By Kate Hubbs

“Mentally Ill Man with Gun is Shot and Killed by Police.”

“Mom Knows Anguish of Calling Police to Deal with Mentally Ill Son.” 

Headlines like those appear almost every day in newspapers across the country.  The stories typically focus on the safety issues that arise when law enforcement officers encounter an individual whose behavior appears to be related to a mental illness.[1]  The news stories also emphasize the complexity of law enforcement responses to people with mental illness.[2]  In the United States, over 8 million people struggle with schizophrenia or bipolar disorder and according to the Treatment Advocacy center, an estimated 40% of people diagnosed with schizophrenia go untreated.[3]  There are a variety of obstacles which prevent individuals from receiving the treatment they need.  For example, many communities have limited community treatment options or a shortage of psychiatric inpatient beds.[4]  Thus, many of those who require mental health treatment may not receive it until a crisis occurs and law enforcement intervenes.[5]  In fact, approximately one-third of individuals with severe mental illness have their first contact with mental health treatment through a law enforcement encounter.[6]  As a result, officers spend a large amount of time and resources serving essentially as mental health professionals; a role in which many have not received training.[7]  Frequently, when interacting with individuals that are struggling with mental health issues, officers are forced to make decisions about how to resolve or diffuse the situation.  Furthermore, even after the current situation is resolved, the person in crisis may be left without receiving further treatment or care that he or she may need.[8]

The adverse effects of law enforcement acting as first responders to mental health crisis situations has a lasting impact not only on the individuals in crisis but also on the larger community.[9]  Individuals experiencing a psychiatric crisis are frequently transported in a police cruiser in the same manner as individuals who have committed a crime; such an experience can result in trauma and stigma for the individual that remains with them far past the resolution of the incident.[10]  In 2017, a Treatment Advocacy Center survey found that law enforcement agencies spent $918 million transporting people with severe mental illness.[11]  It is also estimated that police officers spend about 21% of their time responding to and transferring people for mental health issues.[12]  Sometimes, law enforcement involvement only exasperates the troubling effects on the individual suffering a psychiatric crisis and their families.[13]  These negative experiences may deter the individuals or the family from seeking help during a subsequent crisis.[14]  Lastly, funneling most mental health calls through local law enforcement takes time away from protecting the community at large.[15]  This concern is particularly apparent in rural communities and small jurisdictions where law enforcement agencies are already stretched thin and areas to patrol may be large.[16]  As a result of an increasing awareness in mental health and a national concern about the relationship between law enforcement and responses to mental health calls, many communities are considering alternative methods to handling such calls. 

One program that gained national attention is Cahoots (Crisis Assistance Helping Out on the Streets), a Eugene, Oregon program.  Since the Wall Street Journal published an article detailing the program, many cities have considered this type of program to improve the treatment of people with severe mental illness.  In Eugene, Oregon, when police receive psychiatric crisis calls, they aren’t usually the ones dispatched.[17]  Cahoots, Oregon’s 30-year old program diverts nonviolent, often mental health-related 911 calls to a medic, nurse, or EMT and a crisis worker with years of experience in mental health.[18]  The teams drive up in white vans stocked with medical supplies, blankets, and water while wearing boots, jeans, and T-shirt and helps with issues such as counseling, suicide prevention, substance abuse, housing, and medical care.[19]  Tim Black, the Eugene Cahoots’ operations coordinator noted that “[the] difference in uniforms can assist folks with letting their guard down and being open to accepting the help that is being offered.”[20]  For people with a history of volatile arrests often while in mental health crisis, this approach could help make treatment more accessible, safer, and less traumatic.[21]

Far from the police approach of name and up against the car, the Cahoots team respond to these heightened situations and present themselves in a non-threatening manner in order to prevent an escalation of the situation.[22]  A team like Cahoots helps deescalate heightened tensions in a crisis situation while also attempting to resolve the problem without having to go through the channels of the criminal system.[23]  Ensuring that those who need help are greeted by the people who have the ability and training to help them and point them to further resources within the community.[24] 

Additionally, the Eugene Police Department uses its Cahoots staff for other highlight-emotional circumstances too.[25]  For example, Cahoots delivers death notices, hand out water bottles and socks to people living on the streets, and take after-hours community medical referrals.[26]  Furthermore, the staff offers those services to the city for half the cost of a police officer.[27]  Nationally, police officers are first in line to responding to mental health issues.[28]  The Cahoots program has helped divert 17% of an estimated 130,000 calls to its teams which in turn helped free up Eugene police officers to respond to higher level emergencies. [29]

With the success of the Cahoots Program in Eugene, and the national recognition it has been receiving in the past year, more police departments across the country are training their officers in techniques to deal with the mentally ill.[30]  Cities such as Los Angeles, Houston, and Salt Lake City pair officers with mental-health workers with police officers to respond to certain calls.[31] Furthermore, Denver is one other city currently considering implementing the Cahoots program.[32]  Like many police departments, Denver is feeling the pressure of mental health issues.  From July 2018 to July 2019, the department received about 15,915 mental health-related calls, almost a 9% increase from its annual average over three years.[33]  While it may take several years to create and perfect their own Cahoots program, this step away from relying only on law enforcement and the criminal system and towards an approach that focuses on rehabilitation is one example of the increasing awareness for the need of the decriminalization of mental health individuals.

[1] Zusha Elinson, When Mental-Health Experts, Not Police, Are the First Responders, Wall Street J., (Nov. 24, 2018, 10:00 AM),

[2] Id.

[3] The Role and Impact of Law Enforcement in Transporting Individuals with Severe Mental Illness, A National Survey, Treatment Advoc. Ctr., 1-2 (May 2019),

[4] Id.

[5] Id. at 1.

[6] Id.

[7] Id.

[8] Id.

[9] Id. at 14–15

[10] Id.

[11] Treatment Advoc. Ctr., supra note 3 at 7.

[12] Id. at 9.

[13] Id.

[14] Id.

[15] Id.

[16] Id.

[17] White Bird Clinic, (last visited Oct. 19, 2019).

[18] Id.

[19] Elinson, supra note 1.

[20] LJ Dawson, Taking the Cops Out of Mental Health-Related 911 Rescues, Kaiser Health News, (Oct. 11, 2019),

[21] Id.

[22] Elinson, supra note 1.

[23] Id.

[24] Id.

[25] Dawson, supra note 17.

[26] Id.

[27] Id.

[28] Id.

[29] Id.

[30] Elinson, supra note 1.

[31] Id.

[32] Dawson, supra note 17.

[33] Id.