Introduction

A disproportionate number of police contacts involve people with behavioral health needs, such as those experiencing a mental health crisis or struggling with a substance use disorder.[1] Deflection is one type of program in which police officers are able to refer persons they encounter to behavioral health services as needed.[2] Participation is voluntary and the referral service is free. Deflection aims to reduce criminal justice system involvement and connect people with treatment and other services to improve individual and community health.[3]

We evaluated the development of a new deflection program in Illinois, Little Egypt Alternative Pathways (LEAP), serving Jackson, Johnson, and Williamson counties (southern Illinois is known as Little Egypt due to perceived geographic similarities).[4] The goal is for members of the Illinois State Police (ISP)-led Southern Illinois Enforcement Group (SIEG), a multijurisdictional police task force, to refer people to services in those counties. Figure 1 gives an overview of how participants interact with the program.

Figure 1

Little Egypt Alternative Pathways Deflection Program Flow Chart

Fig1

Treatment Alternatives for Safe Communities’ Center for Health and Justice (TASC CHJ) led program development with multi-day, guided action planning sessions with community stakeholders. Stakeholders learned about deflection programs, formed objectives, and discussed implementation strategies. After six days of action planning, TASC CHJ presented the group’s solutions action plan to develop their deflection program. To evaluate and offer insights into the planning process, we collected data through field observations and surveys and developed recommendations to guide future action planning sessions and promote the success of LEAP’s program.

Methodology

A researcher from the Illinois Criminal Justice Information Authority (ICJIA) attended the six action planning sessions in February and March 2023 for 29 hours of field observation. All action planning sessions were conducted in person and included 6 to 13 local service providers each day (Figure 2). We administered a paper survey to participants at the end of each action planning day to gather information on participants’ action planning process, levels of engagement, intentions for implementation, and perceived benefits of a deflection program. We gathered participant demographic information on day 1 of action planning and administered a collaboration survey on day 5. We analyzed the action planning sessions based on field notes and supportive documents and summarized what transpired each day. We also analyzed the survey data from people who attended each day and the data from the collaboration survey using descriptive statistics. Findings revealed participants’ views about what transpired during the action planning process, what feedback they had about the sessions, and how they perceived collaboration during the process.

Figure 2

Number of Local Participants Attending Action Planning by Day

Fig2

Note. Data source was attendance sheets.

Key Findings

Twenty representatives from 12 local organizations participated in at least one action planning session. One of the participating agencies was ISP, which will serve as the primary participant referral source to deflection specialists. The other action planning participants were service providers from community organizations that will receive referrals from deflection specialists. Most action planning attendees worked in the behavioral health field. Action planning sessions were additionally attended by TASC, Inc. staff (non-TASC CHJ staff), an ICJIA researcher, and a subject matter expert. After TASC CHJ facilitated action planning, TASC, Inc. was charged with employing the deflection specialists for case management and service referrals.

Early in the action planning process, participants identified substance use and mental health crises as the greatest areas of concern in their community. The group agreed interagency communication was important for program success. Participant engagement increased on days 2 and 3 of action planning as the group discussed the participant referral process and what the established outcomes for the program would be. On day 3, participants asked for clarity on TASC CHJ’s and TASC, Inc.’s distinct roles in program development, implementation, and operations. The confusion seemed to be somewhat resolved on day 4 of action planning, when the TASC, Inc. deflection specialists attended and gave more explanation. As the action planning sessions neared their end, the group finalized four program outcomes for the deflection program and, to achieve them, 19 strategies and 63 action steps. Action steps focused on partnerships, community outreach, marketing, and trainings.

Survey results indicated participants felt additional community partners were needed to promote program success. Attendees were satisfied with the action planning process overall, although their satisfaction declined in the second half of the process. Participants were confident that the program would benefit the community, but uncertain about its sustainability and the extent to which all involved organizations shared long-term goals. This perception was not surprising given participants had minimal discussion about short- or long-term program goals.

On the last day of action planning, participants stated they would likely take an active role in program implementation. Collaboration survey results identified insufficient resources and organization participation as the areas of greatest concern. Collaborative strengths included high levels of agreement among respondents about the program being beneficial and about its accomplishment depending on multi-organizational collaborations.

Recommendations

We identified several recommendations from the action planning sessions centering upon attendance and engagement, deflection program implementation, and participant collaboration.

Consider Action Planning Attendance

Enhance Attendance and Engagement

Thirteen local community members participated in the first two days of action planning. Attendance dropped by 54% (7 people) in the last two sessions. The number of participants was higher than that of the neighboring Southing Illinois Community Engagement Response Team’s deflection action planning sessions,[5] but lower than the number of participants at deflection sites in other parts of the state.[6] Participation during the sessions was subdued at times and daily survey responses indicated that some participants were uncomfortable sharing with the group. Therefore, action planning facilitators for future deflection sites should consider how to better engage and retain attendees throughout the sessions. Stakeholder engagement strategies may include identifying appropriate participatory techniques[7] and assessing and resolving conflicting interests.[8] Session duration may also be an issue. Interviews with participants in another site’s action planning process indicated the sessions were considered excessively long; some participants recommending shorter sessions to keep people engaged.[9]

Diversify Attendees

Action planning attendance was particularly strong among members representing behavioral health organizations, indicating a promising array of local organizations that can support deflection participants. Only one member of law enforcement was present, however, which may portend a limitation in engaging members of law enforcement in the LEAP deflection program. This engagement is crucial. A review of over 100 drug court programs across the nation identified law enforcement participation as one of the primary factors impacting program success.[10] Researchers found that programs that included a member of law enforcement on drug court teams saw an 88% greater reduction in recidivism among participants. The recent increase in police distrust has resulted in a reduction in the rates of civilian engagement.[11] Police engagement in community-based deflection programs may help to rebuild trust between community members and law enforcement.

While a subject matter expert was present during action planning sessions, he was from out of state and lacked local context. TASC CHJ may wish to seek local subject matter experts for future action planning sessions.[12] The presence of outsiders may limit the participation of local attendees and undermine the autonomy of a locally run program.[13] Also, if a program is built upon strong outsider leadership it may grow to rely upon such direction and, subsequently, reduce the local participants’ motivation to take leadership roles.[14] The presence of outsider perspectives may necessitate additional attention to resolving conflicted interests, especially if local participants have priorities that go unacknowledged.[15]

Finally, we recommend including persons with lived experience at all action planning sessions and ensuring their voices are heard and respected throughout the program’s development. Substantial research has shown that including people with lived experience in policy, research, and intervention efforts positively impacts their well-being.[16] Involving those with lived substance use experiences in program development and implementation has led to increases in the incorporation of harm reduction practices.[17] Including people with lived experience in program development can strengthen partnerships within the community, ensure program evaluation is congruent with the needs of the community, and enhance program sustainability.[18] We recommend that LEAP attempt to include people with lived experience during the program implementation process. We further recommend TASC CHJ works with local organizations to involve people with lived experience in all stages of program development.

Increase Participant Understanding During Action Planning

Throughout the action planning process, local participants indicated confusion about the role of deflection specialists, the processes for hiring and managing them, and the level of involvement by TASC CHJ. When questions about deflection specialists and TASC, Inc. were directed to TASC CHJ facilitators, they went unanswered. This indicates a potential area of growth for future action planning sessions, with additional information provided on deflection specialists and distinct agency roles. Since attendance fluctuates and each day of action planning may include new members, it may help to provide a brief overview of terms and roles at the beginning of each session.

Set Measurable Goals and Objectives

While the action planning group identified a significant number of action steps to facilitate LEAP deflection program implementation, they engaged in limited discussion of short- and long-term goals. Other deflection site action planning activities[19] have prioritized the following:

  • Short-term actions to be completed in 60 days.
  • Medium-term actions to be completed in 180 days.
  • Long-term actions to be completed in 365 days.

The LEAP action planning group did not identify timelines for their goals, which, along with a lack of measurable objectives, may inhibit successful program implementation. Implementation science reveals even evidence-based programs can fail to produce meaningful results without proper implementation.[20] Organizing goals and activities into short- and long-term categories can help determine whether the program has sufficient time and resources to dedicate to implementation. These two issues frequently necessitate program adaptations.[21]

Previous ICJIA deflection action planning evaluation reports unveiled the importance of measurable outcomes and identified several steps to improve implementation planning.[22] Logic models are commonly used for program development, providing a visual guide to inputs, outputs, and outcomes to promote proposed program feasibility and efficacy. Logic models serve as a reference point for program stakeholders during planning, implementation, and evaluation processes.[23] They help communicate the program’s purpose and expected results and can identify obstacles to program operation.[24] Logic models also can assist with prioritizing resource allocation, can enhance stakeholder accountability, and can prevent mismatches between activities and effects.[25] We present an example of a deflection program logic model to guide participants in developing their own logic models (Figure 3).

Figure 3

Example of Logic Model for the Deflection Program

Fig3

Note. ICJIA researchers created a draft example of a logic model with LEAP in mind; it was not developed by or with the LEAP action planning group.

Enhance Collaboration

Collaboration survey results showed participants strongly agreed that collaboration among partner organizations was essential to achieve deflection program objectives. Further, they indicated that their organizations would benefit from the collaboration, that everyone present was committed to the success of the program, and that participants held each other in high regard. These results show a promising foundation upon which to build a strong multidisciplinary program. As a foundation, collaboration benefits multidisciplinary programs by constructing collective actions to address the complexity of client needs and by creating team dynamics that enhance respect and trust between collaborative members.[26] This foundation can be improved by addressing sufficient resource needs, engaging an appropriate cross-section of members, and identifying and inviting additional organizations to the deflection collaborative to ensure proper representation and increase the people power of the program.[27] In addition, to promote the lasting success of the program, LEAP will need sufficient support from state and local government leaders to ensure all appropriate individuals and organizations are able to participate in the deflection project.[28]

Conclusion

The action planning process brought together local service providers and law enforcement to develop a solutions action plan for the LEAP deflection program in southern Illinois. The program will connect individuals experiencing a substance use disorder or mental health crisis with behavioral health and other services in their community. The final action plan formulated objectives, strategies, and action steps toward implementing the deflection program. Further clarification of the program process and roles, as well as increased local community engagement, can improve program development to promote success.

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  9. Menninger, A., Reichert, J., Kirven, J., Sullivan, N., Roberson, R., & Ott Hill, E. (2023). Implementation evaluation of a deflection program to assist victims of violent crime: Staff and stakeholder feedback. Illinois Criminal Justice Information Authority. [Manuscript in preparation] ↩︎

  10. Carey, S. & Finigan, M. (2013). Top 10 drug court best practices and more: What does the research tell us and how does it relate to the new national drug court standards? [Presentation]. National Association of Drug court Professionals. https://npcresearch.com/wp-content/uploads/Top_10_DC_Best_Practices_and_More.pdf ↩︎

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  17. Cheng, R., & Smith, C. (2009). Engaging people with lived experience for better health outcomes: Collaboration with mental health and addiction service users in research, policy, and treatment. Ministry of Health and Long-Term Care. https://www.researchgate.net/profile/Christopher-Smith-131/publication/260589695_Engaging_People_with_Lived_Experience_for_Better_Health_Outcomes_Collaboration_with_Mental_Health_and_Addiction_Service_Users_in_Research_Policy_and_Treatment/links/0f317531a029393ce7000000/Engaging-People-with-Lived-Experience-for-Better-Health-Outcomes-Collaboration-with-Mental-Health-and-Addiction-Service-Users-in-Research-Policy-and-Treatment.pdf ↩︎

  18. Cioffi, C. C., Hibbard, P. F., Hagaman, A., Tillson, M., & Vest, N. (2023). Perspectives of researchers with lived experience in implementation science research: Opportunities to close the research-to-practice gap in substance use systems of care. Implementation Research and Practice, 4. https://doi.org/10.1177/26334895231180635 ↩︎

  19. Adams, S., Reichert, J., Otto, H. D., & Sanchez, J. (2023). Evaluation of the development of a multijurisdictional police-based deflection program in southern Illinois. Illinois Criminal Justice Information Authority. https://icjia.illinois.gov/researchhub/articles/evaluation-of-the-development-of-a-multijurisdictional-police-based-deflection-program-in-southern-illinois/; Reichert, J., Adams, S., Otto, H. D., & Sanchez, J. (2023). Evaluation of the development of a multijurisdictional police-led deflection program to assist victims of violent crime. Illinois Criminal Justice Information Authority. https://researchhub.icjia-api.cloud/uploads/PDF-230109T15513037.pdf ↩︎

  20. Gleicher, L. (2017). Implementation science in criminal justice: How implementation of evidence-based programs and practices affects outcomes. Illinois Criminal Justice Information Authority. https://icjia.illinois.gov/researchhub/articles/implementation-science-in-criminal-justice-how-implementation-of-evidence-based-programs-and-practices-affects-outcomes ↩︎

  21. Gleicher, L. (2017). Implementation science in criminal justice: How implementation of evidence-based programs and practices affects outcomes. Illinois Criminal Justice Information Authority. https://icjia.illinois.gov/researchhub/articles/implementation-science-in-criminal-justice-how-implementation-of-evidence-based-programs-and-practices-affects-outcomes ↩︎

  22. Adams, S., Reichert, J., Otto, H. D., & Sanchez, J. (2023). Evaluation of the development of a multijurisdictional police-based deflection program in southern Illinois. Illinois Criminal Justice Information Authority. https://icjia.illinois.gov/researchhub/articles/evaluation-of-the-development-of-a-multijurisdictional-police-based-deflection-program-in-southern-illinois/; Reichert, J., Adams, S., Otto, H. D., & Sanchez, J. (2023). Evaluation of the development of a multijurisdictional police-led deflection program to assist victims of violent crime. Illinois Criminal Justice Information Authority. https://researchhub.icjia-api.cloud/uploads/PDF-230109T15513037.pdf; Sullivan, N., Adams, S., Ott Hill, E., & Reichert, J. (2023). Evaluation of the development of a multijurisdictional police-led deflection program in southwestern Illinois. Illinois Criminal Justice Information Authority. [Manuscript submitted for publication]. ↩︎

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  28. Farhourdian, A., Razaghi, E., Hooshyari, Z., Noroozi, A., Pilevari, A., Mokri, A., Mohammadi, M. R., & Malekinejad, M. (2022). Barriers and facilitators to substance use disorder treatment: An overview of systematic reviews. Substance Abuse: Research and Treatment, 16. https://doi.org/10.1177/11782218221118462 ↩︎