This town of 170,000 replaced some cops with medics and mental health workers. It’s worked for over 30 years
By Scottie Andrew, CNN, July 5, 2020
Around 30 years ago, a town in Oregon retrofitted an old van, staffed it with young medics and mental health counselors and sent them out to respond to the kinds of 911 calls that wouldn’t necessarily require police intervention.
In the town of 172,000, they were the first responders for mental health crises, homelessness, substance abuse, threats of suicide — the problems for which there are no easy fixes. The problems that, in the hands of police, have often turned violent.
Today, the program, called CAHOOTS, has three vans, more than double the number of staffers and the attention of a country in crisis.
CAHOOTS is already doing what police reform advocates say is necessary to fundamentally change the US criminal justice system — pass off some responsibilities to unarmed civilians.
Cities much larger and more diverse than Eugene have asked CAHOOTS staff to help them build their own version of the program. CAHOOTS wouldn’t work everywhere, at least not in the form it exists in in Eugene.
But it’s a template for what it’s like to live in a city with limited police.
It’s centered around a holistic approach
CAHOOTS comes from White Bird Clinic, a social services center that’s operated in Eugene since the late 1960s. It was the brainchild of some counterculture activists who’d felt the hole where a community health center should be.
And in 1989, after 20 years of earning the community’s trust, CAHOOTS was created.
It stands for Crisis Assistance Helping Out on the Streets and cheekily refers to the relationship between the community health center that started it and the Eugene Police Department.
Most of the clients White Bird assisted — unsheltered people or those with mental health issues — didn’t respond well to police. And for the many more people they hadn’t yet helped, they wanted to make their services mobile, said David Zeiss, the program’s co-founder.
“We knew that we were good at it,” he said. “And we knew it was something of value to a lot of people … we needed to be known and used by other agencies that commonly encounter crisis situation.”
It works this way: 911 dispatchers filter calls they receive — if they’re violent or criminal, they’re sent to police. If they’re within CAHOOTS’ purview, the van-bound staff will take the call. They prep what equipment they’ll need, drive to the scene and go from there.
The program started small, with a van Zeiss called a “junker,” some passionate paraprofessionals and just enough funding to staff CAHOOTS 40 hours a week.
It always paired one medic, usually a nurse or EMT, with a crisis responder trained in behavioral health. That holistic approach is core to its model.
Per self-reported data, CAHOOTS workers responded to 24,000 calls in 2019 — about 20% of total dispatches. About 150 of those required police backup.
CAHOOTS says the program saves the city about $8.5 million in public safety costs every year, plus another $14 million in ambulance trips and ER costs.
It had to overcome mutual mistrust with police
White Bird’s counterculture roots ran deep — the clinic used to fundraise at Grateful Dead concerts in the West, where volunteer medics would treat Deadheads — so the pairing between police and the clinic wasn’t an immediately fruitful one.
There was “mutual mistrust” between them, said Zeiss, who retired in 2014.
“It’s true there was a tendency to be mistrustful of the police in our agency and our culture,” he said. “It was an obstacle we had to overcome.”
And for the most part, both groups have: Eugene Police Chief Chris Skinner called theirs a “symbiotic relationship” that better serves some residents of Eugene.
“When they show up, they have better success than police officers do,” he said. “We’re wearing a uniform, a gun, a badge — it feels very demonstrative for someone in crisis.”
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