Paul J Joudrey1, Christina R Nelson2, Kelly Lawson3, Kenneth L Morford3, Dakibu Muley4, Cynthia Watson4, Martha Okafor5, Emily A Wang3, Cindy Crusto6. 1. Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA. Electronic address: paul.joudrey@yale.edu. 2. Quinnipiac Frank H. Netter School of Medicine, Hamden, CT, USA. 3. Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA. 4. Community Services Administration, City of New Haven, New Haven, CT, USA. 5. Administration for Children and Families, US Department of Health and Human Services, Washington, DC, USA. 6. Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; Department of Psychology, University of Pretoria, Pretoria, South Africa.
Abstract
BACKGROUND: Despite widespread interest in adoption, there has been limited systematic examination of Law Enforcement Assisted Diversion (LEAD) implementation, a model for police-led arrest diversion for those with substance use disorders (SUD). In the fall of 2017, the City of New Haven started a LEAD program. During the first 9 months of the pilot, only 2 clients were successfully diverted from arrest. Therefore, we examined the and barriers and facilitators of LEAD implementation. METHODS: We conducted semi-structured interviews and field observations of LEAD police officers and health care providers between August 2018 and June 2019. Interviews and field observations were analyzed using directed content analysis and guided by the Integrated Promoting Action on Research Implementation in Health Services framework. RESULTS: Lead professionals participated in 19 semi-structured interviews and three field observations. Barriers to arrest diversion implementation included procedural complexity of arrest diversion, concerns about reduced penalties for substance use among officers, stigma of SUDs, and a belief in a punitive role for policing. Facilitators included a positive longitudinal relationship with potential clients and an understanding of SUD as a chronic disease. CONCLUSION: We identified several barriers to LEAD implementation. Our results suggest promotion of SUD as a chronic disease, ongoing training of officers, and positive incentives for entering substance use treatment should be utilized to facilitate implementation.
BACKGROUND: Despite widespread interest in adoption, there has been limited systematic examination of Law Enforcement Assisted Diversion (LEAD) implementation, a model for police-led arrest diversion for those with substance use disorders (SUD). In the fall of 2017, the City of New Haven started a LEAD program. During the first 9 months of the pilot, only 2 clients were successfully diverted from arrest. Therefore, we examined the and barriers and facilitators of LEAD implementation. METHODS: We conducted semi-structured interviews and field observations of LEAD police officers and health care providers between August 2018 and June 2019. Interviews and field observations were analyzed using directed content analysis and guided by the Integrated Promoting Action on Research Implementation in Health Services framework. RESULTS: Lead professionals participated in 19 semi-structured interviews and three field observations. Barriers to arrest diversion implementation included procedural complexity of arrest diversion, concerns about reduced penalties for substance use among officers, stigma of SUDs, and a belief in a punitive role for policing. Facilitators included a positive longitudinal relationship with potential clients and an understanding of SUD as a chronic disease. CONCLUSION: We identified several barriers to LEAD implementation. Our results suggest promotion of SUD as a chronic disease, ongoing training of officers, and positive incentives for entering substance use treatment should be utilized to facilitate implementation.
Authors: Ingrid A Binswanger; Marc F Stern; Richard A Deyo; Patrick J Heagerty; Allen Cheadle; Joann G Elmore; Thomas D Koepsell Journal: N Engl J Med Date: 2007-01-11 Impact factor: 91.245
Authors: Paul J Joudrey; Maria R Khan; Emily A Wang; Joy D Scheidell; E Jennifer Edelman; D Keith McInnes; Aaron D Fox Journal: Addict Sci Clin Pract Date: 2019-04-15