Transforming the System


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Eliminate the Criminalization of Public Health Issues

All communities should have adequate social services to meet the basic needs of community members and to promote general well-being. However, the criminal justice system has too often been used to deal with issues that deserve a public health response, threatening community health. Many individuals have been subject to harsh sentences, incarceration, and overly broad registration requirements when treatment and service provisions would be more effective at promoting community wellness. Instead, individuals with disabilities should be given effective and appropriate treatment in community health centers, not policed and incarcerated; people who have been convicted of offenses for sex-related conduct should not be placed in overly broad and ineffective registries; and drug policy should be focused on harm reduction and treatment for addiction, rather than as a source for mass incarceration.

Solutions & Actions to Eliminate the Criminalization of Public Health Matters

1) Create a Culture of Respect

Local governments and police departments should ensure that police officers are trained in interacting with people with physical and mental health concerns and disabilities, fostering a culture of respect for human dignity and encouraging respect for all community members. The Department of Justice should issue guidance for law enforcement agents to reduce bias in their interactions with individuals of differing abilities.

2) Invest in Community Treatment

Legislatures should ensure there are adequate resources and facilities for treating people with mental health and substance abuse issues in the community, and create programs to educate the public about screenings and expanded services available through the Affordable Care Act.

3) Train in Appropriate Crisis Intervention

Properly trained medical responders should accompany police officers when they are called to respond to a crisis. Dispatchers and police officers should be trained to recognize conflicts involving mental health issues and deescalate mental health situations when they occur. Where arrest would otherwise be required, the police officers should be trained to divert individuals with apparent mental health issues to a treatment center or other diversion program, as needed. There should be at least one designated person within police departments, serving as the primary contact person and expert for responding to mental crises. This expert may respond to situations as needed, and other police officers should consult this expert for advice and guidance about responding to these situations.

4) Adopt a Public Health Harm Reduction Model

Local and state legislators should adopt a harm reduction model for criminal justice policy, particularly in relation to drug-related conduct, that focuses on treating underlying issues over criminalization.

5) Limit Sex-Related Registries

Congress, local and state legislatures should ensure registration for individuals convicted of sex-related offenses is, if not eliminated, limited to adults who pose a high risk of repeating their offenses and limit access to registries to law enforcement officials on a need-to-know basis.

6) Create Individualized Treatment

Congress, local, and state legislatures should ensure that there is substantial support for treatment programs for persons convicted of sex-related offenses, including treatment plans that are individualized to the individual's learning style and responsive to the individual's risk and needs.

7) De-Prioritize Drug-Related Offenses

The Department of Justice should de-prioritize the prosecution of drug-related offenses and entirely opt out of prosecutions related to marijuana.

8) Fund Syringe Exchange Programs

The Administration should work with Congress to restore and expand federal funding to syringe exchange programs, to reduce the transmission of HIV as part of a comprehensive approach to HIV prevention.

9) Expand Youth Programming

Congress, state, and local legislatures should expand programming, job training and apprenticeships for youth to prevent the disengagement and economic lockout that leads to drug use and involvement in the drug trade.

10) Divert before Booking

Where appropriate and as reduces arrests, local governments and police departments should “pilot diversion programs that place treatment decisions within public health systems rather than the criminal justice system,” including diversion prior to booking, during detention, before adjudication, and upon release. The focus should be on pre-booking and non-arrest diversion for conduct that would otherwise result in a criminal record.

Solutions in Action

We’ve identified programs and initiatives that incorporate some of these solutions. They may provide inspiration, albeit at times imperfect, for others who are interested in instituting some of these policies.

  • Responding to the epidemic of substance abuse in the region and the nation, the mayor of Ithaca, Svante Myrick, formed the Municipal Drug Policy Committee, which released their report, The City of Ithaca’s Plan: A Public Health and Safety Approach to Drugs and Drug Policy, after a year-long study on the best approach to substance abuse in the municipality. The plan calls for a multi-pronged strategy to respond to drug use that is rooted in harm reduction.
  • The first CIT program was created in 1988 in Memphis, TN, and the Memphis Police Department and the “Memphis Chapter of the Alliance for the Mentally Ill (AMI)” partnered to create a pre-booking diversionary approach to mental health crisis events that deescalated police encounters and provided treatment to people with mental health issues rather than incarceration, or violent altercation. It has become a model for thousands of similar programs throughout the country.


Below are flashcards for you to use the next time you have a media interview, need to write an opinion piece, or just need some ideas as you think through your messaging strategy.

Addressing Mental Health Challenges


We’d all like to believe that if we’re facing challenges, or even crisis, our community will step up and help us through, with respect and compassion. That’s how community should work – we share responsibility for each other and come together to face challenges. It’s particularly important to remember this vision of community when considering issues that arise around mental health concerns. Individuals experiencing mental health challenges and crises need their communities to work with them on solutions. They want what we all want: to be met with support, respect, and compassion.


But too often, people are first met by police. We know that the criminal justice system is too often used as a cure-all for social problems that are better suited to social services and public health responses. Criminalization is routinely used in responding to mental health matters. Because of inadequate mental health structures, arrest and jail are at times used to restrain people with mental health issues when medical treatment is actually needed.


We need solutions that uphold our values and treat people how we all would want to be treated. That can happen best through increased health services. For cases when police do become involved police departments should train officers how to interact with and assist people experiencing mental health conditions. The goal should be to foster a culture of respect for human dignity and to encourage respect for community members through de-escalation training, and trainings administered by individuals who are most directly impacted. Within the department, there should be more intensive training of law enforcement agents who will serve as in-house experts and primary contact people when community members are coping with concerns relating to mental health.


Attend community forums on policing and urge decision-makers to adopt police training that focuses on respectful and effective interaction around mental health issues.

For more information on the criminalization of public health issues (such as mental health and substance abuse) and relevant policy solutions to address it, check out:

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