Lorraine Reich and Pauli Halstead: Let’s perfect crisis intervention | TheUnion.com

Lorraine Reich and Pauli Halstead: Let’s perfect crisis intervention

Lorraine Reich and Pauli Halstead | Other Voices

The use of deadly force by police officers, particularly against the mentally ill and people of color, has given rise to federal HR 7120, the George Floyd Justice in Policing Act of 2020. It is estimated that people with untreated mental illness are 16 times more likely to be killed during a law enforcement encounter.

In California, these statistics of police shootings were the impetus for the state Legislature to pass SB 230 (Govt. Code 7286), a comprehensive bill calling for updating use-of-force policies.

Nationwide, training law enforcement in the recognition of mental illness, addiction and homelessness and appropriate use of force is an ongoing focus by communities willing to re-imagine law enforcement roles and budgets.

Many communities have taken mental illness and homelessness emergency calls away from law enforcement, and created crises intervention teams made up of medical and mental health professionals to answer those calls.

The following examples indicate the approaches of a variety of innovative models across the country:


CAHOOTS (Crisis Assistance Helping Out On The Streets). Thirty-one years ago, the city of Eugene, Oregon, developed an innovative community-based public safety system. The program mobilizes two-person teams consisting of a medic (a nurse, paramedic, or emergency medical technician) and a crisis worker who has substantial training and experience in the mental health field.

The CAHOOTS teams deal with a wide range of mental health-related crises, including conflict resolution, welfare checks, substance abuse, suicide threats, and more, relying on trauma-informed de-escalation and harm reduction techniques.

911 calls are routed to CAHOOTS when crime is not involved. CAHOOTS staff are not law enforcement officers and do not carry weapons. Their training and experience are the tools they use to ensure a non-violent resolution of crisis situations.

CAHOOTS is a partially private-public funded program costing just 2 percent of the department’s $66 million annual budget. The CAHOOTS program budget is about $2.1 million annually, while the combined annual budgets for the Eugene and Springfield police departments are $90 million.

In 2017, the CAHOOTS teams answered 17% of the Eugene Police Department’s overall call volume. The program saves the city of Eugene an estimated $8.5 million in public safety spending annually.


The San Francisco Street Crisis Team pilot program is a collaboration between the San Francisco Department of Public Health and the San Francisco Fire Department with significant support from the Department of Emergency Management. The goal of the new program is to provide an appropriate non-law enforcement response to behavioral health emergencies in San Francisco and divert individuals in crisis away from emergency rooms and jail into mental health treatment.

The citywide crisis team operates 24 hours per day, seven days per week, to intervene with people on the street experiencing a substance use or mental health crisis with the goal of engaging them and having them enter into a system of treatment and coordinated care. Each team includes one community paramedic, one behavioral health clinician, and one behavioral health peer specialist.

The city prioritizes community engagement as a critical component of program design, program evaluation, and ultimately program success. For the Street Crisis Team, this community engagement is especially important, and complex, given that it is positioned at the intersection of serious mental illness, substance use, homelessness, police reform, and racial equity.

Launched in November 2020, the public reaches the Street Crisis Team by dialing the new mental health hotline at 311. Since inception, the program has had hundreds of calls and saved hundreds of lives, saving the city millions of dollars in law enforcement costs.


Following the Psychiatric Emergency Response Team model from San Diego, in December 2020, Sheriff Shannan Moon implemented a pilot Mobile Crisis Team consisting of a specially trained sheriff’s deputy and a licensed mental health worker. The Crisis Team does not operate 24/7, however. We are wondering why dispatch or the deputies did not call the team on Feb. 4 in the case of Sage Crawford. This was an obvious mental health crisis situation.

Similarly, last November, the Grass Valley Police Department received a grant for a pilot program. Also using the response team model Grass Valley decided to pair a police officer with a case worker from Hospitality House with a background in clinical social work.

As has shown in the Sage Crawford shooting, the presence of law enforcement itself often escalates an already distressed person in mental health crisis. We question why the Sheriff’s Office and Grass Valley Police Department chose the Psychiatric Emergency Response Team model rather than the CAHOOTS model, which does not involve a uniformed officer.

The Community Oversight Task Force is asking the Nevada County Board of Supervisors to allocate at least 2% of the sheriff’s $46 million annual budget to fund the creation of a 24/7 Crisis Response Team similar to the CAHOOTS model.

Lorraine Reich and Pauli Halstead are members of the Community Oversight Task Force. This is the second of a series.


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