WHEN A WOMAN experienced an opioid overdose during a morning breakfast service at St. Mary’s Episcopal Church in downtown Eugene, Ore., church staff quickly administered naloxone, a medication designed to rapidly reverse an overdose.
Then the police arrived, lights blazing, according to Bingham Powell, rector at St. Mary’s.
Police interference during a drug overdose or mental-health crisis can often turn deadly, putting some of society’s most vulnerable further at risk for harm. Thankfully, when the officers arrived on the scene at St. Mary’s that day, no one was killed. But a police response can also impair the situation in other ways. The woman who had overdosed became frightened by their presence and left.
“This isn’t a story of police misconduct,” Powell said. “It’s just a story of the police showing up, and it caused the person to run away and not get the help they needed.”
What if someone else had arrived on the scene first? In Eugene, it’s entirely possible that they could have. For nearly three decades, the city has been home to CAHOOTS (Crisis Assistance Helping Out On The Streets), an emergency-response program that sends experienced unarmed crisis counselors and EMTs in response to mental health, substance abuse, and homelessness-related crises. The program has become a model for other cities looking to shift community resources away from armed policing in favor of social services.
Unless a situation is violent, the team at St. Mary’s prefers calling CAHOOTS in a crisis, according to Powell.
“Jesus teaches us to love our neighbor, and that is a guiding principle for how we want to be in this world,” Powell explained. “We want to help people, and having police be the only resource is not helpful.”
‘A paradigm shift’
In the 1980s, the U.S. defunded public safety programs in favor of increased policing, which has since become increasingly militarized. Now, the tide is turning. The Black Lives Matter movement has not only shed light on systemic racism and embedded white supremacy ideologies, but on the brutal impacts of overpolicing and the excessive use of deadly force.
People with untreated mental illness are 16 times more likely to be killed during a police encounter than other civilians, according to a 2015 report by the Treatment Advocacy Center. That same year, a Washington Post investigation found that a quarter of the people shot by police in the United States were suffering from a mental or emotional crisis at the time of their death. Most of those officers were not responding to a crime, but rather to a call about a mentally fragile person behaving erratically.
In 2020, following the killings of Breonna Taylor and George Floyd, efforts to defund or abolish the police moved into the mainstream. Activists around the country continue to call on their communities to radically reimagine what public safety and harm prevention could look like without police at the front lines.
“A lot of alternatives to the police don’t always look like alternatives to police at first glance,” said Brendan McQuade, assistant professor of criminology at University of Southern Maine. “They’re set up as a mental health thing or as a harm reduction measure.”
Such alternatives involve “a paradigm shift to something that centers our shared relationships and shared investments,” McQuade added.
While there is tremendous work yet to be done, there exist already examples of municipal programs where public health and harm reduction are the priority. CAHOOTS is one of those.
A new crisis response
CAHOOTS, which was launched as a community initiative in 1989, provides mobile crisis intervention around the clock in Oregon’s Eugene-Springfield metropolitan area. The program is funded by the cities and managed by the White Bird Clinic, a community health center in Eugene.
Crisis responders can be reached through the police nonemergency line or 911. They are dispatched in pairs, are not trained in law enforcement, and do not carry weapons. Not all of them are licensed clinicians, though all are trained to respond to mental health issues.
Ben Adam Climer, a former CAHOOTS EMT and crisis counselor, described it as a “paraclinical” model. “You have a person who’s skilled at telling whether a person needs to see a licensed clinician,” he said. This helps keep the program staffed, he added, and is part of the reason it has worked so well for decades.
Climer, a Mennonite who holds two theology degrees, now consults for CAHOOTS and is working to develop similar programs around the country. Among the many cities looking to replicate CAHOOTS is Los Angeles, where the city council unanimously passed a measure in the summer of 2020 to develop a police-free crisis response for calls not involving weapons or violence.
Most CAHOOTS calls are wellness checks to visit people sleeping in parks, people having psychotic episodes, people who are elderly who haven’t been seen, people who have made suicidal statements on social media, or employees who haven’t shown up to work, according to Climer.
“By our very existence, we prevent police interaction with those folks in those circumstances,” Climer said.
Church leaders in the area say this is why they turn to CAHOOTS in a crisis.
“We call CAHOOTS because we don’t really need the police and the force that they bring,” said Rev. June Fothergill of Ebbert United Methodist Church in Springfield, Ore. In some instances, she notes, police presence has only escalated conflicts.
Climer said his work has been led in large part by his faith. “We are really rooted in this idea that people are worthy of having compassion and love given to them.”
Taking police out of the equation
If CAHOOTS is designed to replace police as the first to respond to a crisis, then Seattle’s LEAD program is an alternative for who comes second.
LEAD, originally an acronym for Law Enforcement Assisted Diversion and recently renamed to Let Everyone Advance with Dignity, is a program created in 2011 to keep people suspected of low-level crimes out of the criminal legal system.
Instead of booking suspects on charges and bringing them to court, police could refer LEAD participants to a case management program in order to receive social services like housing or drug treatment.
A 2015 study by University of Washington researchers found that people who went through the LEAD program had a 58 percent lower likelihood of arrest and 39 percent lower likelihood of being charged with a felony compared to the control group. Cities across the country—including Atlanta; Santa Fe, N.M.; Baltimore; and Albany, N.Y.—have followed the model of Seattle’s LEAD and created similar programs of their own.
Pre-arrest diversion programs, such as LEAD, are not typically considered an alternative to policing. Abolitionists remain skeptical of their impact. “It is a really good release valve for interrupting the flow from police to jail, but it relies on police to do it,” said Victoria Law, journalist and co-author of Prison by Any Other Name: The Harmful Consequences of Popular Reforms. If police officers still see their primary role as arresting crime suspects, even when they are nonviolent, then a pre-arrest diversion program won’t help.
Lisa Daugaard, executive director of the Public Defender Association in Seattle (the nonprofit that runs LEAD), said the program has been designed to become less police-dependent over time.
“From the beginning, we built a second road into LEAD case management, which was meant to facilitate a shift,” she said. Police were given the option to make so-called social contact referrals, which meant referring people to LEAD programs outside the context of probable cause to make an arrest. Now, community members have the option to call LEAD directly, bypassing the police altogether.
“It has never made sense that police were the institution that responded to these kinds of problems,” Daugaard explained. “But because they were called to respond, we needed an off-ramp for those contacts.”
As the culture changes and more people come to appreciate the value of nonpolice and noncarceral responses, the LEAD program can slowly remove police entirely from the equation in many instances. That shift has already begun. The newest version of the program is designed to “only have occasional need to coordinate with law enforcement and is primarily in lieu of a police response,” according to Daugaard.
Rev. Jenny Partch of Highline United Methodist Church has been involved in the effort to bring a version of LEAD to Burien, Wash., where LEAD’s approach to crises has been one of the few things disparate community members can agree on.
Partch is hopeful that a LEAD program can keep members of the community who are experiencing homelessness and substance-abuse disorders out of jail. She recalls a man who frequently came to the church’s cold-weather shelter. He was incarcerated after police ran a warrant search on him while he stood outside the church building.
“He had a drug addiction that he was trying to quit,” Partch said. “It’s difficult as a pastor to have someone like that come to you. This gentleman wanted me to pray with him and was really remorseful for things he had done. But without the programs and the community to help him, we just couldn’t get him over that addiction.” Had LEAD been available then, it might have kept him out of jail, she said.
“Ultimately, if this matures as the model for our community, there will be a phone number that rivals 911 in people’s ability to remember it, and there will be much greater capacity,” Daugaard said.
But the program isn’t there yet. It’s better to think of LEAD as a proof-of-concept rather than a finished solution. To bring this to scale, the program needs to be funded at or beyond the level at which police forces are currently. “It’s not a matter of a few million dollars,” Daugaard said. “It’s a genuinely large investment that is needed.”
“Continuous care is the fundamental gap in the system everywhere,” she added. “We are closer to being able to fill that gap in Seattle-King County than any other community, and we’re nowhere close.”
The fight ahead
LEAD and CAHOOTS both prove that it’s possible to respond to myriad crises without the police, thereby reducing harm in the community and lowering the potential for accidental injury and police misconduct.
The biggest barriers facing both programs are not that they don’t work. It’s that they’re still relatively unknown, underfunded, and only as good as the other social services available to treat chronic problems like homelessness, drug addiction, and poverty.
When the CAHOOTS program is understaffed, response times can be slow. They eventually arrived on the scene where the woman had overdosed at St. Mary’s in Eugene, according to Powell. But not until after the woman had fled.
“Sometimes the problem isn’t CAHOOTS’s fault,” Climer said. “It’s that there isn’t much they can offer the person. We don’t have enough treatment centers and we don’t have enough resources out there for people.”
Partch believes it’s her role as a faith leader to advocate for systemic change alongside specific programs like LEAD.
“If we really believe in every person being in the image of God, then we need to work on the systems that don’t see them as equal, sacred beings,” Partch said.
Partch and other faith leaders are lobbying Burien’s city council to reallocate budget resources from policing to human services, among other changes.
“I completely support the LEAD program,” she said. “But we also have to continue to see the bigger picture. We have multiple systems that all feed together and they’re all broken at this point.” For example, programs like CAHOOTS and LEAD don’t directly address systemic racism and racial disparities in policing and social services.
Faith leaders, who are often at the front lines of helping people in vulnerable situations are uniquely positioned to advocate for alternatives to policing, Daugaard said.
“I think that the faith community has a huge role in naming that, and saying, ‘we are not good with just stopping the old systems. We need there to be a meaningful response to the pretty desperate situations that people are in,’” Daugaard said.
Along with pushing for systemic change, faith leaders can also ask their communities to adopt programs similar to CAHOOTS and LEAD or point to them as models of programs that are proven to work.
“A lot of times the debate gets flattened into police or no,” Daugaard said. “The missing piece has been the design and occupation of that space, such that people have a thing to be for.”
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