Jac Charlier is the Executive Director of the Police, Treatment, and Community Collaborative (PTACC) and the Executive Director of TASC’s Center for Health and Justice. He is a national expert in crime reduction, deflection and pre-arrest diversion, and a leading voice in the emerging national and international deflection movement.

We recently sat down with Jac to discuss the five pathways to deflection, the steps communities can take when establishing programs, how to show efficacy after establishing a program, and the future of the field and movement of deflection.

Can you explain why the five pathways to deflection were established?

Through observing varying programs across the country, we have identified five different pathways that they all fit under when we are speaking about police, Fire, and EMS deflection. As deflection and all its forms grow, from police to co-responder deflection, it is valuable for communities to know that the five pathways exist so that they are aware of the options available to them. The field of deflection is young, so we can’t necessarily say exactly which approach a community should follow because it really depends on the unique challenges of a community. Ideally, we want every community to work towards deploying all five pathways because each pathway opens another avenue for people to get connected to treatment, housing, services, and recovery. We also want to be respectful of the local resources available in a community when determining the best approach. In our observations, we’ve seen that most communities oftentimes start with one pathway, see its impact, and begin exploring other pathways.

How do you go about assessing a community and providing recommendations for which pathway would be the best place for them to start?

We use a well-developed tool called the Solution Action Plan (SAP) that was first an action plan for courts to integrate behavioral health processes into general jurisdiction courts. We brought that planning process into the field of deflection and created the SAP. The first step in the 27-page document is defining the problem or challenge. If we don’t start with shared agreement there, we are going to miss the mark in terms of understanding what the solution is going to be and whether it will work. The second step is to collect some simple data to show that the problem or challenge actually exists and hence the need to spend the time and energy to support a solution. Third is to set the table sufficiently by identifying the organizations and agencies that need to be involved. Those are the first three starting points of any good systems-change transformation. From there, go back to the problem statement, revisit the data, keep asking who needs to be invited to the table, determine what shared systems success will look like, and repeat the cycle a few more times. The SAP is comprehensive, and to be honest, tiring for communities to go through. However, creating a systems-change is never easy. It takes detail, focus, effort, patience, and time to accomplish. The way we say it is there are no simple, easy, short-term solutions to complex, chronic situations.

Is it common to find communities that have multiple pathways deployed but among different stakeholders with misaligned objectives?

Early on, although I’m sure it is still happening to some degree, we would see programs that were completely isolated in their initiatives. We would see a police department deploying one pathway, the public health department deploying another, and neither having knowledge of what the other was doing. Even within police departments I have seen the deployment of multiple pathways that were not integrated because one would say, for example, that they were deploying deflection for homelessness and the other would say they were deploying deflection for mental health, and neither would realize that they’re actually doing the same thing, sometimes with the same community providers and very often with the same participants. This can happen in times of early-stage innovation (deflection is still a young field and only seven years old for most intents and purposes) because people don’t have a name for the field, making it difficult to understand exactly what something is. That is why, going back to the first question, it is important to educate communities on the five deflection pathways and options available to them. This helps people see that they are a part of something that they didn’t realize had a name to it. It also means that communities do not have to “discover” what is already known.

What is the key to successful collaboration amongst programs or pathways if they have been developed by varying stakeholders?

Coming to agreement on the shared problem or challenge to be addressed, and then what constitutes shared success to the problem or challenge, are the first two keys item in collaboration. What is it you are trying to solve? What is it that you all want out of this? The second is to organize by grounding in community. We live in a time, especially in the last few years, where issues of real engagement with community have risen and bubbled up as sorely lacking. There are things that have been left unaddressed for far too long and we have to find solutions, ideas, and thoughts that can sometimes only really emerge out of community. If you think about it, in a practical way, things survive, grow, and are sustainable when they have community support. The community can hold anything up and start it, and likewise it can undo anything and make it come to a halt. Organizing by grounding in community is identifying the community’s needs and where they are willing to drive their energy. It is finding that place in between people’s hopes and what they think could be, and not yet a reality but visible as a possible future. A few steps up from reality and a few steps down from everything we could ever want lies the space of community organizing. The third key item is figuring out the local resources that are going to be needed to grow your initiative. Make sure you are looking at and understanding what the capacity of your community is. Otherwise, the frustration and disappointment of the people who have “seen this, done that” will be real, as will the frustration of the professional staff that have worked on the initiative, and you will lose trust or support of all involved. Remember, the first step when building a program is to identify the problem you want to solve. So, if we want to address women who have mental illness who are mothers, then from the start we better have available known community interventions for women, mental health, and children and family. If we don’t have those resources, then the deflection initiative will fail almost out of the box, or better yet, should not even be launched.

We have seen in our clients that these programs usually start with a visionary person in the community. What are some common traits of that individual in the communities that you have worked with?

I could just go with a generic answer, but instead I’ll pause for a second and think of the leaders that I have seen in this space that have helped initiate these programs. The first that comes to mind is a colleague of mine who is incredibly smart and had the ability to grasp the power of deflection early on, which allowed her to lead early-stage development. Another colleague that comes to mind is one who recognized the concept of grounding in community that I mentioned earlier. He understood that the starting point was not going to be police, and was not going to be treatment, but instead it was going to be the community.  Another trait is the ability to see the breadth of what could be possible. One more is sheer persistence in the face of having no knowledge of how to proceed or what would come of it. If you really think about it, when something is new, the only faith is blind faith! Only after years of lots of people doing something can we get to the point where we can say we know what we are doing. Until then, it’s all about what I call Jac’s golden three: lead, believe, and persist.

What would you say is a great example of a community that has deployed the five pathways effectively?

Plymouth County in Massachusetts is a great example. The breadth and scope of what they have done is wide and far, and they even innovated on top of that. I also hold out the Tucson Deflection Initiative (AZ) in the same level of achievement. Together with treatment partners, community leaders, and nonprofit leaders, they have built a strong network that is organically moving on its own to adapt to what comes next. That’s a stage that all can achieve, if desired and if needed (a critical point!), with a combination of hard work, good luck, and timing. I also want to recognize that when we talk about five pathways, we can also talk about excellence in one pathway. I think of someone like Connie Priddy in West Virginia who takes a pathway, which in her case is the Naloxone Plus pathway, and achieves excellence in it. The Naloxone Plus pathway is providing naloxone as well as connection to treatment, housing, and services. Connie worked so hard on exceeding in this pathway that it really began innovating into things that we didn’t know could be done in terms of reducing opioid overdoses and overdose death. Yes, we want communities to ultimately take the approach of all five pathways, but if you have a very specific problem, you can do a deep dive to address what is facing you. Connie and her team did the deep dive and explored the depths of excellence in a certain pathway, which then led to innovation itself.

Given that many of these programs are funded by grants or very competitive city budgets where you have to justify effectiveness, what do you see as one of the key parts of ensuring efficacy of programs in order to continue receiving funding?

The answer is very simple. You must collect data, develop metrics, and show you’re solving the problem, not perfectly but doing much more good than nothing, and certainly not causing any harm. There is no way around it in this day and age. Right out of the box in the SAP document we talk about the need for data and understanding it. The first step in the SAP is problem identification and the second is to have data to support it. The police need their own version of data, as do treatment services, the community, and the individual, and then so does the deflection initiative itself. As such, it is essential to have a shared data system that can cross all those elements and allow daily use on the individual level, weekly or monthly use on the management or operational and systems level, and semi-annually or annually for the evaluators, funders, system leaders, policy makers, and the general public. It is also important to have a data system that can allow varying access. Deflection is an initiative that crosses systems, geographical and jurisdictional boundaries, as well as profit, nonprofit, and governmental boundaries. Therefore, the data system must be accessible to all and useable by all. Having a system specifically for healthcare is fine, but it is of no value to EMS or police, or if the police have a system, it is not of value to treatment world, and none of it is of value if the individual cannot have some kind of user interface where they can see what they are doing and being reminded, motivated, and engaged.

The pathways started with law enforcement but are broadening beyond that today. Where do you see the field heading?

I’ll lead off with some statistics from the first National Deflection Survey released in 2021, sponsored by the BJA. Of the sites surveyed, 75 percent were started by police, 15 percent were started by EMS, and 10 percent were started by community. As deflection continues to grow in all its forms, we want to see the community generate more of these options for responding to people with mental health or substance use disorder, crisis or non-crisis.  We also need to grow and accelerate focus on equity, because we don’t want to look back in 10 years and say we knew what to do but didn’t do it. If you have worked in the justice system and have not understood the inequity of race, gender, income and poverty, then you need to go into a new field. We also want to find non-law enforcement ways in deflection, mental health, substance use, and homelessness initiatives. Again, not limited to the crisis space, which receives so much focus, but in the non-crisis space as well where we can do what deflection really can do – function as an early, upstream, preventative approach, and not waiting for the overdose, arrest or ER run.

 

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