Building Support for Deflection and Diversion Programs

By reviewing this section of the guide first responders will be able to:

  1. Explain the evidence on benefits of diversion and deflection to community stakeholders and agency personnel
  2. Develop strategies for building support for your local diversion and deflection implementation efforts
  3. Use examples to develop presentations and other materials to communicate the benefits of diversion and deflection programs

All new initiatives require support of policymakers, community stakeholders and the organizations carrying out the implementation efforts. PAARI has supported police and public safety agencies with technical assistance throughout the country, which are not only new, but seek to reimagine the way police address the challenge of drug use in their communities. From police chiefs to front-line personnel and from policy makers to community organizations, these approaches have been initiated and championed by individuals with various roles and responsibilities. Regardless of your role, there are several ways to build support for implementation within your community.

Section A: Promote the Evidence on Effectiveness

First responders can build support by promoting the key evaluation study findings that demonstrate the effectiveness of deflection and diversion programs:



Save Lives And Reduce Harms Of Substance Use

Research has shown that when individuals participate in evidence-based treatment, they are less likely to die from substance use.[15] For example, a review of medication for opioid use disorder (MOUDs) studies, found that MOUD access leads to a reduction in both overall mortality and overdose mortality.[16] Community-level evaluation of Massachusetts agencies that adopted a post-overdose outreach program found a 6% reduction in fatal overdose rate annually for each year of the program relative to communities with non-adopting agencies.[17] Compared to 2020, Plymouth County Outreach (MA) reported an 18% reduction in overdose deaths, and Anne Arundel County (MD) Safe Stations reported an 18% decrease in all overdoses and nearly a 30% decrease in overdose deaths in 2021.[18,19] Similarly, in 2024, Hamilton County, Ohio, which has had an active Quick Response Team since 2018, reported a 52% reduction in overdoses since its peak in 2017.[20]

Connect People To Treatment And Provide Other Resources

Intake models have seen high volumes of people seeking services. For example:

  • In the first year (2015-2016) of the Angel Program initiated by Gloucester PD, 376 people sought assistance (31 per month) and about 95% of those were referred to treatment.[21]
  • In the first two years of The Champion Plan in Brockton PD, 92% of 818 intakes (34 per month) were successfully enrolled in treatment at a facility or in the community.[22]
  • A Way Out (AWO) program in Lake County, IL connected 758 people to treatment in little over 4.5 years of operation across multiple police departments (14 per month).[23]
  • Between April 2017 and December 2018, Anne Arundel County (MD) Safe Stations program connected 70% of 5,131 eligible people to treatment.[24]

Post-overdose follow-up can navigate a high percentage of successful contacts to treatment. For example:

  • 54% of individuals engaged by Tempe (AZ) PD’s post-overdose engagement program staff accepted referral or services, including community- or institutional-based treatment.[25]
  • Plymouth County Outreach (MA) made 809 home visits in 2021 with 74% of individuals accepting services in the comfort of their own homes after they had declined services at the hospital.[26]

Reduce Justice System Involvement And Associated Costs For Individuals

A systematic review of deflection/diversion initiatives showed that these programs are effective in preventing future offending and contact with the criminal justice system. [27] Deflection and pre-arrest diversion programs not only directly reduce justice system involvement for the offense that initiated the contact (and would have led to arrest under enforcement-focused approaches), but they also reduce the likelihood of subsequent arrest after participation.[28] Each arrest, prosecution and incarceration avoids harms associated with these experiences.

Evaluations of the LEAD program in Seattle found that 6-months after participants entered the likelihood of recidivism for participants decreased by 57% relative to the comparison group of non-participants.[29] In addition, Anne Arundel County (MD) reported declines in robberies (-25%), aggravated assaults (-15%), thefts (-22%), burglaries (-37%), and thefts from automobiles (-28%); compared to before and after implementing Safe Stations throughout the county.[30] Moreover, the Tucson Police Department’s deflection program has shown to be more effective in reducing the frequency of illegal drug use compared to traditional arrest. [31]

Save Economic Resources Compared To Standard Enforcement Approaches

According to the National Institute of Drug Addiction (NIDA), treatment is far less costly than incarceration ($4,700 average costs per person per year compared to $24,000)[32]. Research specific to diversion programs found that operational costs are not prohibitive and decrease after initial start up. For example, the LEAD program in Seattle demonstrates that average costs of the program (which includes part of district attorney time in the pre-booking diversion process) was less than $11,000 per year per participant or about $900 per month per participant, and these costs decreased to about $530 after 2.5 years of adoption.[33] These costs are far lower than typical costs associated with arrest, prosecution and, especially, supervision or incarceration. One study found that treatment would save over $17,500 in the societal costs of crime, which includes justice-system expenditures, in a 6-month period in California.[34]

A 2022 evaluation of the Tucson Police Department’s Deflection Program showed a cost savings of $13.40 in personnel costs per incident for deflection programs compared to arrest and projected jail and justice system expense savings for the project exceeded $640,000. This study also showed that less first responder personnel time was used per deflection compared to arrest. [35]

Section B: Promote the Benefits to the Organization

Adoption of innovative practices can come from leadership or key champions within the organization and in response to evolving external context (e.g., public attitudes, peer agency, professional associations). Those seeking to champion the model within their organizations should highlight that, in addition to evidence of effectiveness, adopting deflection and diversion programs:

Aligns With Public Support For Addressing Community Substance Use Challenges With Treatment Rather Than Enforcement And Incarceration

A national survey in 2017 found that 65% of respondents preferred getting an offender into a treatment program for individuals found in possession of opioids instead of serving jail time.[36]  Survey research from Virginia shows that 80% of respondents supported the expansion of community-based treatment programs being provided for their respective communities over arrest.[37] Regardless of the community you serve, support is high for alternatives to enforcement-only approaches.

Can Help To Build Trust Among Communities Particularly Impacted By Disparate Treatment In Arrest, Prosecution And Incarceration

People of color are disproportionately affected by enforcement-only approaches to substance use and related behaviors due in part to socioeconomic inequality[38]. Creating deflection and diversion programs that are applied equitably and equally in communities can greatly repair the harms associated with enforcement and may improve perceptions of trust. (See “Building Successful Partnerships Between Law Enforcement and Public Health Agencies to Address Opioid Use”)

Places The Agency In Line With A Large And Growing Group Of Police Agencies Adopting Deflection And Diversion Programs

A national survey in 2020, sponsored by Bureau of Justice Assistance, identified 659 first-responder deflection programs that included at least one deflection or diversion program[39]. Most (82%) of these programs were adopted between 2016 and 2019 (the last full year studied).[40] The adopting agencies are supported by major federal and state justice agencies and major foundations through policy guidance and funding.

Section C: Promote the Ease of Implementation

Although resources and coordination are necessary to implement novel deflection and diversion programs, agencies of all types, sizes, and regional locations have done so successfully.  Those seeking to implement should recognize and promote the idea that implementation is not overly challenging, by emphasizing:

Funding And Implementation Support Are Available

The Bureau of Justice Assistance-sponsored survey found that programs were supported by a variety of funding sources, including federal and state grants.[41] Approximately $54 billion in Opioid Settlement Funding or Opioid Abatement Funding is newly available over the next 18 years due to civil case settlements involving pharmaceutical companies found responsible for contributing to the opioid epidemic (learn more on our website).[42]  Technical assistance from PAARI and other organizations, including PAARI’s State-by-State Opioid Settlement Fund Guide, and guidance from peer-agencies can assist with overcoming challenges of implementation. For additional information on funding sources see this resource available on PAARI’s website and updated regularly.

Potential Partners (Public Health, Social Work And Community-Based Organizations) Support The Model And Are Ready To Do So In Many Communities

Promoting pathways to treatment is part of the core mission of these kinds of organizations and many of them have partnered with law enforcement agencies throughout the country. The multidisciplinary collaborations done within HUB Models in many sites, including PAARI’s HUB in Plymouth County, MA, are excellent examples of willingness of local service providers and community organizations to work together on complex problems.

Timelines From Formulation To Implementation Can Be Relatively Quick

Intake programs can begin navigating individuals to treatment within months as was seen in several early adopters of the model.[43] For example, a process evaluation of a program run by Madison Police Department in Wisconsin determined that development started in October 2016, and began diverting people by September 2017.

Leadership Support and Training Can Help Officer Buy-In and Engagement with Deflection Efforts

In many communities, first responders are supportive of deflection and diversion efforts that improve outcomes for individuals with substance use disorders, mental illness, and other social issues. For example, one study, completed in 2021, found that after a LEAD training, 72% of the officers were likely/extremely likely to divert within the model; less than 6% were unlikely/extremely unlikely to divert.[44] Additionally, process evaluations of the Tempe AZ program describe officers as supportive of the program.[45]

PAARI has heard of the shifting mindset among law enforcement personnel many times. Leadership and training is critical to the engagement of officers and personnel in deflection programs:

1. Hear Chief Bosse of the Georgetown, PD (KY) talk about his own personal and professional growth and the impact of his department’s program on officers:

from PAARI USA on Vimeo.

2. Hear Lt. Jeremiah Nicastro from Gloucester, PD discuss the rewarding experience of truly helping people through alternatives to arrest:

Successes, Barriers and Lessons Learned from PAARI USA on Vimeo.

3. Hear from Chief Steven D’Agata discussing the importance leadership and buy-in to support his deflection initiative:

Resources Can Be Disseminated to all Programs With Similar Aims and Personnel

Many police departments and their community partners have adopted multiple deflection and diversion initiatives that address behavioral health challenges, including a Co-Response model and utilizing Mobile Crisis Units. These examples can integrate easily with substance use deflection and diversion because they share similar aims and protocols. Agencies also have programming staff already in place that can help to initiate implementation, coordinate early efforts and secure funding.

One example includes programs developed by the non-profit “Face Addiction Now” in Michigan. Their early deflection program, Hope Not Handcuffs  started as a single walk-in model program, but quickly branched out into additional programs that include harm reduction, post-overdose response, naloxone training, and recovery coaching.