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For years we have witnessed an increase in the number law enforcement interactions with individuals in the community with unaddressed behavioral health challenges. Conversely, there remain far too few alternatives to unnecessary arrest or transport to the emergency department.

Middlesex County, in Eastern Massachusetts, is New England’s most populous county. Our criminal justice and behavioral health leaders recognized the need improve capacity and access to behavioral healthcare in the community. In 2018, the Massachusetts legislature created the Middlesex County Restoration Center Commission to develop a pilot that would help solve the “divert-to-what?” question. In Middlesex County, the sheriff’s office offers evidence-based programing and treatment for incarcerated individuals, but individuals should not have to go to jail to receive the services they need.

We are grateful to have recently been invited to join the Safety and Justice Challenge’s new IMPACT behavioral health cohort, to share some of the lessons we have learned, and learn from our partner jurisdictions in this impressive network. The Commission has just entered its fourth year of work, and our path forward will be made easier through this tremendous peer exchange opportunity.

One of the biggest lessons we have learned, and hope to pass along to our partner jurisdictions, is the importance of improving collaboration and communication across siloed fields like public safety and behavioral health. All too often, addressing behavioral health needs of the community remains in traditional agency siloes. From the sheriff’s office to mental health service providers and police departments to peer and advocacy organizations, it is only this kind of collaboration that is able to stop people from falling through the cracks.

Middlesex County has 1.6 million people with 54 different police departments spread across urban, suburban, and rural areas. We are fortunate to have the progressive leadership of our police chiefs focused on diverting individuals away from the criminal justice system and into treatment. Similarly, we are fortunate to have a health and human services community poised to step up to increase outreach and engagement, to partner with public safety, and to provide appropriate assessment, treatment, stabilization, and support services to affected individuals.

In an effort to shift the responsibility back to the behavioral health community, we knew it was necessary to develop a model that knit together services in a way that made them easily accessible to both the public and local law enforcement. We wanted to move away from the traditional model of stabilization and release from the emergency department. The Restoration Center will offer both stabilization as well as a comprehensive assessment to inform referral to treatment so the needs of individuals can be appropriately met. Our goal is not only to stop the cycle of unnecessary incarceration but also to help individuals stay healthy enough that they do not have to return to the center.

After years of planning and implementation our goal is to launch a pilot Restoration Center in 2022. We believe we are well positioned to launch the model we have developed in large part due to our commitment to the cross-sector planning process which started with identifying gaps in the delivery of behavioral healthcare, a cost-benefit analysis, and interviews with individuals with lived experience. Through our state legislature, we were successful in securing initial funding as well as a trust fund that will allow the Commission to accept third-party funding.

Now that the Commission’s 2022 budget includes $1 million in funding for the pilot – endorsed by a recent editorial in the Boston Globe, we can begin our work of identifying a provider. We continue to pursue additional funding to ensure that we can implement a full range of services identified as critical to the success of individuals who might otherwise be arrested or hospitalized.

The center will provide behavioral health services to individuals in mental health or substance use crisis. These services will help support ongoing law enforcement efforts across the county to divert individuals with behavioral health conditions from arrest or unnecessary hospitalization.

Local law enforcement and corrections have shouldered this burden for far too long, with over 70 percent of people in our Middlesex Jail & House of Correction having an open mental health case and 80 percent have a history of substance use.  Each and every one of these individuals receives treatment while incarcerated, but these are services that people should be able to access in the community. Our hope is that the Restoration Center will help stop the cycle of unnecessary incarceration.

We attribute a lot of the success of the Middlesex County Restoration Center Commission to the commitment of our diverse stakeholder group. It is not common to have a sheriff co-chair a legislative commission with the president of a mental health advocacy group. It is also unusual to get representatives of the 80 largest behavioral health providers at the county, police chiefs, the chief administrative justice of the trial court, and key state legislators at that table. And sustaining the focus on a challenging goal for over three years is the rarest thing of all. But that is what it takes.

Unfortunately, political will is often the hardest thing to secure. But we owe it to the people falling through the cracks to get it right.

A new research paper from the Square One Project at Columbia University offers the first comprehensive review of experimental social policy interventions that can end mass incarceration. The review demonstrates that greater investments in healthcare, education, employment, housing and social services – as well as increased scientific rigor in implementation – are needed to effectively decarcerate.

My colleagues Emily Wang, Laura Hawks, Lisa Puglisi, and I reviewed more than 23,000 research articles to produce the paper, “Towards A New Framework for Achieving Decarceration: A Review of the Research Literature on Social Investments.” We sought to answer the question: Which interventions into social policy (investments in housing, healthcare, employment, education, and social support programs) through community-led organizations have been shown to reduce incident incarceration or recidivism? The lack of research was stark: only 53 total papers fit our research protocol and were included in our findings.

Three intervention types had the most consistent and largest reductions in criminal legal system interaction:

1. Early childhood education programs, particularly those that support parents

Some of the most effective early childhood interventions happen before a child is even born. Effective nurse-family partnerships help families stay healthy during pregnancy. Once the baby arrives, these nurses can help monitor important signifiers of good health and teach new mothers best practices in post-partum healthcare for both mother and child. Research indicates improved life outcomes, including decreased interaction with the criminal legal system, for both the mother and the child immediately following the intervention and decades later.

Likewise, the average layperson might not think great preschool programs are significant, but the research suggests that their impact is huge. The cognitive malleability of a preschool-aged child suggests that active stimulation and meaningful educational experiences at this age can improve well-being down the line, and research has proven this true. The research literature demonstrates that the most effective preschool programs are those that have structured, individualized curricula and provide “wraparound services,” or a direct line of communication between teachers and parents or guardians. This can be as simple as a teacher being able to ask a parent, “I’ve noticed that Sam seemed tired today and wasn’t as engaged with his friends as a consequence. Have you noticed a change of sleeping habits?” Parents and teachers can then work together to make sure the child’s full needs are met, in and out of the classroom. While interactions like these seem small or intangible, they are strong contributors to improving tangible measures of well-being.

2. Community-based job placement specialists that help individuals re-entering society find stable, gainful employment

The research shows that it is not enough to give people just any kind of job as they are transitioning from justice system involvement and back into society. It turns out that gainful employment – jobs that are skilled, long-term, provide benefits like healthcare or retirement funds, and offer opportunities for promotion or managerial experience– is the only thing that really reduces criminal legal system interaction. Temporary, non-skilled work at low wages does not help in any significant way.

The most effective transitional employment programs for people reentering society from carceral settings are those that offer case management; in these situations, a case worker will partner with the reentering person to strategize, create resumes, practice interviewing, and even call potential employers to vouch for their suitability. Active collaboration between the reentering person and their case worker empowers people who are reentering to pursue jobs that feel meaningful and well-suited to their interests, skills, and lifestyle.

Likewise, there is heavy emphasis during reentry programming on obtainment of a high school diploma or certificate of General Educational Development (GED). But these do not significantly reduce recidivism – they do not provide many opportunities for meaningful employment. We found that existing research shows that people need an Associate’s or Bachelor’s-level degree to effectively overcome the stigmas they experience on reentering civilian life.

3. Social services care coordination and Multisystemic Therapy

Multisystemic therapy (MST) has been studied in multiple samples of justice-involved youth people, with significant reductions in criminal legal system involvement demonstrated. During MST, young people participate in group or individualized therapy accompanied by psychosomatic medication if needed – essentially traditional cognitive behavioral therapy. In addition, their entire family is involved in their rehabilitation. This means extra sessions with a young person’s family, teachers, or other community members, or at least active communication between the parties and therapist. Because of this broader engagement, MST gives a fuller picture of a child’s socio-emotional context (e.g., “is this child acting out because of family hardship?”), and helps a therapist actively involve adults in the young person’s life in comprehensive care coordination.

What does this mean for the SJC Network?

People who are working to reduce jail populations – for example, as part of the Safety and Justice Challenge – are often siloed from people who make broader decisions about community-led investments in social supports. But our review of the research shows how efforts to reduce jail populations fit into a broader picture of how to effectively end mass incarceration. Reducing the number of people in jails and fortifying our social safety net are the twin pillars of decarceration. Cities and counties participating in SJC should continue actively engaging with community-led organizations providing social policy programming, as the work of SJC and its community counterparts is deeply connected.

For decades, the United States has responded to social issues like mental health and substance use crises, chronic homelessness, and ongoing cycles of interpersonal violence with jail incarceration rather than pursuing innovative strategies that are better suited to address the root causes of these issues. Jail incarceration has disrupted the lives of millions of people—disproportionately harming Black, Indigenous, and people of color—without improving public safety. There is a better way.

Communities can instead invest in agencies and organizations that address these issues outside the criminal justice system. The proven solutions highlighted in a new report released by the Vera Institute of Justice with support from the Safety and Justice Challenge look beyond jails to promote safe and thriving communities.

To be responsive to residents’ needs and account for the harm caused by incarceration, jurisdictions across the country must look for public safety solutions outside of the criminal justice system. Effectively ending the current dependence on jail incarceration requires an ecosystem of services and supports that enhance the mental, physical, and socioeconomic well-being of the people who have been most marginalized.

The report looks in depth at what methods are working to reduce jail use. They include responding to behavioral health crises without incarceration, using crisis call centers, mobile crisis response teams, crisis stabilization measures and other services instead of police and jails. Incarceration will not address chronic homelessness, but permanent supportive housing can. And some jurisdictions are interrupting cycles of violence without incarceration by adopting a public health approach that includes investment in community violence intervention programs.

Some example programs in cities and counties participating in the SJC include:

• Started in 2021, the Portland Street Response (PSR) in Multnomah County, Oregon, is a specialized mobile crisis response program designed to reduce police interaction with people who are experiencing homelessness and/or behavioral health issues. When a 911 call involving these issues comes in, PSR dispatches specially trained medics alongside peer support specialists who have direct experience with similar challenges. In addition to providing care for non–life-threatening medical issues and connecting people to services, the team may provide transportation to shelters, clinics, or another destination the person being helped selects.
• In Cook County, Illinois, the Westside Community Triage and Wellness Center provides urgent behavioral health care and serves as a hub to connect the neighborhood’s largely Black and Latinx residents to ongoing behavioral health services. In Pima County, Arizona, the Crisis Response Center offers 24/7 access to care resources for people who are experiencing behavioral health crises to avoid jail or emergency room settings.
• In Baltimore, Maryland, the Baltimore Community Mediation Center provides mediation services for people experiencing any stage of conflict, including mediation within jails and prisons for people approaching reentry. To ensure mediation services are accessible, the center partners with other public services and community-based organizations. In 2018, with help from around 60 volunteers, the center held close to 600 mediation sessions at more than 130 different locations around the city.
• In multiple cities around the United States, Cure Violence has reduced shootings by adopting a public health approach called Community Violence Intervention (CVI). It conducts public education campaigns to change attitudes about violence, seeking to build relationships with people who are most likely to engage in violent behavior. It relies on “credible messengers,” people who have lived experience with violence in neighborhoods, to perform outreach and intervention.

The report also focuses on grassroots strategies to elevate community expertise, and on effective collaboration with community-based organizations.

• For example, JustLeadershipUSA in New York City—a strategic ally of the Safety and Justice Challenge—is a power-building movement led by organizers directly impacted by the criminal justice system. In 2020, the organization created the #buildCommunities Platform 2.0, a large-scale vision-building exercise conducted in association with the #CLOSErikers campaign. Over three months, the collaborative convened assemblies in eight different neighborhoods in New York City that had been heavily impacted by incarceration and divestment. Conveners facilitated sessions for groups of residents to present, discuss, and workshop ideas together to identify where investment is needed to improve safety and well-being. The vision contributed to a multi-campaign effort that generated a $391 million city commitment to non–criminal justice system programming and resources.
• In 2019, the Los Angeles County Board of Supervisors established a public-private Work Group on Alternatives to Incarceration. The group convened dozens of representatives from nonprofit organizations, service providers, and state and local governments to explore better responses to the “human conditions” of homelessness, poverty, and behavioral health issues. Their work involved creating a roadmap for solutions that provide care and services first and make jail a last resort, a process that engaged government and community residents to think broadly and boldly about strategies for public safety. The group produced more than 100 recommendations to minimize the use of police and jails.

Vera’s report also highlights why criminal justice system responses to these social issues are not enough. Many current approaches to reducing the use of jails fail to address many of the underlying drivers of jail incarceration that would be better addressed through other agencies, organizations, and community-led efforts—unstable housing, poverty, limited educational opportunities, poor health, and inadequate access to services. Moreover, most current local justice reform approaches also fail to account for the racialized harm caused by decades of investments prioritizing criminal justice system agencies over community-based services and often ignore problematic system practices. These shortcomings limit both the efficacy and the reach of many reform efforts.

Ultimately, a network of community-based services and supports could go a long way to address criminalized behaviors in ways safer and more effective than jails.

Historically and up to today, Black, Latinx, and Indigenous communities, and people residing in neighborhoods of historic divestment, are more likely to be harmed by public safety systems.

To truly reimagine public safety, cities must acknowledge these harms and take actionable steps, alongside their residents, toward transformation. In 2020 the names of people lost to police violence became synonymous with the movement toward justice. These tragic losses prompted a long overdue conversation with local leaders. They realized they could no longer treat public safety as solely a function of law enforcement.

The recent upticks in violent crime in many cities, despite low crime rates overall, reinforce the importance of city leaders having guidance and support as they think differently about public safety. Losing momentum toward transformation could lead cities back toward strictly enforcement and punishment-based levers for safety.

In this context, the National League of Cities Reimagining Public Safety Task Force held meetings and listening sessions hoping to collectively set a new vision for what it means to keep residents safe. Meeting from February to August of 2021, Mayors and Councilmembers from more than 20 cities, alongside national partners and community stakeholders, developed five high-level recommendations that support the movement toward safety for everyone.

Through collaboration with their peers, national organizations, and most importantly, their communities, elected officials can innovate and replicate policies and initiatives using these recommendations as a guide. Within each recommendation there is a strong focus on both moving away from policing as the only option and on centering the equitable engagement and involvement of residents in every step of the process.

Captured in the report “A Path Toward Safe & Equitable Cities”, the recommendations provide an initial framework for city action:

1. Direct municipal government leadership toward providing safety and well-being for all. This recommendation guides local leaders towards broader definitions of safety and new ways to measure what it is that makes people feel safe. A focus on wellbeing and public health leads cities toward expansive safety visions.
2. Balance the respective roles of government agencies, residents, and partners. Non-traditional stakeholders need to be involved in safety conversations, planning, and budgeting. Specifically, this inclusion centers members of the community who are often left out but most impacted by the harms of current systems.
3. Significantly expand the use of civilian-led and community-based well-being and prevention-focused strategies. Building on the momentum around community responder models and the amplification of credible messengers as key for any safety plan, this recommendation highlights public health response options to both crisis and violence.
4. Embrace full and transparent oversight and accountability for law enforcement. While the report does not center law enforcement in reimagining public safety, it is important for cities leaders to recognize and embrace their role in the oversight of their local police force. Accountability and transparency matter.
5. Seek guidance and support from peers and experts with the assistance of the National League of Cities. Local elected officials face scrutiny daily. In 2020, they also faced both a global pandemic and a reckoning around policing. Support from their peers and access to other resources is necessary as they take a journey toward community centered safety.

During NLC’s annual City Summit in November 2021, a Municipal Toolkit was released to dig deeper into what cities are doing and can do to bring these recommendations to life. The toolkit takes each recommendation and explains it in depth, draws out local examples where it has worked, and describes what implementing policies and initiatives could look like in communities across the country.

NLC, and the Task Force, recognizes that no city has this figured out completely and that much of what we have seen thus far has been smaller in scale and less equitable than we would like. However, by taking these steps, evaluating them, enhancing them and taking them to scale, transformation is possible. In addition, the American Rescue Plan offers an opportunity for cities to invest in ways not possible before. Not all cities are the same and not every city leader will act in the same way. But, through collaboration with residents, local stakeholders, and national partners, we can move from harm to wellness.

“We are talking about wellness. We are talking about holistic health in our communities. That is what public safety is all about—not just the absence of violence—but the presence of wellness,” said Mayor Ras J. Baraka of Newark, New Jersey. “We need more than the police department to create wellness. Public safety has to be expanded and put in the hands of other folks.”

Probation is the most common sentence in the United States. In 2019, one in 73 adults was on probation, and there were almost 1.5 million more people on probation than in jails and prisons combined. Although the problems of “mass supervision,” particularly the way probation violations contribute to state prison populations, have begun to draw greater critical attention, there is very little information about how probation contributes to local jail populations.

A new report released by the Vera Institute of Justice, with support from the Safety and Justice Challenge, focuses on the ways probation can affect jail populations and what can be done differently.

Research shows people are frequently sentenced to overly long terms of probation and have to comply with an average of 10 to 20 conditions, which are often vague and sometimes conflict with each other. The difficulty of complying with all of these conditions for long periods of time frequently leads to “technical” violations (violations of supervision conditions that are not based on new criminal conduct) and can lead to revocation of probation and imposition of a jail or prison sentence. Nationally, only around 60 percent of people under supervision complete probation successfully.

Probation is also marked by significant racial disparities. Despite being more likely to be sentenced to jail or prison than probation, Black people are still over 2.6 times more likely than white people to be on probation. When they are sentenced to probation, Black people tend to be given more conditions and to be on probation for longer terms than similarly situated white people. They are also more likely to have violations filed against them, to be sanctioned with incarceration, and to have probation revoked and be sentenced to incarceration.

There are multiple ways probation supervision can result in jail incarceration, such as detention of people waiting for court hearings on violations alleged by a probation officer or sentencing of people to jail for probation violations. There is some evidence that increasing numbers of people are choosing to accept a jail sentence up front to avoid probation, as they view probation as too difficult to comply with and likely to result in eventual incarceration anyway.

National data provides almost no details on how probation contributes to jail populations. To begin to remedy this gap, we analyzed jail data from nine jurisdictions participating in the Safety and Justice Challenge. This analysis showed admissions to jail for probation violations vary from a low of 3.9 percent to a high of 23.8 percent. The data also showed that length of stay (LOS) for people with probation violations was much longer than for those held in jail for other reasons. Because of this extended LOS, on any given day, the proportion of people in jail for probation violations greatly exceeded their share of jail admissions. The probation violation ADP ranged from 9.1 percent to just over 50 percent. Our analysis also confirmed significant racial disparities: across the sites for which race data was available, Black and Native American people were held in jail for probation violations at rates far higher than their representation in the general public.

We also highlight strategies in two SJC sites to reduce probation violation populations in jail. For example, St. Louis County placed three full-time probation staff members in their jail to meet right away with people who come in on violations and work on release plans and recommendations that can be delivered directly to judges. This has led to more judges ordering release based on a probation officer’s written recommendations rather than waiting to hold a preliminary hearing.

Allegheny County, meanwhile, adopted multiple strategies to try to prevent people from going to jail on probation detainers and to get those who are jailed released more quickly. A new policy makes probation detainers an option of last resort, as probation officers in most cases must exhaust all other options for keeping people in the community before issuing detainers, while also requiring earlier release planning and regular follow up for people who do get detained. Allegheny County also developed procedures to ensure that probation violations and new charges are resolved at the same hearing, rather than waiting an average of two months between separate hearings. Finally, the County adopted criteria for termination of probation agreed on by the public defender’s and district attorney’s offices, which led to judges ending probation early for more people who were doing well under supervision.

To better understand how probation affects jail populations, probation agencies and local jails should work together to combine data, disaggregated by race and ethnicity, to ensure that they can determine who is in jail for probation violations; whether the violations are all technical or include new charges; whether people are being detained pending a violation hearing, serving a sentence as a direct sanction for a violation, or serving a previously imposed jail sentence after probation has been revoked; and how long people are spending in jail pending hearings and/or after being sentenced for violations.

Because probation can be a significant driver of jail populations, jurisdictions should work to reduce the number of people detained for violations as well as the time they stay in jail for those violations. Sites should consider using alternative non-carceral sentences instead of probation, limiting the length of probation, reducing and tailoring the number of probation conditions, reducing the frequency of reporting and allowing remote reporting, using summonses instead of warrants for violations, eliminating or severely restricting the use of detainers, and using only non-carceral sanctions for technical violations.