New Movement Ignites Interest and Hope

The attempt to address addiction  effectively, and to prevent it when possible, has spawned the development of multiple “movements” over the past century. Most have responded to the times in which they were created, and all started because of frustration with solutions that were failing to fix the problems they wanted fixed.  
NACoA facilitated the dramatic growth in the early 1980s of the Adult Children of Alcoholics (ACoAs) movement while it was developing as the voice and champion for the long ignored and neglected Children of Alcoholics (CoAs) whose childhood years set them up to become the next generation of addicted people.
Thousands of ACoAs who remained silent their whole lives suddenly realized they were not alone and they could speak out loud about their truth and begin to heal. Therapists came to these conferences and returned home with a new view of their clients; many established ACoA support groups; Al-Anon established ACoA Al-Anon meetings; and the movement rolled across the country.

The Prearrest Diversion Movement
Today, another movement is building, and it is the police who are asking for a new approach to addressing people with substance use or mental health disorders. They want what the addiction field and the families of those with these disorders want: available treatment and recovery support instead of arrest and incarceration when these people are not threats to others. The criminal justice system has seen the diminishing relapse and recidivism rates in clients of drug courts and the shorter time to family reunification when parents get treatment and the family participates in a whole family support program like Celebrating Families! As a result, this new movement is gaining the support of those working in the criminal justice arena.
The movement is called “prearrest diversion” and it focuses on developing a warm handover to treatment and help for people suffering from substance use or mental health disorders. Instead of ticketing and arresting such individuals, police chiefs want their officers to guide users to treatment and recovery support so that they can become decent citizens again. There is a growing awareness that putting sick people in jail produces more sickness, higher costs to the prison system, and higher costs to society when these individuals complete their sentences and are released without recovery or the skills necessary to lead healthy and productive lives.
The prearrest diversion movement is called the Police, Treatment, and Community Collaborative (PTAC Collaborative), and it is a major national collaboration of police organizations, treatment organizations, and community systems. It has been propelled by a group of founding member organizations and it held its first national summit in March 2018, bringing together teams of like-minded people from individual communities who developed ways to work collaboratively to develop an effective prearrest diversion program in their communities.
The PTAC Collaborative has established the “PTAC Guiding Principles for Behavioral Health Practice” (2017). It believes that these principles must inform treatment and/or social service providers. They are:

Promote Hope, Health, and Dignity
This is about promoting these ideas “throughout the engagement, treatment, and recovery continuum” (PTAC Collaborative, 2017).

Embrace Diversity
“Fair, impartial, and culturally competent treatment and services need to be available for all types of individuals, no matter their nation of origin, gender identity, sexual orientation, race, religion, or culture” (PTAC Collaborative, 2017).

Systems, Providers, and Staff Must Recognize that Recovery is an Individualized Process
PTAC and its partners must “understand the cycles of change as individuals move through the stages of recovery. To be effective, helping responses and resources must align with the individual’s change process” (PTAC Collaborative, 2017).

Respect that Recovery is a Journey, Not an Event
Treatment and service providers and other prearrest diversion partners must recognize “the differing stages of readiness for SUD treatment programs and the recovery process,” as well as people’s understanding of their recovery. “Efforts that reduce harm to the individual and offer multiple paths to wellness” should be included (PTAC Collaborative, 2017).

Coordinate Care along the Services Continuum
“It is vital that providers work as part of a system that extends beyond behavioral health to encompass physical, mental, spiritual, and social health. PTAC systems of care engage with treatment and service providers in their community to create a network of services and supports across the continuum” (PTAC Collaborative, 2017).

Identify and Reduce Barriers  for Access to Services and  Service Delivery
“Making services easily accessible to the community, law enforcement partners, and consumers” is critical for a diversion program (PTAC Collaborative, 2017). Prohibitions/exclusions that are dated should be reviewed to reduce barriers for access to services and recovery supports. Expanding accessibility to medication-assisted treatment (MAT) and to medication-assisted recovery (MAR) programs is also important and needed.

Apply Holistic, Integrated Care
A network of service providers would include those who can “address and prioritize safety and other basic, real-life problems such as homelessness, domestic violence, chronic medical conditions,” and income and employment supports so people can benefit from treatment services and recover (PTAC Collaborative, 2017).

Incorporate Promising and/or Evidence-Based Practices
“Recovery and support services should include best practices or promising practices supported by research” (PTAC Collaborative, 2017). There should be ongoing education for both professionals and consumers to facilitate utilization of such practices.

Evaluate Process Measures  and Outcomes
Outcomes of prearrest diversion and linkage to care programs need to be evaluated “as well as services including recovery supports by assessing individual and aggregate outcomes of those entering treatment and other services via various pathways” (PTAC Collaborative, 2017). Evaluation should include the entire care continuum from early engagement to long-term recovery.

Utilize Outcomes and Research  to Evolve Care
“PTAC encourages a continuous evolution of collaborative data strategies that work to inform policy; measure the impact of interventions, services, and supports; and improve the quality and outcomes for consumers, their families, and communities” (PTAC Collaborative, 2017).

Unwavering Commitment to  Ethical Conduct and Practice
“Professional ethics are at the core of PTAC. PTAC, not-for-profit, and for-profit behavioral health services; law enforcement; community; and other prearrest diversion program partners have an obligation to articulate basic values, ethical principles, and ethical standards. . . . These principles are relevant to all entities, regardless of their professional functions, the settings in which they work, or the varying populations served” (PTAC Collaborative, 2017).

Moving Upstream
PTAC is a national collaborative working to become part of the DNA of alternatives to arrest and incarceration. The public has come to understand that our country can never address the addiction epidemic and related social and criminal justice problems through the arresting of sick people who need treatment and recovery support. The data is clear. This practice, followed for decades, cannot benefit society nor the arrested individuals who spend a portion of their lives incarcerated, not rehabilitated, passing a heavy and costly weight onto the prison system, the court systems, the school system, the foster care system, and thousands of families for generations. The behavioral health professional community understands that there are new and effective enhancements to traditional treatment and that there are thousands of people in long-term recovery who are creating recovery community support organizations across the country to provide recovery coaching and support for individuals and their struggling family members.
The time to move further upstream is now, and PTAC is stepping into that gap nationally so that collaborative teams can be created locally to foster prearrest diversion and save more lives and more families. With the many enhanced supports for finding recovery and wellness, its thirty founding member organizations, including NACoA, have modeled the effectiveness of open, inviting, and persistent collaboration as PTAC has evolved. Further, it has inspired teams in local communities to establish their own collaborations involving police, district attorneys, and entities in the community that can provide the recovery supports that are beyond behavioral health service providers. All are invited to become part of the national collaboration or to work with colleagues in police work, criminal justice, faith, and other social service entities to create their own prearrest collaboration in their home communities. The PTAC collaborative has developed three “buckets” of membership:

1. PTAC Business Bucket
These are organizations that commit to be responsible for the business of PTAC. This means they do the following:
• Commit to the financial and time resources needed to create and maintain PTAC as a formal entity
• Provide their logo to PTAC (and PTAC distributes their logo out to the field)
• Distribute e-mails to their networks (and PTAC distributes their e-mails to PTAC lists)
• Make the business decisions of the organization (including grants, funding, staffing, conferences, direction, strategy, etc.) in consultation with PTAC leadership.

2. PTAC Leadership Bucket
These are individuals and organizations that commit to stepping into or maintaining a leadership role with PTAC. These organizations participate in the following ways:
• Commit to providing leadership and support for the business of PTAC in one or more strategy areas, tools, and/or deliverables
• Provide their logo to PTAC (and PTAC distributes their logo out to the field)
• Distribute e-mails to their networks (and PTAC distributes their e-mails to PTAC lists)

3. PTAC Member Bucket
These are individuals and organizations that participate in PTAC as they are able and as much or as little as they desire.
Why is NACoA a founding member organization? Because we are saying “No more!” to creating any major solution or strategy to address and conquer the addiction epidemic that ignores the children affected by parental addiction. The addiction field has been too silent for too long. We are the children’s voice, and we intend to be heard. c
Acknowledgements: The author is grateful to PTAC  and its leader, Jac Charlier, for the use of its material  to support this column.

About the Author
Sis Wenger is NACoA’s president  and CEO.

References
Police, Treatment, and Community Collaborative (PTAC Collaborative). (2017). PTAC guiding principles for behavioral health practice. Retrieved from  http://www2.centerforhealthandjustice.org/sites/www2.centerforhealthandjustice.org/files/ publications/PTAC_Guiding_Principles.pdf