The 5th International Conference on Law Enforcement and Public Health (LEPH2019) will present a multi-focused Conference Program that will address three main areas:
- Substantive issues – all the particular issues in which the police-public health partnership is important
- Organisational issues – how to best achieve optimal and sustainable partnerships
- Reflection and methodological issues – creating a science of the public health and law enforcement intersection
LEPH2019 is another important step in further understanding the intersection between police and other law enforcement personnel and those individuals and organisations delivering public health programs in the community. A key theme for LEPH2019 will be ‘Collaborative Leadership’ which builds on previous conferences that described and analysed the issues, examined a range of actual and possible responses and touched on leadership in policy and practice.
LEPH2019 aspires to contribute to the achievement of the Rio+20 Conference’s Sustainable Development Goals (SDGs) to overcome marginalisation.
- LEPH2019 will help promote healthy lives and well-being leading to peaceful and inclusive societies by an integrated approach of law enforcement and public health (SDG 3)
- LEPH2019 will help build police-public health partnerships that are effective, accountable and inclusive (SDG 16)
The achievement of effective public health outcomes is often the result of intersecting law enforcement and public health policy that underpins integrated practice. Law enforcement, especially through the activities of police forces, has a crucial but often unacknowledged role in the protection and promotion of public health. This means that there is an inadequate approach to research and investigation of ways in which law enforcement can be most effectively engaged and be most effective in carrying out their public health role.
As for all LEPH conferences, marginalised communities are an important priority theme of LEPH2019. Marginalisation is the enemy of security and health. Too often around the world police have been agents of marginalisation. Inclusive policing works to overcome marginalisation, by according equal or greater attention and support to populations at increased risk because they are excluded and have unequal access to justice.
Public health is an active partner in crime prevention as well as a range of other complex social issues like mental health, infectious diseases, road trauma, community and domestic violence, alcohol and drugs and disaster management. As well as providing ‘State of the Art’ updates from national and international experts in both police and public health, LEPH2019 will bring together experience and examples of successful partnership initiatives from the widest range of settings.
This is a must attend conference for those working as policymakers, researchers and practitioners in the law enforcement, public health, local government and allied sectors.
Overarching theme: Collaborative leadership
The need to build efficient partnerships to address complex issues is not a new idea, having been explored globally in various disciplines. The constant relevance of the study of partnerships however reveals ongoing issues with their sustainability, resourcing, overarching goals and actual machinery. Within this, leadership, and specifically collaborative leadership, is often raised as a major factor to produce impact and generate visible and measurable outcomes, depart from siloed systems, and trigger organizational or cultural change. This is very relevant to the field of law enforcement and public health, where systemic siloed practices, policies and budgets have often failed to address complex social issues.
The primary goal of collaborative leadership is to obtain effective and efficient results across a wide range of supra-organizational boundaries. As a result, collaborative leaders spend a significant portion of their time building and maintaining relationships, handling conflicts constructively, and sharing or negotiating control and oversight with external stakeholders or community leaders. Leadership in collaborative endeavours significantly departs from
a traditional, hierarchical organization[s] in that participation is voluntary and
egalitarian and often entails cooperation by organizations with different cultures and agendas.
Partnership leaders, accordingly, often lack formal control over members and their actions.
Jeffrey A. Alexander, Maureen E. Comfort, Bryan J. Weiner, Richard Bogue. Leadership in Collaborative Community Health Partnerships. Non profit management and leadership journal. 2003, 12:2 (159-175).
Such sharing of responsibilities, especially across the fields of policing, criminal justice and health, presents challenges as far as the daily job routine is concerned, as well as in the design of co-opted evaluation measures, mixed methods analysis, goal sharing and shared visions.
Subtle cultural shifts are taking place globally in the policy underpinnings of law enforcement and health agencies, who have traditionally seen their role as siloed. However, the historically specialized fields are increasingly beginning to understand the inextricable links between public safety and public health. In part, this has resulted from deliberations about health practitioners as procurers of public safety, as much as the role of police as public health interventionists. At the epicenter of such deliberations, the role of leaders and managers is essential to bringing a new organizational ‘flavour’ to business as usual, shaping debates and shifting policies and practices towards more integrated practices.
- Trauma-informed approaches to policing, childhood adversity and early intervention:
What does trauma-informed awareness mean for practice?
There has been increasing interest in Adverse Childhood Experiences (ACEs) in recent years. Research shows that childhood adversity can create harmful levels of stress which impact on healthy brain development resulting in long-term effects on learning, behaviour and health. Neurobiological research indicates that the ‘toxic stress’ associated with ACEs leads to physical changes in the way the brain develops and increases people’s propensity to experience future stress, adopt health harming behaviours and develop mental and physical illness. Research in Wales has found that ACEs are associated with risky health behaviours, poorer mental health, suicide risk, being a perpetrator or victim of violence and experiencing incarceration. Children and adults with experience of ACEs may come into contact with the criminal justice system both as victims or witnesses and perpetrators of crime. They may also interact with the civil justice through family law systems. Of course, not all people who experience adverse or traumatic childhoods become victims and/or perpetrators of crime. So, understanding why some children do well despite early adverse experiences is also crucial. Identifying which buffers, or ‘protective factors’, can mediate the effects of childhood adversity and trauma can inform policy and practice to help more children reach their full potential. So, a multi-agency approach is required. The police and the justice system have a key role in preventing and, in particular, mitigating the impact of ACEs and avoiding re-traumatisation. There has been growing interest and developments in trauma-informed leadership, training and practice and in exploring routine-inquiry across sectors. So, how are justice organisations and professionals responding to this challenge internationally with their partners and collaborators? And is this experience common and transferable?
- Public Prosecutors and District Attorneys – their role in public health.Public prosecution agencies play a vital but often overlooked role in the legal and public health aspects of community safety and wellness. In contrast to the traditional modern criminal justice system — designed to control crime and to administer sanctions to those who violate the law — current criminal justice reform movements around the world aim to rectify harms done to victims and communities, address the underlying issues of those accused, and prevent future harms.
Prosecutors play a key role in the exploration of non-traditional responses to crime, such as diversion programs, restorative justice, community courts, and drug courts. This requires collaboration between prosecution, police, defense counsel, the courts, and others, notably public health and social service agencies. Treatment responses are particularly challenging but also critically important in cases involving repeat offenders and those with mental health or addiction issues.
While such non-penal responses to harm have been criticized as “soft on crime,” mounting data suggests that thoughtful, evidence-based programming can often have more positive outcomes than traditional penal responses, including increased feelings of resolution for victims, enhanced perceptions of justice for people who are charged with crimes, and decreased recidivism. These early results suggest that prosecutors’ work can and must be informed by the evolving lessons of collaboration between law enforcement and public health.
- Law Enforcement and Mental Health
Literature has documented the essential role of police as gatekeepers to both the mental health and criminal justice systems for the past 70 years. 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 of ill-resourced mental health services and of a lack of systematic availability, police see themselves as being relied on as an emergency mental health service.There is a disproportionate involvement of people with serious mental illnesses and in mental health crises in the criminal justice system: 10-30% of all police contacts involve people with mental illnesses, and high proportions of prisoners in all jurisdictions have a mental illness.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.Despite attempts at integrating police and mental health services by way of policy, legislation and MoUs, there is still a way to go to streamline and integrate what remains collaborative yet siloed operational procedures.
- LE, drugs (incl alcohol) and harm reduction:People who use drugs, policing & legal frameworks, drug related deaths and harm reduction
Both licit and illicit drugs can be associated with adverse health outcomes and with crime and risks to public safety. Police have been critical actors in the reduction of alcohol-related road trauma, and in collaboration with health authorities can ameliorate much of the damage caused by alcohol. The police role in supporting the proven public health approach of harm reduction to achieve common goals is critically important and requires a good understanding of the dynamics of drug markets, of drug use and of dependence, and 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, and a good example of integration of services.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. The role of police and of health practitioners clearly changes with changing policy – but in what ways? How are leaders promoting better research-led policies and influencing collaborative practices?
- Police and other First Responder mental health and wellbeing
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. These threats range from continued exposure to trauma to the relentless demands of shift work.
Today, attention is finally being given to first responders’ wellbeing and resilience, and agencies are only now beginning to recognize the vulnerability of their own members, accentuated by the growing problem of 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 first responders are to operate optimally, deliberations and research focused on the challenges to first responder wellness and resilience are critical. This requires police, emergency and health agencies to take innovative steps to promote wellbeing amongst its 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 the area of officer health and wellness. This includes presentations on the everyday realities and difficulties faced by police members, their leaders and their organizations. Such innovations are critical not only to the resilience of the first responder community, but to the advancement of effective and compassionate encounters with people affected by such issues as well. Presenters are encouraged to create a space whereby conference participants can deliberate on what services and processes are available in furtherance of police resilience.
- Emergency Preparedness – crises and catastrophes
Collaborative leadership is an essential feature of emergency management. This theme covers a very wide range of events in which concerted efforts across health authorities and law enforcement (to just cite a few) are critical to address the worst of circumstances: people impacted by natural disasters, major disease outbreaks and pandemics, mass violence, human-caused disasters, technological disasters and very topically, refugee crises. Adverse health outcomes following these events include injury and death, mental health and physical health problems, drug and alcohol use, increased mental health service demand; community safety is threatened by looting, destruction of property, and theft. Evacuations and food and water relief also call for cooperation and collaboration between health and law enforcement.
- Neurocognitive disorders – ‘Hidden in plain sight’ e.g. epilepsy, Fetal alcohol spectrum disorder, Acquired/Traumatic Brain Injury
Health and criminal justice systems frequently encounter people experiencing communication or cognitive difficulties. In such cases, the needs of the individual may be unclear or misunderstood. As a result, interventions may be inappropriate and susceptible to aggravate harm. Understanding how health and police can collaborate in supporting people with neurocognitive disorders and ‘hidden ‘vulnerabilities, such as acquired brain injury is paramount to providing effective services and abiding by fundamental human rights.This theme covers a very wide range of situations such as contact with people who have dementia, learning difficulties, epilepsy, autism, neurobiological brain injury such as stroke or head trauma, hearing or sight impairment, or when someone is unresponsive through injury. Research and innovation in this area of police intervention and health care is emerging, particularly within the field of speech and language therapy. Yet there remain wide ranging opportunities to share and develop multi-agency learning and research in this crucial area of practice. In this theme, we encourage presentations from a range of disciplines to support understandings of communication innovations, collaborative practices, leadership and research to reduce barriers to effective communication, reduce additional trauma, and improve health and police responses. We are particularly interested in exploring how such learning could be transferable and made available within police and health practice and multi-agency safeguarding to maximise opportunities for appropriate communication interventions.
- Child protection and Sexual abuse, Exploitation
More to come
- Violence –Gender-based violence, violence prevention, domestic violence
Violence, gender-based violence and domestic violence have been deemed an epidemic in most democratic countries.
Worldwide, it has been recognised that violence against women and violence against children are with WHO describing violence against women as a “global health problem of epidemic proportions”.
Deborah A Fry & Stuart P Elliott. (2017) Understanding the linkages between violence against women and violence against children. The Lancet. 5:5, PE472-473.
Violence causes considerable negative public health outcomes including potential disability, and death. Researchers still struggle to find proper ways to evaluate the lifetime health impact of violence, as exposure to violence as a child can increase health risks in later life.Violence is contagious, inter-generationally reproduced, and shows one of the strongest inequalities 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. An evidence base approach to violence prevention within collaborative frameworks sets a promising platform to engage in more constructive, collaborative, integrated forms of leadership
- Racial/ethnic disparities in access to health and involvement with criminal justice
Providing health services and policing services to members of ethnic minority groups often presents unique challenges. Indigenous peoples in Canada, US, Australia and New Zealand face very similar justice and health issues with lower life expectancies, overrepresentation in the courts and corrections and significant health issues, including higher rates of alcohol and other drug use, mental health issues and infectious diseases including HIV. Similarly, refugees or people who do not speak the national language of the country in which they have settled are sometimes facing cultural, language and sometimes religious obstacles to accessing support services.Access to justice and health is intimately related to socioeconomic status and class. Disparities affect ethnic minority communities in ways that are inextricably linked. Such disparities must be addressed holistically, and in culturally-friendly ways.The conference looks to engage with ethnic leadership to better understand culturally-relevant concepts of justice, which includes broader social justice, and collaborative approaches to these highly complex issues, with public health and law enforcement working together with communities.
- LEPH education, incl LEPH PhDs
Despite frequent aspirational calls for cross-sectoral collaboration, public health and safety professionals and institutions continue to work in silos, and – at times – at cross purposes. Numerous factors impede integration, including divergent professional cultures, skill-sets, incentives, as well as the pervasive demand to do more with less. Education and training serves as an additional barrier, but is also one of the key building blocks towards improved collaboration. Achieving police-public health synergy requires an agenda to reform training, skill-building and other educational infrastructure within these sectors, at both frontline and management levels. This includes developing a shared vocabulary, service systems, and key performance indicators, which can then be integrated into law enforcement and public health training curriculums. If police officers continue to take on an increasing role as public health interventionists and collaborators, then we also must start building a theoretical and practicum-based framework for better education. What pedagogical, technological, and other tools can be deployed to deliver new training content in most effective and cost-effective ways?Academic public health education also needs to include the importance and role of law enforcement, especially police, in the public health mission. This theme emphasizes the importance of such training and education in bringing law enforcement and public health practitioners together in their pursuit of healthy and safe communities.
- LEPH in Low and Middle Income Countries
More to come
Examples of Other Topics within a particular theme (by no means exhaustive)
- Infectious disease – epidemics
- Defenders – the role of legal defenders in public health; holistic defence
- LEPH and migration, Roma and travelers
- Epidemiological criminology
- Acid attacks
- Human trafficking
- Female genital mutilation
- Incarceration – prisons as public health institutions
- Road safety and trauma
- Sentinel events analysis
- Sex work
- Suicide prevention
- Hate crime and the new nationalism
- Marginalisation as enemy of security and health: inclusive policing to overcome marginalisation
- Information and data sharing
- Tobacco control