Latest in a series of posts responding to the George Floyd killing
Racism is a public health issue.
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 often turned violent.
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.
CAHOOTS comes from White Bird Clinic, a social services center that’s operated in Eugene since the late 1960s. It was the brainchild of some counterculture activists who’d felt the hole where a community health center should be. And in 1989, after 20 years of earning the community’s trust, CAHOOTS was created
It works this way: 911 dispatchers filter calls they receive — if they’re violent or criminal, they’re sent to police. If they’re within CAHOOTS’ purview, the van-bound staff will take the call. They prep what equipment they’ll need, drive to the scene and go from there.
The program started small, with a van Zeiss called a “junker,” some passionate paraprofessionals and just enough funding to staff CAHOOTS 40 hours a week.
It always paired one medic, usually a nurse or EMT, with a crisis responder trained in behavioral health. That holistic approach is core to its model.
White Bird’s counterculture roots ran deep — the clinic used to fundraise at Grateful Dead concerts in the West, where volunteer medics would treat Deadheads — so the pairing between police and the clinic wasn’t an immediately fruitful one.
There was “mutual mistrust” between them, said Zeiss, who retired in 2014.
“It’s true there was a tendency to be mistrustful of the police in our agency and our culture,” he said. “It was an obstacle we had to overcome.”
And for the most part, both groups have: Eugene Police Chief Chris Skinner called theirs a “symbiotic relationship” that better serves some residents of Eugene.
“When they show up, they have better success than police officers do,” he said. “We’re wearing a uniform, a gun, a badge — it feels very demonstrative for someone in crisis.”
CAHOOTS was created in part because of another disturbing statistic — around 25% of people killed by police show signs of mental illness.
“I believe it’s time for law enforcement to quit being a catch-base for everything our community and society needs,” Skinner said. “We need to get law enforcement professionals back to doing the core mission of protecting communities and enforcing the law, and then match resources with other services like behavioral health — all those things we tend to lump on the plate of law enforcement.”
Staffers respond to substance addiction crises, psychotic episodes, homeless residents and threats of suicide. They make house calls to counsel depressed children at their parents’ request, and they’re contacted by public onlookers when someone isn’t in a position to call CAHOOTS themselves.
Unlike police, CAHOOTS responders can’t force anyone to accept their aid, and they can’t arrest anyone. They’re not armed, and their uniform usually consists of a White Bird T-shirt and jeans — the goal is that the more “civilian-like” they look, the less threatened their clients will feel.
Their approach is different, too. They’re taught in training to abandon the “pseudo-professional” affect that staffers inadvertently take on in talks with clients. And aside from an extensive background in medical care or mental health, all CAHOOTS employees are judged by their “lived experiences,” Brubaker said — people who’ve dealt with many of the situations CAHOOTS clients find themselves in are better able to empathize and serve those people, he said.
Building that rapport and trust with clients is part and parcel with their clinical work.
Advocates for limiting the role of police have pointed to Eugene as an example of social service providers and law enforcement working in harmony.
But a growing group of dissenters feel there’s little room for police in the movement to fundamentally change the American criminal justice system. Services like CAHOOTS, they say, may function better and more broadly without the assistance of police.
Zeiss isn’t sure he agrees. “Partnership with police has always been essential to our model,” he said. “A CAHOOTS-like program without a close relationship with police would be very different from anything we’ve done. I don’t have a coherent vision of a society that has no police force.”
Coulibaly said community leaders are in talks over what to do about police — should their funding go to CAHOOTS, or should more funding be directed toward better educating police about deescalation techniques? They haven’t reached a consensus, he said.
The idea of a separate entity in charge of alternative care is more enticing than ever as cities mull over the efficacy of their police departments.
Breaking news about the Minneapolis program that we wrote about yesterday. Stay tuned for the next post.