Final Exam_Moore 2

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Moore Erica Moore CJ 510: Mental Health and Justice Policy Prof. Matesanz June 30 th , 2023 Final Exam: Option 2 In the United States, mortality from opioids has risen to unprecedented proportions since 2014. States in the New England region have been particularly hit, including Massachusetts, which saw a 350% spike in fatal overdoses between 2000 and 2015 alone (Massachusetts Department of Public Health, 2016). Several of the state's community institutions, like hospitals, are impacted by the overdose issue. Between July 2016 and September 2017, hospital emergency department admissions for opioids increased by more than 30%. Because of this, opiate abuse has become a racial, gender, and socioeconomic public health emergency (Varano et al., 2019). The scope of the opioid crisis has fundamentally changed how many law enforcement organizations approach the fight against opioid abuse in their local areas. Officers advocate an honest approach to the drug problem, advocating a combined public health/law enforcement model where prevention and treatment are prioritized for nonviolent drug offenders, regardless of whether the department serves an urban, suburban, or rural community. This shift is further supported by data suggesting that aggressive policing practices might increase community overdose rates and negatively affect public health preventive initiatives (Hoke et al., 2020). Brockton is approximately twenty five miles south of Boston in eastern Massachusetts. According to estimates from the July 2018 census, Brockton has a population of roughly close to 96,000 (Varano et al., 2019). With 33% of individuals under the age of eighteen and 13% above the age of sixty five, residents of cities are often disproportionately younger. According to data 1

Moore from the 2018 census, 42% of residents are classified as "White" and 41% as "Black/African American" regarding race and ethnicity. The median family income in 2018 was roughly $52,000, and about 17% of residents live below the poverty line. In 2018, the median family income in the US state of Massachusetts was $74,000, and 11% of the population lived in poverty (Varano et al., 2019). The pre-and post-booking models of law enforcement diversionary programs, founded in a public health approach, emerged after the realization that change is necessary. The majority of diversionary programs now use post-booking approaches. They are set up as a combination of social welfare and legal processes that follow an arrest or period of incarceration (Hoke et al., 2020). Critics of post-booking programs assert that the arrest procedure stigmatizes the offender and indicates abstinence is the only permissible consequence. In contrast, others think the ethics of a coercive program are questionable and can harm procedures and results (Hoke et al., 2020). The "therapeutic diversion" program is another name for the pre-arrest strategy. These programs, which are more prevalent for people with mental illnesses, youths, and some drug and alcohol offenders, are less researched than post-booking initiatives. A pre-arrest program's objectives are to keep the offender out of the criminal justice system and to lower the obstacles to entering treatment. This public health approach provides rapid, unrestricted access to numerous treatment options (Hoke et al., 2020). The two types of police-led diversionary programs that are most frequently used are those in which drug users request treatment services by visiting the police station and requesting assistance and those in which the officers play a more active role in identifying those in need in the community. From the viewpoint of a patrol officer, the latter necessitates more active outreach on the officer's part. In contrast, the former is a passive referral initiative where the police are not the primary outreach (Hoke et al., 2020). The Gloucester (MA) 2

Moore model, one of the earliest referral programs of its sort, concentrated on customer outcomes, including participation and sobriety. With 75% completing the placement procedure, the program has an 86% placement rate. 80% of individuals who entered therapy right away stayed in inpatient facilities for no more than seven days. 37% of individuals who replied to the follow- up survey said they maintained abstinence after the treatment program was over (Hoke et al., 2020). Similar outcomes to Gloucester's have been recorded in other communities, including Brockton, Massachusetts. A police-assisted recovery program known as The Champion's Program (TCP) was developed by the Mayor's Office of the City of Brockton. It was created under the leadership of Mayor Bill Carpenter in association with the Brockton Police Department and a nearby nonprofit service provider. In 2016, TCP's doors were opened as part of the mayor's pledge to implement cutting-edge solutions to the opiate crisis. The TCP program was primarily based on Gloucester's ANGEL (Varano et al., 2019). A local substance abuse service provider was also integrated to connect clients to treatment providers and keep in touch with clients after treatment placement. Some of the objectives of TCP are to ensure that all people looking for addiction treatment obtain the proper referrals and placements and that all participants should get overdose prevention instruction and a resource packet with details on nearby services. TCP is a neighborhood resource available to everyone, including Brockton residents and non-residents (Varano et al., 2019). This program remains one of the main tactics for the Brockton Mayor's Opioid Overdose Prevention Coalition. It is actively promoted as one of the city's main entry sites for treatment. Because of the program's tight ties to law enforcement, other police agencies throughout the county and even around Massachusetts are now using it as a resource for people seeking rapid access to therapy. 3

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Moore The Brockton Police Department and the Gandara Center, a behavioral health and drug misuse treatment provider, have formed a unique cooperation known as the TCP model (Varano et al., 2019). Anyone seeking therapeutic services must enroll in the program through the Brockton Police Department. Those in need of assistance can ordinarily make an application for admission to the program at the Brockton Police Department during the program's scheduled hours. These hours align with the regular business hours of the Gandara Center and TCP employees, which are 9 a.m. to 5 p.m., Monday through Friday (Varano et al., 2019). Prospective customers seeking to access the program beyond regular business hours are urged to return then. Some potential clients have chosen to wait in the police department lobby for extended amounts of time; they might wait there for hours because they are nervous that they might begin using drugs again if alone. Most of the time, the Brockton Police Department has complied with these demands (Varano et al., 2019). The applicants must appear in person and declare their desire to attend TCP at the Brockton Police Department's front desk at police headquarters. The TCP program model mandates that upon arrival at the police station, the front desk officer must take the person's name and date of birth and conduct a warrant check on them. If an active warrant is discovered, the person will be taken into custody and brought to court to resolve the warrant (Varano et al., 2019). The TCP program model also mandates that the front desk agent do a thorough criminal background check on the person and look for any felony drug trafficking or distribution offenses. People who had involvement in trafficking or distribution in the past were excluded from the program, it was decided. The person will not be permitted access to TCP if these allegations are confirmed. A provider of behavioral, mental health, and drug misuse services, The Gandara Center concentrates its efforts on underserved and minority groups (Varano et al., 2019). A TCP staff member from the Gandara Center shows up at the police 4

Moore station when they receive word that a prescreened client is in the lobby and personally guides them to the program offices. When they come, a staff member will finish the intake procedure on their behalf. Along with names, dates of birth, races, ethnicities, addresses, phone numbers, veteran status, and emergency contact information, demographic data is also gathered. During intake, additional data is recorded in the case management system, such as the person's insurance information, overdose history, drug use history, treatment history, self-reported medical history, and mental health history (Varano et al., 2019). This provides staff members all the information they need to assist people who are struggling with drug abuse and mental illness by creating a detailed profile. When a treatment placement is found, the staff member will add the details of that placement to the intake form and the sort of treatment required. The staff member will start looking for a suitable treatment setting once the intake procedure is through and they know the client's immediate treatment needs. Inpatient, outpatient, or community-based clinical support service programs are the most common treatment settings, followed by detoxification. A crucial partner in the program model, the local Brockton ambulance service, transports the client to the treatment institution after a treatment placement is found (Varano et al., 2019). The program model prioritizes ensuring a smooth transition from the Gandara Center to the ambulance service and, ultimately, to the service provider. It guarantees adherence to the program model and responsibility. Everyone who receives services at the Gandara Center receives overdose prevention training covering overdose recognition and response techniques (Varano et al., 2019). Each client leaves the Gandara Center with a bundle of information about nearby resources and a dose of naloxone. The client is also required to complete an "Exit Survey," which asks questions regarding the client's satisfaction with the TCP intake process and how they were handled by 5

Moore program personnel and police during the process after the intake and placement process. Staff members try to ascertain clients' current treatment status, existing support systems, current unmet requirements, and information on relapse during these follow-up contacts (Varano et al., 2019). While evaluating pre-booking diversionary programs based on consumer results is one method, other studies have examined officers' views towards the necessity and suitability of diversionary programs and their readiness to engage in the diversionary process actively. In their survey, Reichert et al. (2017) found that 86% of the officers approved the diversionary program, while the majority of the officers indicated a need for more training. Despite their backing, the officers indicated that referral activity could have been more active. Only 20% of officers said they would "often" or "always" refer someone instead of making an arrest when they came across someone who owned drugs and battling with addiction. Also, 27% of police officers said they "rarely" or "never" made referrals. While expressing approval for the approach, Hunter et al. (2005) discovered that officers needed more clarity regarding the program's capacity to draw individuals into treatment programs.These shocking statistics are proof of how a different approach should be used when training police officers in these scenarios. Having most police officers arrest individuals who are clearly suffering from drug abuse and need help is only going to damage the system even further and create distrust within the community. According to outreach workers, the officer referral process needed to be improved since so many officers made exceptions and chose not to make referrals. According to that study, referrals were not made because the police believed the offender to be unfit, too old, incoherent, dangerous, or otherwise. The outreach workers noted that the desk sergeant's workload was another obstacle to treatment and that if an outreach worker were not present at the police department when the offender arrived, a referral would not likely be made. The number of years of service impacts 6

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Moore officers' views toward the treatment process, according to Rouhani et al. (2019). Experienced police officers had a higher propensity to think that a diversionary program, instead of an arrest, would lower crime and increase public safety. Years of service impacted an officer's knowledge of available services, awareness of treatment hurdles, and comfort level when recommending an offender for treatment programming. Because they understood that therapy was not always readily available to offenders, seasoned police officers also showed signs of being more realistic about treatment services than younger officers. According to Hoke et al. (2020) study, most officers in the Brockton Police Department agree that there are drug problems in their neighborhoods. As a result, they support the principles and goals of the Police Assisting in Recovery (PAIR) program. Nevertheless, some police officers did not view the training as beneficial because they needed to see program promotion as a part of their job description. Given that the department practices community-centered policing, this viewpoint is intriguing. The command staff of the department needs to promote the value of community outreach and highlight how it contributes to lowering crime and raising the standard of living in the neighborhood before police will buy into participating in outreach themselves (Hoke et al., 2020). One thing that several of the more effective police-led diversionary programs have in common is that the chief supports the program. This top-down commitment might be required to consistently convey the value of the program to departmental staff as well as community members. Officers' perceptions of their role in community outreach may be diminished or restrict participation in such initiatives without ongoing support from the command staff (Hoke et al., 2020). The Brockton Police Department's officers endorsed the PAIR program; however, while responding to calls, they indicated little to no involvement, consistent with previous research. They cited a variety of reasons for their lack of participation, 7

Moore including the fact that they saw outreach as outside the scope of their job duties, that the offender did not want their assistance or was not in a fit state to accept it, that the situation presented risks or safety concerns, and that they felt the offender should bear responsibility for the circumstances (Hoke et al., 2020). The nature of the officer's first interaction with the resident may preclude outreach at that particular moment. If concerns like safety and offender coherence prevent officers from making referrals, perhaps reducing those obstacles would encourage officers to do so. Perhaps a more acceptable setting for cops to operate as the point of contact is community-centered events when an interaction between police and civilians is more controlled (Hoke et al., 2020). Officer who believe that outreach is not within the scope of their duties and that the offender is solely responsible for their recovery is another huge implication. Departments must understand the value of crime prevention to increase public safety if police-led diversionary programs are to be successful. More effective than many enforcement techniques can be proactive actions that aim to deter crime and lower the risk for specific community members (Hoke et al., 2020). Departments should be able to shift to a model where the duty for intervention is perceived as holistic rather than personal if officers acknowledge the importance of the drug problem in their communities and support some intervention. By immediately informing the officers about the outcomes of the initiatives, the command staff can attempt to shape and direct their perceptions. Most officers in both departments needed to be made aware of whether community members were utilizing the intervention (Hoke et al., 2020). The departments may have wasted a chance to influence staff behaviors and opinions by omitting to communicate this information. Future studies should investigate whether a command staff member's lack of follow-up results in an officer acting inactively. However, the size of the police 8

Moore force might be significant. According to the study by Hoke et al. (2020), the smaller police department reported more significant participation in the program. The size of their department and community and the depth of their expertise and experience addressing a wide range of circumstances may contribute to their increased participation. Officers in large departments might respond to fewer drug-related calls or have specific officers used more frequently in these circumstances. Police-led treatment-on-demand intervention models are a relatively new community-based strategy, and how establishing appropriate outcome metrics is a topic of much discussion. Program participants self-identify and choose to participate in The Champion's Plan (TCP), and they are typically not required by law. TCP is not designed to work with clients with a particular connection to the criminal justice system or who have had negative interactions with the police. It is inappropriate to utilize arrest-based indicators like "recidivism" as results because TCP clients do not come to the program's notice through formal or informal involvement with the criminal justice system (Varano et al., 2019). One of the most critical public health problems affecting states and local communities in recent memory is the opiate overdose catastrophe that is sweeping the country. It has affected almost every area of our communities and has broken down barriers of race, gender, and financial status in numerous ways. Although there is a growing consensus at almost all levels of government and even within political parties that something must be done to stop this disease from spreading, it is unclear exactly what that action should entail. Across the country, police and policymakers have been trying different tactics to stop this epidemic, and in cities like Brockton, Massachusetts, political and law enforcement leadership decided to ignore the crisis no longer and wait for others to take on the treatment leadership position. The effectiveness of law enforcement diversionary programs, particularly those that employ the pre-arrest paradigm 9

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Moore like the PAIR program previously described, should be further investigated in future studies. The findings of Hoke et al. (2020) show that police officers are interested in and aware of the benefits of PAIR training. To fully participate in such a program, additional police officers must overcome some obstacles. In addition to the intricacy of the initial call for service and point of contact, barriers include officers' conceptions of their responsibilities in offender recovery and their participation in the outreach process. The absence of a departmental champion for such interventions may further limit officer commitment to and involvement in initiatives like PAIR. It is essential to improve communication between law enforcement officers, command staff, outreach specialists, and treatment program employees to identify implementation issues and the solutions that will address them. Officers in our sample also mentioned the need for community- wide drug treatment and education campaigns. 10

Moore References: Hoke, S., Baker, K., & Wenrich, K. (2020). An assessment of officer attitudes toward the training and use of a pre-booking diversionary program. Journal of Substance Abuse Treatment , 115 , 108036. https://doi.org/10.1016/j.jsat.2020.108036 Hunter, G., McSweeney, T., & Turnbull, P. J. (2005). The introduction of drug arrest Referral Schemes in London: A partnership between Drug Services and the police. International Journal of Drug Policy , 16 (5), 343–352. https://doi.org/10.1016/j.drugpo.2005.06.008 J. Reichert, L. Gleicher, L. Mock, S. & Adams, K. Lopez. (2017). Police-led referrals to treatment for substance use disorders in rural Illinois: An examination of the safe passage initiative. Illinois Criminal Justice Information Authority, Center for Justice Research and Evaluation . Retrieved from https://icjia.illinois.gov/researchhub/articles/police-led- referrals-to-treatment-for-substance-use-disorders-in-rural-illinois-an-examination-of-the- safe-passage-initiative Massachusetts Department of Public Health. (2016). An assessment of opioid-related deaths in Massachusetts (2013-2014). Retrieved from http://www.mass.gov/eohhs/docs/dph/quality/ drugcontrol/county-level-pmp/chapter-55-report.pdf Rouhani, S., Gudlavalleti, R., Atzmon, D., Park, J. N., Olson, S. P., & Sherman, S. G. (2019). Police attitudes towards pre-booking diversion in Baltimore, Maryland. International Journal of Drug Policy , 65 , 78–85. https://doi.org/10.1016/j.drugpo.2018.11.012 11

Moore Varano, S. P., Kelley, P., & Makhlouta, N. (2019). The city of Brockton’s “Champion plan”: The role of police departments in facilitating access to treatment. International Journal of Offender Therapy and Comparative Criminology , 63 (15–16), 2630–2653. https://doi.org/10.1177/0306624x19866127 12

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