Where Calling the Police Isn't the Only Option

The CAHOOTS crisis-response program saves its city money and its people living on the streets a great deal of unwanted police contact – contact that in other places is a common cause of excessive force and arrests that solve nothing. And, while less than 1% of its calls require police backup, the resource-thin agency cautions that it is a partner with police, not an antagonistic replacement, and that its model cannot simply be copied wholesale regardless of where it's used.

Mobile crisis response teams, like CAHOOTS and the Ulster County mobile teams, deploy crisis workers and medics instead of police to situations like mental health crises and welfare checks, to avoid unnecessary escalation. Counties with mobile teams say the quality of care they receive has dramatically improved. In Ulster county alone, they receive about 4,000 diverted 911 calls annually and only five to 10% of them require police backup.

Organizations like Network 180 are working to pair social workers with law enforcement to answer 911 calls to redirect those in need of care away from jail or emergency rooms, where people experiencing a mental health crisis are often sent. The group has also helped establish a peer respite center and a separate space for psychiatric patients at an area emergency room. These efforts are all done to establish a continuum of care in local behavioral health services, providing alternatives to incarceration and inpatient treatment.

CAHOOTS offers counseling, conflict resolution, mediation and referral and transportation to social services and/or basic emergency medical care to people experiencing a mental health crisis. CAHOOTS is available 24/7 and sends out crisis workers and medics as an alternative to uniformed police officers. CAHOOTS has significantly lightened law enforcement’s load, allowing officers to focus more on other public safety issues while preventing unnecessarily sending people through the criminal justice system.

Although several Colorado law enforcement agencies have trained officers on how to de-escalate interactions with people in a crisis, including people with disabilities, the state in 2022 will become the latest to mandate such training for all law enforcement officers. The training is backed by a study that suggests it helps police better recognize and understand the reactions that people with disabilities might have under stress in a confrontation with police. Trained officers in Boulder last year successfully ended one potentially violent incident without serious inury.

Tucson Police Department's Homeless Outreach Team operates on the premise that even though many want to see police excluded from any role in dealing with homelessness, residents still call 911 and demand a police response. So the team, working with the city's homeless services counselors, can usually turn such contacts into an offer of help. Its officers are trained more and have more time than patrol officers to talk to people and determine their needs. Tucson's unhoused population surged in 2020, and police helped hundreds get housed or get other services without resorting to arrests and jail.

When people refuse mental health care while under court orders to get treatment, Tucson police send a mental health support team to take the people to crisis observation clinics or hospitals. The teams have the training and extra time that regular patrol officers often lack, so that such calls can result in a peaceful transport to get the person help, rather than to jail or ending in violence. Having the police involved at all poses policy questions that agencies wrestle with. But thousands of people per year are getting transported to places providing care instead of punishment.

Tucson Police Department's Substance Use Resource Team reaches out on the streets to people with substance-use disorder, offering them treatment instead of arrest and jail. The team is an extension of the department's mental health support team and was started in response to the opioid epidemic. Officers talk to people they find on the streets, or follow up on 911 calls for overdoses. Not everyone accepts the offered help, and some end up arrested on warrants. But, at a time of rising overdose deaths, the officers and the peer support specialists who accompany them often can get people into treatment.

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.

Four years after pairing social workers with police officers on certain nonemergency calls, Denver's STAR program began dispatching a mental-health clinician and paramedic as sole first responders when health and social services are needed rather than arrests, jail, and the risk of police violence. The program in its first six months, though limited by geography and hours, handled 748 calls without any police involvement. Police, in fact, are relaying many of the calls that STAR takes. STAR teaches other large cities useful lessons, but it's only as good as the local mental-health infrastructure.