Police-led drug diversion (PDD) schemes can divert individuals caught in possession of controlled substances away from the harms associated with criminal justice pathways and toward treatment, education, or welfare support. As an alternative to prosecution, it has been established that the use of well-implemented diversion schemes may lead to reductions in reoffending, efficiencies in police time, and reductions in costs for the wider criminal justice system. However, there has been insufficient evidence to draw conclusions about the role that needs assessments play in achieving the desired aims of PDD.

This paper analyzes how three PDD schemes in England provide opportunities for individuals to make life-improving changes, focusing on the role of needs assessments. Adopting a realist framework to evaluate diversion schemes in three police forces, we carried out semistructured interviews with police officers, diversion staff, individuals who had been diverted, and other stakeholders. We identified multiple opportunities to assess the needs of people who use drugs. This included the initial interaction with the police, subsequent screening processes (often referred to as “triage”), and at other points of interaction with the diversion service provider. While all schemes provided opportunities for the diverted individual to receive relevant support, there was considerable variation in how this was made available. PDD scheme components included: the duration of the program; the process of referrals to other services; the nature of support; the level of handholding and signposting; and how the support matched the individual's specific needs. Despite variation across police forces, PDD schemes can provide opportunities which enable people who use drugs to begin to recognize, communicate, or acknowledge their own needs. Our findings suggest that the breadth of harm reduction claims—which are central to many PDD scheme aims—can be better realized when assessment of individual needs leads to tailored support and meaningful engagement with health and wider social services.