Tag mobile crisis intervention | White Bird Clinic
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Spotlight on CAHOOTS

Crisis Assistance Helping Out On The Streets

For thirty years, CAHOOTS (Crisis Assistance Helping Out On The Streets) has been providing mobile crisis intervention. Lately, the program has attracted notice, from national news media as well as from communities across the country.

Recent Media

From California to New York, people are looking for strategic guidance and training so they can replicate CAHOOTS’ success as an innovative model for reducing the risk of violent civilian/police encounters.

Help Expand CAHOOTS

To celebrate our fiftieth, we’re growing our programs, demonstrating our commitment to serving low income, under-resourced community members. In response to burgeoning community need, we are expanding the hours of CAHOOTS (Crisis Assistance Helping Out On The Streets) mobile crisis services, which responded to over 23,000 calls in 2018, saving an estimated $6M in emergency medical services costs alone.

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Mental Health First Responders Visit Oakland

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:

  • Olympia, WA
  • Portland, OR
  • Denver, CO
  • New York, NY
  • Indianapolis, IN
  • Roseburg, OR


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.

Crisis 101

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.

Protective 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.

Risk Factors:

  • 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.

CAHOOTS Model Featured in Street Roots Newspaper article “Rethinking our first response”

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.

In 2019, Portland Mayor Ted Wheeler, Police Chief Danielle Outlaw and Commissioner Jo Ann Hardesty’s staff have all come to Eugene to learn about the CAHOOTS model response to non-criminal matters resulting from homelessness. Kaia joined our crisis worker and medic team for a shift and shared her story, available in PDF for download here with permission.

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)…

Help Expand CAHOOTS

To celebrate our fiftieth, we’re growing our programs, demonstrating our commitment to serving low income, under-resourced community members. In response to burgeoning community need, we are expanding the hours of CAHOOTS (Crisis Assistance Helping Out On The Streets) mobile crisis services, which responded to over 23,000 calls in 2018, saving an estimated $6M in emergency medical services costs alone.

When Mental-Health Experts, Not Police, Are the First Responders

The Wall Street Journal featured CAHOOTS as a model for reducing risk of violence in a November 24, 2018 article by Zusha Elinson. It is included below and as a PDF with permission from the publisher.

Help Expand CAHOOTS

To celebrate our fiftieth, we’re growing our programs, demonstrating our commitment to serving low income, under-resourced community members. In response to burgeoning community need, we are expanding the hours of CAHOOTS (Crisis Assistance Helping Out On The Streets) mobile crisis services, which responded to over 23,000 calls in 2018, saving an estimated $6M in emergency medical services costs alone.