Total systems failure: police officers’ perspectives on the impacts of the justice, health, and social service systems on people who use drugs

Abstract

Background Police in Canada have become main responders to behavioural health concerns in the community—a role that disproportionately harms people who use drugs (PWUD). Recent calls to defund the police emphasize the need to shift responsibility for non-criminal health issues from police to health and social services. This study explores the role of police interactions in responding to PWUD within the broader institutional and structural contexts in which they operate. Methods We conducted a qualitative thematic analysis of interviews with sixteen police officers across nine jurisdictions in British Columbia, Canada. We examined police officers’ everyday policing experiences interacting with PWUD, enforcing drug laws, and working alongside other service sectors. Results Officers explained that the criminal justice system is one component of a wider network of systems that collectively fail to meet the needs of PWUD. They recognized that PWUD who interact with police often experienced intersecting structural vulnerabilities such as poverty, homelessness, and intergenerational trauma. Harmful drug laws in conjunction with inadequate treatment and housing resources contributed to a funnelling of PWUD into interactions with police. They provided several recommendations for reform including specialized health and justice roles, formalized intersectoral collaboration, and poverty reduction. Conclusions Overall, this study provides unique insights into the positioning and role of police officers within a “total systems failure” that negatively impact PWUD. Police have become responders-by-default for issues that are fundamentally related to people’s health conditions and socioeconomic circumstances. Addressing failures across the health, social, and justice systems to meet the needs of PWUD will require an examination of the shortcomings across these systems, as well as substantial funding and system reforms.

Sociometric network analysis in illicit drugs research: A scoping review

“…We conclude with the suggestion that SNA may be well suited to studying illicit drugs from a whole-of-system approach, which takes into account how the health, social, and criminal justice systems overlap and how people are positioned within them [ 131 ]. A systems perspective is also compatible with a social determinants of health framework, which proposes that health is influenced by many different individual and system-level factors, such as people’s jobs, age, economic policies, and political regimes.…”

A Realist Review of How Community-Based Drug Checking Services Could Be Designed and Implemented to Promote Engagement of People Who Use Drugs

“…Although clear legislative guidance may provide a more coherent approach to DCS implementation, it is likely that services in many jurisdictions will continue to rely on less formal arrangements. It is important that further research is undertaken to identify how such arrangements are formed and maintained, and how they work in practice, particularly regarding any tensions between public health-oriented approaches to policing and expectations around law enforcement [59,129].…”

Our public safety system is a perfect storm

“…Beyond the challenges with mental health, policing is deemed intertwined with the wider criminal justice system with many suggesting the public safety system is broken. 8,9,13 This phrase is used among the popular media, politicians, advocacy groups, provider organizations, law enforcement groups, the judicial system, and even governments responsible for community safety. [23][24][25] Common are beliefs that strengthening enforcement to keep repeat and violent offenders off our streets, filling vacant police positions province-wide, implementing crisis nurse/counsellor/police response models, crisis help lines, and body-cameras, will fix the crisis in public safety.…”

“…Attempting to build a complete picture of mental health crime and the factors that affect it requires data held by a variety of agencies and multiple government agencies. 8,9 These include police, medicine, health, fire and emergency medical services, courts, law, and a host of other government, non-profit, and for-profit groups. Without a doubt, developing these multi-organization cross-silo data-sharing partnerships present unique challenges.…”