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In applying critical realism to the study of outcomes for ‘vulnerable’ people in police custody, we illustrate how theory and practice can move beyond debates about whether people are disabled by intrinsic characteristics or extrinsic conditions and consider the interplay between these through am interdisciplinary lens. The impacts of austerity on welfare and the health service, the recent cost of living crisis, a wider recognition of vulnerability, and a shift to the right politically has created a perfect storm for police services. More people are encountering the criminal justice system and many of these require extensive support, at a time when resources are stretched to breaking point. The disabilities which we consider impact upon ability to engage with and understand criminal proceedings, so our discussion includes mental health conditions, learning disabilities, neurodivergent conditions, and speech, language, and communication needs (SLCN). In this paper we identify barriers encountered by disabled people under investigation by the police, and go on to identify underlying mechanisms and conditions under which these barriers are produced and reproduced.