Evaluation of Yellow Line Project

The Yellow Line Project (YLP) has operated in Blue Earth County (BEC) in Minnesota since 2018. It was created to help police officers that encounter individuals with behavioral health problems enable access to treatment options and other supports instead of incarceration. The project attempts to screen individuals for mental or chemical health problems and provide an early response to connect to services with the overall goal of breaking the cycle of recidivism caused by underlying behavioral health needs. During its early phases, the screening process was focused in the pre-booking area and offered law enforcement courses of action for these individuals other than emergency rooms, detox, or jail. There are now three primary pathways for a YLP intervention. In addition to offering pre-arrest alternatives, there are street-level screenings and screenings for individuals in jail less than three days. YLP sometimes also provides services to the incarcerated population to facilitate transitions to treatment or home after release.

The goal of the YLP is to screen 100% of individuals with because of SUD or mental health concerns who encounter law enforcement and could potentially be incarcerated as a result. In a typical encounter that might involve an individual with mental health problems or SUD, law enforcement would make a call for service to YLP, and a Community Based Coordinator (CBC) would assist with further screening and discuss any considerations for charges. This help provided by the CBC makes the screening process easier for law enforcement and provides alternative upstream choices for the individual. Regardless of whether the charges remain, the CBC would recommend appropriate services and referral to develop a Yellow Line Plan if the individual is eligible and chooses to participate.

In addition to the successful instances connecting individuals to treatment services, YLP has seen improved mutuality between human services and law enforcement (philosophically, practically, and systematically) and some financial cost reductions in treatment and detox, jail bed days, and ancillary court costs. The main objective of the impact evaluation is to determine if the YLP has reduced recidivism, increased access to behavioral health treatment, or reduced hospitalizations. The target population is adult individuals with behavioral health problems who have received criminal charges in BEC.

Our impact evaluation of YLP investigated the effect the program had on reducing short-term recidivism and changing utilization of mental health (MH) and substance use disorder (SUD) treatment for Minnesotans with who encounter law enforcement. The evaluation used a quasi-experimental study design to compare the impact of participants, relative to like non-participants.

We found, compared to the baseline period and relative to similar non-participants, YLP participants:

Experienced a 17% reduction in their risk of future recidivism;
Were approximately 1.5 times more likely to use SUD treatment services in the short term and less likely to use the emergency department for nonfatal overdoses;
Were 2 to 3 times more likely to use MH treatment services for a full year after encountering YLP and 3 times more likely to use intensive MH services (e.g., hospitalizations); and
Were no more likely to use Medications for Opioid Use Disorder.

Our findings indicate YLP has a significant, positive impact on its goals of interrupting the cycle of recidivism and connecting people with behavioral healthcare resources. Compared to all people who are arrested, YLP targets individuals who law enforcement officers perceive as having a higher risk of recidivism due to prior interactions or BH concerns. Our analysis of program participants indicates this is true, as participants had significantly less time between court cases than a closely matched group of non-participants before exposure to the program. YLP was able to substantially reduce that greater risk of recidivism and bring it in line with the average rate of the matched group after exposure to the program. These findings are supported by a county-wide analysis that shows a similar reduction in recidivism in Blue Earth County, relative to peer counties which have not implemented a program like YLP.

(Technical appendices forthcoming)