Thank you for reaching out to White Bird Clinic regarding CAHOOTS.
Please fill out the following form to help us direct your inquiry. We’d like to know more about your organization and community’s goals and where you are at in the process of establishing a mobile crisis response program.
Please click here for the survey form.
Gracias por contactar a White Bird en cuanto al programa CAHOOTS.
Por favor complete el siguiente formulario para poder responder a sus preguntas. Nos interesa saber más sobre su organización y las metas de su comunidad, y dónde se encuentran en el proceso de establecer un programa ambulante de reacción a las crisises.
White Bird has received a generous grant from Hearts for Hospice to assist uninsured clients with End of Life Counseling services, in addition to supporting community outreach and education, training, and operational expenses for the project. White Bird End of Life Counseling is a compassionate, client-centered service that provides support for psychosocial, emotional, and spiritual issues related to death and dying. Our goal is to help ease people through the process of dying, especially those who could not otherwise receive support or services. When a person is terminally ill and has few resources, they may wait until their health deteriorates to the point of hospitalization before seeking services. This means not getting the necessary care until it’s unavoidable. Once the person is ill enough to visit the emergency department, they may be hospitalized or transferred to a nursing home. Our End of Life Counseling program seeks to serve clients who may otherwise be at risk of these stressful outcomes.
The project is lead by Amy May (MSW, QMHP), a member of the White Bird Counseling Department and the CAHOOTS (Crisis Assistance Helping Out On the Streets) team. She has a personal interest in end of life counseling and providing emotional, mental, and spiritual support for people who traditionally have difficulty accessing counseling services. These difficulties may include behavioral issues, substance use disorder, lack of in-home services due to lack of housing, or difficulty maintaining housing. Her beliefs stem from a concern that the dying process is overlooked in our culture, rather than recognized as something sacred and crucial. End of life counseling seeks to help people accept that process and to become at peace with all the difficulties and unknowns. Traditional hospice services partially fill this role, but do not provide ongoing mental health counseling and may be inaccessible to people who are unhoused.
Counselor Amy May discussed her work as an end of life counselor and death doula at White Bird Clinic with Paul van Waardenburg in the latest Revolution RN podcast https://t.co/T6jom2sb6P
— White Bird Clinic (@WhiteBirdClinic) August 4, 2020
White Bird will provide end of life counseling in clients’ homes and over the phone/video, by addressing the social determinants of health, coordinating care, and providing case management. When a person is terminally ill and has few resources, they may wait until their health deteriorates to the point of hospitalization before seeking services. Eugene and Springfield are served by several hospice programs, but only ours provides ongoing therapy at home. We combine the end of life doula model with mental health counseling, with special emphasis on low income and unhoused community members. Before our program, the area had only two such doulas, neither of whom were counselors. The project will serve a need for people who may be socially isolated, low income, housing insecure, disengaged from the social service system, or face other barriers to accessing hospice services.
by Savannah “Poppy” Marin
We have officially moved our clinic for the remodel that is being done at 1400 Mill Street. Our new location is 450 W. 5th Avenue. Our temporary space has one medical exam room and one behavioral health room for seeing patients. There are no walk-up appointments being offered at this time. While our capacity to see patients in person have been somewhat reduced, we continue to offer tele-med and tele-psych appointments in addition to in-person care and we have resumed accepting new patients who wish to establish care with a primary care provider.
Beginning Monday, White Bird Medical Clinic will be offering services at 450 W. 5th Ave in Eugene while our main medical building undergoes renovations. Services are by appointment only. To make an appointment, call 541-484-4800. pic.twitter.com/i7WFrLyPm6
— White Bird Clinic (@WhiteBirdClinic) March 27, 2021
We are looking forward to returning to the remodeled clinic! Post-remodel, the medical clinic will give us the opportunity to serve a lot more patients with the addition of a walk-in clinic. There are so many new possibilities for increased patient care on the horizon. We also have welcomed some new faces to the medical clinic staff, and are always looking to hire more!
White Bird Medical Clinic is not handling the scheduling or administering COVID vaccination shots. White Bird vaccination clinic is a separate team, operating at the WOW Hall. Please do not direct calls or questions about vaccination to the medical clinic, as it ties up our phones and interferes with patient care. Please refer those who wish to register for vaccination or have questions regarding vaccination, click here or call the vaccination scheduling line at (541) 246-2341. Thank you!
White Bird Medical Clinic provides compassionate health care to people who might not otherwise get care, treating all with dignity and respect. We offer quality health care to everyone on a sliding fee scale.
Responding to someone in crisis can be difficult, and knowing someone is suicidal can be scary, especially when we’re not sure how to respond. For many of us, our natural reactions to crisis can quickly escalate a situation and make things worse. That’s why professional crisis workers seek out training and practice crisis intervention strategies so that they’re prepared to navigate a crisis situation and offer support. When we develop a plan for offering support in crisis situations, it is more likely we will not go into crisis ourselves when assisting someone.
Often, for those experiencing suicidal thoughts, help can be as simple as having someone to talk to. For many, social isolation, history of trauma, mental health issues, or belonging to historically oppressed groups can lead to periods of suicidal ideation. But how do you know if someone is experiencing suicidal ideation? Often there may be signs of suicidal thoughts or behaviors.
Some warning signs of suicidal ideation can include:
- Threatening to hurt or kill oneself
- Seeking access to means to hurt or kill oneself
- Talking, thinking or writing about death, dying or suicide
- Increased use of alcohol or drugs
- Withdrawing from family, friends or society
- Showing rage or talking about seeking revenge, appearing agitated or angry
- Talking about feeling empty, hopeless, or having no reason to live, or being a burden to others
- Making a plan or looking for a way to kill themselves, such as searching online, stockpiling pills, or buying a gun
- Talking about great guilt or shame
- Feeling unbearable pain (emotional pain or physical pain)
- Acting recklessly or engaging in risky activities that could lead to death, such as driving extremely fast
- Giving away important possessions
If these warning signs apply to you or someone you know, get help as soon as possible, particularly if the behavior is new or has increased recently. Suicidal ideation is complex and there is no single cause, people of all genders, ages, and ethnicities can be at risk. In fact, many different factors contribute to someone making a suicide attempt. But people most at risk tend to share certain characteristics known as risk factors.
Often, family and friends are the first to recognize the warning signs of suicidal ideation and can be the first to assist in reaching out and getting help. Showing someone who may be experiencing a crisis that you care can make a world of difference in their life. Know how to start the conversation. Know how to ask, “Are you suicidal?” Know how to say, “I’m here for you,” and really mean it. Be aware of resources available in your community like the White Bird Crisis Line, CAHOOTS Mobile Crisis Services or the Help Book.
Risk Factors vs. Protective Factors
Characteristic and attribute that reduce the likelihood of attempting or completing suicide are known as Protective Factors. They are skills, strengths, or resources that help people deal more adequately with stressful events. Protective Factors enhance resilience and help to counterbalance Risk Factors.
- Effective clinical care for mental, physical, and substance abuse disorders
- Easy access to a variety of clinical interventions and support for help seeking
- Family and community support (connectedness)
- Support from ongoing medical and mental health care relationships
- Skills in problem solving, conflict resolution, and nonviolent ways of handling disputes
- Cultural and religious beliefs that discourage suicide and support instincts for self-preservation
Risk factors impact our ability to manage high stress situations. Being aware of these factors can assist if you are in crisis or helping someone in crisis.
- Being exposed to others’ suicidal behavior, such as that of family members, peers, or celebrities
- Depression, other mental disorders, or substance abuse disorder
- Certain medical conditions
- Chronic pain
- A prior suicide attempt
- Family history of a mental disorder or substance abuse
- Family history of suicide
- Family violence, including physical or sexual abuse
- Having guns or other firearms in the home
- Having recently been released from prison or jail
Suicidal thoughts can come on at any time like a tidal wave. Like a tidal wave, suicidal thoughts can leave a wake of destruction in their path. It is important for someone experiencing these strong thoughts and emotions to have an anchor during one these episodes. Suicidal ideation can make it seem like death is the only way out in that moment. Our rational mind may not be able to see any other solution when amid suicidal ideation. If we can help someone ride out the wave until they receive professional help, the likelihood of suicide is greatly reduced. Below are 10 steps to assist you in helping someone in crisis.
Ten Steps to Help a Person in Crisis
Step 1. Encourage the person to communicate with you.
Step 2. Be respectful and acknowledge the person’s feelings.
Step 3. Don’t be patronizing or judgmental.
Step 4. Never promise to keep someone’s suicidal feelings a secret.
Step 5. Offer reassurance that things can get better.
Step 6. Encourage the person to avoid alcohol and drug use.
Step 7. Remove potentially dangerous items from the person’s home, if possible.
Step 8. Encourage the person to call a suicide hotline number. You as the helper can also call.
Step 9. Encourage the person to seek professional help.
Step 10. Offer to help the person take steps to get assistance and support.
For our 24/7 CAHOOTS mobile crisis services, call the police non-emergency numbers 541-726-3714 (Springfield) and 541-682-5111 (Eugene). For our 24/7 crisis hotline, call 541-687-4000 or toll free at 1-800-422-7558.
Vox’s daily news explainer podcast featured White Bird Clinic’s CAHOOTS program, and how it has been an effective alternative to police involvement in mental health crises for 30 years.
White Bird Clinic is proud to be a part of spreading this type of response across Oregon and the rest of the United States! Sen. Ron Wyden’s bill, if passed, will expand CAHOOTS-like programs throughout the U.S.
Press Release from Jeff Merkley, US Senator for Oregon
After Down Payment on the Policy Included in Reconciliation Relief Legislation, CAHOOTS Act Builds on Proven Models to Help Americans with Mental Illness and Enhances Medicaid Funding to States
Washington, D.C. – Senate Finance Committee Chair Ron Wyden, D-Ore., Senator Catherine Cortez Masto, D-Nev., and six senators today proposed a bill to help states adopt mobile crisis response teams that can be dispatched when a person is experiencing a mental health or substance use disorder (SUD) crisis instead of immediately involving law enforcement. The funding is provided through an enhanced federal match rate for state Medicaid programs.
“I’m proud there is a down payment on CAHOOTS in the emergency relief package moving through Congress now,” Wyden said. “Every day there are stories across the country of Americans in mental distress getting killed or mistreated because they did not receive the emergency mental health services they needed. White Bird Clinic in Eugene, Oregon has been a pioneer for years in this area, and it’s high time the CAHOOTS model is made available to states and local governments across the country. I am eager to get the down payment signed into law and continue working to get further investments in mobile crisis services made under the bill across the finish line.”
“Individuals experiencing a behavioral health crisis deserve to be treated with compassion and care by health care and social workers,”Cortez Masto said. “These professionals are extensively trained in deescalating situations and addressing mental health crises, and this legislation would help more states across the country fund mobile crisis teams. I’m hopeful that these investments in community-based crisis intervention services will be included in the final version of the current coronavirus relief package, and I’ll continue to advocate for effective, trauma-informed care for those in need.”
Earlier this month, the House Energy and Commerce Committee included a provision in its budget reconciliation language for COIVD-19 relief that makes an investment in these services by funding state Medicaid programs at an enhanced 85 percent federal match if they choose to provide qualifying community-based crisis intervention services and funding state planning grants to apply for the option. The pandemic has taken a serious toll on the mental health and wellbeing of Americans with studies showing a four-fold increase in the rates of anxiety and depressive disorders since the beginning of the pandemic.
The CAHOOTS program pioneered by Oregon’s @WhiteBirdClinic has shown us a safe and effective alternative to using law enforcement in mental health crises. I’m proposing legislation to expand this model nationwide and modernize our country’s outdated approach to crisis treatment.
— Ron Wyden (@RonWyden) February 18, 2021
The bill, the Crisis Assistance Helping Out On The Streets (CAHOOTS) Act, grants states further enhanced federal Medicaid funding for three years to provide community-based mobile crisis services to individuals experiencing a mental health or SUD crisis. It also provides $25 million for planning grants to states and evaluations to help establish or build out mobile crisis programs and evaluate them.
Senators Jeff Merkley, D-Ore., Bob Casey, D-Pa., Tina Smith, D-Minn., Dianne Feinstein, D-Calif., Sheldon Whitehouse, D-R.I., and Bernie Sanders, D-Vt., are co-sponsors of the CAHOOTS Act.
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By Ben Adam Climer and Brenton Gicker
From the January 2021 edition of Psychiatric Times
CAHOOTS (Crisis Assistance Helping Out On The Streets) is a mobile crisis-intervention program that was created in 1989 as a collaboration between White Bird Clinic and the City of Eugene, Oregon. Its mission is to improve the city’s response to mental illness, substance abuse, and homelessness.
CAHOOTS is operated by White Bird Clinic, which was formed in 1969 by members of the 1960s countercultural movement. They were interested in alternative and experimental approaches to addressing societal problems. Today, White Bird Clinic operates more than a dozen programs, primarily serving low-in-come and indigent clientele.
The CAHOOTS model was developed through discussions with the city government, police department, fire department, emergency medical services (EMS), mental health department, and others. The name CAHOOTS is based on the irony of White Bird Clinic’s alternative, countercultural staff collaborating with law enforcement and mainstream agencies for the common good.
When it began, CAHOOTS had very limited availability in Eugene. It has grown into a 24-hour service in 2 cities, Eugene and Springfield, with multiple vans running during peak hours in Eugene. The program—which now responds to more than 65 calls per day—has more than quadrupled in size during the past decade due to societal needs and the increasing popularity of the program.
Programs based on the CAHOOTS model are being launched in numerous cities, including Denver, Oakland, Olympia, Portland, and others. Federal legislation could mandate states to create CAHOOTS-style programs in the near future.
Senators Ron Wyden of Oregon and Catherine Cortez Masto of Nevada have proposed a bill that would give states $25 million to establish or build up existing programs.
How Does It Work?
When CAHOOTS was formed, the Eugene police and fire departments were a single entity called the Department of Public Safety. CAHOOTS was designed to be a hybrid service capable of handling noncriminal, nonemergency police and medical calls, as well as other requests for service that are not clearly criminal or medical.
Eugene’s police and fire departments eventually split. CAHOOTS was absorbed into the police department’s budget and dispatch system. It continues to respond to requests typically handled by police and EMS with its integrated health care model.
CAHOOTS operates with teams of 2: a crisis intervention worker who is skilled in counseling and deescalation techniques, and a medic who is either an EMT or a nurse. This pairing allows CAHOOTS teams to respond to a broad range of situations. For example, if an individual is feeling suicidal and they cut themselves, is the situation medical or psychiatric? Obviously, it is both, and CAHOOTS teams are equipped to address both issues. Typically, such a call involving an individual who engaged in self-harm would result in a response from police and EMS. This over-response is rarely necessary. It can also be costly and intimidating for the patient. They are not criminals, and their wounds are often not serious enough to require more than basic first aid in the field. These patients are usually seeking help, and a CAHOOTS team is trained to address both the emotional and physical needs of the patient while alleviating the need for police and EMS involvement. If necessary, CAHOOTS can transport patients to facilities such as the emergency department, crisis center, detox center, or shelter free of charge.
CAHOOTS is contacted by police dispatchers. If you call the nonemergency police line or 911 in the cities of Eugene or Springfield, you can request CAHOOTS for a broad range of problems, including mental health crises, intoxication, minor medical needs, and more. Dispatchers also route certain police and EMS calls to CAHOOTS if they determine that is appropriate.
CAHOOTS, to a large extent, operates as a free, confidential, alternative or auxiliary to police and EMS. Those services are overburdened with psych-social calls that they are often ill-equipped to handle. CAHOOTS staff rely on their persuasion and deescalation skills to manage situations, not force. Only in rare cases do CAHOOTS staff request police or EMS to transport patients against their will.
A Backup Plan
If a psychiatrist or other mental health provider in the Eugene/Springfield area is concerned about a patient, they can call CAHOOTS for assistance. This usually results in a welfare check.
Let us say, hypothetically, that you are concerned about a patient with bipolar disorder. After a lengthy period of stability, they have been complaining to you that they feel like their prescribed medication is no longer working effectively. You begin receiving phone messages and emails from them consisting of fanatical rantings and incoherent gibberish.
You are concerned, but it is not so severe that you feel compelled to call the police. Perhaps you are reluctant to call law enforcement for a variety of reasons. What do you do? You call CAHOOTS.
Having responded to a similar scenario recently, let me describe what occurred. The patient, although not expecting us, welcomed our response. They explained to us that they felt like their medication was ineffective, and, after days of mania, they were feeling depressed and suicidal.
The patient recognized their own decompensation, and eagerly accepted transport to the hospital. Their mental health care provider was informed that we were transporting them and called the hospital to provide additional information.
We transported the patient to the hospital, and they were admitted to the inpatient psychiatric unit for stabilization. Collaboration between prehospital, hospital, and outpatient services facilitated that incident as smoothly as possible.
Barriers and How to Help
Prehospital mental health crisis response is underdeveloped. Most often, police and EMS are the only options. In some cities, clinicians with masters or doctoral degrees are sent with first responders. Unfortunately, the supply of these clinicians is not enough to meet the demand, but does it need to? Ambulances do not staff medical doctors. Why should prehospital mental health care require masters/doctoral level licensed clinicians? Telepsychiatry services, while important, are no substitute for direct human contact, especially given that some patients will need to be transported to a higher level of care and many do not have the means or ability to participate in telehealth services (because of lack of capacity or lack of resources).
The biggest barrier to CAHOOTS-style mobile crisis expansion is the belief that without licensed clinicians and police, prehospital mental health assistance is ineffective and unsafe. If psychiatrists want a program like this in their area, they can help by using their considerable authority to assure the community that response teams like CAHOOTS can work. Because of their direct lines of communication to the police and familiarity with police procedures, CAHOOTS staff are able to respond to high acuity mental health crisis scenarios in the field beyond what is typically allowed for mental health service providers, which often facilitates positive outcomes and can even prevent deadly outcomes. Their support is vital for program success.
Mr. Climer worked for CAHOOTS as a crisis worker for 5 years and an EMT for 2.5 of those years. He now lives in Pasadena, CA where he helps Southern California cities develop CAHOOTS-style programs. Mr. Gicker is a registered nurse and emergency medical technician who has worked for CAHOOTS since 2008.
White Bird counselor Amy May talked with KXCR Community Radio Station‘s Larry Bloomfield in Florence, OR about her work as an End-of-Life Counselor and Death Doula. White Bird End of Life Counseling is a compassionate, client-centered service that provides support for psychosocial, emotional, and spiritual issues related to death and dying.
Our goal is to help ease people through the process of dying, especially those who could not otherwise receive support or services. When a person is terminally ill and has few resources, they may wait until their health deteriorates to the point of hospitalization before seeking services. This means not getting the necessary care until it’s unavoidable. Once the person is ill enough to visit the emergency department, they may be hospitalized or transferred to a nursing home. Our End of Life Counseling program seeks to serve clients who may otherwise be at risk of these stressful outcomes.
For more information about accessing these services, please email firstname.lastname@example.org or call 458-215-1170.
At White Bird, our SOAR-trained Public Benefits Advocate provides assistance to eligible individuals in completing thorough, quality SSDI/SSI applications. The focus is on individuals who are homeless and at risk of homelessness who experience mental health and/or physical health conditions. These services are offered free of charge.
For more information and to set up an appointment, please contact us at 541-816-2793 between 10am and 4pm.
A screening process helps to determine potential eligibility based on many various factors like work history, income, marital status, and resources. The application itself can take a couple of hours to fill out, and it’s important to have all the information ready prior to applying. Potential clients should anticipate meeting with the Benefits Advocate 3-5 times before actually completing the application.
The Benefits Advocate can assist clients in obtaining information, but it will make things go faster if the client has the following information:
- List of medical sources that have treated the client, with strong focus on the last two years’ records
- Sources can include: primary care doctors, hospitals and ERs, behavioral health hospitals, mental health counselors, psychiatrists, corrections facilities, education records, vocational rehab or job training programs, social services agencies
- A list of tests or procedures ordered (x-rays, MRIs, mental health assessments, etc.)
- A list of medications prescribed (if applicable)
- The last 15 years’ work history
What the Public Benefits Advocate Can Do:
- Acts as a representative on the claim – allows the benefits advocate to speak to the Social Security Administration and Disability Determination Services (SSA and DDS) on the client’s behalf. Also receives copies of all correspondence sent to the claimant; can be a consistent point contact person for SSA/DDS.
- Requests medical records with the claimant’s permission.
- Assists the claimant in navigating the disability application process, including help filling out reports and responding to requests from SSA/DDS.
- Makes referrals for other White Bird programs/services, as well as other community resources
- Helps claimants file a reconsideration for a denied claim (for clients who have already filed an initial claim with the benefits advocate)
- Make referrals to disability attorneys when appropriate (reconsiderations and Administrative Law Judge hearings).
What the Benefits Advocate Can’t Do:
- Cannot do it without the client! It is vital that the client stays involved in the process and maintains communication with the Benefits Advocate. MANY disability claims get denied simply because the claimant does not maintain contact or respond to requests from SSA/DDS
- Cannot guarantee approval on a claim. We screen clients for various eligibility factors and work with people who have a strong chance of being approved, but it is SSA/DDS that makes a determination of disability status.
- Cannot “expedite” or otherwise speed up the process. We can help the claimant put together a complete application and proactively fill out reports in advance of them being requested, but the agencies that make the decisions are often dealing with a backlog of applications and sometimes things move slowly.
- Cannot see into SSA’s or DDS’s systems or files. The benefits advocate does not work for SSA or other governmental agencies; the benefits advocate can communicate SSA/DDS and confirm that these agencies have what they need, but does not have direct access to the records.
*SSI/SSDI Outreach, Access, and Recovery (SOAR) is funded by the Substance Abuse and Mental Health Services Administration (SAMHSA) and is a national program designed to increase access to the disability income benefit programs administered by the Social Security Administration (SSA) for eligible adults who are experiencing or at risk of homelessness and have a serious mental illness, medical impairment, and/or a co-occurring substance use disorder.
For more information and to set up an appointment, please contact us at 541-816-2793 between 10am and 4pm.
In Memory of Anthony Laveroni
A few weeks ago, Jose Soto-Gates, White Bird Clinic’s Fundraiser, was contacted by a group of students involved with Greek life on the UO campus wanted to raise money for White Bird in memory of their dear friend, Anthony Laveroni. Together, they created a fundraising page to support mental health services and invite contributions from the wider community.
Sigma Alpha Epsilon Fraternity will be hosting a Suicide Prevention Week, where they will be distributing the White Bird Help Book to all the fraternity’s and Sorority’s on campus to promote the 24 hour WB Crisis line services as well to highlight the help book as a community resource.
White Bird Medical Clinic has partnered with Kaiser Permanente to develop a safe, COVID-19 screening and testing center for Lane County’s unhoused populations. The screening center will be located in White Bird’s primary care walk-in clinic, with construction planned to start February 2021. The new primary care walk-in clinic will offer on-demand acute care to our community’s most vulnerable residents. Without access to walk-in primary care, patients utilize emergency room treatment for acute but not emergent problems, reducing the availability of treatment for life-threatening emergencies.
In addition, treatment at an emergency room is at least five times more costly than a primary care encounter. With ambulance transport, emergency treatment becomes an order of magnitude more expensive than primary care. These dramatically increased costs, along with reduced availability of treatment for life-threatening emergencies, constitute a crisis for our community and the institutions that provide and fund health care. With your help we will continue preventing unnecessary emergency room treatment and subsequent hospital admissions and preserve healthcare system capacity essential for accommodating an increase in COVID-19 hospitalizations.
As winter approaches, Kaiser Permanente’s $100,000 award will help White Bird construct a separate entrance to their Eugene clinic on Mill Street and add negative-pressure exam rooms for safe COVID-19 symptom monitoring. https://t.co/SLjcTDHR4l
— White Bird Clinic (@WhiteBirdClinic) November 14, 2020
When complete, the new facility will allow White Bird to quickly identify and respond to emerging health care needs, preventing the infection and spread of COVID-19 in people experiencing homelessness through symptom monitoring, screening, and testing. It will also enhance White Bird’s work coordinating care for the local population of unhoused individuals, strengthen partnerships with referring agencies and organizations, and support coordinating community efforts to suppress COVID-19. An additional benefit will be the capacity to conduct point of care testing for dental clinic patients, in order to keep dental staff safe and improve access to oral health care.
White Bird Clinic to construct screening and testing center for unhoused – Register-Guard, November 2020
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.
A birth certificate is an important legal document. It is needed to apply for other forms of identification (such as a driver’s license, Social Security card, or state ID card) that you need in order to:
- Get a place to live
- Apply for and receive public assistance, and
- Remove other barriers.
Starting July 1, 2018, individuals who are homeless can come to White Bird to get help ordering their Oregon birth certificate free of charge. We will
- Help you complete the birth record order form
- Give you information on what documents are needed
- Provide you a check for payment
You will need to mail your order form, check, documentation, and completed application to Oregon Vital Records. Vital Records will mail your birth certificate to you in care of the address on the order form.
For more information, please contact NEST at 541-342-1295 or drop in Tuesday through Thursday 9:30am to 12:30pm. Please check in first at 341 E 12th Ave.
Frequently asked questions:
Can I get my birth certificate for free if I was born in another state?
This program is for persons born in Oregon. Check with the state where you were born to see if they offer free birth certificates to persons who are homeless.
Do I have to provide proof of identity?
Yes. A list of acceptable proofs of identity is on the Oregon Vital Records website. If you don’t have acceptable proofs of identity, we will help you work with Oregon Vital Records to determine what information is needed to release your birth certificate.
Can I get free birth certificates for my family?
No. The grant program was established for individuals who are homeless to get their own birth certificate free of charge. This grant program does not provide funds to get family members’ birth certificates.
Where will my birth certificate be mailed?
Your birth certificate will be mailed to the address on your order form. The envelope will be addressed to you since it is your birth certificate.
Will I be able to use the birth certificate to get other documents such as an Oregon identification card or driver’s license?
Yes. A birth certificate is a legal document used to establish identity. It shows who you are, and when and where you were born. Your birth certificate is a legal document and is confidential. Be sure to keep it in a safe place.
For more information, please contact NEST at 541-342-1295 or drop in Tuesday through Thursday 9:30am to 12:30pm. Please check in first at 341 E 12th Ave.
White Bird Clinic’s 24/7 Crisis Services program is available 24/7 for Lane County residents. Trained counselors have a deep ability to empathize with clients, as well as extensive knowledge of local resources that are appropriate to provide ongoing care. https://whitebirdclinic.org/crisis
The Oregon Behavioral Health Support Line is a free and confidential resource for all Oregonians who are looking for emotional support. Call 1-800-923-HELP (4357). You do not need to be in mental health crisis to call this line. If you need or want help beyond what the line can provide, you will be connected to those services. This can include community-based services such as housing, food assistance or clinical services. Certified interpreters are also available for those who speak a language other than English. Through this number, you can also connect with Lines for Life (linesforlife.org), a suicide prevention organization with specific resources for youth, military personnel and their families, and those affected by substance abuse problems.
SAMHSA’s Disaster Distress Helpline provides 24/7, 365-day-a-year crisis counseling and support to people experiencing emotional distress related to natural or human-caused disasters. Call SAMHSA’s Disaster Distress Helpline at 1-800-985-5990 or text TalkWithUs to 66746 to speak to a trained crisis counselor.
15th Night’s Crisis Line at 541-246-4046 assists in locating and leveraging existing community resources in order to help a youth who has run away or is currently experiencing homelessness to meet their needs. https://www.15thnight.org/get-help-now
The Child Center’s Crisis Response Program is available 24/7 at 1-888-989-9990 for families with children & youth experiencing mental or behavioral health crises in Lane Cty. https://www.thechildcenter.org/press-releases/
Alternatives To Calling 911 https://whitebirdclinic.org/resources/emergency-crisis-lines/
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.
Does death make you uncomfortable & you prefer to avoid the topic altogether?
Are you thinking more about death because of Covid-19?
Are you leaving loved ones unprepared to make decisions by not discussing your end of life preferences?
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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.
“It’s long past time to re-imagine policing in ways that reduce violence and structural racism, and health care can play a key role in that effort,” Wyden said. “Oregon has a proven model in the CAHOOTS program, and I want other states and communities to have federal resources to pursue similar approaches. Americans struggling with mental illness don’t always require law enforcement to be dispatched when they are experiencing a crisis – CAHOOTS is proof positive there is another way.”
.@RonWyden to introduce a national mental health care and public safety proposal, called the CAHOOTS Act, modeled after the #Eugene-based unarmed crisis response team. @WhiteBirdClinic https://t.co/QnHsY2fmJz
— Michelle Maxwell (@MichelleAtTheRG) August 4, 2020
“For individuals experiencing a behavioral health crisis, the assistance of trained health care and social workers is more effective than interventions from law enforcement in deescalating the situation and helping to connect those individuals with vital services to address the problems that led to the crisis,” said Cortez Masto. “I’m proud to support legislation that will provide Nevada and states across the country with additional Medicaid funding to help them set up mobile crisis teams that have a proven track-record of providing effective, trauma-informed care to those in need.”
“We hope that the CAHOOTS model pioneered by White Bird Clinic in Eugene, OR can help communities across the United States develop public safety systems that align with their values,” said Chris Hecht, Executive Coordinator of White Bird Clinic. “Dispatching medical and behavioral health professionals to care for community members in crisis is a proven way to improve outcomes, combat racism, and avoid violence. We thank Senator Wyden for this legislation because we are eager to share a model that has succeeded in our community for 31 years.”
The bill, the Crisis Assistance Helping Out On The Streets (CAHOOTS) Act, grants states enhanced federal Medicaid funding (a 95% federal match) for three years to provide community-based mobile crisis services to individuals experiencing a mental health or SUD crisis. It also provides $25 million for planning grants to states to help establish or build out mobile crisis programs.
The bill is part of Wyden’s agenda to address a persistent lack of access to mental health care for too many Americans. He is also pursuing legislation to support access to wraparound services that help individuals after the initial crisis response.
by Rashida Tlaib Apr 23, 2020 in “The Appeal”
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.
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.
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.”