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CAHOOTS: A Model for Alternative Emergency Response

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October 07, 2020

CAHOOTS: A Model for Alternative Emergency Response

A presentation describing CAHOOTS - a non-police mobile crisis response service in Eugene, Oregon - and how this model could be a better alternative for many situations currently handled by police in Santa Cruz County.



October 07, 2020


  1. CAHOOTS: A Model for Alternative Emergency Response Presented by Roxy

    Davis, M.A. Q&A Moderated by Mark Cieslikowski Alternative Emergency Response Working Group
  2. In this presentation… § Why do we need an alternative

    to police for response to crisis situations? § Overview of the CAHOOTS model § Conclusion & next steps
  3. Why do we need an alternative to police? § Police

    are usually the first responders to crisis situations, but are not equipped to handle many of these situations effectively § Police responding to a crisis may arrest, injure, or even kill the person in crisis rather than providing the help needed § Even if no one is harmed, a police response costs more and is less helpful than non-police crisis intervention
  4. Why do we need an alternative to police? § Police

    spend a huge amount of time and resources responding to crisis situations § In FY 2017, welfare checks made up 22% of calls to SCPD § Less than 16% of calls to SCPD were classified as crime-related § For SCSO, 43-56% of calls each month in 2020 have been welfare checks
  5. Why do we need an alternative to police? § Police

    are burdened by these types of calls § From the 2018 SCPD operations analysis report: “The city has defaulted the handling of almost all social ills in the city to the police department, especially those dealing with the homeless population. Through the focus groups conducted with the department’s supervisors and line-level personnel, it was obvious there is a high level of frustration among all employees regarding the responsibilities of dealing with the homelessness issue.”
  6. Why do we need an alternative to police? Findings from

    focus groups with SCPD employees: § “80 percent of all calls for service are homeless-related that they can’t do anything with.” § “Officers no longer do crime-related work because of dealing with homeless issues.” § “Officers feel burdened by the amount of homeless- related calls.” § “Officers have no tools or resources to deal with homeless population. ”
  7. Why do we need an alternative to police? Police responding

    to a crisis may escalate the situation or arrest the person in crisis § People in distress are likely to become more fearful and upset when armed police officers respond § Police may arrest the person in crisis § Exposes them to the harms of criminal justice system involvement and incarceration – especially dangerous for people with mental/physical illness or disability Tamario Smith, 21, died in SC County Jail on May 10, 2020
  8. Why do we need an alternative to police? Police responding

    to a crisis may injure or even kill the person in crisis § Studies have found that 27-81% of people killed by police have some kind of mental illness or disability (Perry & Carter-Long, 2016) § People of color (especially Indigenous and Black) are especially at risk of police violence Sean Arlt, 32, killed by SCPD in October 2016 during a mental health crisis
  9. Why do we need an alternative to police? From SCPD

    Chief Andy Mills’ blog (6/16/20): § “I recently spoke with a sergeant about defunding. He said, ‘If someone could take the homeless issues entirely from us and stop us from responding to mental health calls—please, take the money!’ The sad reality is that no one else has stepped up as the first responder to these issues.”
  10. Mobile Crisis Intervention: The CAHOOTS Model § What’s the alternative?

    Adapted from materials by Ben Adam Climer
  11. What is CAHOOTS? § Established in 1989 in Eugene, OR

    by White Bird Clinic § Recently expanded to Springfield, OR § A non-police first response to residents experiencing mental health, substance use, and homelessness-related crises § Provides de-escalation of crisis situations, non- emergency medical care, transportation to services, and more, at a fraction of the cost of police or fire/EMS
  12. The CAHOOTS team § Each unit has two staff: a

    crisis counselor and an EMT § Crisis counselor provides de-escalation and crisis support § EMT does medical assessment, rules out physical issues that might present as mental health issues, and provides first aid § Rigorous training process lasts 3-6 months
  13. Who does CAHOOTS serve? § CAHOOTS services are available to

    everyone! § People living on the street § People experiencing psychosis or mania § People having suicidal thoughts § Family members in a dispute § Minor medical issues such as wound care, blood sugar, body aches, etc. § People who have fallen out of touch with loved ones § People living in shelters or transitional housing § Intoxicated people
  14. Common CAHOOTS interventions § Crisis de-escalation § Medical evaluations §

    Transport to staffed services § Referrals to ongoing care § Conflict mediation § Wellness checks § Provide food and supplies to unhoused people § Partnered with the local food bank to be a “mobile pantry” § Mobile needle exchange
  15. Responses to suicidality § In 2018, 69% of suicide interventions

    were CAHOOTS only § 25% involved police – almost always police calling CAHOOTS to come help § 64% did not involve hospital visits § In 2019, 7% of CAHOOTS calls involved suicidal ideation
  16. Safety concerns § CAHOOTS has a philosophy of not treating

    people with mental illness as inherently dangerous § In 31 years, no CAHOOTS staff member has ever been injured by a person they were responding to on a call § CAHOOTS evokes a different response from people than police § Team members approach calmly and with compassion, provide a soothing presence to de-escalate § Uniforms are intentionally casual-looking – a t-shirt or hoodie and jeans – to put people at ease § CAHOOTS is only there to help and has no power to harm, either through the legal system or through force/weapons
  17. How to access CAHOOTS services § Anyone can request CAHOOTS

    via 911 or non- emergency number § CAHOOTS is unique in that it is dispatched by the same system as police, fire, and EMS § This means it actually diverts calls that would normally go to other first responders
  18. Police diversions § Eugene PD estimates that CAHOOTS diverts 8-10%

    of all police calls § With more funding, CAHOOTS could handle more § In 2018, 86% of calls did not involve police; 13% were requests to assist police § <1% of CAHOOTS calls required police to respond § In 2018, 3,360 CAHOOTS responses were classified as jail diversions
  19. EMS diversions § In 2017, there were ~4000 medical calls

    for service § ~3000 ER diversions § ~2000 ambulance diversions § E.g. client with serious arm wound – refused to go to hospital so CAHOOTS rebandaged every day until it healed § 36% of suicidal patients transported to ER § Only 6% of suicidal patients had EMS present
  20. Cost- effectiveness § CAHOOTS is much less costly than other

    first responders § Can handle situations with fewer personnel § Diverts from jail & ER for further cost savings § In FY 2017, SCPD responded to 67,904 calls on a budget of $26 million = ~$380/call § SCPD budget has since increased to $31m in FY 2021 § In 2019, CAHOOTS responded to 29,087 calls on a budget of $2 million = ~$70/call
  21. Cost- effectiveness: Case study § This interaction involved a deputy,

    a mental evaluation team, a fire engine, and an ambulance § One CAHOOTS team of two people could have handled this entire interaction independently!
  22. Conclusion § The CAHOOTS model provides a more compassionate, safer,

    and more helpful response to crisis than police § This model alleviates burden on police and other first responders § There is a demonstrated need for this in Santa Cruz § This model is much more cost-effective than having police or EMS respond to these kinds of calls
  23. What’s next? § The CAHOOTS model is spreading to other

    cities (most notably Denver), and many other cities and counties are currently exploring adopting it § Our hope is to start a program using this model in Santa Cruz County, ideally county-wide § Study session being organized for the Santa Cruz City Council & other leadership in Santa Cruz County § Date TBD, but planned for sometime in October § Email policealternatives@dsasantacruz.org to get involved or for more info!
  24. Thank you! Questions? AER Working Group Contact: policealternatives@dsasantacruz.org