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COSSUP First Responder Deflection Mentoring Initiative

The First Responder Deflection Mentoring Initiative will provide communities interested in starting or enhancing a deflection program with the opportunity to learn from established or innovative programs that have shown success in supporting individuals with substance use disorder in their community. The mentor sites serve as models for individuals and teams interested in starting a program or for established programs interested in learning innovative practices.

Communities are able to submit an online application to visit a mentor program. The Bureau of Justice Assistance will support the travel of up to three individuals from approved communities to participate in an onsite visit to one of the mentor sites. First Responder Deflection mentor sites will provide mentorship in a hybrid capacity, with virtual and in-person visits with their mentees. During site visits, mentors will provide opportunities for observation and peer-to-peer exchanges, including opportunities to observe the first responder deflection program in action and allow mentee sites to engage with program personnel.

What Is First Responder Deflection?

First responders (law enforcement, fire services, or emergency medical services) are on the front lines of the battle against substance use disorder (SUD), responding to calls for service involving individuals with or affected by SUD. In response, a variety of law enforcement-, fire department-, and emergency medical services (EMS)-led responses have emerged across the country. Implemented in partnership with SUD treatment providers, peers, people with lived experience, and recovery organizations, these multidisciplinary deflection initiatives are serving as an early, upstream warm handoff to community-based treatment, housing, services, and recovery.

There are six frameworks or pathways of deflection, each of which addresses specific public health and public safety challenges faced by communities. As a deflection design is unique to each community, the range of variations on which pathways a community is using varies.


An individual voluntarily initiates contact with a first responder (law enforcement, fire services, or EMS) for a referral to treatment and services. If the contact is initiated with a law enforcement agency, the individual makes contact without fear of arrest.


A first responder intentionally identifies or seeks out individuals with SUD to refer the individuals to or engage them in treatment; outreach is often conducted by a team consisting of a clinician and/or a peer with lived experience.


A first responder and program partner (often a clinician or peer with lived experience) conduct outreach specifically to individuals who have recently experienced an opioid overdose to engage them in and provide linkages to treatment.


As a preventative measure, during routine activities such as patrol or response to a service call, a first responder engages individuals and provides a referral to treatment or to a case manager. (Note: If law enforcement is the first responder, no charges are filed or arrests made.)


During routine activities such as patrol or response to a service call during which charges otherwise would be filed, law enforcement officers provide a referral to treatment or to a case manager or issue a non-criminal citation to report to a program. Charges are held in abeyance until treatment and/or a social service plan is successfully completed.


In response to a call for service, a team comprising community-based behavioral health professionals (e.g., crisis workers, clinicians, peer specialists, etc.), and/or other credible messengers—individuals with lived experience—sometimes in partnership with medical professionals, engages individuals to help de-escalate crises, mediate low-level conflicts, or address quality of life issues by providing a referral to treatment, services, or to a case manager.

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