Harm Reduction Policing: An Evaluation of Law Enforcement Assisted Diversion (LEAD) in San Francisco

Abstract

In 2017, San Francisco (SF) implemented Law Enforcement Assisted Diversion (LEAD), a program Beckett described as harm reduction policing. Through a process and outcome evaluation of LEAD SF, this paper demonstrates the positive impacts of harm reduction policing, on those who use drugs and/or engage in sex work. When law enforcement officers used their discretion to divert individuals into LEAD rather than arrest, those individuals had significantly fewer felony and misdemeanor arrests and felony cases, in comparison to a propensity score matched group. The focus group and interview data describe that the collaboration, the warm handoff, and LEAD’s harm reduction principles were mechanisms of success. However, obtaining officer buy-in was a key challenge. Despite that obstacle, LEAD SF’s harm reduction policing reduces offending, improves the wellbeing of people who use drugs and engage in sex work, and allows the police to carry out their mandate to protect and serve.

Keywords

harm reduction policing pre-arrest pre-booking diversion Law Enforcement Assisted Diversion (LEAD)evaluation mechanism drug offenders sex workers

Get full access to this article

View all access options for this article.

References

Apel

R. J.

Sweeten

(2010). Propensity score matching in criminology and criminal justice. In Piquero

A. R.

Weisburd

D. L.

(Eds.), Handbook of quantitative criminology (pp. 543–562). Springer.

Applied Survey Research. (2020). San Francisco homeless count & survey: Comprehensive report 2019. https://hsh.sfgov.org/wp-content/uploads/2020/01/2019HIRDReport_SanFrancisco_FinalDraft-1.pdf

Aitken

Moore

Higgs

Kelsal

Kerger

(2002). The impact of a police crackdown on a street drug scene: Evidence from the street. International Journal of Drug Policy, 13(3), 193–202. https://doi.org/10.1016/S0955-3959(02)00075-0

Bacon

(2021). Desistance from criminalisation: Police culture and new directions in drugs policing. Policing and Society, 1–18. https://doi.org/10.1080/10439463.2021.1920587

Barberi

Taxman

F. S.

(2019). Diversion and alternatives to arrest: A qualitative understanding of police and substance users’ perspective. Journal of Drug Issues, 49(4), 703–717. https://doi.org/10.1177/0022042619861273

Beckett

(2014). Seattle’s Law Enforcement Assisted Diversion program: Lessons learned from the first two years. University of Washington. https://www.fordfound.org/media/2543/2014-lead-process-evaluation.pdf

Beckett

(2016). The uses and abuses of police discretion: Toward harm reduction policing. Harvard Law & Policy Review, 10(1), 77–100.

Bluthenthal

R. N.

Lorvick

Kral

A. H.

Erringer

E. A.

Kahn

J. G.

(1999). Collateral damage in the war on drugs: HIV risk behaviors among injection drug users. International Journal of Drug Policy, 10(1), 25–38. https://doi.org/10.1016/S0955-3959(98)00076-0

Bratina

M. P.

Carrero

K. M.

Kim

Merlo

A. V.

(2020). Crisis intervention team training: When police encounter persons with mental illness. Police Practice and Research, 21(3), 279–296. https://doi.org10.1080/15614263.2018.1484290

10.

Braun

Clarke

(2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101. https://doi.org/10.1191/1478088706qp063oa

11.

City and County of San Francisco (2017). Law Enforcement Assisted Diversion San Francisco: Grant proposal. https://www.sfdph.org/dph/files/leadSF/SFDPH-LEAD-Proposal-REVISED.pdf

12.

Clifasefi

S. L.

Lonczak

H. S.

Collins

S. E.

(2017). Seattle's Law Enforcement Assisted Diversion (LEAD) program: Within-subjects changes on housing, employment, and income/benefits outcomes and associations with recidivism. Crime & Delinquency, 63(4), 429–445. https://doi.org/10.1177/0011128716687550

13.

Csete

Kamarulzaman

Kazatchkine

Altice

Balicki

Buxton

Cepeda

Comfort

Goosby

Goulão

Hart

Kerr

Lajous

A. M.

Lewis

Martin

Mejía

Camacho

Mathieson

Obot

, . . . Beyrer

(2016). Public health and international drug policy. The Lancet, 387(10026), 1427–1480.

14.

Collins

S. E.

Lonczak

H. S.

Clifasefi

S. L.

(2017). Seattle's Law Enforcement Assisted Diversion (LEAD): Program effects on recidivism outcomes. Evaluation and Program Planning, 64, 49–56. https://doi.org/10.1016/j.evalprogplan.2017.05.008

15.

Collins

S. E.

Lonczak

H. S.

Clifasefi

S. L.

(2019). Seattle’s Law Enforcement Assisted Diversion (LEAD): Program effects on criminal justice and legal utilization and costs. Journal of Experimental Criminology, 15(2), 201–211. https://doi.org/10.1007/s11292-019-09352-7

16.

Compton

M. T.

Broussard

Reed

T. A.

Crisafio

Watson

A. C.

(2015). Surveys of police chiefs and sheriffs and of police officers about CIT programs. Psychiatric Services (Washington, D.C.), 66(7), 760–763. https://doi.org/10.1176/appi.ps.201300451

17.

Flath

Tobin

King

Lee

Latkin

(2019). Maximizing order or harm? Arrests among a social network of people who inject drugs in a large urban city. Journal of Ethnicity in Criminal Justice, 17(2), 186–202. https://doi.org/10.1080/15377938.2019.1593909

18.

Fedders

(2019). Opioid policing. Indiana Law Journal, 94(2), 389–450.

19.

Friedman

S. R.

Cooper

H. L.

Tempalski

Keem

Friedman

Flom

P. L.

Des Jarlais

D. C.

(2006). Relationships of deterrence and law enforcement to drug-related harms among drug injectors in US metropolitan areas. AIDS (London, England), 20(1), 93–99. https://doi.org/10.1097/01.aids.0000196176.65551.a3

20.

Groff

E. R.

Haberman

Wood

J. D.

(2019). The effects of body-worn cameras on police-citizen encounters and police activity: Evaluation of a pilot implementation in Philadelphia, PA. Journal Experimental Criminology, 16, 1–18. https://doi.org/10.1007/s11292-019-09383-0

21.

Kammersgaard

(2019). Harm reduction policing: From drug law enforcement to protection. Contemporary Drug Problems, 46(4), 345–362. https://doi.org/10.1177/0091450919871313

22.

Krupanski

(2018). Police and harm reduction: How law enforcement can advance public safety, public health, and public confidence. https://www.opensocietyfoundations.org/publications/police-harm-reduction

23.

LEAD National Support Bureau. (n.d.a). About LEAD. https://www.leadbureau.org/about-lead.

24.

LEAD National Support Bureau. (n.d.b). LEAD: Advancing criminal justice reform in 2020. https://www.leadbureau.org/

25.

LEAD National Support Bureau. (n.d.c). LEAD National Support Bureau [Homepage]. https://www.leadbureau.org/

26.

Long

J. S.

Freese

(2014). Regression models for categorical dependent variables using Stata (3rd ed.). Stata Press.

27.

Magaña

E. J.

Perrone

Malm

(2021 ). A process evaluation of San Francisco’s Law Enforcement Assisted Diversion (LEAD) program. Criminal Justice Policy Review. https://doi.org/10.1177/08874034211033328

28.

Malm

Perrone

Magaña

J. (2020). Law Enforcement Assisted Diversion (LEAD) external evaluation report to the California State Legislature. Board of State and Community Corrections.

29.

Morrissey

Nyrop

Lee

(2019). Landscapes of loss and recovery: The anthropology of police-community relations and harm reduction. Human Organization, 78(1), 28–42.

30.

National Institute of Justice. (2016, July 11). Program profile: Law Enforcement Assisted Diversion (LEAD) program (Seattle, Washington). CrimeSolutions.gov. https://www.crimesolutions.gov/ProgramDetails.aspx?ID=477

31.

New Mexico Sentencing Commission. (2018). Santa Fe Law Enforcement Assisted Diversion (LEAD): An analysis of pilot phase outcomes. http://nmsc.unm.edu/reports/index.html

32.

President’s Task Force on 21st Century Policing. (2015). Final report of the President’s Task Force on 21st Century Policing. Office of Community Oriented Policing Services. https://cops.usdoj.gov/pdf/taskforce/taskforce_finalreport.pdf

33.

Public Defender Association. (2020, August 14). LEAD program transformation and website changes. http://www.defender.org/news/lead-program-transformation-and-website-changes

34.

Reuter

(2009). Ten years after the United Nations general assembly special session (UNGASS): Assessing drug problems, policies and reform proposals. Addiction (Abingdon, England), 104(4), 510–517. https://doi.org/10.1111/j.1360-0443.2009.02536.x

35.

Rhodes

(2009). Risk environments and drug harms: A social science for harm reduction approach. The International Journal on Drug Policy, 20(3), 193–201. https://doi.org/10.1016/j.drugpo.2008.10.003

36.

Roberts

(2021). LEAD us not into temptation: A response to Barbara Fedders’s ‘opioid policing. The British Journal of General Practice: The Journal of the Royal College of General Practitioners, 71(706), 222–103. https://ssrn.com/abstract=3399975

37.

Roe

(2005). Harm reduction as paradigm: Is better than bad good enough? The origins of harm reduction. Critical Public Health, 15(3), 243–250. https://doi.org/10.1080/09581590500372188

38.

Rouhani

Gudlavalleti

Atzmon

Park

J. N.

Olson

S. P.

Sherman

S. G.

(2019). Police attitudes towards pre-booking diversion in Baltimore, Maryland. The International Journal on Drug Policy, 65, 78–85. https://doi.org/10.1016/j.drugpo.2018.11.012

39.

Satterberg

Daugaard

(2019). Connections, not convictions: Prosecution of people with substance use disorder in the age of America's behavioral health crisis. UCLA Criminal Justice Law Review, 3(1), 137–152. https://escholarship.org/uc/item/36c7c07m

40.

Shadish

W. R.

Cook

T. D.

Campbell

D. T.

(2002). Experimental and quasi-experimental designs for generalized causal inference. Houghton Mifflin Company.

41.

Small

Kerr

Charette

Schechter

Spittal

P. M.

(2006). Impacts of intensified police activity on injection drug users: Evidence from an ethnographic investigation. International Journal of Drug Policy, 17(2), 85–95. https://doi.org/10.1016/j.drugpo.2005.12.005

42.

Spohn

Holleran

(2002). Recidivism rates of felony offenders: A focus on drug offenders. Criminology, 40(2), 329–358. https://doi.org/10.1111/j.1745-9125.2002.tb00959.x

43.

Terrill

Paoline

E. A., I. I. I.

(2007). Non-arrest decision making in police-citizen encounters. Police Quarterly, 10, 308–331. https://doi.org/10.1177/1098611107299998

44.

Wiley

S. A.

Esbensen

F. A.

(2016). The effect of police contact: Does official intervention result in deviance amplification? Crime & Delinquency, 62(3), 283–307. https://doi.org/10.1177/0011128713492496

45.

Wood

J. D.

Watson

A. C.

Barber

(2021). What can we expect of police in the face of deficient mental health systems? Qualitative insights from Chicago police officers. Journal of Psychiatric and Mental Health Nursing, 28(1), 28–42. https://doi.org/10.1111/jpm.12691.

46.

Worden

R. E.

McLean

S. J.

(2018). Discretion and diversion in Albany’s LEAD program. Criminal Justice Policy Review, 29(6–7), 584–610. https://doi.org/10.1177/0887403417723960

47.

U.S. Census Bureau. (2019). American community survey 5-year estimates. http://censusreporter.org/profiles/14000US06075012202-census-tract-12202-san-francisco-ca/>