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Eugene, OR

Crisis Assistance Helping Out On The Streets (CAHOOTS) – Eugene, OR

Crisis Assistance Helping Out On The Streets (CAHOOTS) is a community responder program that has been operating out of Eugene, Oregon for more than 30 years. The CAHOOTS model has inspired similar programs around the country, and White Bird Clinic (their local nonprofit mental health and crisis services partner) has a consultant team that assists other jurisdictions seeking to develop their own models. Through CAHOOTS, mobile crisis intervention teams are dispatched throughout the city after a person calls 911 or the local non-emergency contact number. CAHOOTS’ services are offered 24/7 and include trauma-informed de-escalation, welfare checks, first aid and non-emergency medical care, suicide prevention and intervention, housing crisis assistance, and crisis counseling.

The following information outlines CAHOOTS’ efforts since it began; it follows the sections of the toolkit. Readers can connect to other parts of the toolkit by clicking below the headers for more details.

 

Photo credit: SeanPavone, Envato

 

Community Engagement and Collaboration

  • CAHOOTS regularly engages with people who have lived experience in the behavioral health and criminal justice systems; these individuals represent a majority of their stakeholders.
  • CAHOOTS developed a Stewardship Council to receive input from a diverse representation of the community, including organizations and community members. Diversity of staff at every level has been critical to their operations, both in the field and in decision-making conversations.
  • CAHOOTS facilitates conversations with stakeholders outside of traditional workday hours in order to be accessible. The program also often provides food or child care, and ensures that materials they produce are accessible and easy to understand. Additionally, they make it a practice to send out updates after there has been meeting or conversation to keep everyone informed.

Needs Assessment

  • CAHOOTS leaders reviewed what the public health entities in Eugene were highlighting as key concerns and compared it to input that they received from the community to determine what services they should provide.
  • The program also gathered information on call center scripts and training processes, and has continued coordinating with local service providers to ensure clients are sent to the appropriate providers based on the services that are available and when.
  • CAHOOTS staff stay in contact with the emergency department that it utilizes most frequently and also has its own internal crisis line. CAHOOTS has multiple hospital liaisons, so they can actively engage with staff and assess referrals and the overall processes for connecting people to services.

Call Triaging

  • Some call types are sent to CAHOOTS by default. These include “public assist,” which is a general category of requests for officer assistance that can involve minor disputes or anything noncriminal; transport request; suicidal subject; housing crisis; counseling and mediation; welfare check; “subject down, which refers to an unresponsive person, often related to intoxication; and emergency messages, e.g., death notifications to family members.
  • For other call types, like a reported intoxicated person, a CAHOOTS team is not the default response, but dispatchers can deploy them at their discretion or at the request of the caller.
  • Typical dispatch method: Police dispatcher calls for community responders over the police radio or the community responders self-dispatch by claiming a call.
  • Other alternatives: Callers to White Bird’s 24/7 crisis line may be referred to CAHOOTS dispatch for an in-person response.
  • Managing the queue: The CAHOOTS program has three responder teams operating during peak hours. Dispatch will not interrupt a CAHOOTS team if they are already on a call; calls identified as appropriate for community responders wait in the dispatch queue until the responders become available.

Program Staffing

  • Each CAHOOTS team includes two people: a medical professional (either a nurse or an emergency medical technician) and a mental health crisis worker.
  • In its hiring process, CAHOOTS focuses on identifying crisis workers who have lived experiences with behavioral health needs and people with previous experience working in social services focusing on mental health, homelessness/poverty, and/or substance use.

Use of Data to Inform Decision Making

Safety and Wellness

  • The CAHOOTS program handles about 19 percent of all police calls for service in Eugene, and less than 1 percent of their calls require police backup. In more than 3 decades, the program has never had a casualty, and police and program staff are unable to remember an injury or close call.
  • Zero staff injuries have been caused by clients out of 22,000 calls in 2020.
  • Calls for police backup: In 2018 (the latest report available), CAHOOTS staff called for police backup 311 times out of 17,700 calls.

Financial Sustainability

  • CAHOOTS is operated through a contract between the Eugene police department and the White Bird Clinic, and as such, is funded through the police department’s general fund allocation.

Legislation Strategies

  • In 2021, a bill was passed and signed by the governor, expanding crisis stabilization services. The bill is intended to help other cities and counties in Oregon fund similar teams to CAHOOTS that focus on de-escalating situations and crisis intervention.
  • Visit Oregon 2021 Senate Bill 2417 for more information.