Started in 1989 by the White Bird Clinic, the CAHOOTS (Crisis Assistance Helping Out on the Streets) mobile crisis intervention program responds to non-police emergencies in the cities of Eugene and Springfield, Oregon. Each CAHOOTS team is staffed by a medic who is either a nurse, paramedic, or emergency medical technician, and a mental health crisis worker. Each team member receives over 500 hours of training, which includes education on de-escalation and crisis intervention. Teams are unarmed and are identifiable only by the CAHOOTS van and t-shirts that team members wear.
CAHOOTS teams operate 24/7/365 and respond to calls involving a variety of issues, including mental health crises, homelessness, suicide threats, substance use disorder, non-emergent medical issues, and conflict resolution. These types of calls are those to which police or emergency medical services would typically respond but which do not involve criminal activity or a need for emergency medical treatment. CAHOOTS teams are dispatched either through the Eugene police-fire-ambulance communications center or through the Springfield non-emergency number and can be dispatched in addition to or in lieu of police or ambulance services. Dispatchers receive training to identify non-violent situations for which CAHOOTS is the best option and route those calls to CAHOOTS for a response. Upon arrival to the location or during the response, if the CAHOOTS team determines that a police presence is needed, it will call for a law enforcement response. In 2019, CAHOOTS teams responded to almost 24,000 calls and requested police back-up only 250 times.
Over 19 percent of calls to which CAHOOTS responds involve individuals with severe and persistent mental illness, a situation which CAHOOTS team members are uniquely qualified to handle as, unlike the CAHOOTS team members, police officers are typically not trained to handle mental health crises in individuals. CAHOOTS team members also provide limited medical treatment for individuals, including assessments, medication management, and suicidal ideation/risk assessment.
CAHOOTS serves a vital public interest. The program is funded through the Eugene Police Department and various grants at a cost of approximately $2.1 million per year. However, by freeing up law enforcement to respond to emergency calls involving criminal activity, CAHOOTS saves the Eugene, Oregon taxpayers an average of $8.5 million every year. Further, by keeping patients out of the emergency room and preventing ambulance transportation for individuals with minor, non-emergent injuries or mental health issues, CAHOOTS saved roughly $14 million in emergency medical systems costs in 2019.
For cities and towns looking to duplicate the CAHOOTS model, CAHOOTS offers consulting services, training materials and operating manuals, and other technical assistance, including ongoing program support. For further information on CAHOOTS, please logon to: https://whitebirdclinic.org/wp-content/uploads/2020/07/CAHOOTS-Media.pdf or https://whitebirdclinic.org/cahoots/.