Expand First Response and Crisis Intervention Teams

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, across the country, a variety of diversion services have emerged -- led by law enforcement agencies, fire departments, and emergency medical services (EMS). 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.

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." 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.

• 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.