Holding up San Antonio as an example, a report by a justice system policy group recommends that law enforcement agencies change their practices regarding mental illness, sex workers and addiction without waiting for legislative action.

"We're at this 'aha' moment in criminal justice reform, where a number of events have kind of sparked this critical dialogue that we need to rethink all aspects of the criminal justice system," said David Cloud, a co-author of "First Do No Harm: Advancing Public Health in Policing Practices," released by the Vera Institute of Justice on Tuesday.

The deaths of Sandra Bland, Deputy Darren Goforth and others in and outside of Texas related to mental illness have brought the law enforcement community together in efforts to identify and reroute people who need treatment.

Cloud said such incidents have also given way to discussions about reform, which became the impetus for the study.

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The study makes four recommendations for law enforcement:

  • Reach out to advocacy groups and their constituents to build trust, empower marginalized individuals and promote dignity
  • Minimize arrests in the vicinity of harm-reduction clinics, such as those that offer needle-exchange programs, to encourage people to continue to use such services
  • Create overdose prevention programs and collaborative efforts by working with health professionals to form best practices in law enforcement, including training to resuscitate people experiencing an overdose
  • For people in need of treatment, change the metric for success from arrests made to arrests averted.

Police officers – whom Cloud said are often described as "street-corner psychiatrists" – are ill equipped to deal with public health issues. He added that they're also hampered by being part of a culture that focuses more on punishment than treatment — though that culture is evolving.

"When you have a public entity that's responsible for reducing the use and harms that addiction and poverty and things like that have, you have to judge the success those systems by much more than just the number of arrests and the number of incarcerations and the dollars," he said. "You have to think much more critically about, really – shouldn't the number of arrests that we prevent be the goal? Shouldn't we be more concerned about connecting the population to the types of health services we know they need?"

The report lists San Antonio as an example of policy changes in the right direction. There, county and city law enforcement worked with the county jail, mental health authority, courts, hospitals and other groups to create a "smart justice" policing model, saving an estimated $50 million from 2003-08, according to the report.

"They've had enormous success in diverting people with mental illness," said Kate E. Murphy, mental health policy fellow with the Center for Health Care Policy at the Texas Public Policy Foundation.

Texas cities, small and large, are recognizing the need and success of focusing on treatment and diversion, she said.

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Though legislative action might be unnecessary in some cases, lawmakers have pushed for similar reform statewide. Last legislative session, lawmakers passed a Good Samaritan bill that would have protected victims and witnesses of drug overdoses from prosecution if they called 911. Gov. Greg Abbott vetoed the legislation, saying that the bill lacked the "adequate protections to prevent its misuse by habitual drug abusers and drug dealers."

"That's one thing that I think can make a huge difference, particularly when we're talking about a true life-and-death situation with overdoses," Murphy said of such protections.

In the past three months, state officials have responded to killings and in-custody deaths related to mental illness with demands for change, including how jails process inmates and respond to treatment needs.

Law enforcement and corrections officials, especially in rural counties, agree that reform is needed, but resources are scarce, they have said. Policy makers need to review their priorities, Cloud said.

"That begs the question: What are we spending money on?" Cloud said. "What value are we getting out of it? These problems don't just go away."

Disclosure: The Texas Public Policy Foundation is a corporate sponsor of The Texas Tribune. A complete list of Tribune donors and sponsors can be viewed here.