My View: Quickest Change for Policing – CAHOOTS Model

By David M. Greenwald

The Davis City Council in December signed on to a nine-point plan for reimagining policing.  Some of the steps will be more difficult than others, but one clear path for change lies with a model that has been successfully deployed for 30 years in Eugene, Oregon.

Nationally, as the push is on for reform, reformers have now focused on the crisis-response program that many believe has resulted in a reduced footprint of law enforcement and a decrease in the likelihood of police violence.

At the core is the belief that, while the phrase “defund the police” is wrought with polarization and misinterpretation, there is also a fundamental belief that we are calling on police to do too many things, problems that cannot and should not be solved through the use of an armed police response.

We have also seen—repeatedly—that mental health calls are fraught with danger, as police respond to situations where command and respond scenarios do not work, and police are often ill-equipped to counsel and de-escalate in such situations.

The case of Daniel Prude in Rochester, NY, is one example.  Prude, acting erratically, was having a mental-health crisis, and the police responded by placing a mesh hood over his head and holding him to the ground until he stopped moving.  He would die a week later from “complications of asphyxia in the setting of physical restraint,” according to the medical examiner.

Proper response by the police?  Would a better trained responder have been able to resolve the situation without the loss of life?

Defenders of the police will often make the point—if people would simply comply with police orders, there would be a reduction of shootings.  But that simplistic approach overlooks fundamental complexities of the combination of mental health crises and self-medication that often lead to the most dangerous scenarios for both police and victims.

The notion that someone may lack the capacity to comply is often lost.  The notion that a simple command model of policing that ignores the need for skills at conflict resolution and de-escalation of confrontations is often missed as well.

The question we should be asking is how does society handle incidents, many of which are rooted in mental health problems rather than criminal intent—and if not law enforcement, who should intervene?

The answer I first stumbled across in Alex Vidal’s The End of Policing and have since seen cropping up more and more is CAHOOTS.

This week the Atlantic carried a lengthy article where the reporter visited Eugene this summer and reported that “CAHOOTS had 310 outstanding requests for information from communities around the country.”

CAHOOTS stands for Crisis Assistance Helping Out on the Streets, and it is a non-profit, public-private partnership that is “designed to help the city’s most vulnerable citizens in ways the police cannot.”

The article reports, “In Eugene, if you dial 911 because your brother or son is having a mental-health or drug-related episode, the call is likely to get a response from CAHOOTS, whose staff of unarmed outreach workers and medics is trained in crisis intervention and de-escalation. Operated by a community health clinic and funded through the police department, CAHOOTS accounts for just 2 percent of the department’s $66 million annual budget.”

Pilot programs are beginning now in places like San Francisco and Oakland.  Senator Ron Wyden introduced the CAHOOTS Act which would offer Medicaid funds for the program.

“It’s long past time to reimagine policing in ways that reduce violence and structural racism,” he said.

The article in the Atlantic lays out the fascinating history of the program and how it evolved over several decades to emerge in the late 1980s.  The reporter also offers a fascinating first hand account of CAHOOTS responses.

Barry Friedman, a law professor at NYU, posted a working paper on policing in March 2020.  The paper examined what police officers are called upon to do on a daily basis and highlights a fundamental mismatch between their training and those jobs.

In addition to enforcing laws, they are asked to be first responder, mediator and social worker.

“Crimefighting actually is a very small part of what police do every day, and their actual work requires an entirely different range of skills, among them: mediation skills to address conflict, social work skills to get people the long-term solutions they need, interviewing and investigative skills to really solve crimes, and victim-assistance,” he writes.

Yet he found that “police are barely trained in any of this, so, it is no surprise harm is the result.”

The Atlantic reports that “police are regularly involved in incidents that escalate partly because of a failure to consider mental-health issues.”

At this point, CAHOOTS costs Eugene just over one million (corrected from $225,000 originally reported) as a 24/7 service.  It has limits.

The Atlantic notes, “Yet CAHOOTS is still limited by the rules that govern its role in crisis response. Its teams are not permitted to respond when there’s ‘any indication of violence or weapons,’ or to handle calls involving ‘a crime, a potentially hostile person, a potentially dangerous situation … or an emergency medical problem.’”

According to CAHOOTS, they respond to about 17 percent of all calls handled by dispatch—although the police contend that many of those calls would not have gotten a police response to begin with.  The police thus believe the actual diversion rate is closer to 5 to 8 percent.

The Atlantic asked the Eugene Police Chief to assess their contribution, and he said, “The less time I put police officers in conflicts with people, the less of the time those conflicts go bad.”

Indeed, the reporter notes, “That, in a sense, is the same argument made by activists who have mentioned alternatives such as CAHOOTS in their demands to shrink the footprint of policing nationwide.”

My argument is more basic.  It follows from Professor Friedman’s findings.  If we are asking police to move beyond crime fighting to address other situations from homelessness to substance abuse to mental illness and beyond, we need one of two solutions.

Either we need to train police on the myriad of actual calls they get or we need different responders in the first place.  Many activists argue that many of these situations do not call for an armed response.  I would argue, even if some of them do need armed back up, we are probably better off having people trained to handle these responses rather than a one-size fits all approach.

As the reporter notes, “CAHOOTS has undoubtedly saved lives in Eugene. The question for cities hoping to emulate its success is how its approach might be adapted and scaled up.”  Or, in the case of Davis, perhaps the question is the reverse—how do we scale it down or partner with cities like Woodland and West Sacramento to make it cost-effective?

—David M. Greenwald reporting

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