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Frequently Asked Questions

What is LEAD?

LEAD enhances public safety and equity by diverting people with unmet behavioral health needs and income instability away from incarceration and prosecution, and into non-punitive, collaborative, community-based systems of response and care. The success of a LEAD initiative depends on the strength of diverse partnerships. Through a shared commitment to changing systems and changing lives, LEAD is forging a safer, healthier, and more equitable future for communities.

What problem is LEAD designed to address?

Two-thirds of all people booked into jail in the United States have a mental illness or problematic substance use. Over 60% of people in jail are held for low-level misdemeanors or infractions. Jail generally makes things worse — studies show that spending even brief periods in jail can make it more difficult for a person to keep or find a job or housing while also increasing the likelihood of future incarceration. 

It’s become widely accepted that we can’t arrest our way out of the problems stemming from unmanaged substance use or mental illness. But the crime and harms they can cause must not be ignored or minimized. The LEAD model offers communities a better approach to safety and equity.

What makes LEAD different?

LEAD is not a program – it’s a framework for changing outcomes for both systems and individuals.

LEAD differs from many forms of diversion or alternatives to police response. Unlike other diversion models, LEAD doesn’t impose sanctions, isn’t primarily court based, doesn’t require police contact, doesn’t require an immediate cessation of concerning behavior, and works with people as long as they want LEAD’s help.

Unlike crisis-response efforts, LEAD’s intensive case management isn’t limited to just a single encounter but continues as long as it’s useful. In contrast to specialty courts, LEAD doesn’t demand adherence to mandatory conditions. Consistent with harm reduction principles, LEAD doesn’t require abstinence, and unlike divert-to-treatment approaches, LEAD doesn’t establish treatment as a precondition to other forms of care.

LEAD provides an ongoing framework to coordinate with legal system partners who often have other (non-divertible) cases involving an individual LEAD participant, to reduce the chance that the left hand will undo the progress the right hand has labored to achieve.

And by continuously engaging stakeholders who may traditionally have felt at odds with one another, LEAD shifts systemic policies, practices, and resources to improve both individual and collective well-being.

Is anyone eligible for LEAD?

Many people who come into occasional contact with the criminal legal, social service, or behavioral health systems – via a single arrest, a temporary economic hurdle, or a difficult psychological period – can successfully find their way through these challenges without suffering severe and lasting consequences. For them, the established system of response and care may prove to be sufficiently accessible and manageable.

These are not the people LEAD is intended to serve.

Instead, LEAD is expressly designed to provide a new system of care for people whose complex, ongoing, unmet behavioral health needs result in disruptive or unlawful behavior. They may lack reliable shelter, income, food, health care, and positive social networks, and may find existing systems inaccessible, impossibly complicated, or insufficiently responsive.

What is success, in LEAD?

Overall, LEAD aims to enhance public health, safety, and equity by improving care for people who have been historically rejected by multiple systems, while reducing dependence on the criminal legal system in response to unmet behavioral health needs and poverty.

At base, success in LEAD means the incremental reduction in harm: of participants to themselves, of the harm they cause to others, and of the harm others cause to them – including systemic harm. But a person’s progress along the harm-reduction continuum may not be straight or linear. Thus, individual successes in LEAD must always be measured by incremental progress toward goals participants identify for themselves, in concert with their case manager.

And just as LEAD strives to help people improve their individual circumstances, it also strives to help communities improve their collective well-being as a whole, by reorienting the systems that shape health, safety, and equity. So it’s important for every LEAD site to measure not just individual progress but to assess systemic shifts as well.

Are LEAD operations 24/7?

This is a really important question, and the answer should be “yes.”

Law enforcement officers are typically acutely aware that they operate 24/7/365 but that most other agencies do not, which leaves officers as the only people available to respond to people in need.

It’s very difficult to build a system of response which has many carve-outs; projects that qualify their availability or that make officers’ jobs harder – “We don’t take referrals after midnight,” for example, “Officers have to use an additional form” – rapidly lose officer interest and faith.

Hence, case managers should be available in early morning hours and/or after regular business hours to match hours of greatest police enforcement activity; sites can check local arrest data to gather insight into the demand and needs.

With that said, we do not generally advise having case managers working shifts in late night hours. Maintaining full overnight capacity can waste valuable resources as case managers wait for the phone to ring at a time when, in practice, there are often few calls. Instead, 24/7 coverage can be provided by having an on-call supervisor or case manager carry a specific “off-hours referral phone” or by having an answering service route calls to a supervisor, making sure this system is connected to the same number that officers would call during regular, staffed, hours.

If a jurisdiction is wondering whether all-night case management is necessary to respond to high levels of late-night arrests for divertible offenses, it can be a good idea to check the local arrest data with this question in mind.

Sometimes, there may be a special operation in which law enforcement informs the case management team that they plan to send a large number of arrest diversions in off hours. In this case, a local LEAD site might coordinate with law enforcement to match capacity to this temporary increased need.

What does “divert” mean, in LEAD?

In LEAD, divert means, most simply: “Connecting people otherwise exposed to the criminal legal system to long-term, harm reduction, street-based case management.”

Once enrolled in LEAD and assigned a case manager, participants know that they have a consistent, patient, nonjudgmental person who will stand by them, help them understand their priorities, and make progress on those goals.

LEAD case management becomes the responsive, ready conduit to the system available resources. Case managers then can coordinate with prosecutors and police to resolve other cases and warrants in a way that is as consistent as possible with the individual intervention plan for that participant.

How long does it take before someone changes their behavior?

There is really a single answer for this question: Everyone’s path to changing their behaviors and improving their lives is unique.

It’s important to remember that most LEAD participants have been on one trajectory for decades; enrolling in LEAD is, itself, a change in their trajectory.

Even so, demonstrable behavior change won’t happen overnight. Recovery is not linear, often entails setbacks, and may include relationship testing through seemingly counter-productive choices or self-sabotage.

Over time, however, these dynamics often yield to motivational interviewing and the trauma informed recovery methods employed by LEAD case managers.

Does LEAD just enable people?

LEAD is committed to advancing SAMHSA’s definition of recovery, and LEAD methods closely match that working definition.

Broadly speaking, people enroll in LEAD when they are struggling to survive, their lives entail an unsustainable level of chaos, and all other systems have failed them. LEAD is committed to meeting people where they are (literally) – but not leaving them there.

LEAD doesn’t transform people’s lives overnight, but it pairs each participant with a trusted ally who makes an unconditional commitment to staying in relationship with them, supporting them to work toward their goals.

What happens when people get arrested again after diversion?

For the people LEAD is intended to serve, unlawful or problematic behavior may continue for a protracted period after enrolling in the program – behavior change doesn’t happen overnight, and most participants’ situations are complex and very challenging at the point that they enter the program. Case managers can offer some immediate crisis intervention support, but deeper shifts in the participant’s circumstances will take time.

If the new arrest is for LEAD-eligible conduct, the police officer again has the option to divert the person to LEAD on a new referral; in turn, the OWG will include this new information in their ongoing considerations of how best to support the participant’s gradual advancement.

If the new arrest is not for a diversion-eligible offense, or if the officer chooses not to divert it pre-booking, it can still be the focus of conferencing between case manager and LEAD Liaison Prosecutor, to ensure it doesn’t unnecessarily set back the individual’s situation or make recovery harder.

How can LEAD work alongside other initiatives?

As an alternative response that builds a long-term system of care, LEAD can beneficially coexist alongside many other interventions. 1) In communities that have crisis-response teams, for example, LEAD can enhance the long-term post-crisis system of care. 2) For communities with specialty courts, LEAD can serve as an adaptive resource for people who might otherwise struggle to comply with court dates or mandates. 3) For communities interested in developing non-police alternative responses to public disorder, LEAD can serve as both first responders and long-term care coordinators.

Do LEAD participants still need to go to court?

LEAD participants are not necessarily free of involvement in the courts: they may have prior, unresolved cases that were not diverted to LEAD, or they may be charged with new, non-divertible offenses while enrolled in LEAD, or they may be enrolled in a specialty court for a non-diverted case. In some jurisdictions, courts may initiate community referrals to LEAD services, with the clear understanding that LEAD is not a probation department, and will not report misconduct by participants or testify in revocation proceedings against participants.

But in every instance, LEAD staff can still provide useful support to participants who have pending court cases. By coordinating case management and court dates, LEAD can help participants navigate court processes; by helping participants engage with services, LEAD can help them fulfill conditions imposed by the court; by developing intensive support plans, LEAD can provide prosecutors and courts with community-based alternatives to incarceration, and with information needed to resolve cases in ways that don’t implode participants’ progress.

What about housing/treatment availability?

Even if your region doesn’t have enough supportive, affordable, or subsidized housing units or treatment beds – and we have yet to encounter one that does – LEAD is still an improvement on the “system as usual.”

Intensive case management and flex funds are additional resources being offered to people who struggle to access and/or make effective use of existing resources.

LEAD’s collaborative stewardship also creates the opportunity for people involved in local funding decisions to gain new insight about the gaps in the local behavioral health system and overall social safety net. With this deeper, fuller understanding, they are more likely to reevaluate existing fiscal priorities and adjust their decision-making accordingly.

What’s the appropriate role of peer staff?

In LEAD, peer staff should not be relegated to a support role, as often happens in more traditional social service agencies. In LEAD, peer staff bring valuable lived experience and perspectives to the table, much of which can’t be taught in a classroom or degree program.

In Seattle-King County LEAD, for example, peers comprise at least half the case manager positions and are not differentiated from other case managers; many have both lived experience and formal clinical training and credentials, and others earn credentials while on the job.

All LEAD case management teams should blend clinical skill, clinical supervision, and lived experience.

How many officers should we train?

The best answer is, “train all of them,” starting with officers assigned to the LEAD catchment area or pilot district, along with officers from other arresting authorities in the jurisdiction (e.g., state police, park police, etc.).

Because officers are transferred with some regularity, it’s best to foster basic working knowledge of LEAD with as many officers and command staff as possible.

It’s also important to build LEAD processes into the basic systems of the department, rather than it being a free-standing isolated project involving only a few chosen officers.

What does participant engagement mean?

Engagement looks different for every participant, depending on their needs and access to resources. The right engagement plan takes into account the specific barriers affecting a given individual, like lack of transportation, mental health crises, developmental differences, or general transience and instability.

A participant may be reluctant to open up to a case manager at first, so case managers are trained in how to make informal, non-intrusive contact that serves as the foundation for a more trusting relationship. Other participants may be eager to get into housing, checking in with their case managers every day to see how things are progressing. Still others may stabilize, live independently, and want to check in with their case manager every so often, or when a problem emerges.

All of these constitute meaningful engagement and should be valued; for many people, their case manager may be the first person in decades (or ever) who consistently shows up, doesn’t shame them, and listens. The engagement arc is also likely to shift over time, and steady, consistent outreach may be the only way engagement occurs during prolonged periods.

How do you get police officer buy-in?

Key strategies for building police officer buy-in include designing the program and developing policies and protocols with their input – ideally, input from the officers who will be tasked with carrying out diversions and their supervisors at the table from the beginning. Law enforcement-led training is invaluable, so that the approach is introduced by “one of our own” or a peer. Roll call check-ins on a regular basis can help identify issues that need attention or process problems. Soliciting officer input and thoughts, rather than calling sessions “trainings,” is easier to accept.

In ordinary policing models, officers are seldom kept informed of what happens after they’ve made an arrest; in contrast, LEAD’s multidisciplinary OWGs provide officers with consistent opportunities to participate in ongoing conversations about the people they’ve engaged with. It’s common for officers to express appreciation for this opportunity to engage in shared problem-solving with other agencies.

The most important way to build buy-in, however, is for case managers to meet officers out in the field in difficult conditions (in the rain, early morning, in an alley with a very challenging individual) and competently and rapidly make the situation better. No one can resist help with a hard problem, and sharing the work is a real barrier-breaker.

Is LEAD less expensive than arrest and detention?

It is difficult to definitively calculate whether LEAD – or any other intervention – is less expensive than prosecution and detention. That’s because it is difficult to achieve cost savings within systems until there’s a significant and sustained decrease in use, resulting in reductions in corresponding staffing and overhead costs.

A more fruitful question to ask may be, “Is LEAD a better value, dollar for dollar, than jail and prosecution for achieving the desired changes and outcomes?”

Proving that LEAD actually saves taxpayer dollars in the long run may make a compelling case for investing in this front-end strategy. Further, a strong case can be made that LEAD should cost more than it does, if communities are really to provide the resources required for participants to thrive.

That said, those added resources (especially housing and a lawful income source) could be obtained if those background systems are filled in, not just for LEAD participants but for a wider population. This means that such costs should not be attributed to the LEAD model itself, since LEAD really serves as a valve between the criminal legal system and the under-resourced realm of homeless housing, trauma informed care, low barrier services, and economic stabilization.

Last updated August 8, 2023
  • Arrest Diversion

    Arrest diversions give law enforcement officers the option of referring people to LEAD at the point of arrest (either pre- or post-arrest) for diversion-eligible offenses, instead of booking them into jail and referring them for prosecution.
  • Bureau of Justice Assistance

    The federal Bureau of Justice Assistance (BJA) is a component of the Office of Justice Programs within the United States Department of Justice. BJA provides leadership and assistance (through grants, research, and technical assistance) to local programs that improve and reinforce the administration of justice in our country.
  • CARA

    The Comprehensive Addiction and Recovery Act of 2016 (CARA) represents the nation’s most comprehensive effort to address the opioid epidemic, encompassing all six pillars necessary for a coordinated response – prevention, treatment, recovery, law enforcement, criminal legal reform, and overdose reversal.
  • Case Management

    LEAD-style case management is the heart and soul of LEAD’s effective, coordinated system of care, one that reorients existing resources to better meet the needs of people for whom standard models of care just aren’t effective. As a participant centered practice, LEAD-style case management operates in the streets, literally and figuratively meeting people where they…
  • CLT

    A Community Leadership Team (CLT) is part of the stewardship structure for LEAD. Composed of members who represent multiple community voices - faith community, advocacy coalitions, business organizations, and others – the CLT helps identify priorities, informs planning and development, and fosters transparency and accountability.
  • Code of Federal Regulations

    The Code of Federal Regulations (CFR) is a compilation of administrative laws governing federal regulatory agency practice and procedures. Revised annually, it contains the whole of the daily Federal Register, along with previously issued regulations that are still current. It is divided into 50 titles, each representing a general subject area (e.g., commerce, military) and…
  • Community Referral

    Community referrals provide community partners with the opportunity to refer people who are known to chronically engage in problematic, perhaps unlawful, behavior related to behavioral health issues or poverty without police involvement and without using the emergency response system (911 or equivalent).
  • GAINS Sequential Intercept Model (SIM)

    The Sequential Intercept Model was developed as a conceptual model to inform community-based responses to the involvement of people with mental and substance use disorders in the criminal justice system. It was developed over several years in the early 2000s by Mark Munetz, MD and Patricia A. Griffin, PhD, along with Henry J. Steadman, PhD, of Policy Research Associates,…
  • Golden Rule #1

    No one in LEAD can be worse off because of LEAD — for instance, in the case where they shared information with case managers that was, in turn, shared with other partners (especially police, prosecutors, or courts).
  • Golden Rule #2

    Within their zone of authority and while considering insights provided by other LEAD stakeholders, every LEAD partner should do what they believe is most likely to support positive behavior change in the specific circumstances. This is the second of LEAD’s two Golden Rules.
  • Harm Reduction

    Harm reduction is a theory and practice that aims to reduce the level of harm (for oneself and for a larger community) that can be associated with unmanaged behavioral illness, including drug use. Rather than demanding abstinence, harm reduction focuses on opportunities to incrementally change behaviors that cause harm to oneself or others. This principle…
  • Housing First

    Housing First is an evidence-based approach to fostering stabilization by connecting people to housing as quickly as possible. It recognizes that a safe and consistent place to live is an essential precondition for other kinds of positive behavior change. Consistent with harm reduction principles, Housing First emerged as an alternative to approaches that required people…
  • Law Enforcement

    The term "law enforcement" is used throughout this toolkit to describe police officers, sheriff’s deputies, and others endowed with arresting authority; these may include campus public safety officers, environmental enforcement officers, transit authority officers, and more.
  • Liaison Prosecutor

    LEAD Liaison Prosecutors serve on the OWG and coordinate LEAD participants’ pre-existing court cases, warrants, or case filings that arise after they enroll in LEAD. They gather information from case managers on the goals of individual defendants, their progress and challenges, and the effects that pending cases might have on that progress.
  • LSB

    The LEAD Support Bureau (LSB) was founded in 2016 to respond to growing interest in LEAD replication across the United States. A project of PDA, a nonprofit organization based in Seattle, the Bureau is the only authorized resource to provide training, technical assistance, and strategic guidance on the LEAD model.
  • Motivational Interviewing

    Motivational Interviewing (MI) is a foundational technique for LEAD. An evidence-based approach to supporting positive behavior change, MI is a client-centered, collaborative style of communication designed to help people identify and achieve their goals by eliciting and exploring their own reasons for change. Using a guiding (not directive) style of communication, MI meets people where…
  • MOU

    A Memorandum of Understanding (MOU), signed by the relevant decision-making authorities, documents the principal agreements being made by each of the participating entities. Typically, this is a high-level summary description of how each entity will participate in or contribute to LEAD, with an appendix addressing any specific agreements about logistics and operations of the PCG.…
  • Net-Widening

    Net-widening is the phenomenon in which a society or community increases the array of behaviors (and thus people) subject to control by the criminal legal system. Net-widening can occur when policies and practices explicitly intended to reduce criminal legal involvement paradoxically result in a larger number of people being caught in the criminal legal net.
  • Operational Protocol

    The operational protocol details eligibility criteria, divertible charges, a strategy for prioritization of referrals when volume exceeds capacity, referral policies and methods, agreements on documentation, and operating agreements that detail relevant duties and roles specific to each operational partner.
  • OWG

    The LEAD Operational Work Group (OWG) is composed of line staff, including mid-level supervisors, who carry out the day-to-day operations of LEAD. The members are appointed by the PCG and typically include police officers, assistant prosecutors, public defenders, case managers, other service providers, and community leadership representatives. The OWG provides a common table to collectively…
  • PCG

    The Policy Coordinating Group (PCG) is made up of decision-makers and community representatives who are collectively responsible for shepherding the overall initiative: setting goals and policies, defining diversion-eligible offenses, approving protocols, overseeing data and evaluation, selecting service providers, overseeing project management, identifying funding and resources, and managing strategic development. The PCG is made up of…
  • Post-Enrollment Cases

    Post-enrollment cases stem from new arrests or charges after a participant enrolls in LEAD. It should be noted that some post-enrollment cases could, confusingly, relate to incidents that took place before enrollment but that may have sat in a filing queue for weeks or months before filing. It is also common for people enrolled in…
  • Project Manager

    The Project Manager (PM) is responsible for coordinating all aspects of the LEAD initiative and managing its day-to-day activities. A trusted partner of all partners and key staff position, the Project Manager serves as resource and liaison to both the PCG and the OWG. LEAD is a consortium of politically independent actors; therefore it is…
  • Recovery

    Recovery as defined by SAMHSA is "a process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential."
  • ROI

    The multi-party release of information (ROI) is the essential precondition for ongoing care coordination among LEAD operational partners, allowing case managers to share information as needed and appropriate with police, prosecutors, judges, other care providers, and even neighborhood businesses and government officials, if to do so is in the participant’s interest.

    The Substance Abuse and Mental Health Services Administration (SAMHSA) is the agency within the U.S. Department of Health and Human Services (HHS) that leads public health efforts to advance the behavioral health of the nation and to improve the lives of individuals living with mental and substance use disorders, and their families. It represents an…
  • Social Contact Referral

    Social contact referrals give law enforcement officers the opportunity to refer people whose law violations may be related to behavioral health issues or poverty without waiting for a potential arrest.
  • Warm Handoff

    A LEAD warm handoff describes the process by which a LEAD participant is diverted out of the criminal legal system and into LEAD’s community-based case management. In a LEAD warm handoff, rather than making an arrest, a police officer calls the LEAD case management, who comes to the scene or the police station to meet…

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Founded in 2016 to respond to growing interest in LEAD replication across the United States, the LEAD Support Bureau is the only authorized resource to provide training, technical assistance, and strategic guidance on the LEAD model.
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Community toolkit

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Produced by the LEAD Support Bureau, this toolkit is designed to support communities that are exploring, developing, launching, or operating LEAD initiatives. It is intended to complement the customized technical assistance available through the LEAD Support Bureau.
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