xLEPH2021 Program Themes
The program for the 6th International Conference on Law Enforcement and Public Health (LEPH2021) will address:
- Substantive issues: the huge range of complex issues in which partnerships and collaboration between police and other arms of law enforcement and the criminal justice system, and the broad range of public health actors and agencies, are vitally important and not constrained by institutional or cultural boundaries;
- Organisational issues: what kinds of problem-solving institutions are needed to make these law enforcement and public health partnerships work; and what are the consequences of innovation and the spanning of boundaries for those working in LE and PH professions?
- Reflection and methodological issues: creating a science of public health and law enforcement sectors and understandings working together, across disciplinary boundaries, and .
The law enforcement and public health movement, the Global LEPH Association and the LEPH2021 conference all contribute to the UN Sustainable Development Goals (SDGs), overcoming marginalization and inequality:
- SDG 3: Ensure healthy lives and promote well-being for all at all ages: LEPH2021 will help promote healthy lives and well-being leading to peaceful and inclusive societies, by examining and promoting integrated approaches of law enforcement and public health.
- SDG 11: Make cities and human settlements inclusive, safe, resilient and sustainable: LEPH2021 promotes partnerships for safety and inclusivity for all.
- SDG 16: Promote peaceful and inclusive societies for sustainable development, provide access to justice for all and build effective, accountable and inclusive institutions at all levels: LEPH2021 will help build law enforcement and public health partnerships that are effective, accountable and inclusive, working with communities at all levels.
Community safety and wellbeing, and the achievement of effective public health outcomes, are the result of intersecting law enforcement and public health policies and approaches that underpin integrated practice. The Law Enforcement sector, especially through the activities of public prosecutors and police agencies, has a crucial but often unacknowledged role in the protection and promotion of public health. There has been inadequate research and investigation of ways in which the Law Enforcement sector can be most effectively engaged and be most effective in carrying out its public health role.
As in all the LEPH conferences, marginalized communities and health and justice inequities are important priority themes of LEPH2021. Marginalization is the enemy of security and health for all; the viral pandemic scenario playing out before us now, and involving all of us in every aspect of our lives, is demonstrating the truth of this, with poor communities and communities of color disproportionately affected by the COVID-19 epidemic.
Inclusive policing, public health-oriented policing and Law Enforcement and Public Health partnerships work to overcome marginalization, by according equal or greater attention and support to populations at increased risk because they are excluded, because they have more exposure to determinants of ill-health and because they have unequal access to justice. The LEPH conferences seek to highlight the perspective of people with lived experience of different life and medical conditions and of their interactions with law enforcement.
Public Health is also an active partner in crime prevention, as well as confronting a huge range of complex social issues with implications for the Law Enforcement sector, such as mental health, infectious diseases (including the Corvid-19 and HIV epidemics), road trauma, community and domestic violence, gang and gun violence, alcohol and drugs (especially opioid overdoses and methamphetamine) and emergency preparedness and disaster management. As well as providing ‘State of the Art’ updates from national and international experts in both police and public health, LEPH2021 will bring together the latest research, experience and examples of successful partnership initiatives from the widest range of settings, and resources and experts in translating research findings into practice.
Overarching theme: Defying Boundaries
There has been a constant progression in the focus of the LEPH conferences since the first in 2012, which began the process of describing the field of study and endeavor in the intersecting fields. Later conferences carried on this process and also focused on analysis and the beginnings of a research agenda, which in turn focused on the importance of understanding partnerships – and then the role and practice of collaborative leadership in achieving sustainable partnerships.
In 2021 this progression will continue. From the 2019 conference, the study of partnerships revealed ongoing issues with their sustainability, resourcing, overarching goals and actual machinery. Leadership, and specifically collaborative leadership, was identified as a major factor in generating visible and measurable outcomes, depart from siloed systems, and trigger organizational or cultural change. Systemic siloed practices, policies and budgets in the law enforcement and public health sectors have often led to failures to address complex social issues. Collaborative leadership is necessary to share and negotiate control and oversight both between sectors and with external stakeholders and community leaders.
Governments, communities and the historically specialized fields themselves are increasingly beginning to understand the inextricable links between public safety and public health. Health practitioners are increasingly seen as procurers of public safety, and police and public prosecutors as public health interventionists. The role of collaborative leaders is essential to shifting policies and practices towards more integrated practices – but there remain many defining boundaries which become barriers to collaboration and integration. These include disciplinary structures, professional cultures, traditions and rivalries, workloads and work practices and sheer inertia.
It takes courage to address and defy boundaries, where these are barriers to effective approaches. Professions need the self-confidence to be open to outside scrutiny and comment; GLEPHA and the LEPH conferences are creating safe spaces for this to happen, where all have their eyes on the common goals of community safety and wellbeing. The LEPH2021 conference will advance progress towards multisectoral co-ordination, respectful collaborative approaches and partnerships, and effective and sustained integration of responses to complex health and social issues.
Major themes
Law enforcement and mental health
The roles of prosecutors in the public health mission
Violence prevention and the public health approach to policing violence: especially gun, gang and domestic violence
Law enforcement and harm reduction for illicit drug use
Health and well-being of first responders
Research in the LEPH intersection
Multisectoral organization at the jurisdictional level
Law enforcement and mental health
One in five adults in the United States experiences a mental illness, and one in twenty-five experience serious mental illnesses that interfere with life functioning. People who experience serious mental illness are disproportionately represented in the criminal justice system; they are more likely to be arrested, spend more time in jail and are at heightened risk of recidivism. Mental illness heightens the risk of suicide, which represents more than half of gun-related deaths in the United States, and of use of and suffering from licit and illicit drugs. Mental health budgets are being cut in many countries, and many low and middle income countries have no or only rudimentary community based mental health services. As a result, police see themselves as and most often are relied on as an emergency mental health service, especially in moments of crisis, but 10-30% of all routine police contacts involve people with mental illnesses. Police perceive mental health related calls as very unpredictable and dangerous, which without adequate training in de-escalation can rapidly escalate to disastrous ends. Mental health related calls can and sometimes do result in police or persons with mental illness being seriously or fatally wounded. Police often do not feel adequately trained to effectively respond to mental health crises, see mental health calls as very time-consuming and divert officers from other crime fighting activities, and that mental health providers are not very responsive. This theme examines the state of the evidence on efforts to harmonize law, policy and practice across the sectors of law enforcement and behavioral health, and showcases innovative approaches to integrate responses.
The roles of public prosecutors in the public health mission
Prosecutors are vital to the preservation of public wellbeing within the communities they serve, but it is only recently that they have begun to focus on evidence-based, non-punitive methods for maintaining public safety. Mounting evidence shows just how harmful “traditional prosecution” has been to vulnerable communities such as communities of color and indigent populations, and innovative prosecutors are increasingly looking to other fields to help grapple with underlying issues stemming from generational harm, systemic inequity, and institutional distrust. The result are modern collaborations between law enforcement, health systems, local government, and academia. Working together, these agencies are already tackling issues such as frequent system utilizers and crimes stemming from substance use- or mental health issues. Early data suggests that thoughtful, evidence-based programming often has more positive outcomes than penal responses do, suggesting that prosecutors’ work should be informed by the evolving lessons of increased collaboration between law enforcement and public health.
Violence prevention and the public health approach to policing violence: especially gun, gang and domestic violence
The reduction of violence is a critical issue across the sectors of law enforcement and public health, yet the two sectors have traditionally approached the issue from separate organizational perspectives. In all communities, violence in many and disparate forms causes substantial negative public health outcomes, including disability and death. The lifetime health impact of violence has not yet been adequately comprehended, as exposure to violence as a child can increase health risks in later life. Exposure to violence increases risks of acquired brain injury and cognitive deficit, mental health disturbance and violent behavior among those exposed. Violence, gender-based violence and domestic violence have been deemed by the World Health Organization as an epidemic in most democratic countries. Violence is contagious, inter-generationally reproduced, and shows one of the strongest inequity gradients. By conceptualizing prevention as a public health approach to violence, a wide range of interventions, especially early intervention, can become available to public health practitioners, social workers and crime prevention officers. Violence prevention is a critical element in tackling public health issues. This theme examines law enforcement and public health collaborations in addressing violence, through joint theoretical and methodological approaches, including epidemiological criminology and sentinel events analysis. An evidence-based approach to violence prevention within collaborative frameworks sets a promising platform to engage in more constructive, collaborative, integrated forms of leadership.
Law enforcement and harm reduction for illicit drug use
Problems associated with illicit drug use and dependence sit at the nexus between law enforcement and public health, being associated with crime and adverse health outcomes, including overdose and blood-borne virus transmission. The opioid overdose epidemic has afflicted countries around the world: in the U.S., more than 130 people have died each day in from an opioid-related overdose. Behavioral and mental health issues associated with the use of methamphetamines and other stimulants can be extremely challenging. The police role in supporting public health approaches to achieve the common goals of reducing the harm caused to the individual and to the community is critically important, and requires a mutually respectful partnership between police and harm reduction programs. Naloxone initiatives and pill testing are recent examples of how harm reduction practices can benefit community members. Policies regarding currently illicit drugs vary worldwide and are evolving in different countries and regions – sometimes rapidly. Decriminalisation and legalization of cannabis has occurred in many places, some which previously had immensely restrictive and punitive policies, shaping legal opportunities and challenges associated with cross-sector cooperation. The roles of police and prosecutors, and of health and drug treatment services, change with changing policy – this theme examines the nexus between police, health and social services and ways of striking a balance between public safety and public health.
Health and well-being of first responders
You can’t have healthy partnerships without healthy partners. Police officers, first responders and health practitioners are expected to cope with a myriad of complex and often deeply troubling situations, reinforced by informal ‘by-default resilience’ cultures which sometimes do not allow for expressions of vulnerability, or enough time to deal with one’s own vulnerability. They face daily threats to their mental health and well-being, ranging from continued exposure to trauma to the relentless demands of shift work. Attention is finally being given to first responders’ wellbeing and resilience, and agencies are recognizing the vulnerability of their members, accentuated by the growing problem of alcohol and other drug use and addiction and high rates of suicide in the profession. Police are often viewed as resilient when they may simply have developed ways of coping that ultimately lead to burnout and post-traumatic stress disorder. Health practitioners’ resilience is often credited to the fast-paced environment of hospital emergency wards, and constant demands on staff and health outcomes. If police and other first responders are to operate optimally, a focus on challenges to first responder wellness and resilience are critical. This requires police, emergency and health agencies to take steps to promote wellbeing amongst their members, ensure that help seeking is encouraged and enabled, and embed access to health and wellbeing services within internal policies. This theme area encompasses the latest of research evidence and policy innovations in addressing officer health and wellness, critical not only to the resilience of first responders but also to effective and compassionate encounters with people affected by such issues. Presenters are encouraged to create a space whereby conference participants can deliberate on what services and processes are available in furtherance of police resilience.
Research at the LEPH intersection
Through previous LEPH conferences and the growing LEPH literature examining an extensive body of experience, the inextricability of the two sectors in addressing complex issues has been clearly demonstrated. There is now a need for an intensive and ongoing multidisciplinary research effort to provide the evidence base to inform both LE and PH practice and partnership. Police and prosecutors, on the one hand, should understand both the need for their work to be informed by evidence, and the need to reduce the untoward effects of their interventions; public health practitioners, on the other, need to better understand the role of police and prosecutors in the public health mission. Both can learn from the other, and it is the academic and applied research effort which can facilitate this.
In many jurisdictions, Police and prosecutors often lack the tools, language, and concepts to conceive of their work in a properly intersectional and collaborative way, and are unaware of how the evidence and methods of public health can usefully shape the strategy and practices of policing and law enforcement. Academic public health is largely unaware of the role and importance of law enforcement actors in achieving public health goals. And both need experience in joint research, to address the ‘the dialogue of the deaf’. This theme will address these needs, focusing on methods and tools for LEPH research, and promote discussion and exploration of metrics of success – bridging public health and criminal justice performance measures.
Multisectoral organization at the jurisdictional level
How best can jurisdictions organize multiple agencies to achieve the collaborative vision of LEPH? There is a need for a better understanding of how to organize multiple agencies in the same jurisdiction: to identify change agents who can address the institutional and other barriers to shifting focus from public safety (narrower) to public health (broader), and to promote alliances in propagating public health policies. The LEPH conferences can provide a comparative perspective, looking at approaches to these issues in different contexts and seeking to identify principles common to effective working which can find their optimum expression at the local level.
Other key themes
Injury prevention including road trauma
ACEs
Emergency Preparedness – crises and catastrophes
Neuroadversity – FASD, epilepsy, A/TBI, autism spectrum
Trauma-informed approaches to policing, childhood adversity and early intervention: What does trauma-informed awareness mean for practice?
LEPH education, incl LEPH PhDs
LEPH in Low and Middle Income Countries
All Conference Themes
This is not an exhaustive list – it illustrates many but by no means all of the issues which require collaboration and partnerships between the Law Enforcement and the Public Health sectors.
Law enforcement and mental health:
- Crisis Intervention Teams
- Tasers and mental health
- Dual diagnoses: police interactions with persons with dual diagnoses (mental illness and substance use)
- Police interactions with mentally ill people: police response to people in various types of emotional and psychiatric crisis and trauma
Violence prevention:
- gender-based violence, domestic violence, violence against women;
- gun violence, gang violence
- prevention of school violence: including school discipline, school resource officers and preventing the school to prison pipeline
- Sexual assault
Law enforcement and harm reduction:
- Opioid crisis, including opioid litigation – and the police role in responses; naloxone
- Law enforcement interactions with key affected populations and people living with HIV and other blood-borne viruses
- Supervised consumption facilities/Overdose Prevention Sites: International models and lessons learned
- How to avoid turning an overdose into a crime scene
- The prosecutor’s role in drug policy reform
Alcohol and other drugs
- Differing perspectives on alcohol and drug dependence
- Assaults in and around licensed liquor establishment
- Drunk and drug-impaired driving
- Tobacco control
Legal and prosecutorial approaches to public health
- The role of public prosecutors
- The role of defenders
- Holistic defense
The role of law enforcement in infectious disease control
- Epidemics and pandemics
Injury prevention
- Road trauma
- Suicide
First responder wellness:
- organizational stress, community stress, workforce that responds
- PTSD
Racial disparities and inequities in access to health and involvement with the CJS:
- Racially marginalized communities and LEPH
- Indigenous communities and LEPH
Incarceration:
- prisons as public health institutions
- prison to college pipeline
Other law enforcement actors: Sheriffs’ offices, University and transit police, Private policing and security, courts and the judiciary, medical examiners and coroners, jails and prisons.
Law enforcement and migration:
- trauma, criminal victimization, communicable disease risks
Homelessness:
- access to health and housing: housing first
- crime, disorder and victimization associated
ACEs and trauma:
- Adverse Childhood Events, Adverse Community Environments
- Life-courses and different age-groups and the consequences for LEPH
Neuroadversity: Neurocognitive and behavioral conditions
- communication disorders
- epilepsy, Parkinsonism, FASD, autism spectrum, dementia,
Social determinants of health
- Polarization within communities / between groups and possible LEPH approaches
- Meaning and impact of social networks in a LEPH context
Reproductive Justice issues and Criminalization of Public Health Concerns
- the intersection of public health issues that are finding their way into the criminal justice system (abortions, HIV infection, COVID-19 etc);
Juveniles in the justice system – unique challenges, and needs:
- Arrest and cuffing
- Juvenile interrogation and Miranda practices
- Youth-focused LE training that seeks to bring a trauma-informed lens
Hate crime and the new nationalism
Human trafficking and sexual exploitation
Veterans issues
Role of media and journalists (e.g. crime writers) in shaping the narratives around the issues (e.g. violence)
Climate change
Cities – Urban peace initiatives
Digital & Cyber on the intersection of LEPH
Information and data sharing
Role of law enforcement in developing pro-social activities:
- What are all the pro-social activities law enforcement can support to build healthier communities that need less enforcement?