First Do No Harm Advancing Public Health in Policing Practices

First Do No Sq Final


Millions of medically vulnerable and socially marginalized people cycle through the criminal justice system each year due to serious structural problems entrenched in American society. The absence of a coherent and effective social safety net means that people lack access to physical and mental health care, social services, and housing options in their communities. This report details the cultural divide among system actors that amplify and sustain these problems and offers recommendations on how law enforcement policymakers and practitioners—in collaboration with public health officials and harm reduction advocates (who use a range of strategies to reduce the harmful consequences of risky behavior, particularly drug use) —can enhance both public safety and community health.

Key Takeaway

By working with public health stakeholders, police can improve how they respond to people living with substance use and mental health needs by incorporating principles of health promotion and harm reduction into their mission, as a means to improve community health while protecting public safety.

Publication Highlights

  • Against the backdrop of the largest expansion of the criminal justice system in U.S. history, police officers have found themselves routinely serving as de-facto street corner psychiatrists and frontline mental health workers.

  • Fear of arrest and incarceration can deter people with drug addictions from seeking treatment. Untreated addictions can lead to poor health, resulting in the spread of infectious disease within a community. 

  • Successful partnerships between police and harm reduction programs—for example the LEAD (Law Enforcement Assisted Diversion) program—show how these two groups can work together to prevent the spread of disease and the over-incarceration of vulnerable communities.

Key Facts


Series: Dispatches from T.R.U.E.

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The books would pile up so much that I would send home a banker box full of books every few months to keep within the confines of my property allotment of six cubic feet. My parents dutifully packed them in the storage area of their home, waiting for our reunion. I spent so much time in those books they became my closest friends. Their attention co...

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An offender in the T.R.U.E. unit asked me, “Why do you want to participate in this program?”  I explained that I was tired of the revolving door in Corrections and the disruption it causes to the community.  They then asked, “What experiences do you have dealing with this population?” Even though there has never been a unit like this in an ...

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