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The Los Angeles Diversion, Outreach, and Opportunities for Recovery (LA DOOR) program is a Proposition 47–funded program designed by the Los Angeles City Attorney's Office (LACA) to provide a comprehensive, health-focused, preventative approach that proactively engages individuals at elevated risk of returning to LACA on a new misdemeanor offense related to substance use, mental illness, or homelessness. This report documents the findings of a process and outcome evaluation of Cohort 2 of the LA DOOR program, covering services provided from January 2020 through February 2023. The goal of this evaluation is to better understand how the LA DOOR program was implemented and examine the effect of the program on various outcomes. This report describes an overview of the program, evaluation methods, the logic model that guided the evaluation, findings from stakeholder interviews and client focus groups, and analyses of program data. Qualitative interviews and focus groups revealed key strengths and challenges of the program and focused on specific challenges of operating during the coronavirus disease 2019 (COVID-19) pandemic. Analyses of quantitative data describe the population of clients who are receiving LA DOOR services, the needs of that population, and the services provided. Together, these findings shed light on opportunities for future program implementation and evaluation. Interested stakeholders of this report include LACA, the California Board of State and Community Corrections, and the City of Los Angeles, as well as other entities that provide supportive services to criminal justice populations or that might be interested in implementing a similar program.

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Sheppard Pratt is one of the oldest providers of mental health care in the United States, having first opened as an inpatient psychiatric hospital in suburban Baltimore in 1891. Beginning in the early 1990s, Sheppard Pratt transitioned into a community-based mental health specialty care system, combining its traditional inpatient services with an increasingly diverse array of community-based outpatient clinical, residential, and recovery-oriented services. Today, Sheppard Pratt operates a comprehensive continuum of care that is unique within the United States and comprises more than 160 programs at more than 380 sites across Maryland and West Virginia. To explore how Sheppard Pratt's experience can potentially inform national mental health policy, the authors interviewed senior staff at Sheppard Pratt to understand the distinctive characteristics of the organization, ways in which it addresses challenges that mental health policymakers face, and continuing challenges that it faces in reaching its own goals.

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Many law enforcement and other first responder agencies have adopted deflection as a front-line response to the increasing number of drug overdoses and deaths in the United States over the past two decades. Deflection programs aim to connect individuals with substance use disorder (not necessarily limited to opioids or one particular substance) who encounter the criminal justice system with treatment and other services according to the individual's needs. This report describes the findings from a multi-site evaluation of law enforcement deflection in the United States. The authors describe how each program is implemented and identify key program facilitators and barriers. For two of the six sites, the authors conducted outcome analyses to determine whether the model is effective in reducing drug-related deaths and overdoses, arrests, and treatment admissions.