Individuals – Broner et al. (2004)

Study Reference:

Broner, N., Lattimore, P. K., Cowell, A. J., & Schlenger, W. E. (2004). Effects of diversion on adults with co-occurring mental illness and substance use: Outcomes from a national multi-site study. Behavioral Sciences and the Law, 22, 519-541.

Location in the Matrix; Methodological Rigor; Outcome:

Individuals; Focused; Reactive; Moderately Rigorous; No evidence of an effect

What police practice or strategy was examined?

The study investigated diversion programs designed for adults with co-occurring mental illness and substance use disorders. These programs aim to interrupt the traditional criminal justice process, enhancing access to community treatment, housing, and support services, thereby reducing criminal justice confinement. Diversion approaches were categorized into police-led pre-booking programs, occurring before arrest, and non-police-led post-booking programs, occurring after arrest. Pre-booking models involved police officers trained to recognize mental illness and manage encounters appropriately, potentially diverting individuals to treatment centers instead of arresting them. The trained police officers assessed the necessity of arrest and appropriateness of diversion, taking the individuals to a centralized location, such as an emergency room or treatment center.

How was the intervention evaluated?

The evaluation of the pre-booking programs identified subjects for diverted and non-diverted groups across three sites (i.e., Memphis, Portland, Pennsylvania) from October 1998 through May 2000. Baseline interviews were conducted within two weeks of either diversion acceptance or identification for non-diverted subjects. Follow-up interviews took place at 3 months and at 12 months, across the three sites, to assess outcomes of the diversion programs such as service utilization, mental health symptoms, substance use, criminal justice activity, and quality of life, all of which were from self-report surveys. The study employed a quasi-experimental design to compare diverted individuals with those who did not receive the pre-booking programs, adjusting for potential differences between them (i.e., demographics, criminal history, mental health, substance use, and days at risk). It is important to note that the mechanisms for diversion varied significantly across the sites.

What were the key findings?

The study found that individuals who received the pre-booking programs were somewhat more likely to receive psychiatric services, especially in the initial 3-month period following diversion. However, there was no evidence that the programs led to significant reductions in criminal recidivism, mental health symptoms, or substance use compared to non-diverted individuals​​. Rather, in Portland, there were some noteworthy backfire effects: drug use, victimization, and arrest increased among those who received the pre-booking program compared to those did not.

What were the implications for law enforcement?

The findings suggest that diversion programs for individuals with non-violent and low-level violent offenses do not pose a greater risk to public safety than standard criminal justice processing. Such programs can provide treatment and social services instead of incarceration without compromising public safety. The authors underscore the need for diversion programs to enhance linkages to and delivery of services, highlighting the potential for diversion to serve as a cost-effective alternative to incarceration, especially for individuals with co-occurring disorders. However, at the same time, this study calls into question the effectiveness of diversion programs in reducing criminal recidivism, mental health symptoms, and substance use.

Where can I find more information about this intervention, similar types of intervention, or related studies?