In CAHOOTS with the Right People: Mobile Crisis Intervention

Illustrated by Haley Pak

This past summer, Americans have had to confront both the pervasive racial injustice and ill-equipped public health infrastructure that underlie the harmful consequences that COVID-19 has had. On the one hand, the COVID-19 pandemic had a debilitating effect on the morale and mental health of individuals across the globe. On the other hand, a wider reckoning with the violent history and present of the United States has reinvigorated the Black Lives Matter movement and incited demands to defund the police. With the increased tension and uncertainty, it may be tempting to dwell on the rhetoric and overwhelming losses. It is easy to forget that the people who suffer the most are often treated the worst, and vice versa. In response to this crisis, one organization has risen to the challenge of reaching out to those who need the most help.

  When an emergent situation arises, a common response is to call 9-1-1. As a result, the police handle cases ranging from mass shootings to accidental iPhone dials to mental health crises. This broad range of responsibilities is taught in just 28 weeks in the St. Louis Police Academy at the Metropolitan Police Department in the city of St. Louis, Missouri [6]. Police departments across the nation have become call centers for general SOS cries.

  But not all calls should be treated equally. When people struggling with mental health issues are perceived and treated as criminals, an emergency call can be deadly. The Washington Post found that since 2015, about a quarter of all people killed by police officers in America had a diagnosed mental illness [4]. Daniel Prude was one of many that unfortunately suffered from a mental breakdown in public that led to misunderstanding and mistreatment. Prude suffered from fatal injuries at the hands of the police [3]. In this instance, calling the police cost a person’s life rather than protecting the wellbeing of the community.

  To combat the shortcomings of a system that was never meant to bear the weight of caring for the mental health of its individuals, Crisis Assistance Helping Out on the Streets (CAHOOTS) exists in Eugene, Oregon to provide mobile crisis intervention 24/7 [1]. They do not function as a substitute for the police department; rather, they work in conjunction with the police-fire-ambulance department to dispatch teams of a medic and crisis worker to provide care or medical attention in mental health crises.

  This organization was started in 1989 when the White Bird Clinic collaborated with the city of Eugene to improve the city’s response to mental illness, substance abuse and homelessness. The White Bird Clinic was formed only two decades prior to the formation of CAHOOTS. Its controversial establishment in the community began when the clinic opened its doors to teenage drug abusers. The Clinic represented an unwelcome countercultural acceptance. Since then, the White Bird Clinic has evolved and gained more respect in the community. The clinic continues to be unique, however,  in its interest in alternative and experimental approaches to societal problems. White Bird Clinic’s coordinator, Bob Dritz underscores the Clinic’s mission of taking “on assignments that no other organization wants or has the ability to perform” [5].

At present, CAHOOTS responds to more than 65 calls every day [2]. Demand is high, but not just in the Eugene-Springfield Metro area. More cities are beginning to implement similar mobile crisis intervention teams including Denver, Oakland, Olympia and Portland [2]. This integrated health care model could be a key solution in providing better crisis care for our cities’ homeless population, our neighbors and ourselves.

Edited by: Grace Halupnik and Lily Luu
Illustrated by: Haley Pak



Alicia Yang is a sophomore from ??? She can be reached at aliciayang@wustl.edu


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