New York, NY – The Vera Institute of Justice (Vera) today released a new report containing recommendations on how community health providers and police can work together to promote access to health services for marginalized populations often caught up in the criminal justice system—people who live in poverty, use drugs, or live with mental illness—while reducing needless and expensive cycles of arrest and incarceration. It provides practical strategies for incorporating principles of harm reduction—which aims to remedy the negative effects of drug use and other high-risk behaviors, even when people are not ready or willing to give up the behavior—and health promotion into policing practices.

The report, First Do No Harm: Advancing Public Health in Policing Practices, is the latest in a series from Vera’s Justice Reform for Healthy Communities Initiative, which aims to improve the health and well-being of the individuals and communities most affected by mass incarceration. At the center of these communities are the millions of medically vulnerable and socially marginalized people who cycle through the criminal justice system each year instead of receiving the care they need, often due to being arrested on minor offenses such as drug possession, loitering, or public intoxication.

The concurrent effects of the war on drugs and shortcomings of the movement to deinstitutionalize people with serious mental illness and intellectual disabilities—both of which happened during an unprecedented expansion of the U.S. criminal justice system—has created a system in which people lack access to housing, health, and social services they need, and police bear the burden of acting as social workers and treatment providers. In 2013, 83% of the more than 11.3 million arrests made by police nationwide were for possession of a controlled substance, and research estimates that seven to 10 percent of all police interactions involve a person with a mental illness. In too many jurisdictions, jails are the only place where uninsured and underserved people can access health and social services.

“Policing practices impact the health of communities in profound ways. By keeping people out of the justice system who are more in need of health and healing than punishment, we can begin to repair the harm done by the absence of social services and overreliance on arrest and incarceration that has affected the most vulnerable members of our society for generations,” said David Cloud, senior program associate at the Vera Institute of Justice and co-author of the report. “More and more people are acknowledging that the war on drugs has ended up as a huge driver of needless arrests, incarcerations, and criminal records. We can and must capitalize on this moment of unprecedented opportunity to change the way that police interact with drug users and other stigmatized groups. This unquestionably requires closer partnerships between police, public health leaders, and community advocates to find common ground and advance the shared goal of creating safe, healthy communities.”

A new coalition of more than 130 law enforcement officials calling to reduce incarceration in order to improve public safety, along with recent reforms to the national health care system, encourages new collaboration between community health providers and law enforcement agencies. The report outlines the following steps that law enforcement, public health agencies, and community service providers can take without legislative action to align their policies, cultures, and practices:

• Reach out to advocacy groups and their constituents. In one recent example, New York State’s partnership with the Harm Reduction Coalition resulted in New York City adopting their training manual on best practices for drug treatment and more than 5,000 officers outside of the city receiving training.
• Minimize arrests around harm reduction clinics. When syringe exchange programs are created (often through state-level legislation) to prevent the spread of infectious diseases such as HIV, police should develop collaborative policies with these programs in order to not target their participants—which can not only deter participants from the programs, but also increase the spread of diseases. 
• Create overdose prevention programs. The Obama administration’s recent announcement that it will seek to double the amount of providers that can prescribe life-saving antidotes for heroin overdoses creates new opportunities for police—who are often the first responders to 911 calls—to develop and implement their own overdose response strategies in partnership with local hospitals. 
• Develop collaborative diversion programs. In San Antonio, for example, police worked with the county’s jail, mental health department, criminal courts, hospitals, and homeless programs to develop a “Smart Justice” policing model that included training police on responding to emergency calls that might involve people with mental illness and establishing drop-off centers that provide a variety of medical and social services. In the past five years, it has saved the city an estimated $50 million dollars.

The full report, with further recommendations, can be accessed on Vera’s website at www.vera.org/public-health-and-policing. It will be featured at an upcoming panel discussion hosted by Vera and the Open Society Foundations,“Policing and Public Health: Advancing Harm Reduction Strategies in Law Enforcement Practice.”