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CAHOOTS launches mobile crisis response 101 course as cities across the country look to start similar programs

Each CAHOOTS team consists of a nurse or EMT and a crisis worker. The curriculum of its new course aims to share what CAHOOTS workers have learned over the decades.
Credit: KGW

EUGENE, Ore. — In the summer of 2020, after the murder of George Floyd sparked a global movement against racism and police brutality, many activists, nonprofits and governments began to search for an alternative to policing as the default crisis response method.

Around the nation, eyes turned to Eugene-based White Bird Clinic’s CAHOOTS. The unarmed, 24/7 mobile crisis intervention team seemed to answer the question many were asking — How can a community respond to crises effectively?’

“We were receiving lots of interest about our program, more so than we knew what to do with,” Abbey Carlstrom, with CAHOOTS, said.

About a year ago, Carlstrom joined the CAHOOTS team to help its efforts to respond to this growing demand for its blueprint. Last week, White Bird Clinic and CAHOOTS announced that they are launching a course open to organizations who want to understand what makes the 32-year-old program work.

“We're teaching, like, mobile crisis response 101,” she said.

CAHOOTS, which stands for Crisis Assistance Helping Out On The Streets, is prone to clever acronyms — their new course is called BASIC-MCR, which stands for Building and Sustainably Implementing Community Mobile Crisis Response. It’s planned to run three times per year with cohorts made up of eight teams of up to five participants from municipalities, nonprofits and community groups across the country.

“The BASIC-MCR model will be a crucial next step in making real connections with communities outside of Lane County,” said CAHOOTS crisis worker Chelsea Swift in an email to The Register-Guard. “What is most exciting is these connections will not just exist in a vacuum between a White Bird Clinic representative and the ‘contractor.’ ”

The course will be a group environment and each session will be co-facilitated by different CAHOOTS workers so attendees will hear directly from those who have the most intimate understanding of what the work looks like in practice.

A mix of groups are interested, from city governments to nonprofit organizations and grassroot agencies.

“There are programs across the country that are getting started including Louisville, Phoenix, Arizona, many cities in New York (state), and Santa Rosa, California,” Carlstrom said. “And that's just the tip of the iceberg.”

Collaborating on what could be

In the height of the American counter-culture movement, Eugene hippies, distrustful of the establishment and specifically police, wanted somewhere else to go to, so a collective of likeminded activists, medics and social workers founded the White Bird Clinic in 1969.

There was some concern 20 years later when the prospect of the group’s emergency response team working together — "in cahoots" — with Eugene police as the group was made up “fairly anarchistic hippies,” according to one of CAHOOTS’ founders.

But the odd marriage has lasted over the years. In Eugene, CAHOOTS is dispatched through the police-fire-ambulance communications center. In Springfield, it's through the Springfield non-emergency number.

Each CAHOOTS team consists of a nurse or an EMT and a crisis worker, someone who has several years' experience in the mental health field. In 2019, CAHOOTS responded to 24,000 calls for assistance. Currently, about three dozen workers respond to around 20 calls a day in 12-hour shifts.

The curriculum of its new course aims to share what CAHOOTS workers have learned over the decades – the good, the bad and the ugly.

“Given that we've been around for 32 years, we have some really valuable insight into what programs that are just launching might be able to consider and things that they can prepare for or design differently than we had,” Carlstrom said. “Funding is obviously part of that — the CAHOOTS program is sorely underfunded. We really are encouraging these other programs to prioritize paying their first responders a living wage.”

Longevity doesn't equal 'gold standard'

Since there's always more to learn, the BASIC-MCR course is not just about teaching, but creating a shared learning environment among those trying to imagine new possibilities.

“The CAHOOTS program has been basically alone in this industry … so we have a lot to learn from other groups as well,” Carlstrom said. “Just because we've been around the longest does not mean that we're in any way a gold standard.”

The curriculum is built around the experience and expertise of CAHOOTS workers. CAHOOTS plans to share industry insights, strategies and implementation tools to groups planning similar programs from its perspective as the longest running non-police mobile crisis response unit in the country.

The course will emphasize collective learning among participating teams that are in different stages of program development. Most ambitiously, it aims to establish a supportive network for the burgeoning industry of mobile crisis response.

Live sessions will be accompanied by supplemental readings, exercises, assignments and guest speakers.

The course curriculum is informed by common questions from groups looking to launch a pilot mobile crisis response program, as well as modules from its own internal training academy.

Participating teams can include up to four stakeholders, including program managers, strategists, directors, and members of partnering agencies such as the police department. Enrollment in the course requires that each team include a representative from the community.

“Representatives from various cities, counties and organizations including our own will work together to create new systems full ofvibrant community-based strategies that move us away from coercive, carceral and racism-driven approaches to mental health crises, unhoused communities and drug use,” said Rory Elliot, a spokesperson for CAHOOTS, in an email.

The tuition for BASIC-MCR course is $4,000 per team with two partial scholarships available for nonprofit groups and one full scholarship available for a grassroots community-led group.

Participating teams can include up to four stakeholders, including program managers, strategists, directors, and members of partnering agencies such as the police department. Enrollment in the course requires that each team include a representative from the community.

“Representatives from various cities, counties and organizations including our own will work together to create new systems full ofvibrant community-based strategies that move us away from coercive, carceral and racism-driven approaches to mental health crises, unhoused communities and drug use,” said Rory Elliot, a spokesperson for CAHOOTS, in an email.

The tuition for BASIC-MCR course is $4,000 per team with two partial scholarships available for nonprofit groups and one full scholarship available for a grassroots community-led group.

Not a one-size-fits-all approach

As many cities have vied for a new model of crisis response, CAHOOTS workers have always been adamant that the approach needs to be adjusted to the needs of the specific communities it serves.

This is part of why CAHOOTS workers are making the program less standard consulting work and more of a collaborative educational environment.

“Our program is catered to the needs of our community,” Carlstrom said.

“The majority of CAHOOTS calls are for unhoused people and that is unique to Eugene, and that's going to look different in a metropolitan area or in a place where maybe they are experiencing an opioid epidemic.”

In 2019, about 35% of calls for CAHOOTS were for transportation, 15% of which was transportation to shelters. Other communities might serve different people with different needs, and programing would need to be adjusted accordingly.

Spreading the good word while creating a stream of income

At this point, the BASIC-MCR course is not a certification. Participation in the course doesn’t end in CAHOOTS credentialing or imply an endorsement of the resulting programs.

This inaugural course is designed to help the beginning phases and early implementation of similar programs.

If it goes well, there could be more to come, a sort of “CAHOOTS 201,’’ Carlstrom said.

All proceeds from the course will support funding needs within CAHOOTS.

“It is unique for White Bird in that it's going to be one of the only things that brings in a profit, potentially," Carlstrom said.

“There's a hope that if we're in the spotlight in this way that it might help the program leverage the financial support that it needs.”

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