management.

• Provide training and education. Offer training sessions to law enforcement agencies on how to complete pre-booking forms accurately, emphasizing how medical, mental health, and safety information protect both staff and arrestees.

• Implement collaborative meetings. Hold regular meetings with arresting agency leadership to review processes, discuss challenges, and reinforce the requirement for pre-booking documentation.

• Develop easy-to-use forms and processes. Simplify forms to make them quick and clear to complete in the field, and provide electronic submission options, if possible, to reduce paperwork barriers.

• Designate liaisons. Assign a jail administrator or intake supervisor as a point of contact for questions about pre-booking forms to ensure prompt support and problem resolution.

• Include interagency agreements. Incorporate pre-booking form requirements in intergovernmental agreements or memoranda of understanding (MOUs) to formalize expectations and accountability.

• Discuss expectations given various booking scenarios in advance.

Best Practices for Effective Notification

To ensure effective information transfer, law enforcement agencies should implement clear protocols and training:

• Thorough Pre-booking Screening: Officers should be trained to conduct a preliminary, yet comprehensive, screening for signs of medical distress, mental health issues, and suicidal ideation at the point of arrest or during transport.

• Direct Communication: Verbal communication between arresting officers and booking/medical staff at the jail is crucial. This allows for immediate clarification and emphasizes the urgency of certain information.

• Detailed Documentation: All relevant observations, statements made by the arrestee, and known medical or mental health history must be thoroughly documented in arrest reports and any handover forms.

• Collaboration and Training: Regular collaboration and joint training sessions between law enforcement and correctional staff can foster a better understanding of each other's roles and the critical importance of information sharing.

• Utilizing Crisis Intervention Training (CIT): Officers trained in CIT are better equipped to identify and de-escalate mental health crises and can provide more detailed and accurate information to jail staff.

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Conclusion

Notification of jail staff regarding an arrestee’s suicide risk, medical condition, or mental health status is not just a best practice — it’s a fundamental element of safe, responsible law enforcement and corrections work.

It ensures that vulnerable individuals receive timely and appropriate care, prevents medical emergencies, helps prevent in-custody deaths, and supports continuity of care from the field to the jail setting. This communication upholds legal and ethical obligations under duty of care standards, reduces liability exposure for agencies, protects the well-being of staff and other AIC, and ultimately mitigates risk in an already high-risk environment.