First Do No Harm: Advancing Public Health in Policing Practices
Date:  11-24-2015

New report offers recommendations for eliminating disconnect between police and public health systems
In an article in the Texas Tribune, David Cloud made a statement that some might find unusually progressive coming from the head of a law enforcement agency. According to the Tribune, Cloud, the Chief Deputy Sheriff of King County, Washington, feels there is a great disconnect between public health agencies, community leaders promoting harm reduction and police, whom he refers to as “street-corner psychiatrists.” Cloud stated:

"When you have a public entity that's responsible for reducing the use and harms that addiction and poverty and things like that have, you have to judge the success those systems by much more than just the number of arrests and the number of incarcerations and the dollars. You have to think much more critically about, really – shouldn't the number of arrests that we prevent be the goal? Shouldn't we be more concerned about connecting the population to the types of health services we know they need?"

Cloud and Chelsea Davis, are authors of the newly released Vera Institute of Justice report, “First Do No Harm: Advancing Public Health in Policing Practices,” which promotes a symbiotic relationship between police, health care providers and other organizations and agencies to offer treatment and support to those whom society condemns and often criminalizes, such as those with substance abuse or mental health issues, or those who work in the sex trade. Cloud and Davis make the argument that stigmatizing marginalized people instead of eradicating the root of the problems is costly in terms of ruined lives and communities, as well as to the tax payers.

In the Foreword of “First Do No Harm” Cloud and Chelsea Davis write:

“Millions of medically vulnerable and socially marginalized people cycle through the criminal justice system each year because of serious structural problems entrenched in American society. The absence of a coherent and effective social safety net means that individuals lack access to health care, mental health care, social services, and housing options in their communities. In cities and communities across the nation, police act as reluctant social workers without the benefit of training and treatment providers of last resort for people with chronic, unmet health and social service needs. They must assume these roles because of laws and policies that have criminalized quality-of-life offenses and minor drug-related behaviors, with the greatest burden falling upon the poor and communities of color.

Unfortunately, the cultural divide and lack of cooperation among law enforcement, public health agencies, and harm reduction advocates amplify and sustain these problems. As a former police chief and currently a chief deputy sheriff with more than 32 years’ experience in law enforcement and the former executive director of one of New York City’s first syringe-exchange programs and current executive director of the Harm Reduction Coalition for more than 20 years, we recognize the need for joint leadership, a shared vision, and mutual trust among police and community health systems. It is imperative for improving how local governments address vexing health and social problems such as drug use, mental illness, sex work, and poverty. We must work together in strengthening our partnerships so that we may improve and sustain the health and safety of our communities.”

The report offers the following recommendations to police:

  • Reach out to advocacy groups and their constituents to build trust, empower marginalized individuals and promote dignity

  • Minimize arrests in the vicinity of harm-reduction clinics, such as those that offer needle-exchange programs, to encourage people to continue to use such services

  • Create overdose prevention programs and collaborative efforts by working with health professionals to form best practices in law enforcement, including training to resuscitate people experiencing an overdose

  • For people in need of treatment, change the metric for success from arrests made to arrests averted.

    Read the full report here.