As the conversation about police reform heats up, one point of agreement between law enforcement and activists has come into focus: more often than not, police aren’t sent out to stop crime. Instead, they are dispatched to deal with citizens in distress, community members who need the kinds of help that law enforcement is not designed to provide.

A recent analysis of calls for police service in 10 cities across the U.S. revealed that only about 1 percent involved violent crime. Other reports have put the figure at about 10 percent.

Today’s policing can involve “bad guys” who are more defenseless than dangerous. A 2015 report from the Los Angeles city administrative officer estimated that arrests of homeless persons accounted for over 14 percent of all arrests made by police in a year, at a cost of $80 million. At that time, the homeless population was estimated at 23,000; the current number is more than 53,000.

“Policing tends to get relied on as the stopgap because we’re out and about 24/7,” says Max Bosel, the chief of police in Mountain View, Calif. “That makes it possible to put a resource onto a problem, but the question is whether it’s the best resource for that problem.”

Working out better approaches is going to take time and effort. “There’s not a switch we can flip,” he says. “It’s going to take listening and awareness on the police side as well as the reform side,” he adds. “There’s a lot of misunderstanding about what police do or don’t do.”

As debate about the path forward plays out in the streets, the press and in community meetings, a number of local governments are implementing emergency response programs with the potential to provide better outcomes for all sides.

You Get What You Pay For

Anand Subramanian, managing director of the research and action institute PolicyLink, served as executive director of a San Francisco Blue Ribbon Panel on Transparency, Accountability, and Fairness in Law Enforcement. Among other things, it examined policies and training relating to use of force when dealing with citizens in crisis.

“Through that work, I came to realize that the barriers to reform were greater than the barriers to imagining and building new systems,” he says.

Training police in community-centered approaches has been attempted to restore trust and improve interactions between citizens and law enforcement, but Subramanian believes more is needed to keep communities safe.

“The lack of funding for services and infrastructure at the local level leads to problems that we're asking police to respond to,” he says. “We would eliminate the need for such responses if we invested more in addressing root causes.”

Subramanian wants to see investments in pilot projects, based on best practices and research regarding innovative approaches, that go beyond business as usual to get at problems such as addiction, educational failure, homelessness, and unemployment that breed trouble in communities.

“What we really want are effective solutions that are grounded in health, that are grounded in cost-effectiveness,” he says. “This is also a fiscal responsibility question.”

So far, federal response to calls for changes in policing has zeroed in on excessive force and officer accountability, as reflected in a June executive order and a reform bill that recently passed the House.

Local government is ahead of the game, however. Programs that provide a humane response to citizens in crisis are well established in some communities and expanding to others.

This mobile crisis van enables a two-person team, consisting of a medic and crisis worker, to respond to 911 calls and provide transport if needed. (Photo: Brian Bull, KLCC)


Socio-Medical Aid 

More than 50 years ago, a counterculture collective formed in Eugene, Ore., with help from medical workers and citizens. It provided support to disillusioned young people who had dropped out, living on the streets and cut off from medical, legal and substance abuse services.

Initially known as the “White Bird Socio-medical Aid Station,” it incorporated as a nonprofit in 1970, under the name White Bird Clinic. Today, the services White Bird provides include medical and dental clinics, drug and alcohol treatment and counseling.

White Bird also developed a program that has become a model for others throughout the country, a mobile crisis intervention unit known as Crisis Assistance Helping Out On The Streets (CAHOOTS).

Launched as a community policing initiative in 1989, CAHOOTS offers a community-based response option for citizens who are in trouble because of substance abuse, homelessness or other personal crises.

CAHOOTS is integrated into the emergency response system of the police departments for the Oregon cities of Springfield and Eugene and dispatchers are trained to recognize situations that don’t involve a threat of violence. They route these calls to CAHOOTS, which dispatches a two-person team comprised of a medic (a nurse or an EMT) and a crisis worker.

Benjamin Brubaker is both a CAHOOTS crisis worker and a co-executive director of White Bird Clinic. He’s consulted with law enforcement officers throughout the country.

“Many are tired of being the de facto response when people fall through safety nets,” he says. “They’re looking for other ways to handle these things, and that's where White Bird enters into the picture.”

When dispatched, the CAHOOTS response team assesses the situation and helps with any immediate issues, including medical needs. It refers the individual to additional services when called for, and can provide transport and a “warm handoff” to them.

“Not only does the client get better care, but this avoids the possibility of additional trauma by having the individual go to an inappropriate service and still not have their needs met,” says Brubaker.

Last year, CAHOOTS teams handled about 24,000 calls, 20 percent of all the 911 calls received by police. They called for backup in 150 instances, just over half of 1 percent.

By responding when police aren’t really needed, CAHOOTS has saved taxpayers an average $8.5 million per year in law enforcement costs. It also diverts patients who would otherwise end up in the ER. At a time when both necessity and political pressure are leading to budget cuts, such savings matter more than ever.

“We’re all about people stealing our ideas,” says Brubaker. “The national spotlight that’s been thrust on us by recent events fits into our long-term dream.”

At present, CAHOOTS is assisting in the development of programs in other states, including California, New Mexico, Indiana, Connecticut and New York. In June, under the stewardship of Chief of Police Paul Pazen, the city of Denver launched Support Team Assisted Response (STAR), a pilot project based on approaches CAHOOTS has refined over several decades.

CAHOOTS crisis worker Kimber Haws talks to a teen who had threatened to jump out of a moving vehicle. (Photo: Brian Bull, KLCC)


Recognizing the Moment

Pazen first heard of the CAHOOTS program three years ago, before he was chief, and began to meet with community representatives to talk about bringing such a program to Denver. This would be the first trial of the model in a major American city.

A working group took up the discussion, with members from community-based organizations dealing with homelessness and drug addiction, Denver’s Black Lives Matter 5280, parents of children who had bad experiences with law enforcement, city council members and others.

“We had a lot of stakeholders at the table, folks that are supportive of the police and those who are not the biggest fans of the police department,” Chief Pazen says. “We saw the value of a program like this and worked to figure out how we could get it going, including funding.”

A ballot initiative in 2018 approved by 70 percent of Denver citizens provided a mechanism to fund a new nonprofit, the Caring for Denver Foundation, with the mission of supporting “community-informed” approaches to mental health and substance abuse. The STAR pilot is funded by the foundation.

Brubaker came to Denver to talk about CAHOOTS. Denver also sent a team of 911 dispatchers from the police department to Eugene to learn how dispatchers there worked with police and decided which calls could be diverted to crisis response teams.

Like CAHOOTS, STAR utilizes a van-based team of a paramedic and a clinician. As is the case in Oregon, team members do not have law enforcement powers and do not make arrests. The trial phase is focused on central downtown Denver. Soon after the pilot was launched in June, chief Pazen began to get feedback.

“I have police officers asking, ‘How can we get more coverage from STAR? We see what it’s doing in the pilot area and we want more of that,’” he says.

Pazen is also interested in exploring ways to provide long-term assistance to citizens who receive crisis services from STAR, and has recently added a case manager program.

“We’re going to help somebody in need or crisis today, but what about next week, next month, next year?” he says. “Case managers can help us follow up and get to the long-term outcomes that we hope to see.”

His department recognizes the moment it is in, and the strength of the movement calling for change, Pazen says. “We need to ensure that we are listening to our community and their ideas about what policing might look like in the future.”

Closing the Foresight Gap

Programs such as CAHOOTS and STAR reduce the likelihood that citizens in distress will fall into deeper holes at the hands of persons not trained to deal with their problems, or bear the additional burden of having their distress criminalized. As much as they are a significant step forward, they are required to the degree that other systems are failing.

“A lot of criminal behavior starts with unmet human needs,” says Benjamin Brubaker of White Bird. “The trick is convincing people to have the foresight to get ahead of those things and to spend the money upfront to prevent them from happening.”

Brubaker has seen progress in this direction when diverse sectors of a community — law enforcement, government, service providers, parents — meet and take a hard look at where things are broken in their community.

“Conversations have to start at this level,” he says. “We do the things we do because we feel they are right, but we don’t have all the answers. We want to be part of the conversation.”