In CAHOOTS in Oregon City of Eugene employs alternative response model to help people in crisis

CAHOOTS emergency response vehicle | Provided photo

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By Taylor Perse

Ebony Morgan drives her van through the streets of Eugene, Ore., until she reaches a man curled up on the sidewalk under the eaves of a building. As a crisis worker for the nonprofit CAHOOTS, she was alerted by an emergency dispatcher that the man needed a welfare check.

Unlike in most cities, police weren’t dispatched to respond to the call. Morgan and her work partner were sent instead. When they arrived, they talked to the man, assessed his mental health and asked if he would like to be taken to a shelter or service provider. He got to make the choice. And when Morgan departed, he wasn’t cited or arrested, but was aware of the options he had about how to get help.

Eugene, on the southern end of the Willamette Valley and home to the University of Oregon, has a modest population of about 170,000. But at least one study shows the city leads the nation for per capita homelessness. According to a “point in time” survey conducted by housing advocates in Eugene last year, one-third of the homeless people contacted say they are living with a mental illness, while a quarter of them said they use drugs. And according to a 2017 study by the Treatment Advocacy Center in Virginia, people with untreated mental illness are 16 times more likely to be killed by law enforcement.

The police killing of George Floyd in Minneapolis sparked a loud national outcry against police brutality and racism. With the ensuing  movement to defund the police and increased advocacy for mental health, activists in communities throughout the United States are beginning to consider alternative methods to law enforcement in order to prevent police from being the catch-all for social services.

For more than 30 years Eugene’s CAHOOTS (Crisis And Help Out On The Streets) has taken on the task. The program was founded in 1989 by another local nonprofit, White Bird Clinic, and serves as a 24/7 mobile unit to help those in need, effectively mitigating the need for officers to respond to a call.

Operating three vans between the cities of Eugene and nearby Springfield, CAHOOTS helps individuals in crisis by providing counseling, partnering with service providers and working with law enforcement. CAHOOTS responds to dozens of calls each day.

Eugene Mayor Lucy Vinis said the nonprofit acts as its own entity, but also receives support from the city and law enforcement in allowing the crisis workers to do their job.

“It’s important to recognize CAHOOTS is a critical bridge in the structure,” she said. CAHOOTS took 17 percent of Eugene and Springfield police calls in 2017, a figure that could be replicated for bigger cities by partnering with community resources.

Leaders in communities across the country have increasingly recognized the need for crisis intervention as an alternative to police response, and CAHOOTS representatives have been flooded with requests to help officials replicate the program in other cities, particularly in reaction to the George Floyd death in Minneapolis. Agency officials have also recently appeared on CNN, PBS and NPR.

White Bird Clinic was founded In 1969 as a one-stop shop for counseling, medical treatment, drug and alcohol treatment and dental services for those who didn’t have those resources otherwise. A couple decades later, with funding from the city, White Bird Clinic expanded its services and created CAHOOTS, a program that would work with emergency services to help people in crisis on the streets.

Morgan is a full-time CAHOOTS crisis worker. When her 12-hour shift begins, she meets with her partner, and they gear up with their laptops and police radios, also ensuring the van is stocked with medical supplies. Because of short staffing and an overflow of calls, Morgan says they often start their day with a backlog of requests. Sometimes when they are enroute and a more pressing case comes up, they have to divert to it.

“We respond to the most urgent thing first,” she said.

Each CAHOOTS crisis worker spends 500 hours training for crisis management and de-escalation, so that they can learn to stay calm in all situations.They must also have relevant experience in their background. Former EMTs, nurses and social workers have worked for CAHOOTS.

“A good portion of our training will be on handling a crisis and de-escalation. Keeping yourself calm when the situation isn’t feeling calm. Keeping that control over the nervous system,” Morgan said.

Though it is her job as the intermediary party to approach people, CAHOOTS cannot force anyone to go anywhere. During welfare checks, Morgan says individuals sometimes will choose to forgo services. She explains to them that if they do not move or go get the help they need, someone may call police, which could lead to a ticket for trespassing.

“We tell them ‘You have a right to do what you want but we’d like to support you to have a better outcome,” Morgan said. The CAHOOTS approach is to honor an individual’s choice, but give them the information to make an informed decision.

In addition to welfare checks, they also provide rapid health assessments and transfers to other services. If someone needs shelter for the night, CAHOOTS can drop them off at the Eugene Mission, for example.

Community partners working with CAHOOTS say the reason it is successful is the 30-year partnership with the city, service providers and law enforcement.

Eugene Police Department Chief Chris Skinner says those years have been spent building relationships with CAHOOTS workers, while recognizing that CAHOOTS is a separate entity that functions separately from law enforcement.

Though working through the same dispatch system, the officers often respond to different situations. In cases where safety is a concern, EPD responds to a CAHOOTS call to secure the situation, backing out if it’s safe for CAHOOTS to step in. Last year, out of a total of 24,000 CAHOOTS calls, police backup was called only 150 times.

“You don’t want to under-respond to something that’s dangerous, but you don’t want to over-respond. Kind of finding that balance is really important. And our dispatch and call takers do a really good job of that,” Skinner said.

While CAHOOTS provides specific compassionate service to Eugene residents who find themselves in trouble, the program has not completely stopped police encounters that end in tragedy. And EPD has been criticized by some city residents for officer-involved shootings. In 2015, for instance, EPD shot and killed a veteran with PTSD after responding to a call that he threatened suicide. Earlier this year, the veteran’s family lost a wrongful death lawsuit they filed as a result of the incident. Because the veteran involved had a weapon, CAHOOTS was not allowed to respond.

In addition to taking police calls, CAHOOTS has also taken a burden off local service providers by transporting people to shelters and medical centers. Sheryl Balthrop, executive director of the Eugene Mission, describes CAHOOTS as a part of a larger ecosystem for services.

Although the Mission is the largest shelter in Oregon, she says it is still understaffed. Having CAHOOTS as a partner to drop off and respond to individuals in crisis at the shelter makes a substantial impact on the shelter’s capacity, without involving police.

“It enhances service providers’ ability to help people in a wider base,” Balthrop said. “The last thing we want to do is call law enforcement from a safety perspective and say ‘no’ to folks who want to stay.”

The Eugene community currently emphasizes the need for more funding to expand services and to lower the turnover rate of CAHOOTS employees. Lane County is 4,722 square miles, but CAHOOTS only has the capacity to provide services to the two bigger cities in the county. For bigger counties implementing the program, enough funding to provide care is essential.

“If we had the capacity to expand and could do so, at least to nearby areas, it would be helpful. What gets tricky about is how spaced out everything is,” Morgan said.

CAHOOTS currently runs on about $2.1 million a year, small in comparison to EPD’s $68 million dollar budget for 2021. In the past year, the budget has increased slightly to add about five extra hours of labor.

In order for crisis response models like CAHOOTS to make an impact, Balthrop says it is imperative that they have community-wide support and adequate funding.

“We need to have these middle approaches, these bridges,” Balthrop says. “Without them I think the cost to us as human beings and a community would be quite dramatic.”

Editor’s note: Take the following survey to tell Voices what you think about the prospect of creating a mobile crisis team in Monterey County.

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