Individuals – Perrone et al. (2022)

Study Reference:

Perrone, D., Malm, A., & Magaña, E. J. (2022). Harm reduction policing: An evaluation of law enforcement assisted diversion (LEAD) in San Francisco. Police Quarterly, 25(1), 7-32.


Location in the Matrix; Methodological Rigor; Outcome:

Individuals; Focused; Reactive; Rigorous; Effective


What police practice or strategy was examined?

This study evaluated the Law Enforcement Assisted Diversion (LEAD) program that was implemented in San Francisco in 2017. This program was administered in two districts that were experiencing high levels of mental health, housing, and substance abuse problems. This intervention was a multi-agency collaboration, granting officers discretion to offer individuals the LEAD diversion program as an alternative to arresting them. Involved agencies include the department of public health, county and city police departments, public defender’s office, district attorney’s office, adult probation department, Drug Policy alliance, mental health service providers, and internal evaluation teams.  Individuals qualified for these LEAD referrals if they engaged in an arrestable LEAD-eligible offense or if officers felt the individual might benefit from the LEAD program (but had not committed a criminal act). A few examples of LEAD-eligible offenses include charges for a controlled substance, sale or transportation of a controlled substance, and prostitution and solicitation. Individuals were excluded from the diversion program if they possessed controlled substance quantities over 5 grams, sold to minors or sold in a school zone, had an open case involving violence or weapons, had a prior strike conviction within the previous 8 years, or had a no contact order in place. Individuals on probation, parole, or under custodial supervision needed agency approval to participate in the diversion program. This program was intended for individuals engaging in sex work and/or those who use drugs. Individuals engaging in the LEAD program were connected to services, including mental health, housing, employment, and substance abuse treatment services.


How was the intervention evaluated?

A mixed methods approach was used to evaluate the intervention. A process evaluation was conducted using data from focus groups and interviews with program staff. An outcome evaluation was conducted using an equivalent-group longitudinal quasi-experimental design. Using propensity score matching, individuals enrolled in the LEAD program (i.e., treatment group; N = 98) were matched to individuals (i.e., comparison group; N = 98) that committed LEAD eligible offenses but were not referred to the diversion program. Matching was based on sex, race, age at referral/eligible offense, and pre-treatment criminal history. Citations, misdemeanor arrests, felony arrests, misdemeanor cases, and felony cases were used as outcomes, comparing treatment and control individuals for the 12-month period following the intervention.


What were the key findings?

Individuals that engaged in the LEAD program had significantly lower rates of misdemeanor arrests, felony arrests, and felony cases during the 12-month follow-up period. There were no significant differences for misdemeanor cases and citations. LEAD staff attributed the program’s success to the strong relationships developed between agencies, the seamless use of a case manager, and the overall harm reduction approach. However, the LEAD staff also noted obstacles relating to officer buy-in to the harm-reduction program.


What were the implications for law enforcement?

The authors concluded the LEAD program successfully reduced the likelihood of future arrests and prevented individuals from experiencing the harms of criminal justice involvement. Diversion programs, and harm reduction policing more generally, can serve as an effective alternative to traditional criminal justice sanctions for people who engage in sex work and use drugs, with the authors suggesting it can improve their overall wellbeing. However, the authors underscore the potential racial and gender biases of the program, with some LEAD staff expressing concerned that the program benefitted certain individuals more than others.


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