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.

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.

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 managementLEAD-style case management is the heart and soul of LEAD’s effective, coordinated system of care, one that reorients e… More 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 reductionHarm reduction is a theory and practice that aims to reduce the level of harm (for oneself and for a larger community) t… More 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.

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.

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 managerLEAD-style case management is the heart and soul of LEAD’s effective, coordinated system of care, one that reorients e… More.

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.

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

Law enforcementThe term “law enforcement” is used throughout this toolkit to describe police officers, sheriff’s deputies, and others… More 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 managersLEAD-style case management is the heart and soul of LEAD’s effective, coordinated system of care, one that reorients e… More 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 managerLEAD-style case management is the heart and soul of LEAD’s effective, coordinated system of care, one that reorients e… More 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 managementLEAD-style case management is the heart and soul of LEAD’s effective, coordinated system of care, one that reorients e… More 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 diversionsArrest diversions give law enforcement officers the option of referring people to LEAD at the point of arrest (either pr… More in off hours. In this case, a local LEAD site might coordinate with law enforcement to match capacity to this temporary increased need.

In LEAD, divert means, most simply: “Connecting people otherwise exposed to the criminal legal system to long-term, harm reductionHarm reduction is a theory and practice that aims to reduce the level of harm (for oneself and for a larger community) t… More, street-based case managementLEAD-style case management is the heart and soul of LEAD’s effective, coordinated system of care, one that reorients e… More.”

Once enrolled in LEAD and assigned a case managerLEAD-style case management is the heart and soul of LEAD’s effective, coordinated system of care, one that reorients e… More, 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 managersLEAD-style case management is the heart and soul of LEAD’s effective, coordinated system of care, one that reorients e… More 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.

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. RecoveryRecovery as defined by SAMHSA is “a process of change through which individuals improve their health and wellness, live … 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 interviewingMotivational Interviewing (MI) is a foundational technique for LEAD. An evidence-based approach to supporting positive b… More and the trauma informed recovery methods employed by LEAD case managersLEAD-style case management is the heart and soul of LEAD’s effective, coordinated system of care, one that reorients e… More.

LEAD is committed to advancing SAMHSA’s definition of recoveryRecovery as defined by SAMHSA is “a process of change through which individuals improve their health and wellness, live …, 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.

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 managersLEAD-style case management is the heart and soul of LEAD’s effective, coordinated system of care, one that reorients e… More 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 managerLEAD-style case management is the heart and soul of LEAD’s effective, coordinated system of care, one that reorients e… More and LEAD Liaison ProsecutorLEAD Liaison Prosecutors serve on the OWG and coordinate LEAD participants’ pre-existing court cases, warrants, or cas… More, to ensure it doesn’t unnecessarily set back the individual’s situation or make recoveryRecovery as defined by SAMHSA is “a process of change through which individuals improve their health and wellness, live … harder.

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.

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 referralsCommunity referrals provide community partners with the opportunity to refer people who are known to chronically engage … More 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 managementLEAD-style case management is the heart and soul of LEAD’s effective, coordinated system of care, one that reorients e… More 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.

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 managementLEAD-style case management is the heart and soul of LEAD’s effective, coordinated system of care, one that reorients e… More 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.

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 managerLEAD-style case management is the heart and soul of LEAD’s effective, coordinated system of care, one that reorients e… More positions and are not differentiated from other case managersLEAD-style case management is the heart and soul of LEAD’s effective, coordinated system of care, one that reorients e… More; many have both lived experience and formal clinical training and credentials, and others earn credentials while on the job.

All LEAD case managementLEAD-style case management is the heart and soul of LEAD’s effective, coordinated system of care, one that reorients e… More teams should blend clinical skill, clinical supervision, and lived experience.

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.

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 managerLEAD-style case management is the heart and soul of LEAD’s effective, coordinated system of care, one that reorients e… More at first, so case managersLEAD-style case management is the heart and soul of LEAD’s effective, coordinated system of care, one that reorients e… More 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.

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 managersLEAD-style case management is the heart and soul of LEAD’s effective, coordinated system of care, one that reorients e… More 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.

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.