In Denver, Unarmed Mental Health Workers Respond To Hundreds Of 911 Calls Instead Of Police

San Francisco's Street Crisis Response Team is a pilot project meant to divert 911 calls for mental health emergencies from police to new teams of mobile counselors. Though it started with only one team and later expanded to four, the project in less than six months took 20% of the eligible calls. More than half the clients were helped on the streets, while most others were hospitalized or connected with shelters. The city is proposing a major expansion of this and related teams aimed at reducing the reliance on police in non-violent situations.

In its first six months, Denver's STAR program (Support Team Assistance Response) handled 748 emergency calls that in the past would have gone to the police or firefighters. Two-person teams of a medic and clinician helped people with personal crises related mainly to homelessness and mental illness. None of the calls required police involvement and no one was arrested. The city plans to spend more to expand the program, which is meant to prevent needless violence and incarceration from calls to the police that other types of first-responders can better address.

Six San Francisco neighborhoods are now served by the city's Street Crisis Response Teams, which answer 911 calls for non-violent mental or behavioral health crises without police involvement. In its first two months in one neighborhood, the Tenderloin, the team handled 199 calls without any violent incidents or any need for police intervention. That led to the expansion to five more neighborhoods. The program is modeled on Eugene, Oregon's CAHOOTS project's street medics and counselors, but with an additional "peer specialist," someone with lived experience to counsel unhoused people on the streets.

As the nation’s largest city to embrace an alternative approach to responding to 911 calls in non-violent personal crises, Denver finished the first year of its pilot program having never needed police backup when its medics and social workers handled problems on the streets. About a third of calls to STAR (Support Team Assisted Response) came from police who saw STAR as a better responder to certain calls. In about 40% of calls, people in mental health or substance use crises received the services they needed without involving arrests or conflicts with police.

Following the death of Daniel Prude in Rochester police custody, the city consulted with the operators of Eugene's CAHOOTS program to craft its own version of a team of unarmed responders to help resolve mental health or substance abuse crises without the use of violence. Rochester's Person In Crisis (PIC) team has averaged about 21 calls per day since January. All calls are made with the police in tandem, unlike CAHOOTS' model. Some violent incidents in Rochester have raised questions about PIC's ability to defuse conflict. But the operators say they have begun to make a positive difference.

When Las Vegas' restrictions on encampments pushed unhoused people into a shopping center outside the restricted zone, Vegas Stronger worked with business owners and the police to intervene without the need for arrests and jail. Although only two months old, the nonprofit has helped about 30 people through the network of services it has arranged. Services include housing, mental health and substance abuse treatment, and other connections to services people need to stay healthy and off the streets. Police welcome the interventions because they are relieved of handling non-criminal matters.

Honolulu could benefit from adopting the approach to mental-health crisis calls to 911 that Eugene, Oregon, uses. But it would need to make big changes first in its critical infrastructure. Eugene's CAHOOTS program sends counselors and medics on 17% of the calls coming to its city's 911 center, saving millions on police, ambulances, and emergency room visits. Non-police responders de-escalate potential conflicts and get people the help they need without arrest or violence. Honolulu is primed to examine this approach, as many cities have done, but it's not a simple matter to start it.

The CAHOOTS program, which sends medics and counselors on certain 911 calls instead of the police, has become a national model in the wake of 2020's criminal-justice protests. But its roots reach back half a century, when a free medical clinic serving the hippie counterculture emerged as a public-health response to drug, mental health, and other non-violent emergencies. CAHOOTS has grown into a 24/7 service that saves Eugene millions in policing and medical spending, and saves many on the streets from unnecessarily punitive interactions with the police.

Although Eugene, Oregon's long-running, successful CAHOOTS program serves as one model for the new Portland Street Response, a more relevant model can be found in Denver's STAR program. Like CAHOOTS, STAR responds to mental-health and other crisis calls with medics and counselors rather than police officers. But Denver's size, demographics, and homelessness make it much more analogous to Portland. In STAR's first six months, it handled nearly 750 calls without a single arrest. Both STAR and PSR are starting small, so more resources are needed if the pilot projects succeed.

Denver's STAR program (Support Team Assisted Response) replaced police officers with health professionals on 748 calls for help. In incidents involving mental health, homelessness, and substance abuse, police backup was never needed, no one was arrested, and minor crises did not risk escalating into violence because of police presence. The six-month pilot project will expand to more parts of the city and more hours of the week, with an infusion of city money to supplement the private funding that got the program started.