Law enforcement and mental health don’t have to be mutually exclusive or even at odds. In fact an innovative model out of the Eugene-Springfield, metro area of Oregon is answering the call — literally.

          A program of White Bird Clinic, Crisis Assistance Helping Out On The Streets, or CAHOOTS, provides mobile crisis intervention. Each team responding to calls consists of a medic and a crisis worker, and several of these professionals are cross trained in both areas.

          According to White Bird Clinic’s Director of Consulting Timothy Black, CAHOOTS has been officially around for more than three decades. But the lineage starts about 20 years earlier, in the late 1960s. At that time Eugene was seeing a lot of the same socioeconomic and mental health issues as the Bay Area. Being situated between San Francisco and Canada, there was a regular flow of people who brought with them their own struggles and addictions. At the same time, they had groups like the Merry Pranksters making their presence known.

          “So, we were experiencing a kind of culture shock, and with it, this recognition that the existing systems in our community just weren’t adequate to respond to the level of need, i.e., mental health needs, treatment for addiction and housing, etc.,” said Black. “And with some of the early deinstitutionalization practices that the Kennedy administration enacted, that was kind of the perfect storm.”

          These conditions are what promoted CAHOOTS founders to band together and create an “alternative model” to address these realities, Black said. The “Bummer Squad,” as it became known, was a grassroots response to crises of various natures. Over time its members were associated as a trusted resource for crisis intervention, even if they were acting in a de facto manner. A few decades later brought a turning point for CAHOOTS and the community at large.

          “A community policing grant became available in the late 1980s for the city of Eugene, and that was where we got the pilot funding for this formal response,” said Black. “The larger chunk (of funding) went to develop a more traditional mental health unit, kind of under the guise of community policing. But then they kept the chunk and said, ‘Okay, White Bird Clinic … we really value what you do in the community. We see how folks look to you, and we know that we use you all the time for your crisis center. So, let’s work together on this.'”

          If you ask Black, the Bummer Squad’s service delivery model really paved the way for its success. As the name CAHOOTS implies, these institutions don’t have to be in opposition but can work in tandem to problem solve. A lot has changed since the days of the late 1980s, in terms of both funding and needs, and the organization has adapted over the years to respond to the changing times.

          “When we first started out, it was a five-days-a-week, eight-hours-a-day response, Tuesdays through Saturdays 4 p.m. to midnight. And we really had kind of a small service footprint for a long time. It wasn’t until the early 2000s that we started to really expand on any sort of meaningful scale. And it was really in 2010, that we had our first really big expansion of services. And it’s only been the last four years that we’ve been doing this and on a 24/7 basis. So, it’s taken us a while to get to where we are.”

          Any meaningful sustainable change takes time to implement. But it can pay off in the end. In the case of Eugene-Springfield, scaling up funding for CAHOOTS has meant local police can focus their time on calls that pertain to actual policing, not mental health crises per se. The CAHOOTS program budget is about $2.1 million annually, according to its website, 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.

          But what can’t be quantified per se is the weight lifted from law enforcement.

          “We’re talking about something that really is oriented around making their job easier,” said Black. “This (allows) each public safety system to be able to focus on doing fewer things better. And if we can support them by responding to those mental health calls and requests for social service, this means the officers are free to do things that community policing says they should be doing, like getting out of their squad cars and building relationships with the community.”

          In other words, when police can shift from being reactive to proactive, everyone wins. But according to Black — who now consults with communities around the country about bringing the CAHOOTS model to their area — this shift comes with a lot of heavy lifting. For one, he said, there has to be what he refers to as alignment around the concept. Are elected officials and other community leaders on board?

          In his experiences, the cities and towns who are the most effective at implementing such a program have a grassroots organization rallying behind the cause. Second, the community needs to have an existing robust network of social services already in place in order for the CAHOOTS model to work upon execution.

          “The most successful foundation is going to be one where a community has low-barrier services designed to address basic needs and additional addiction issues,” he said.

          For example, you can’t just open a detox facility and expect to get results. You need to have an outpatient treatment facility as part of the solution. The same goes for adequate mental health resources so people don’t keep ending up in and out of the hospital in a vicious cycle.           His advice? “Get everybody at the table and in agreement that they want to move forward on something together. And really having that foundation of those resources for the community are the two things that really would make implementation as successful as it could be.”

          According to White Bird Clinic’s Director of Consulting Timothy Black, CAHOOTS has been officially around for more than three decades. But the lineage starts about 20 years earlier, in the late 1960s. At that time Eugene was seeing a lot of the same socioeconomic and mental health issues as the Bay Area. Being situated between San Francisco and Canada, there was a regular flow of people who brought with them their own struggles and addictions. At the same time, they had groups like the Merry Pranksters making their presence known.

          “So, we were experiencing a kind of culture shock, and with it, this recognition that the existing systems in our community just weren’t adequate to respond to the level of need, i.e., mental health needs, treatment for addiction and housing, etc.,” said Black. “And with some of the early deinstitutionalization practices that the Kennedy administration enacted, that was kind of the perfect storm.”

          These conditions are what promoted CAHOOTS founders to band together and create an “alternative model” to address these realities, Black said. The “Bummer Squad,” as it became known, was a grassroots response to crises of various natures. Over time its members were associated as a trusted resource for crisis intervention, even if they were acting in a de facto manner. A few decades later brought a turning point for CAHOOTS and the community at large.

          “A community policing grant became available in the late 1980s for the city of Eugene, and that was where we got the pilot funding for this formal response,” said Black. “The larger chunk (of funding) went to develop a more traditional mental health unit, kind of under the guise of community policing. But then they kept the chunk and said, ‘Okay, White Bird Clinic … we really value what you do in the community. We see how folks look to you, and we know that we use you all the time for your crisis center. So, let’s work together on this.'”

          If you ask Black, the Bummer Squad’s service delivery model really paved the way for its success. As the name CAHOOTS implies, these institutions don’t have to be in opposition but can work in tandem to problem solve. A lot has changed since the days of the late 1980s, in terms of both funding and needs, and the organization has adapted over the years to respond to the changing times.

          “When we first started out, it was a five-days-a-week, eight-hours-a-day response, Tuesdays through Saturdays 4 p.m. to midnight. And we really had kind of a small service footprint for a long time. It wasn’t until the early 2000s that we started to really expand on any sort of meaningful scale. And it was really in 2010, that we had our first really big expansion of services. And it’s only been the last four years that we’ve been doing this and on a 24/7 basis. So, it’s taken us a while to get to where we are.”

          Any meaningful sustainable change takes time to implement. But it can pay off in the end. In the case of Eugene-Springfield, scaling up funding for CAHOOTS has meant local police can focus their time on calls that pertain to actual policing, not mental health crises per se. The CAHOOTS program budget is about $2.1 million annually, according to its website, 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.

          But what can’t be quantified per se is the weight lifted from law enforcement.

          “We’re talking about something that really is oriented around making their job easier,” said Black. “This (allows) each public safety system to be able to focus on doing fewer things better. And if we can support them by responding to those mental health calls and requests for social service, this means the officers are free to do things that community policing says they should be doing, like getting out of their squad cars and building relationships with the community.”

          In other words, when police can shift from being reactive to proactive, everyone wins. But according to Black — who now consults with communities around the country about bringing the CAHOOTS model to their area — this shift comes with a lot of heavy lifting. For one, he said, there has to be what he refers to as alignment around the concept. Are elected officials and other community leaders on board?

          In his experiences, the cities and towns who are the most effective at implementing such a program have a grassroots organization rallying behind the cause. Second, the community needs to have an existing robust network of social services already in place in order for the CAHOOTS model to work upon execution.

          “The most successful foundation is going to be one where a community has low-barrier services designed to address basic needs and additional addiction issues,” he said.

          For example, you can’t just open a detox facility and expect to get results. You need to have an outpatient treatment facility as part of the solution. The same goes for adequate mental health resources so people don’t keep ending up in and out of the hospital in a vicious cycle.           His advice? “Get everybody at the table and in agreement that they want to move forward on something together. And really having that foundation of those resources for the community are the two things that really would make implementation as successful as it could be.”