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

• Author: Dina Perrone,Erica Jovanna Magaña,Aili Malm
• Date: 01 March 2022
• DOI: 10.1177/10986111211037585
• Published date: 01 March 2022
• Subject Matter: Articles

Article

Harm Reduction

Policing: An Evaluation

of Law Enforcement

Assisted Diversion

(LEAD) in San Francisco

Dina Perrone

1

, Aili Malm

1

, and

Erica Jovanna Maga~

na

2

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

1

School of Criminology, Criminal Justice, & Emergency Management, California State University, Long

Beach, United States

2

Department of Criminal Justice & Criminology, Washington State University, Pullman, United States

Corresponding Author:

Dina Perrone, California State University, Long Beach, CA, United States.

Email: Dina.Perrone@csulb.edu

Police Quarterly

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DOI: 10.1177/10986111211037585

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2022, Vol. 25(1) 7 –32

8 Police Quarterly 25(1)

The murder of George Floyd in May 2020 sparked waves of public protest for

police reform. And while the event triggering this outcry was tragically reminis-

cent of past incidents of police brutality, the focus of recent reform efforts is

different. The current call for reform centers on the ever-expanding police man-

date. As social services and social policies to address poverty, homelessness,

mental health, and substance use have been cut or terminated, the police

have been called upon to respond. They outreach to those who are houseless.

They triage those who have mental health episodes. They respond to overdoses.

They link individuals to services. They engage with those who solicit and are

involved in sex work. And yet, an officer’s primary tool is the power to arrest; a

power that does not effectively address these conditions. Police officers, though,

have always had discretion to not use this power, and often do so for non-

violent offenses (e.g., Terrill & Paoline, 2007). However, not arresting is often

perceived as doing nothing and neglecting the primary mandate of police – to

protect and serve.

To address the ever-expanding mandate, some police departments have created

officer units (e.g., Crisis Intervention and Quality of Life Teams) specifically

designed to refer individuals living on the streets, engaging in erratic and risky

substance use, experiencing mental health episodes, and participating in sex work

to social services – sobering centers, homeless shelters, and mental health facilities.

But, too often, these services have limited availability or are not capable of meeting

diverse needs, leaving the individuals and the officers seeking to help them hanging

out to dry (see Compton et al., 2015; Wood et al., 2021). Officers have expressed

frustration about the inability to take a person to a treatment facility, particularly

after business hours (e.g., Barberi & Taxman, 2019). Yet, officers are seeking

alternatives to respond to the suffering they witness in their communities. They

have recognized, as much research has shown (e.g., Aitken et al., 2002; Bluthenthal

et al., 1999; Flath et al., 2019; Friedman et al., 2006; Reuter, 2009; Small et al.,

2006), that arresting, convicting, and incarcerating those who use drugs, do not

have housing, have poor mental health, or engage in sex work does not change

behavior, reduce crime, or increase safety over the long-term (i.e., it is not

evidence-based). Rather, those they arrest eventually return to the streets and

are more likely to recidivate (e.g., Spohn & Holleran, 2002; Wiley & Esbensen,

2016). The health and safety of the individual and their community does not

improve (e.g., Csete et al., 2016). Relying on arrest often increases harm. Seattle,

Washington identified these issues and developed a novel alternative – Law

Enforcement Assisted Diversion (LEAD).

In 2011, Seattle implemented the flagship LEAD program, a multiagency

collaboration among law enforcement departments, prosecutors, public defend-

ers, case management agencies, and state and local service providers (LEAD

National Support Bureau, n.d.a). The key goal of LEAD was to provide those

who violate low-level drug laws and/or engage in sex work with social, health,

and behavioral health services in lieu of arrest and possible incarceration.

2Police Quarterly 0(0)