U.S. Sen. Ron Wyden announced plans to introduce a bill in the U.S. Senate aimed at bringing CAHOOTS response model mental health services to cities and towns across the nation through increased Medicaid funding.
Senator Ron Wyden will meet with White Bird CAHOOTS staff at CAHOOTS headquarters at 970 W 7th Ave in Eugene to discuss how this groundbreaking program can be a model for a national policing reform package and how Congress can best support the work. “The Justice in Policing Act of 2020 takes a vital first step toward accountability, and I am all in with pressing forward to achieve this legislation’s urgently needed re-focus of resources and policies,” said Sen. Wyden. Sen. Wyden co-sponsored the legislation, which would hold police accountable, change the culture of law enforcement and build trust between law enforcement and communities in Oregon and nationwide.
31 years ago White Bird Clinic launched CAHOOTS (Crisis Assistance Helping Out On The Streets) as a community policing initiative to provide mental health first response for crises involving mental illness, homelessness, and addiction. CAHOOTS offers compassionate, effective, timely care while diverting a considerable portion of the public safety workload, conserving police and fire department capacity. In 2019, CAHOOTS handled 17% of the Eugene Police Department’s calls. In 2017, police officers nationally spent 21% of their time responding to or transporting people with mental illness.
Dispatching appropriate responders for each unique situation is essential to ensuring the best outcome. CAHOOTS focuses exclusively on meeting the medical and mental health needs of the community, making it more appropriate, economical, and effective than traditional models involving agencies with a much larger scope of responsibility.
Police officers and fire fighters receive training in a broad set of skills, making their deployment to non-emergent situations unnecessarily costly. The CAHOOTS model also ensures that health and behavioral health care are integrated from the onset of intervention and treatment, adding to the efficacy and economy of the model.
White Bird’s CAHOOTS program has attracted notice from international news media as communities across the nation and around the world confront the need to reimagine public safety to ensure that it equitably serves human beings of all races and ethnicities.
CAHOOTS is providing strategic guidance and training to assist communities in developing innovative public safety systems that align with their values.
In 1969, a group of student activists and concerned practitioners came together to provide crisis services and free medical care for counter-culture youth in Eugene, OR. Having grown continuously since then, today White Bird Clinic has 10 programs, 220 staff members, and more than 400 volunteers each year.
NPR’s Ari Shapiro talked with crisis workers Benjamin Brubaker and Ebony Morgan at White Bird Clinic in Eugene, Ore., about their Crisis Assistance Helping Out On The Streets program as an alternative to police intervention. Read the transcript…
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 oftenturnedviolent.
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.
In The Appeal‘s Explainer series, Justice Collaborative lawyers, journalists, and other legal experts help unpack some of the most complicated issues in the criminal justice system.
Co-authors Tim Black, CAHOOTS Operations Coordinator, and Patrisse Cullors, Artist and Activist, “break down the problems behind the headlines—like bail, civil asset forfeiture, or the Brady doctrine—so that everyone can understand them. Wherever possible, we try to utilize the stories of those affected by the criminal justice system to show how these laws and principles should work, and how they often fail.”
31 years ago the City of Eugene, Oregon developed an innovative community-based public safety system to provide mental health first response for crises involving mental illness, homelessness, and addiction. White Bird Clinic launched CAHOOTS (Crisis Assistance Helping Out On The Streets) as a community policing initiative in 1989.
The CAHOOTS model has been in the spotlight recently as our nation struggles to reimagine public safety. The program mobilizes two-person teams consisting of a medic (a nurse, paramedic, or EMT) and a crisis worker who has substantial training and experience in the mental health field. The CAHOOTS teams deal with a wide range of mental health-related crises, including conflict resolution, welfare checks, substance abuse, suicide threats, and more, relying on trauma-informed de-escalation and harm reduction techniques. CAHOOTS staff are not law enforcement officers and do not carry weapons; their training and experience are the tools they use to ensure a non-violent resolution of crisis situations. They also handle non-emergent medical issues, avoiding costly ambulance transport and emergency room treatment.
A November 2016 study published in the American Journal of Preventative Medicine estimated that 20% to 50% of fatal encounters with law enforcement involved an individual with a mental illness. The CAHOOTS model demonstrates that these fatal encounters are not inevitable. Last year, out of a total of roughly 24,000 CAHOOTS calls, police backup was requested only 150 times.
The cost savings are considerable. The CAHOOTS program budget is about $2.1 million annually, while the combined annual budgets for the Eugene and Springfield police departments are $90 million. In 2017, the CAHOOTS teams answered 17% of the Eugene Police Department’s overall call volume. The program saves the city of Eugene an estimated $8.5 million in public safety spending annually.
CAHOOTS calls come to Eugene’s 911 system or the police non-emergency number. Dispatchers are trained to recognize non-violent situations with a behavioral health component and route those calls to CAHOOTS. A team will respond, assess the situation and provide immediate stabilization in case of urgent medical need or psychological crisis, assessment, information, referral, advocacy, and, when warranted, transportation to the next step in treatment.
White Bird’s CAHOOTS provides consulting and strategic guidance to communities across the nation that are seeking to replicate CAHOOTS’ model. Contact us if you are interested in our consultation services program.
Written by Ebony Morgan CAHOOTS Crisis Intervention Communications Team
Cahoots has been operating as a mobile crisis intervention program in Eugene since 1989. We respond in teams of two with a medic and trained crisis worker, handling 20% of the 911 calls in our area last year. This is a responsibility we take extremely seriously, and we feel privileged to do this work.
Across the nation, communities are demanding that elected leaders defund police, reallocate resources, and re-evaluate current approaches to public safety. As the first program of our kind, we are in a unique position to share our experience and knowledge with other cities that are now considering alternatives to policing. We are humbled by this and have become acutely aware of our privileged position within a system designed to oppress.
At our roots, Cahoots is innovative, forward-thinking, and dedicated to serving marginalized populations. Despite this, we are not immune to the effects of systemic racism and if we are going to lead by example, we must first do the work internally. We take responsibility for our past silence, and we commit to being advocates for change. We are actively seeking out, evaluating, and eradicating the ways that white supremacy exists within our structure and we encourage other organizations to do the same.
Cahoots proudly stands with Black Lives Matter. We believe it is not enough simply to disapprove of racism. Rather, we assert that individuals, organizations, communities, and the nation as a whole have a responsibility to be anti-racist. We will speak up when we see power inequities. We will amplify oppressed voices. We will continue to educate ourselves. We will not shy away from any aforementioned commitments due to potential risks. We will reflect regularly and welcome feedback as we learn to use our privilege constructively.
We are appalled by the lynching of George Floyd, aware that he was not the first nor the last to die a preventable death due to the color of his skin. Police brutality is not an isolated issue. It is a symptom of the broader toxic culture of white supremacy that was woven into the fiber of this nation as we know it during its inception.
Racism is a public health crisis. For the sake of health equity, we have a responsibility to dismantle systems of oppression. This will take a lot of effort and we will have to be intentional about addressing racism’s effects on the social determinants of health. We must begin this work immediately.
“Across the nation, political leaders are struggling to strike a balance between righting injustices in ways that might mollify those protesting racism and brutality while at the same time maintaining public safety. Some of the more original experiments in reimagining policing are unfolding in the Pacific Northwest…teams in Eugene handled 18% of the 133,000 calls to 911 last year, requesting police backup only 150 times, said Chris Hecht, executive coordinator of White Bird Clinic, which runs the operation called Cahoots. The program, short for Crisis Assistance Helping Out on the Streets, operated on a $2-million budget last year that he said saved the Eugene-Springfield, Ore., area about $14 million in costs of ambulance transport and emergency room care.
Hecht said that the teams, in place for three decades, can arrive at the scene of a homeless person experiencing a physical or mental health crisis, defuse the situation and prevent harm in ways that police officers are neither trained nor equipped to do.
“The folks we’re working with often have a history of really unfortunate interactions with police, hospitals or other institutions,” Hecht said. “When a couple of people step out of one of our vans wearing jeans and hoodies, just right there we have a leg up on our colleagues in public safety.”
“One model that members of the Minneapolis City Council cite is Cahoots, a nonprofit mobile crisis intervention program that has handled mental health calls in Eugene, OR since 1989.
CAHOOTS employees responded to more than 24,000 calls for service last year — about 20 percent of the area’s 911 calls — on a budget of about $2 million, probably far less than what it would cost the Police Department to do the work, said coordinator Tim Black.
“There’s a strong argument to be made from a fiscally conservative perspective,” Mr. Black said. “Public safety institutions generally have these massive budgets and there’s questions about what they are doing.”
What would an Emergency First Responders Corps look like?
“The most important aspect of the Emergency First Responder Corps is that it must be civilian and designed to help people. The idea isn’t novel — it is something neighbors have been doing for centuries, and the time is now to take comprehensive approach to formalizing it to help our most vulnerable communities.
A good model of this exists in Eugene, Oregon, CAHOOTS — Crisis Assistance Helping Out on the Streets — has worked for decades to help people in crisis. They deal with those who are suicidal, houseless, infirm, or just having trouble getting the basics they need to survive. It’s fully integrated into the local service community. And they are effective. In 2018, CAHOOTS responded to 24,000 calls. CAHOOTS and the White Bird Clinic were recently awarded federal funding to expand telemedicine access during the current pandemic.”
The Briefing: a new vision for first responders during the COVID-19 pandemic
CAHOOTS program coordinator Tim Black joined Congresswoman Rashida Tlaib and our self-described “biggest fan of CAHOOTS in the Rockies” Colorado State Representative Leslie Herod to discuss the CAHOOTS model and why there is a need for a behavioral health branch of public safety in communities across the nation.
White Bird’s CAHOOTS (Crisis Assistance Helping Out On The Streets) program continues to make headlines. CBS Evening News with Norah O’Donnell correspondent Omar Villafranca went on a ride-along with CAHOOTS to see them at work and learn why the program is being considered by cities across the country.
Denver police officials said they are considering the model as an option to push beyond their existing co-responder program. New York City is looking to the program as “a model for non-police response to non-criminal emergencies.”
Salem nonprofits are looking at the model for mobile crisis response. “CAHOOTS gets 2 percent of the police budget, but with that 2 percent they handle 17 percent of public safety calls,” said Ashley Hamilton, who’s helping spearhead the idea.
Rogue Valley law enforcement, mental health professionals and advocates, elected officials and other concerned community members gathered at the Medford Police Department to hear Tim Black talk via Skype about the program in September. In November, city commissioners are expected to discuss how the program would work in Portland.
The power of White Bird’s CAHOOTS program lies in its community relationships and the ability of first responders to simply ask, ‘How can I support you today?’ White Bird Clinic is proud to be a part of spreading this type of response across Oregon and the rest of the United States. Please consider a donation to help us expand our model.
White Bird Clinic’s CAHOOTS program is meeting with stakeholders to share an innovative model for mobile crisis intervention that would otherwise be handled by public safety or emergency medical response.
OAKLAND, CA – White Bird Clinic of Eugene, OR has developed an innovative public/private partnership delivering crisis and community health first response effectively and at significant cost savings. For thirty years, CAHOOTS (Crisis Assistance Helping Out On The Streets) has been providing mobile crisis intervention 24/7, dispatched through the EMS non-emergency system. This week, members of CAHOOTS are in Oakland to meet with the Mayor, the Coalition for Police Accountability, and other community stakeholders to discuss implementing the innovative model locally.
Each CAHOOTS team consists of a medic (a nurse or an EMT) with a crisis worker who has substantial training and experience in the mental health field. The team provides behavioral health first response/responders, immediate stabilization in case of urgent medical need or psychological crisis, assessment, information, referral, advocacy and, when warranted, transportation to the next step in treatment.
White Bird Clinic started CAHOOTS in 1989 in partnership with the Eugene Police Department as a community policing initiative. CAHOOTS offers compassionate, effective, timely care while diverting a considerable portion of the public safety workload, freeing the police and fire departments to respond to the highest priority calls. CAHOOTS handles 17% of the Eugene Police Department’s non-emergency calls. In 2017, police officers nationally spent 21% of their time responding to or transporting people with mental illness.
CAHOOTS focuses exclusively on meeting the medical and mental health needs of the community, making it both more economical and more effective than traditional models involving agencies with a larger scope of responsibility. Police officers and firefighters receive comprehensive training in a broad set of skills, making their deployment to non-emergent situations unnecessarily costly. The CAHOOTS model also ensures that health and behavior health care are integrated from the onset of intervention and treatment, adding to the efficacy and economy of the model.
White Bird’s CAHOOTS program has attracted notice, from national news media as well as from communities across the country. The Wall Street Journal’s November 24th article When Mental- Health Experts, Not Police, Are the First Responders showcased CAHOOTS as an innovative model for reducing the risk of violent civilian/police encounters. Communities from California to New York have asked for strategic guidance and training so they can replicate CAHOOTS’ success.
Currently, CAHOOTS is working with the following communities:
New York, NY
In 1969, a group of student activists and concerned practitioners came together to provide crisis services and free medical care for counter-culture youth in Eugene, OR. Having grown continuously since then, today White Bird Clinic has 10 programs, 220 staff members, and more than 400 volunteers each year. White Bird Clinic is a collective environment organized to empower people to gain control of their social, emotional, and physical well-being through direct service, education, and community.
The mission of the Coalition for Police Accountability is to advocate for accountability of the Oakland Police Department to the community so that the Oakland Police Department operates with equitable, just, constitutional, transparent policies and practices that reflect the values and engender the trust of the community.
Kaia Sands, Executive Director of Street Roots, a Portland newspaper that creates income opportunities for people experiencing homelessness and poverty through media that is a catalyst for individual and social change, visited White Bird Clinic’s mobile crisis support program, CAHOOTS (Crisis Assistance Helping Out On The Streets) this month.
Street Roots visit to CAHOOTS helped to inform their plan for a Portland Street Response team. This would be a non-law enforcement system of six well-marked mobile response vans teamed with a specially-trained firefighter-EMT and peer support specialist dispatched through both 911 and nonemergency channels. Street Roots explores how these issues are being responded to in Portland and Eugene and how we can build a better system. Read more (PDF)…
We are happy to announce that we received both first and second place recognition for “Best Program for the Homeless” in Eugene Weekly‘s annual 2018 Best of Eugene. CAHOOTS took first place and White Bird Clinic took second. Read more…
This past weekend represented an unusually high number of heroin and other opiate overdoses in the Eugene/Springfield area, but these overdoses have been in keeping with recently observed trends. There have been two distinct patterns of heroin and other opiate related overdoses occurring with increased frequency: poly-substance OD’s and fentanyl contaminated OD’s:
Poly-substance overdoses present a unique frustration to first-responders because they generally combine opiates, alcohol, and other substances often including benzodiazopenes or other prescription pharmaceuticals, which requires field stabilization and hospital treatment.
Fentanyl contamination has been detected in various street drugs and counterfeit prescription medications in the Pacific Northwest, and has been particularly common locally in a strain of heroin that has been encountered by users and first responders in recent weeks.
Lane Co. EMS, EPD, SPD, and CAHOOTS all carry the opiate overdose reversing medication Naloxone, commonly referred to by its trade name, Narcan. Naloxone is administered to treat overdose patients presenting with respiratory distress caused by the overdose, the medication enters the respiratory center of the brain stem and flushes neural synapses by out-competing the opiates present in the blood stream to to temporarily reverse respiratory inhibition; for patients whose breathing has ceased Naloxone is frequently administered along with CPR.
CAHOOTS, specifically, has not experienced a significant increase in overdose responses, largely because the increased public awareness of the opiate crisis has increased the aggressiveness of EMS and law enforcement responses to these emergencies. White Bird’s main clinic staff including the Crisis Team and Front Rooms/Reception staff have, on the other hand, reported a significant increase in interventions this year, with three incidents of Naloxone and CPR administration in the past 2 months. White Bird has begun the process of standardizing Naloxone training for all staff in addition to First Aid and CPR requirements.
Locally, the increased frequency of opiate overdoses has not been accompanied by a proportionate increase in overdose deaths. Increased public awareness has led to increased public involvement, with bystander-administered Naloxone and CPR saving brain tissue and lives prior to professional responders arriving on scene, and with increased awareness of Oregon’s Good Samaritan Law amongst drug users reducing the fear and stigma associated with calling 911 to seek assistance in an emergency.
The lives saved have demonstrated the benefits of harm reduction policies:
Public health education and outreach efforts increase awareness of the situation, increasing the likelihood of an overdose being recognized and treated.
Good Samaritan Laws provide bystanders who interact with law enforcement temporary respite from prosecution, decreasing the likelihood of an overdose patient being abandoned.
Broad availability of Naloxone—it is available over-the-counter at most pharmacies free of charge for individuals covered by private insurance or OHP and is also available free of charge along with training through HIV Alliance—increases the likelihood of the medication being available in the event of an emergency.
Bystander education including CPR training for community groups and Naloxone administration training for users, their peers, families, and those who work with them facilitates rapid overdose intervention.
Aggressive EMS and police responses to overdoses due to their increased public profile decreases the likelihood of overdose patients fleeing the scene of their resuscitation, only to cease breathing again due to lack of follow-up care.
The Eugene HIV Alliance, through their syringe exchange program, has made the injectable form of Narcan available. It also provides training to individuals and groups on how to administer it.
The syringe exchange is held five days a week at different locations, and the service is free.
When you walk in the Out of the Darkness Walks, you join the effort with hundreds of thousands of people to raise awareness and funds that allow the American Foundation for Suicide Prevention (AFSP) to invest in new research, create educational programs, advocate for public policy, and support survivors of suicide loss.
CAHOOTS will be tabling and answering questions about what services we provide and how to access them. We will also be facilitating a safe space for anyone struggling with emotions in reference to the event.
Walk Date: 09/30/2018
Walk Location: Alton Baker Park – Eugene, OR
Check-in/Registration Time: 09/30/2018 at10:00 am
Walk Begins: 11:00 am
Walk Ends: 1:00 pm
For more information, please contact:
Contact Name: Sara Scofield
Contact Phone: 541-513-5937
Contact Email: firstname.lastname@example.org
Online registration closes at noon (local time) the Friday before the walk. However, anyone who would like to participate can register in person at the walk from the time check-in begins until the walk starts. Registration is free and open to the public. Walk donations are accepted until December 31st.
Congratulations to CAHOOTS medic and crisis workers Rose Fenwick and Kimber Hawes, who were honored at a ceremony yesterday by the Eugene Police Department with the 2018 Partnership Award! Thank you for your care and compassion in serving our community.
On April 10th, CAHOOTS was selected by the Lane County Board of Commissioners as a recipient of the 2018 Excellence in Public Health Award. The award was presented during the Commissioners’ meeting to recognize the CAHOOTS team’s work in the field as behavioral health first responders, as well as their efforts in outreach, training, education, and support for individuals and groups throughout the area.
Following recent events at the Academy of Arts and Academics in Springfield, counselors from CAHOOTS and White Bird Clinic’s Crisis office responded to the school to provide grief and loss counseling to students, staff, and their families. An extension of the weekly Mobile Mental Health Resource Clinic already staffed by members of the CAHOOTS team, these counselors facilitated both individual and group counseling and will continue to work with A3 and the Springfield School District to support everyone affected by this tragedy.
CAHOOTS mobile crisis counseling services are available in Springfield 24 hours a day, 7 days a week, and can be requested via Springfield Police non-emergency dispatch at (541)726-3714.
Additional crisis support is also available 24/7 by phone at (541)687-4000, or walk-in at White Bird’s Crisis clinic, 341 E. 12th Ave in Eugene.
CAHOOTS, staffed by people like Daniel Murray (left) Sam Williamson, Kate Gillespie, Robert Parrish, Henry Cakebread, Brenton Gicker and Laurel Lisovskis provide medical services to those most in need in our community. (Chris Pietsch/The Register-Guard)
The CAHOOTS (Crisis Assistance Helping Out On The Streets) program began in Eugene in 1989 as a collaboration between the city of Eugene and White Bird Clinic.
CAHOOTS started small: one van equipped with medical supplies and trained personnel, operating part-time in Eugene. Its mission was simple: to offer help to individuals and families, housed and unhoused, in crisis.
The idea was that it would be better — and cheaper — to have people trained and experienced in counseling and medical care to respond to these calls, which had been going to police and fire departments.
The wisdom of that decision has been amply borne out since then by CAHOOTS’ exponential growth over the last three decades and the place it has made for itself in the Eugene-Springfield community.
It has more than tripled its local presence with two vans in Eugene and one in Springfield, and gone from part-time patrols to 24-7 service.
The two-person teams that staff each van respond to an average of about 15 to 16 calls in a 12-hour shift in Eugene, although it can be as many as 25 calls per shift — slightly less in Springfield, CAHOOTS employee Brenton Gicker says, which works out to tens of thousands of calls per year.
Gicker is a registered nurse and emergency medical technician; his partner on a recent night, Maddy Slayden, is a paramedic.
They and their co-workers are a welcome presence on the streets of Eugene-Springfield, greeted with warmth by police officers, with relief by business owners who prefer the option of calling CAHOOTS to calling police, and with respect by the people they help.
CAHOOTS is a significant part of the network of organizations and agencies that provide help to the growing number of people who are homeless locally — about half of CAHOOTS’ calls are to help someone who is homeless, ranging in age from children to seniors.
The CAHOOTS teams have earned respect in the homeless community not just for the help they provide — from distributing socks and bottles of water to emergency medical care and help accessing resources such as medical treatment and emergency shelter — but by the way they do it.
The CAHOOTS employees offer dignity and courtesy, which are often in short supply for people who are homeless.
A typical shift — if there were such a thing — for a CAHOOTS team might include responding to a call about a homeless person disrupting a business; working with a family in crisis; helping someone who is suffering from substance abuse, mental illness or developmental disabilities access services and find safe shelter for the night; treating injuries; picking up people who are being discharged from a hospital or clinic with no place to go and taking them to a safe place where they can get help; and responding to a call from a landlord worried about the welfare of a tenant.
They are trained to address issues such as mental illness or substance abuse and skilled in coaxing people to agree to get the help they need.
Many of their calls involve driving people who are suffering from mental illness or substance abuse to an emergency
room or, if their problem doesn’t merit medical care, to a safe place to spend the night.
Despite more than tripling the size of CAHOOTS in the past few years, the need for its services continues to grow faster than CAHOOTS’ resources.
“I’m frustrated because we can’t be everywhere at once,” Gicker says. “There’s always things we’d like to be involved in, sometimes we don’t have the resources we need, or access to information. I feel like we’re often only scratching the surface.”
CAHOOTS is a uniquely local response to local needs — people familiar with the program say they don’t know of anything quite like it elsewhere.
Its growth in recent years has shown the need for its service; the response within the community, its ability to meet them given the resources.
It’s time to start thinking about expanding a program that has been successful and that serves a need that continues to grow.
Ideally, adding another van would be a step toward meeting this growing need, as well as allowing expansion of service to areas such as Santa Clara and Goshen that have few resources. It also would allow CAHOOTS staff to respond more quickly to calls seeking help, reach more people who are in need of help, and spend more time working to connect people with the resources they need.
It’s hard to put a dollar value on what CAHOOTS does — how do you determine, for example, how many people didn’t die on the streets because of CAHOOTS? How many people who were able to get help that allowed them to stabilize their lives, or medical care that relieved suffering? How do you quantify exactly how much taxpayer money was saved by using CAHOOTS instead of police or firefighters, or the value to businesses of knowing they can call CAHOOTS for help?
But the role the CAHOOTS teams play in Lane County is a critical one, and likely to become even more critical in the coming years.