
Around 30 years ago, a town in Oregon retrofitted an old van, staffed it with young medics and mental health counselors and sent them out to respond to the kinds of 911 calls that wouldn't necessarily require police intervention.
In the town of 172,000, they were the first responders for mental health crises, homelessness, substance abuse, threats of suicide -- the problems for which there are no easy fixes. The problems that, in the hands of police, have often turned violent.
Today, the program, called CAHOOTS, has three vans, more than double the number of staffers and the attention of a country in crisis.
CAHOOTS is already doing what police reform advocates say is necessary to fundamentally change the US criminal justice system -- pass off some responsibilities to unarmed civilians.
Cities much larger and more diverse than Eugene have asked CAHOOTS staff to help them build their own version of the program. CAHOOTS wouldn't work everywhere, at least not in the form it exists in in Eugene.
But it's a template for what it's like to live in a city with limited police.
Most of the clients White Bird assisted -- unsheltered people or those with mental health issues -- didn't respond well to police. And for the many more people they hadn't yet helped, they wanted to make their services mobile, said David Zeiss, the program's co-founder.
"We knew that we were good at it," he said. "And we knew it was something of value to a lot of people ... we needed to be known and used by other agencies that commonly encounter crisis situation."
It works this way: 911 dispatchers filter calls they receive -- if they're violent or criminal, they're sent to police. If they're within CAHOOTS' purview, the van-bound staff will take the call. They prep what equipment they'll need, drive to the scene and go from there.
It always paired one medic, usually a nurse or EMT, with a crisis responder trained in behavioral health. That holistic approach is core to its model.
Per self-reported data, CAHOOTS workers responded to 24,000 calls in 2019 -- about 20% of total dispatches. About 150 of those required police backup.
CAHOOTS says the program saves the city about $8.5 million in public safety costs every year, plus another $14 million in ambulance trips and ER costs.
Staffers respond to substance addiction crises, psychotic episodes, homeless residents and threats of suicide. They make house calls to counsel depressed children at their parents' request, and they're contacted by public onlookers when someone isn't in a position to call CAHOOTS themselves.
Unlike police, CAHOOTS responders can't force anyone to accept their aid, and they can't arrest anyone. They're not armed, and their uniform usually consists of a White Bird T-shirt and jeans -- the goal is that the more "civilian-like" they look, the less threatened their clients will feel.
Their approach is different, too. They're taught in training to abandon the "pseudo-professional" affect that staffers inadvertently take on in talks with clients.And aside from an extensive background in medical care or mental health, all CAHOOTS employees are judged by their "lived experiences," Brubaker said -- people who've dealt with many of the situations CAHOOTS clients find themselves in are better able to empathize and serve those people, he said.
And for the most part, both groups have: Eugene Police Chief Chris Skinner called theirs a "symbiotic relationship" that better serves some residents of Eugene.
"When they show up, they have better success than police officers do," he said. "We're wearing a uniform, a gun, a badge -- it feels very demonstrative for someone in crisis."
Most of CAHOOTS' clients are homeless, and just under a third of them have severe mental illnesses. It's a weight off the shoulders of police, Skinner said.
"I believe it's time for law enforcement to quit being a catch-base for everything our community and society needs," Skinner said.
"We need to get law enforcement professionals back to doing the core mission of protecting communities and enforcing the law, and then match resources with other services like behavioral health -- all those things we tend to lump on the plate of law enforcement."
"Partnership with police has always been essential to our model," he said. "A CAHOOTS-like program without a close relationship with police would be very different from anything we've done. I don't have a coherent vision of a society that has no police force."
He said the current movement has seemingly pitted service providers like CAHOOTS against police, which may stoke suspicion among police over "whether we're really their allies or their competitors," he said.
"In some sense, that may be true. But I think we still need to focus on being part of a system, and a system that includes police for some functions," Zeiss said.
The idea of a separate entity in charge of alternative care is more enticing than ever as cities mull over the efficacy of their police departments.
CAHOOTS has met the moment. Brubaker said he's consulting with cities on how to implement their own CAHOOTS-inspired program, subbing White Bird Clinic for a local organization that serves a similar role.
There are a few criteria, though, that Brubaker considers immutable: The CAHOOTS stand-in should be operated by a local non-profit separate from the government that already has an established, positive rapport with the community, and it should ideally be staffed by people who reflect the diversity of that community.
CAHOOTS consulted Olympia, Washington, on the creation of its own Crisis Response Unit, which is staffed by two social workers. Denver is piloting a program, also inspired by CAHOOTS, led by a local social justice organization.
White Bird Clinic and CAHOOTS coordinators can't go into other communities and set up copies of CAHOOTS. What works in Eugene wouldn't work in New York, or in Miami, or in larger cities more diverse than Eugene (less than 2% of the population is Black, according to census data).
Brubaker knows that a "fill-in-the-blank" style of reform wouldn't work. But CAHOOTS does provide a template.