Expand Law Enforcement Assisted Diversion and Deflection Programs

Introductory Paragraph

Diversion and deflection programs seek to re-direct, or channel people away from the justice system. This practice is based on the theory that processing individuals through the justice system may do more harm than good or may not be an appropriate response for someone with behavioral health needs. While the exact number of diversion and deflection programs in the United States is currently unknown, their growth In communities has become accelerated by research showing that they can impact recidivism and help individuals avoid the consequences of having a criminal record. Over the past few decades, much of the innovation in deflection and diversion has focused on individuals whose interactions with the justice system are driven by behavioral health needs. The outcomes sought by diverting or deflecting individuals are generally three-fold:

• Reduce crime by connecting individuals with resources and services that decrease the likelihood of future offenses.
• Assist individuals according to their self-identified needs and provide support and opportunities to change the behaviors that brought them to the attention of the justice system.
• Reduce utilization of limited justice system resources by reducing re-arrest, recidivism, and future justice system expenditures.

Key Information

Pre-Arrest Diversion & Deflection Programs

These two types of program are related, but distinct. Deflection is the practice by which law enforcement or other first responders, such as fire and EMS, connect individuals to community-based treatment and/or services when arrest would not have been necessary or permitted. This is done in lieu of inaction when issues of addiction, mental health, and/or other needs are present. Deflection is performed without fear by the individual that if they do not “accept the deflection” they will subsequently be arrested. Pre-arrest diversion is the practice by which law enforcement officers connect individuals who otherwise would have been eligible for criminal charges to community-based treatment and/or services, in lieu of arrest. This diverts them from the justice system into the community. Some pre-arrest diversion programs have policies that mandate holding charges in abeyance until treatment or other requirements, such as restitution or community service, are completed, at which time the charges are dropped. Although pre-arrest diversion is facilitated by justice system stakeholders (usually police and sheriffs), clients are diverted to community-based services. Pre-arrest diversion programs should not be confused with prosecutorial diversion, which occurs after individuals have already been arrested and become involved in the justice system. In contrast, pre-arrest diversion occurs before the filing of charges.

Pre-arrest diversion programs are designed to reduce the number of persons who are arrested and placed in jail because of a mental health problem, these programs shift responsibility for rehabilitation from the criminal justice system to the mental health system. Early diversion programs provide an alternative to arrest for individuals with substance use and/or mental health disorders, as well as for low-risk offenders. They allow these individuals to avoid the collateral consequences that result from arrest and contact with the criminal justice system. The movement for early diversion is data-driven and is grounded in the belief that public safety and public health approaches must work in tandem to support vulnerable individuals with substance use disorder and/or mental illness. Instead of shifting responsibility or cost from one system actor to another, this collaborative approach creates additional tools and supports for those on the front line. It provides appropriate treatment for eligible individuals. It opens up community opportunities for systemic change by leadership looking for creative solutions to complicated problems. Thus, these programs serve the best interest of the individuals involved, the community, and taxpayers. A variety of case studies provide documentation of the following beneficial outcomes of pre-arrest diversion and deflection programs:

• Break the costly cycle of justice system involvement for eligible individuals.
• Increase cross-sector collaboration to create new pathways to community-based behavioral health services.
• Enhance relations between community members and law enforcement.
• Decrease crime, incarceration, and recidivism rates.
• Lessen the burden on justice systems.
• Improve public health and safety.
• Reduce the burden on individuals who commit non-violent, low-level offenses.
• Ensure equal access to pre-arrest diversion regardless of race, income, or geography; and
• Save taxpayer dollars

The Five Pathways to Treatment Model.

In 2014, Treatment Alternatives for Safe Communities (TASC) and Center for Health and Justice (CHJ) developed the first iteration of the Five Pathways to Treatment. This offered different methods for deflection that first responders could use, at the point of contact, to move someone from the justice system to community-based treatment. Each pathway has unique characteristics that make it appropriate to address particular problems such as SUD, mental health disorder, homelessness, and other issues. Identifying and naming these pathways created a common language for practitioners to use in the new, emerging field of deflection. For each pathway listed below, the targeted population or circumstance appropriate for the pathway is elaborated.

• Self-Referral: Drug–involved individuals are encouraged to initiate the engagement with law enforcement without fear of arrest, and an immediate treatment referral is made.
• Active Outreach: Participants are identified by law enforcement, but are engaged primarily by an outreach team, often with a clinician and/or a peer with lived experience, who actively contacts them and motivates them to engage in treatment. Individuals with SUDs are the targeted population.
• Naloxone Plus: A first responder and program partner (often a clinician or peer with lived experience) conducts outreach specifically to individuals who have experienced an overdose recently to engage them in and provide linkages to treatment. Individuals with opioid use disorder are the targeted population.
• First-Responder/Officer Prevention: During routine activities such as patrol or response to a service call, a first responder conducts engagement and provides treatment referrals. If a law enforcement officer is the first responder, no charges are filed or arrests made. The targeted population are persons in crisis, or with non-crisis mental health disorders and SUDs, or in situations involving homelessness or sex work.
• Officer Intervention: (applicable only for law enforcement) During routine activities such as patrol or response to a service call, a law enforcement officer engages an individual and provides treatment referrals or issues noncriminal citations for that individual to report to a program. Charges are held until treatment and/or a social service plan is successfully completed. The targeted population are persons in crisis, or with non-crisis mental health disorders and SUDs, or in situations involving homelessness or sex work.

The Sequential Intercept Model (SIM)

SIM helps communities identify resources and gaps in services at each of six "interception points." The SIM mapping process brings together leaders and different agencies and systems to work together to identify local strategies and action plans to divert people with mental and substance use disorders away from the justice system into treatment. The six SIM intercepts are described below:

• Community Services. This involves opportunities to divert people into local crisis care services. Resources are available without requiring people in crisis to call 911, but sometimes 911 and law enforcement are the only resources available. The emphasis is on connecting people with treatment or services instead of arresting or charging them with a crime.
• Law Enforcement. At this point, diversion is performed by law enforcement and other emergency service providers who respond to people with mental and substance use disorders. It allows people to be diverted to treatment instead of being arrested or booked into jail.
• Initial Court Hearings/Initial Detention. This involves diversion to community-based treatment by jail clinicians, social workers, or court officials during jail intake, booking, or an initial hearing.
• Jails/Courts. This interception involves diversion to community-based services through jail or court processes and programs after a person has been booked into jail. It includes services that prevent the worsening of a person’s illness during their stay in jail or prison.
• Reentry supports reentry back into the community after jail or prison to reduce further justice involvement. It includes reentry coordinators, peer support staff, or community in-reach to link people with proper mental health and substance use treatment services.
• Community Corrections. This involves community-based criminal justice supervision with added supports for people with mental and substance use disorders to prevent violations or offenses that may result in another jail or prison stay.

Relevant Research

Collaborative Research Report. This survey was performed by the Treatment Alternatives for Safe Communities, The University of Chicago, and the US Justice Department. It is titled "Report of the National Survey to Assess Law Enforcement-Led Diversion and First Responder Deflection Programs in Response to the Opioid Crisis. It provides a comprehensive overview of the field and its role in responding to the opioid crisis, as well as how deflection/first responder deflection offers alternatives to law enforcement and first responders in their work.

Impactful Federal, State, and Local Policies

• The Office of National Drug Control Policy funded a study that provides a model for states to use to generate legislation authorizing diversion. When the template is followed and enacted by a state, it allows law enforcement officers to divert some individuals with substance use disorders or mental health conditions away from arrest and prosecution to treatment and other supportive services. This helps states legislate collaborative programs between law enforcement, treatment providers, and community organizations to support individuals to access treatment and services and avoid justice involvement.

• The R Street Report This policies report reviews all fifty states relating to pre-arrest diversion and crisis response including legal status and legislative actions.

Available Tools and Resources

The U.S. Department of Justice Bureau of Justice Assistance (BJA) manages the Comprehensive Opioid, Stimulant & Substance Abuse Program (COSSAP). Its Law Enforcement/First Responder Diversion and Referral Mentoring Initiative provides communities interested in starting diversion and/or referral programs with the opportunity to learn from established or innovative programs that have shown success in meeting the treatment needs of individuals with a substance use disorder, and in some cases may have experienced an overdose.

The Police Assisted Addiction and Recovery Initiative (PAARI) helps police departments create non-arrest pathways to substance use disorder treatment and recovery like the ANGEL program in Gloucester, Massachusetts. PAARI works with over 400 police departments in 32 states and helps communities customize their programs to their circumstances. Offered services include technical assistance, policy templates and tools, seed grants, and connections to experts with established programs.

Law Enforcement Assisted Diversion (LEAD) is a community-based diversion approach with the goals of improving public safety and reducing unnecessary justice system involvement of people who participate in the program. The site includes a video, tools and resources.

The Police Treatment And Community Collaborative (PTACC) is an alliance of practitioners in law enforcement, behavioral health, advocacy, research, and public policy. It provides a webinar titled "Starting Your Pre-Arrest Diversion (PAD) Effort: Law Enforcement, Behavioral Health, and Community Together" which gives information on pre-arrest diversion models. The PTACC mission is to strategically widen community behavioral health and social service options available through law enforcement diversion. The purpose of the Collaborative is to provide vision, leadership, advocacy, and education to facilitate the practice of pre-arrest diversion across the United States. Their focus is to educate law enforcement and communities on pre-diversion for those who have committed nonviolent misdemeanors. This helps people to be moved away from the criminal justice system and toward appropriate treatment or services which can support these individuals, helping them avoid falling into the revolving door of the criminal justice system. "PTACC is the national voice of the deflection and pre-arrest diversion field." PTACC recognizes that there are multiple models of pre-arrest diversion. It has adopted the TASC model, described above, as its "Pathways to Community" because using one or more of them creates pathways to treatment or social services. PTACC endorses each of the five pathways and encourages communities to explore the approaches which best meet their needs. PTACC encourages availability of as many pathways as possible to maximize diversion opportunities and connection to treatment, recovery support, and community services. PTACC is organized into eight strategic areas, each having their own working groups and associated websites:

• Children and Families
• Community, Diversity, and Equity
• International Deflection and Diversion
• Policy and Legislation
• Public Safety
• Research
• Stigma Reduction
• Treatment, Housing, and Recovery

SAFE Project has published the "Law Enforcement Pre-Arrest Diversion Resource Guide" in collaboration with PTACC. It is designed to help law enforcement agencies create pre-arrest diversion programs for individuals with substance use disorder. The guide describes pre-arrest diversion, defines two types of pre-arrest diversion programs, and provides case studies of PTACC's five pathways. The guide can be downloaded. Also, see the SAFE Project wiki titled “Improve Recovery Support for People in the Criminal Justice System."

The Center for Prison Reform published "Jail Diversion Programs in America."

Promising Practices

Alabama -- The Mercy Project. Walker County had the fifth-highest per capita rate of overdoses in the United States and the highest overdose rate of any county in the state. As a result, Sheriff Nick Smith wanted to create a program to help people struggling with SUD and to reduce the recidivism rate resulting from substance misuse. Interested participants fill out an application and then receive consultation. People are ineligible for program entry if they are facing drug charges or have outstanding warrants. However, the consultation allows a potential participant to turn in any drugs or drug paraphernalia without the threat of arrest. Although the individual must still enter the justice system, drug court is an option. If the person is accepted into the program, consultation determines individual treatment needs.

Arizona. The Arizona Angel Initiative is a community-based, police-assisted program. Police departments work in partnership with community-based treatment providers and the Governor's Office of Youth, Faith and Family. This program is modeled after a similar program in Gloucester, Massachusetts.

Florida. The Pre-Arrest Diversion/Adult Civil Citation (PAD/ACC) is a model pre-arrest diversion program. The Leon County/Tallahassee program holds offenders accountable for their crime, but instead of being arrested and prosecuted by the traditional criminal justice system, the person receives civil sanctions, such as community service. Following referral by law enforcement, one essential element of the program is the use of evidence-based behavioral health intervention services to reduce the likelihood of future criminal activity. PAD/ACC also works to avoid an arrest record for those who successfully complete the program. The decision to arrest or refer for behavioral health assessment and intervention services is best made by the law enforcement officer who is on the scene and understands the nature of the offense at the time it occurred. Since its inception, the program has had over 1300 participants. The Civil Citation model has grown throughout the State of Florida. Today the Civil Citation Network (CCN) assists communities in implementation of the model.

Illinois -- A Way Out. In Lake County, an Illinois Law Enforcement Assisted Diversion (LEAD) pilot program was designed to fast-track users to substance use programs and services. This program is available 24 hours a day, 7 days a week, at participating police departments across Lake County. It ensures that no criminal charges will be sought for those who may be in possession of narcotics or paraphernalia, if assistance is sought out by the prospective program participant. “A Way Out” is a program developed by the Lake County Opioid Initiative to create additional treatment access points, reduce crime, reduce substance-related harms, re-frame the role law enforcement plays in community safety, and unite the community. For too long, substance use has been stigmatized and dealt with as a criminal issue. Substance use is a public health problem that needs to be addressed as such. Lake County Opioid Initiative is committed to developing innovative ways to create positive change regarding substance use and mental health.

Illinois -- Safe Passage. People who realize they need help can go to one of the participating law enforcement agencies in Lee and Whiteside Counties without fear of being arrested. If they ask for help with their drug addiction and turn in their drugs, they will be placed in a treatment facility, usually within 24 hours. Once initial paperwork is completed, persons will be paired with a volunteer who will guide them through the process. Safe Passage partners with treatment centers throughout Illinois and the Midwest.

Maryland.' Stop, Triage, Engage, Educate and Rehabilitate (STEER) in Montgomery County is a pre-booking law enforcement and drug treatment and recovery linkage program that aims to provide rapid identification, deflection, and access to treatment for drug-involved individuals as an alternative to conventional arrest. Individuals are assigned a care coordinator who focuses on rapid treatment access, retention, motivation, engagement, and completion and conducts a full clinical assessment and referral. Police officers use a screening tool to decide whether a person is a candidate for this deflection. The risk assessment may be used by a police officer who is responding to a call for service or in an on-view situation. Charges can be held in abeyance while the person is seeking services. STEER operates around the core value proposition of deflection, namely ensuring the “correct” movement of citizens either into the criminal justice system or away from it. As a result of moving people towards the human services system, STEER exemplifies the following outcomes:

• reducing crime
• rebuilding community relations
• reducing drug use
• restoring the lives of citizens

Minnesota. The Yellow Line Project in Blue Earth County provides a collaboration between law enforcement, human services, and care providers to improve coordination and access to treatment for individuals with substance use or mental health conditions, instead of in incarceration.

New Jersey. In Ocean County, the Blue Heroin Addiction Recovery and Treatment (HART) is New Jersey's first program allowing substance users to seek help from authorities without risk of prosecution.

New York. Hope Not Handcuffs is an initiative started by Families Against Narcotics (FAN). It aims to bring law enforcement and community organizations together in an effort to find viable treatment options for individuals seeking help to reduce dependency with heroin, prescription drugs, and alcohol. A person struggling with any drug addiction can come to a participating police agency and ask for help. They will be greeted with support, compassion, and respect. If accepted into the program, the individual will be guided through a brief intake process to ensure proper treatment placement.

Ohio. In Toledo, the Lucas County Sheriff’s Office developed the Drug Abuse Response Team (DART) model. Lucas County credits it with diverting more than a thousand people from the criminal-justice system and into treatment during its first 4 years. 70% of participants successfully entered detox and treatment programs. The Ohio legislature has since approved a pilot grant program to assist other Ohio counties in implementing the DART program. 39 programs received grant funding for 21-month-long pilots. The Lucas County DART program has over 20 officers from several area law enforcement agencies, including Toledo PD, the Sheriff’s Department, and the Division of Children and Families. Each officer works with parents with substance use disorder whose children have been put in foster care, in order for parents to get access to treatment, so that the family can be reunited.

Washington. Law Enforcement Assisted Diversion (LEAD) is a pre-booking diversion program developed in King County to address low-level drug and prostitution crimes in Seattle and King County. The program allows law enforcement officers to redirect low-level offenders engaged in drug or prostitution activity to community-based services, instead of jail and prosecution. By diverting eligible individuals to services, LEAD is committed to improving public safety and public order and to reducing the criminal behavior of people who participate in the program. The King County LEAD program has evolved to a national model with a support organization, the LEAD National Support Bureau, which assists departments in establishing LEAD programs.