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Brief Description
= Introductory Paragraph =
= Introductory Paragraph =


Law enforcement officers and other first responders, such as emergency medical technicians, firefighters, and paramedics, are on the front lines of the illicit substance use epidemic, frequently responding to drug overdoses and calls for services involving individuals with substance use and co-occurring disorders. In response, a variety of law enforcement-led diversion and fire/emergency medical services (EMS)-led responses have emerged across the country. In partnership with substance use disorder (SUD) treatment providers, peers, and recovery personnel, these multidisciplinary programs are helping to reduce overdoses by connecting individuals to community-based treatment.
In addition to law enforcement officers, other first responders, such as emergency medical technicians, firefighters, and paramedics, are on the front lines of the illicit substance use epidemic. They frequently respond to drug overdoses and calls for services involving individuals with substance use and co-occurring disorders. As a result, a variety of law enforcement-led diversion and fire/emergency medical services (EMS)-led responses have emerged across the country. In partnership with substance use disorder treatment providers, peers, and recovery personnel, these multidisciplinary programs are helping to reduce overdoses by connecting individuals to community-based treatment. First-responder diversion programs represent a pivotal opportunity to redirect individuals with SUDs, mental health disorders, and co-occurring disorders away from jails or emergency departments and toward community-based treatment for substance use, mental health services, recovery support, housing, and social services.<ref>https://www.cossapresources.org/Content/Documents/Articles/CHJ_Pathways_to_Diversion_Self-Referral.pdf</ref>


<br/> &nbsp;Law enforcement and first-responder diversion program models represent a pivotal opportunity to redirect individuals with SUDs, mental health disorders (MHDs), and co-occurring disorders away from jails or emergency departments and toward community-based treatment for substance use, mental health services, recovery support, housing, and social services.<ref>https://www.cossapresources.org/Content/Documents/Articles/CHJ_Pathways_to_Diversion_Self-Referral.pdf</ref><br/> <br/> .&nbsp;
= Key Information =


&nbsp;
There are two approaches used by first responders -- “deflection” and “pre-arrest diversion.” These are detailed in the SAFE article titled, "Expand Law Enforcement Assisted Diversion and Deflection Programs." <ref>https://www.yoursafesolutions.us/wiki/Expand_Law_Enforcement_Assisted_Diversion_and_Deflection_Programs</ref> It is important to note, as two sides of the same coin, deflection and pre-arrest diversion are complementary practices of a systems approach at the intersection of first responders, behavioral health service providers, recovery support, and community. These collaborative interventions connect public safety with public health systems to create community-based pathways to treatment and services for people who have SUD, mental health disorders, or co-occurring disorders. In partnership with SUD treatment providers, other service providers, peers, deflection specialists, and recovery personnel, these multidisciplinary programs help reduce overdoses.


= Key Information =
= Relevant Research =


&nbsp;
'''PTACC''' published a research report on the benefits of diversion programs. Key findings indicate that despite the lack of large-scale and multi-site evaluation efforts, there are important trends emerging from early research on pre-arrest diversion initiatives across the US. Here are some key results drawn from empirical research on a variety of programs. <ref>https://secureservercdn.net/198.71.233.33/lpo.969.myftpupload.com/wp-content/uploads/2020/06/PTACC_Key_Research_FINAL.pdf</ref>


There are five pathways for first responders highlighted below. Each of which has the goal of providing a structured response that diverts a person exhibiting&nbsp;behaviors due to substance use, mental health disorder, or other treatable condition to an appropriate medical or treatment agency. For each of the pathways, the targeted population or circumstance appropriate for the pathway is elaborated.
*Pre-Arrest Diversion represents the first intercept with the criminal justice system, making it a prime opportunity to redirect adults with mental health conditions and substance use disorders from jails and to connect them with community-based service providers.
*The majority of adults booked into local jails require mental health services and treatment for SUDs, which are typically not provided in local facilities.
*Behavioral health conditions are associated with repeat criminal justice contact, and SUDs are the strongest predictor of jail readmission.
*Pre-arrest diversion programs assess and address behavioral health needs associated with continual involvement in the criminal justice system.
*Preliminary results indicate participants who fully engage in pre-arrest diversion programs tend to have low rates of recidivism for extended periods of time.


<br/> In 2014, Treatment Alternatives for Safe Communities (TASC), Center for Health and Justice (CHJ) developed the first iteration of the Five Pathways to Treatment, which offered different pathways for deflection that first responders could use to move someone from the justice system at the point of contact with law enforcement to community-based treatment. Each pathway has unique characteristics that make it appropriate to address particular problems such as SUD, OUD, MHD, homelessness, and other issues. Identifying and naming these pathways created a common language for practitioners to use in the new, emerging field of deflection.<ref>https://www.cossapresources.org/Content/Documents/Articles/CHJ-TASC_Nation_Survey_Report.pdf</ref>
= Impactful Federal, State, and Local Policies =


These programs are collaborative interventions connecting public safety (e.g., law enforcement, fire, and emergency medical services [EMS]) with public health systems to create community- based pathways to treatment and services for people who have SUD, mental health disorders (MHD), or co-occurring disorders. In partnership with SUD treatment providers, other service providers, peers, deflection specialists, and recovery personnel, these multidisciplinary programs help reduce overdoses through connection to community-based treatment and services. For law enforcement, deflection programs can enable individuals to receive referrals to services without fear of arrest if the individual does not accept deflection (in cases when law enforcement would have otherwise taken no action) or can serve in lieu of arrest when charges are present and an arrest would have otherwise occurred.
Communities are subject to state laws and regulations that directly impact their ability to institute pre-arrest diversion and other crisis response strategies. Often, strategies are locally designed and implemented and do not operate in a legal or political vacuum. Laws that grant local officials noncriminal responses to crises can propel diversion efforts or provide alternative, supplemental crisis responses. Laws that require criminal responses or otherwise circumscribe when and how non-law enforcement responders are able to intervene can impede them. Current statewide barriers exist in pre-arrest diversion and crisis response strategies.


<br/> Self-Referral: An individual voluntarily initiates contact with a first-responder agency (law enforcement, fire department, or EMS) for a treatment referral. If contact is initiated with a law enforcement agency, the individual makes that contact without fear of arrest. Individuals with SUDs are targeted population.
'''R Street''' has a Statewide Policies report which reviews legal status and legislative actions in all fifty states relating to pre-arrest diversion and crisis response. <ref>https://www.opioidlibrary.org/wp-content/uploads/2019/12/R_Street_Statewide_Policies_Relating_to_PAD_Crisis_Repsonse.pdf</ref> Policies relating to pre-arrest diversion and crisis response include:
*Emergency Mental Health Hold laws authorize certain first responders to take an individual experiencing a mental health crisis into a form of civil custody in order for them to be evaluated by appropriate mental health or medical personnel.
*Protective Custody. These procedures operate as the substance use analog to emergency mental health holds by authorizing first responders to place an individual experiencing an acute substance use episode in temporary civil custody.
*Citation Authority statutes permit or require law enforcement officers to issue a citation to individuals alleged to have committed certain specified offenses, instead of detaining them or placing them under arrest.
*Good Samaritan laws offer immunity from arrest, criminal charges, prosecution or conviction for limited, drug-related offenses as an incentive for individuals to call for assistance for someone experiencing a suspected overdose.
*Ambulance Transport laws and regulations can influence where emergency medical services may take an individual experiencing a crisis, potentially by requiring transport to a hospital emergency department or otherwise discouraging the use of alternative destinations.  


Active Outreach: A first responder intentionally identifies or seeks out individuals with SUDs to refer them to, or engage them in, treatment; outreach is often done by a team consisting of a clinician and/or peer with lived experience. Individuals with SUDs are targeted population.
'''Illinois Senate Bill 3023''' is one example of legislation on deflection. The 2018 Community-Law Enforcement Partnership for Deflection and Substance Use Disorder Treatment Act authorizes and encourages local law enforcement leaders to partner with treatment and community members on programs that deflect individuals who have overdosed or who have substance use problems away from the justice system and into addiction treatment services. <ref>https://www.centerforhealthandjustice.org/chjweb/tertiary_page.aspx?id=84&title=SB-3023-Community-Law-Enforcement-Partnership-for-Deflection-and-Treatment#:~:text=Illinois%20Senate%20Bill%203023%2C%20signed,that%20%E2%80%9Cdeflect%E2%80%9D%20individuals%20who%20have</ref>


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.
= Available Tools and Resources =


First-Responder/OfficerPrevention: 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 noncrisis mental health disorders and SUDs, or in situations involving homelessness or&nbsp; sex work.&nbsp;
'''SAMHSA''' provides a guidebook titled, "Crisis Intervention Team (CIT) Methods for Using Data to Inform Practice: A Step-by-Step Guide. <ref>https://www.opioidlibrary.org/document/crisis-intervention-team-cit-methods-for-using-data-to-inform-practice-a-step-by-step-guide/</ref>


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.&nbsp; The targeted population are persons in crisis, or with noncrisis mental health disorders and SUDs, or in situations involving homelessness or sex work.
'''SAFE Project:'''
*'''SAFE Connections.''' This SAFE Project subprogram of the SAFE Choices portfolio provides an opportunity to impact youth recidivism and redirect young lives toward reaching their full potential.<ref>https://www.safeproject.us/safe-choices/connections/</ref>
*'''Bridging Prevention and Recovery (BPR): A Community Approach to Systems Change.''' This SAFE Project program, offered in-person and virtually, guides community leaders through an action-oriented model to systemically integrate prevention and recovery systems to strengthen programs and improve outcomes. BPR is a 3.5 day training program that culminates with 6 technical assistance sessions tailored to each community’s unique set of needs to support implementation and sustainability of joint prevention and recovery community projects.<ref>https://www.safeproject.us/bridging-prevention-recovery/</ref>
*See the wiki titled "Improve Links to Treatment for People who Experience Non-Lethal overdoses or Naloxone Revivals" for more detailed information on ways to improve linkage to services for those who have experienced a non-lethal overdose or have survived a Naloxone revival. <ref>https://www.yoursafesolutions.us/wiki/Improve_Links_to_Treatment_for_People_who_Experience_Non-Lethal_Overdoses_or_Naloxone_Revivals</ref>


.
'''Crisis Intervention Team International''' published "A Best Practice Guide for Transforming Community Responses to Mental Health Crises." <ref>https://www.opioidlibrary.org/wp-content/uploads/2019/10/CIT-guide-desktop-printing-2019_08_16-1.pdf</ref>


= Relevant Research =
'''The National League of Cities''' offers "Working Across Systems for Better Results: City Efforts to address Mental Health, Substance Use and Homelessness Through Emergency Response and Crisis Stabilization" highlighting case studies in cities in Kansas, Texas, and West Virginia. <ref>https://www.opioidlibrary.org/wp-content/uploads/2020/01/YEF_MentalHealth_IssueBrief2_Final.pdf</ref>


In this section, please capture any recent findings, reports, or data on the topic. Please also highlight any gaps or existing disparities. Please include references and links to the information so that we may add a footnote for the reader to find further information. Do we have any available research about discriminatory practices? Is there information about the value of access to educational opportunities?
'''Advanced Recovery Systems University''' provides an online library of webinars specific to mental health and substance use within the first responder community. <ref>https://arsuniversity.thinkific.com/collections?category=ba5e2b</ref>


= Impactful Federal, State, and Local Policies =
= Promising Practices =


Please list any federal, state, or local laws, policies, or regulations that support this topic or ones that could be a possible barrier. Are there laws or policies other states should know about and replicate for success?
*'''Maryland.''' Safe Stations is an innovative new program in Anne Arundel County. It shifts barriers to treatment for those community members who are ready to recover from drug addiction. Persons seeking treatment for addiction can visit any police or fire station across the county, day or night, to dispose of any paraphernalia and find assistance gaining access to care. <ref>https://www.annapolis.gov/1325/Safe-Stations</ref>


= Available Tools and Resources =
*'''New Hampshire.''' The Safe Station Program offers help to anyone with substance use disorder at any Manchester Fire Department. The firefighters will arrange for or provide a medical assessment within their scope of training. If there is cause for concern that there is something else medically wrong with the patient, transportation to an appropriate level medical facility will be provided. Each individual seeking assistance will be required to drop any needles and/or paraphernalia into a collection bin located at each fire station prior to speaking with coaches or seeking treatment. <ref>https://manchesterinklink.com/as-safe-station-ends-those-in-need-of-addiction-treatment-and-recovery-services-directed-to-call-2-1-1/</ref>


Oftentimes, there are already great resources in the field that have been developed, but they are not housed in a single place. Please use this section to share information about those resources and drive the reader to that resource. It may be a worksheet, toolkit, fact sheet, framework/model, infographic, new technology, etc. I suggest no more than 5 really good links and a corresponding description for the reader. We also can use this section to highlight some of the great resources and programs at SAFE Project.
'''Ohio.''' The Hamilton County Heroin Task Force partnered with law enforcement, fire departments and social workers to create the Quick Response Team. It follows up with overdose victims and offers them addiction treatment. The goal is to have a first responder follow up with overdose victims within the “recovery window” (72 hours after an overdose reversal) and to provide a warm hand off to treatment options. Teams work to find overdose survivors using a database maintained by the Greater Cincinnati Fusion Center, a public safety data-collecting agency. Teams also use “predictive analysis” to track drug activity to target potential overdoses with the help of University of Cincinnati’s Institute of Crime Science. QRT has since been launched as a national model. <ref>https://www.cossapresources.org/Content/Documents/Diversion_Library/HCTF_Hamilton_County_OH_Program_Policy_508.pdf</ref>
 
= Promising Practices =


Please link to any best practice models or case studies that highlight creative/innovative or successful efforts in support of this strategy. Is there a community that does a really good job in this area that other communities should replicate? Please write a brief description and provide a link.
''' Tennessee.''' The Crisis Intervention Team (CIT) program is a community partnership working with mental health consumers and family members. Officers are part of a specialized team which can respond to a crisis at any time, and they will work with the community to resolve each situation in a manner that shows concern for the citizen’s well-being. The CIT is made up of volunteer officers from each Uniform Patrol Precinct. CIT officers are called upon to respond to crisis calls that present those officers, face-to-face, with complex issues relating to mental illness. CIT officers also perform their regular duty assignment as patrol officers. The Memphis Police Department has 268 CIT officers who participate in specialized training under the instructional supervision of mental health providers, family advocates, and mental health consumer groups. Due to the training, CIT officers can, with confidence, offer a more humane and calm approach. These officers maintain a 24/7 coverage. <ref>https://www.memphistn.gov/government/police-department/crisis-intervention-team/</ref>


= Sources =
= Sources =

Latest revision as of 15:23, 24 October 2024

Introductory Paragraph

In addition to law enforcement officers, other first responders, such as emergency medical technicians, firefighters, and paramedics, are on the front lines of the illicit substance use epidemic. They frequently respond to drug overdoses and calls for services involving individuals with substance use and co-occurring disorders. As a result, a variety of law enforcement-led diversion and fire/emergency medical services (EMS)-led responses have emerged across the country. In partnership with substance use disorder treatment providers, peers, and recovery personnel, these multidisciplinary programs are helping to reduce overdoses by connecting individuals to community-based treatment. First-responder diversion programs represent a pivotal opportunity to redirect individuals with SUDs, mental health disorders, and co-occurring disorders away from jails or emergency departments and toward community-based treatment for substance use, mental health services, recovery support, housing, and social services.[1]

Key Information

There are two approaches used by first responders -- “deflection” and “pre-arrest diversion.” These are detailed in the SAFE article titled, "Expand Law Enforcement Assisted Diversion and Deflection Programs." [2] It is important to note, as two sides of the same coin, deflection and pre-arrest diversion are complementary practices of a systems approach at the intersection of first responders, behavioral health service providers, recovery support, and community. These collaborative interventions connect public safety with public health systems to create community-based pathways to treatment and services for people who have SUD, mental health disorders, or co-occurring disorders. In partnership with SUD treatment providers, other service providers, peers, deflection specialists, and recovery personnel, these multidisciplinary programs help reduce overdoses.

Relevant Research

PTACC published a research report on the benefits of diversion programs. Key findings indicate that despite the lack of large-scale and multi-site evaluation efforts, there are important trends emerging from early research on pre-arrest diversion initiatives across the US. Here are some key results drawn from empirical research on a variety of programs. [3]

  • Pre-Arrest Diversion represents the first intercept with the criminal justice system, making it a prime opportunity to redirect adults with mental health conditions and substance use disorders from jails and to connect them with community-based service providers.
  • The majority of adults booked into local jails require mental health services and treatment for SUDs, which are typically not provided in local facilities.
  • Behavioral health conditions are associated with repeat criminal justice contact, and SUDs are the strongest predictor of jail readmission.
  • Pre-arrest diversion programs assess and address behavioral health needs associated with continual involvement in the criminal justice system.
  • Preliminary results indicate participants who fully engage in pre-arrest diversion programs tend to have low rates of recidivism for extended periods of time.

Impactful Federal, State, and Local Policies

Communities are subject to state laws and regulations that directly impact their ability to institute pre-arrest diversion and other crisis response strategies. Often, strategies are locally designed and implemented and do not operate in a legal or political vacuum. Laws that grant local officials noncriminal responses to crises can propel diversion efforts or provide alternative, supplemental crisis responses. Laws that require criminal responses or otherwise circumscribe when and how non-law enforcement responders are able to intervene can impede them. Current statewide barriers exist in pre-arrest diversion and crisis response strategies.

R Street has a Statewide Policies report which reviews legal status and legislative actions in all fifty states relating to pre-arrest diversion and crisis response. [4] Policies relating to pre-arrest diversion and crisis response include:

  • Emergency Mental Health Hold laws authorize certain first responders to take an individual experiencing a mental health crisis into a form of civil custody in order for them to be evaluated by appropriate mental health or medical personnel.
  • Protective Custody. These procedures operate as the substance use analog to emergency mental health holds by authorizing first responders to place an individual experiencing an acute substance use episode in temporary civil custody.
  • Citation Authority statutes permit or require law enforcement officers to issue a citation to individuals alleged to have committed certain specified offenses, instead of detaining them or placing them under arrest.
  • Good Samaritan laws offer immunity from arrest, criminal charges, prosecution or conviction for limited, drug-related offenses as an incentive for individuals to call for assistance for someone experiencing a suspected overdose.
  • Ambulance Transport laws and regulations can influence where emergency medical services may take an individual experiencing a crisis, potentially by requiring transport to a hospital emergency department or otherwise discouraging the use of alternative destinations.

Illinois Senate Bill 3023 is one example of legislation on deflection. The 2018 Community-Law Enforcement Partnership for Deflection and Substance Use Disorder Treatment Act authorizes and encourages local law enforcement leaders to partner with treatment and community members on programs that deflect individuals who have overdosed or who have substance use problems away from the justice system and into addiction treatment services. [5]

Available Tools and Resources

SAMHSA provides a guidebook titled, "Crisis Intervention Team (CIT) Methods for Using Data to Inform Practice: A Step-by-Step Guide. [6]

SAFE Project:

  • SAFE Connections. This SAFE Project subprogram of the SAFE Choices portfolio provides an opportunity to impact youth recidivism and redirect young lives toward reaching their full potential.[7]
  • Bridging Prevention and Recovery (BPR): A Community Approach to Systems Change. This SAFE Project program, offered in-person and virtually, guides community leaders through an action-oriented model to systemically integrate prevention and recovery systems to strengthen programs and improve outcomes. BPR is a 3.5 day training program that culminates with 6 technical assistance sessions tailored to each community’s unique set of needs to support implementation and sustainability of joint prevention and recovery community projects.[8]
  • See the wiki titled "Improve Links to Treatment for People who Experience Non-Lethal overdoses or Naloxone Revivals" for more detailed information on ways to improve linkage to services for those who have experienced a non-lethal overdose or have survived a Naloxone revival. [9]

Crisis Intervention Team International published "A Best Practice Guide for Transforming Community Responses to Mental Health Crises." [10]

The National League of Cities offers "Working Across Systems for Better Results: City Efforts to address Mental Health, Substance Use and Homelessness Through Emergency Response and Crisis Stabilization" highlighting case studies in cities in Kansas, Texas, and West Virginia. [11]

Advanced Recovery Systems University provides an online library of webinars specific to mental health and substance use within the first responder community. [12]

Promising Practices

  • Maryland. Safe Stations is an innovative new program in Anne Arundel County. It shifts barriers to treatment for those community members who are ready to recover from drug addiction. Persons seeking treatment for addiction can visit any police or fire station across the county, day or night, to dispose of any paraphernalia and find assistance gaining access to care. [13]
  • New Hampshire. The Safe Station Program offers help to anyone with substance use disorder at any Manchester Fire Department. The firefighters will arrange for or provide a medical assessment within their scope of training. If there is cause for concern that there is something else medically wrong with the patient, transportation to an appropriate level medical facility will be provided. Each individual seeking assistance will be required to drop any needles and/or paraphernalia into a collection bin located at each fire station prior to speaking with coaches or seeking treatment. [14]

Ohio. The Hamilton County Heroin Task Force partnered with law enforcement, fire departments and social workers to create the Quick Response Team. It follows up with overdose victims and offers them addiction treatment. The goal is to have a first responder follow up with overdose victims within the “recovery window” (72 hours after an overdose reversal) and to provide a warm hand off to treatment options. Teams work to find overdose survivors using a database maintained by the Greater Cincinnati Fusion Center, a public safety data-collecting agency. Teams also use “predictive analysis” to track drug activity to target potential overdoses with the help of University of Cincinnati’s Institute of Crime Science. QRT has since been launched as a national model. [15]

Tennessee. The Crisis Intervention Team (CIT) program is a community partnership working with mental health consumers and family members. Officers are part of a specialized team which can respond to a crisis at any time, and they will work with the community to resolve each situation in a manner that shows concern for the citizen’s well-being. The CIT is made up of volunteer officers from each Uniform Patrol Precinct. CIT officers are called upon to respond to crisis calls that present those officers, face-to-face, with complex issues relating to mental illness. CIT officers also perform their regular duty assignment as patrol officers. The Memphis Police Department has 268 CIT officers who participate in specialized training under the instructional supervision of mental health providers, family advocates, and mental health consumer groups. Due to the training, CIT officers can, with confidence, offer a more humane and calm approach. These officers maintain a 24/7 coverage. [16]

Sources

  1. ↑ https://www.cossapresources.org/Content/Documents/Articles/CHJ_Pathways_to_Diversion_Self-Referral.pdf
  2. ↑ https://www.yoursafesolutions.us/wiki/Expand_Law_Enforcement_Assisted_Diversion_and_Deflection_Programs
  3. ↑ https://secureservercdn.net/198.71.233.33/lpo.969.myftpupload.com/wp-content/uploads/2020/06/PTACC_Key_Research_FINAL.pdf
  4. ↑ https://www.opioidlibrary.org/wp-content/uploads/2019/12/R_Street_Statewide_Policies_Relating_to_PAD_Crisis_Repsonse.pdf
  5. ↑ https://www.centerforhealthandjustice.org/chjweb/tertiary_page.aspx?id=84&title=SB-3023-Community-Law-Enforcement-Partnership-for-Deflection-and-Treatment#:~:text=Illinois%20Senate%20Bill%203023%2C%20signed,that%20%E2%80%9Cdeflect%E2%80%9D%20individuals%20who%20have
  6. ↑ https://www.opioidlibrary.org/document/crisis-intervention-team-cit-methods-for-using-data-to-inform-practice-a-step-by-step-guide/
  7. ↑ https://www.safeproject.us/safe-choices/connections/
  8. ↑ https://www.safeproject.us/bridging-prevention-recovery/
  9. ↑ https://www.yoursafesolutions.us/wiki/Improve_Links_to_Treatment_for_People_who_Experience_Non-Lethal_Overdoses_or_Naloxone_Revivals
  10. ↑ https://www.opioidlibrary.org/wp-content/uploads/2019/10/CIT-guide-desktop-printing-2019_08_16-1.pdf
  11. ↑ https://www.opioidlibrary.org/wp-content/uploads/2020/01/YEF_MentalHealth_IssueBrief2_Final.pdf
  12. ↑ https://arsuniversity.thinkific.com/collections?category=ba5e2b
  13. ↑ https://www.annapolis.gov/1325/Safe-Stations
  14. ↑ https://manchesterinklink.com/as-safe-station-ends-those-in-need-of-addiction-treatment-and-recovery-services-directed-to-call-2-1-1/
  15. ↑ https://www.cossapresources.org/Content/Documents/Diversion_Library/HCTF_Hamilton_County_OH_Program_Policy_508.pdf
  16. ↑ https://www.memphistn.gov/government/police-department/crisis-intervention-team/
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