Expand First Response and Crisis Intervention Teams
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Brief Description
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.
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.[1]
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Key Information
Deflection programs
here are five pathways for first responders highlighted below. Each of which has the goal of providing a structured response that diverts a person exhibiting 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.
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.
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.
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.
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.
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/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 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 noncrisis mental health disorders and SUDs, or in situations involving homelessness or sex work.
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Relevant Research
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?
Impactful Federal, State, and Local Policies
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?
Available Tools and Resources
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.
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.