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. In addition to law enforcement officers, other first responders, such as emergency medical technicians and firefighters, 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). These first-responder 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.

While the exact number of diversion and deflection programs in the United States is currently unknown, their growth 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

Deflection & Diversion Programs

Two approaches used by first responders are deflection and pre-arrest diversion programs. It is important to note, these are complementary practices within a systems approach at the intersection of first responders, behavioral health service providers, recovery support, and community. These collaborative interventions connect public safety and public health systems to create community-based pathways to treatment and services for people who have SUD, mental health disorders, or co-occurring disorders. These multidisciplinary programs are forging partnership between first responders and treatment providers, peers, and recovery personnel, and they are succeeding in reducing overdoses by connecting individuals to community-based treatment.

Deflection and pre-arrest diversion 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 substance use, 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 complex 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.

The Police Treatment And Community Collaborative (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.

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.

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.

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 treatment services.

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. 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.

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.

SAFE Project:

• "Law Enforcement Pre-Arrest Diversion Resource Guide" was created in collaboration with PTACC. It is a downloadable resource 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, includes background information and research, and provides case studies of PTACC's five pathways. The guide can be downloaded.
• Integrated-Forensic Peer Recovery Specialist (I-FPRS) Training. This SAFE Project program is a comprehensive set of curriculums designed for Peer Recovery Specialists, organizations, and groups working with justice-involved individuals who experience substance use disorders. This training equips participants to navigate the intersection of behavioral health and the criminal justice system.
• SAFE Connections. This subprogram of the SAFE Choices portfolio provides an opportunity to impact youth recidivism and redirect young lives toward reaching their full potential.
• See the wiki titled "Shift from Punishment to Treatment Approach" for more detailed information on using evidence-based practices for treating those in the criminal justice system with substance use issues.
• 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.

The U.S. Department of Justice Bureau of Justice Assistance (BJA) manages the Comprehensive Opioid, Stimulant & Substance Use Program (COSSUP). 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.

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

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

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

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 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.

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.

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

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 use. 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. 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.

Georgia. The Adult Felony Drug Court Program in Clayton County is an 18-to-24-month program that gives nonviolent drug offenders with a substance use disorder the chance to avoid incarceration.

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 substance use 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 -- 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 substance use disorder. Persons seeking treatment 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.

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

Massachusetts -- Arlington Opiate Outreach Initiative. This community-based strategy has two major components. First is the proactive outreach to known substance users. This involves a clinician at the police department reaching out to the known population of persons with substance use disorders to support them in developing a plan to ensure their survival, to provide access to services, and to facilitate the long-term process of recovery. The second component is the Arlington Community Training & Support (Arlington ACTS) which involves a series of community-based meetings. These are co-facilitated by the police department’s clinician and a community substance use intervention expert and are aimed at creating a supportive non-judgmental environment for substance users and their families.

Massachusetts -- Plymouth County Outreach (PCO) was developed through the Public Safety, Community Coalition, and the Faith Based Subcommittees of the Plymouth County Drug Abuse Task Force. Since its inception, PCO has fostered innovative law enforcement collaboration with faith-based coalitions, the District Attorney’s Office, The Sheriff’s Department, all 27 police departments, 5 major hospitals, the Division of Children and Families, recovery coaches, District Court Probation, and the Police Assisted Addiction and Recovery Initiative (PAARI). The two main aspects of the program are overdose follow-up and community drop-in centers. Within 12-24 hours of an overdose, an outreach team consisting of plainclothes officers, a licensed clinician, and/or a recovery coach will conduct a home visit of the overdose survivor. The intent of the outreach effort is to provide resources and support to those with substance use disorders and/or their families with the hope of getting people into treatment and connecting family/friends with existing resources in the county. Drop-in centers are held each week in various sites across Plymouth County. These centers host a growing number of health care providers who help with treatment options and train and distribute Narcan for free.

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 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.

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 substance use 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.

North Carolina. The HOPE Initiative in Nashville was the first pre-arrest diversion program in North Carolina. Its purpose is to assist those individuals with substance use disorder find treatment options, get into treatment, and begin recovery. While other programs were centered on opioids, the HOPE Initiative was willing to accept any substance use disorder. Partnerships were established with the local district attorney’s office, the Eastpointe Local Management Entity, UNC Nash Hospital, Coastal Plain Hospital (Detox facility), Police Assisted Addiction and Recovery Initiative (PAARI), and many others. The program allows individuals to come to the Nashville Police Department to start their recovery process by turning over any drugs and/or paraphernalia without fear of charges. The first organization in the HOPE Initiative served 320 clients in 2 years. The program is funded through donations, grants, and fundraisers.

Ohio -- Drug Abuse Response Team (DART). Developed by the Lucas County Sheriff’s Office, DART has been credited with diverting more than a thousand people from the criminal-justice system in Toledo 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.

Ohio -- Hamilton County Heroin Task Force partnered with law enforcement, fire departments and social workers to create the Quick Response Team (QRT). It follows up with overdose victims and offers them substance use 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.

Tennessee. The Crisis Intervention Team (CIT) program is a community partnership working with mental health consumers and family members. The CIT is made up of volunteer officers from each Uniform Patrol Precinct. 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. 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. After the training, CIT officers can, with confidence, offer a more humane and calm approach. These officers maintain a 24/7 coverage.

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.