Evaluation of the Development of a Multijurisdictional Police-Based Deflection Program in Southern Illinois

Introduction

In 2019, an estimated 22 million Americans had substance use disorders and nearly 1 million persons died of a drug overdose since 1999.^[1] Police often encounter community members who misuse substances and may be in need of treatment or other services. A growing number of police departments are employing deflection, a public health-public safety model that allows police to deflect individuals from criminal justice system involvement, including potential arrest, and emergency or crisis services by referring them to treatment and other service providers.^[2] Deflection can help eliminate barriers to service seeking, which include social stigmas, waiting lists, and limited funding.^[3]

This evaluation examines the development of a deflection program in southern Illinois. During program development, local stakeholders participated in a guided action planning process for the program. The stakeholders met for three days to develop an action plan. Action planning can increase community engagement, supports development of clear and concise program goals, and leads to strategies that effectively achieve those goals.^[4] The program’s action plan features objectives, strategies, and steps to aid in program implementation.

The action planning ultimately formed the Southern Illinois Community Engagement Response Team (SI-CERT), a deflection program serving seven southern Illinois counties: Alexander, Franklin, Hardin, Jefferson, Massac, Pulaski, and Randolph. The program relies on officers on the Southern Illinois Drug Task Force to identify and refer potential clients. The multijurisdictional law enforcement task force is comprised of officers from different police departments in a geographic area.

Background on the Illinois Deflection Project

SI-CERT is part of a larger project lead and funded by the Illinois Department of Human Services (IDHS), in collaboration with the Illinois State Police (ISP). In addition to SI-CERT, additional Illinois sites have created, or are creating, programs in which multijurisdictional task forces deflect community members to needed services including sites in East St. Louis, Illinois and Central Illinois (multiple southern and central Illinois counties).

Project Funding

Beginning in 2022, the IDHS Cannabis Regulation Fund through the Cannabis Regulation and Tax Act (410 ILCS 705) has supported the action planning. IDHS receives 20% of the remaining Cannabis Regulation Fund allocations after costs associated with the implementation, administration, and enforcement of the Cannabis Regulation and Tax Act are paid.^[5] These funds may be used for treatment, education, and prevention of substance use disorder and mental health prevention (Illinois Department of Human Services, 2021). IDHS used these funds to contract with TASC Center for Health and Justice (CHJ) to conduct action planning, guide program implementation, and employ program staff. The Illinois Criminal Justice Information Authority (ICJIA) initially provided research support through U.S. Bureau of Justice Assistance grant funds and then in 2022 was funded through an IDHS contract.

Methodology

In evaluating the action planning process, the ICJIA research team examined a number of data sources, including field observations, supportive documents, and participant surveys. The secretary of the ICJIA Institutional Review Board approved the proposed research as a program evaluation. Researchers completed field observation of the action planning process on August 18, 19, and 20, 2021, for 19 hours. Organizers conducted and audio recorded the action planning sessions in person in Du Quoin, Illinois. One researcher attended the sessions in person, while another attended virtually. Four local social service providers participated in at least one day of planning.

After each session, we administered a paper survey to participants (Table 1). We asked about the action planning process, about collaboration with other participants, and their intentions post-action planning with responses on a 4-point Likert scale.

Table 1

Paper Survey Respondents

Data Analysis

We collected and analyzed field notes and supportive documents. We summarized what transpired sequentially for each of the three days of action planning as each session built on the previous day’s work. We entered the paper survey responses to Excel for data analysis. We exported the online survey data from Qualtrics to Excel and analyzed survey data using descriptive statistics.

Study Limitations

We experienced some limitations in evaluating this effort. First, we drew mostly on discussions during the sessions without knowing participants’ internal thoughts and feelings, except through brief, close-ended survey questions. Second, only two local social service providers participated, representation of the local community in this evaluation was limited. Finally, as Chicago-based researchers, we were “outsiders,” not living or working in the community being served, unable to ascertain group dynamics or potential interpersonal issues, and without much historical and community context.

Key Findings

We noted a number of key findings describing action planning participant engagement and discussions, as well as participant feedback on the action planning process. The action planning process spanned three days and engaged few representatives of local social service providers and community groups. Over 40 people participated in the initial kick-off meeting. Six people representing four organizations participated at least one day of the process. An additional six outsiders [representatives of Illinois Department of Human Services (IDHS), Treatment Alternatives for Safe Communities (TASC), ICJIA, Police, Treatment, and Community Collaborative (PTACC), and subject matter experts] attended at least one session. ICJIA researchers provided a local drug crime data presentation on Day 1.

During observation of the action planning process, some participants appeared unaware of the initiative or why they had been asked to participate. Despite initial confusion, the group was engaged in the process. Group members engaged in discussions to create action steps to developing the program. The participants discussed community issues, needs, collaboration, resources, and program design. They struggled to develop a measurable objective for the program.

Based on the surveys, participants agreed the group succeeded in defining the problem(s) and that the program would help their community. They also believed collaboration among the members was strong. Nearly all participants noted too few local social service providers participated.

The discussions resulted in the Solutions Action Plan (SAP) document which included objectives and action steps for the next phase of the program: implementation. The final SAP contained three outcomes, nine strategies, and 15 action steps. Figure 1 provides an overview of the deflection program in practice based on the plan developed by the participants.

Figure 1

Southern Illinois Deflection Program Flow Chart

Recommendations

Based on the evaluation findings, we offer observations on the process and suggestions for enhancing future action planning and program development. Some recommendations may require resources that may not be available.

Consider Action Planning Attendees

Engage a Larger Number of Local Participants

As noted, four local social service providers participated in the action planning sessions. Only two of the providers were present all three days. TASC CHJ conducted extensive pre-action planning outreach to all who attended the kick-off session and identified new providers and potential partner organizations prior to action planning. Further, organizers sent reminder emails on Day 1 and Day 2 to all organizations inviting them to attend even if they had missed part of the process.

Lack of access to treatment facing rural residents is likely to hinder the continued involvement of those entering treatment.^[6] A large number of community organizations and local social service providers representing multiple service areas should be present at the planning meetings.

The best way to address complexities of substance use disorder is through a multidisciplinary model of care.^[7] Medical, psychiatric and psychosocial needs must be addressed to successfully treat substance use disorder.^[8] Community/local social service partners were identified and invited during the kick-off meeting and participants were unaware of reasons for the lack of participation. While survey responses noted that the right community/local social service partners were at the table, more needed to be present. According to the World Health Organization, “Whenever possible, different services need to be engaged in treatment delivery with appropriate coordination, including psychiatric, psychological and mental health care; social care and other services, including for housing and job skills/ employment and, if necessary, legal assistance.”

One possible reason for the lack of community/local social service provider involvement was that many were already engaged in a project to create a mobile crisis team in the area. Coordinating project timelines with preferred stakeholders would help to avoid scheduling overlaps. Being overcommitted and not having time or ability to fully commit to the issue is often an obstacle to participation.^[9]

Consider Role of Subject Matter Experts and Outsiders

The organizers should consider reducing the number of outsiders who do not live or work in the southern Illinois area attending the action planning sessions.^[10] Five outsiders were present in person and two attended virtually throughout the process, including TASC CHJ, IDHS, TASC operations, and ICJIA representatives and subject matter experts. If possible, organizers should recruit local experts and decrease the number of non-participating personnel present during the process.

Increase Participant Understanding During Action Planning

Participants were lacking details on the deflection program and action planning process. Facilitators presented background information and an explanation of the action planning process at the kick-off meeting, which was well attended. However, only four of the kick-off participants attended the action planning meetings. Two participants attending on Day 2 stated they were told to attend by their supervisor and were unclear on the premise of the program.

The organizers should establish, and make clear, the purpose of the sessions early in the process. Sharing a purpose statement in advance can “ensure everyone who attends the meeting comes with shared goals and expectations.”^[11] To help establish the purpose of the planning sessions, organizers should “begin with the end in mind,” which will help them provide details with clarity and mutual understanding.^[12] These details include group goals and roles of the participants, facilitator, organizers, researchers, and any others attending the action planning session.^[13]

Create Goals and Measurable Objectives

The group easily developed and agreed on objectives. Yet the majority of them were not measurable. When action planning, groups should start with broader goals and distill them into objectives.^[14] According to the Centers for Disease Control and Prevention:

• Goals are statements explaining what the program seeks to accomplish. Goals are broad general statements with long-range direction. Objectives break the goal down into smaller parts that provide specific, measurable
• Objectives are the results expected to achieve by the program.
  • Process objectives are activities completed in a specific time period.
  • Outcome objectives are intended results or effects of a program, often changes in policy, knowledge, attitudes, or behavior.^[15]

TASC CHJ acknowledged the importance of developing detailed goals and objectives, but due to the limited number of action planning participants, they intentionally did not work to develop detailed goals and objectives (J. Charlier, personal communication, March 3, 2022).

Develop Logic Models

In order to “get off to a good start”, logic models can help new programs during the planning phase. Logic models visually depict the relationship between inputs (e.g., resources, stakeholders), outputs (e.g., program activities), ways to measure outputs, and short- and long-term goals.^[16] They also help organize and conceptualize how the program’s inputs and outputs will help achieve its intended goals.^[17]

Action planning participants can collectively develop a logic model during planning and use it to:

• Clarify program strategy.
• Identify appropriate outcome targets (and avoid over-promising).
• Align efforts with those of other organizations.
• Assess the potential effectiveness of an approach.
• Set priorities for allocating resources.
• Estimate timelines.
• Identify necessary partnerships.
• Focus discussions and make planning time more efficient.^[18]

TASC CHJ decided that due to the small size of the group, a logic model would be taxing for the participants to develop (J. Charlier, personal communication, March 5, 2022). Therefore, the action planning group did not work on developing a logic model. However, organizers should consider using logic models to further help participants conceptualize their program.

Conclusion

We conducted an evaluation of the action planning process of a program to assist individuals in seven counties in southern Illinois with behavioral health needs. The program will use a deflection model, in which multijurisdictional drug task force police refer individuals to services. Action planning increases community engagement, results in clear and concise goals, and helps to identify steps toward achieve goals and objectives.^[19] Action planning process participants discussed community issues, needs, collaboration, and resources, as well as program structure, design, and implementation. The discussions culminated in an action plan document with objectives and action steps for the next phase of the program: implementation.

Recommendations for future action planning included ensuring attendance and participation of a well-rounded group of local service providers. This helps assure all stakeholders have a voice in the project and all service areas are detailed and covered. Next, we suggested less involvement/discussion from subject matter experts, especially when local team participants are fully engaged. Finally, defining measurable goals and objectives and creating a logic model can help the local deflection team develop a viable program.