Wellbeing and Mental Health

This US city sends mental health workers instead of police to non-criminal emergency calls

A police body camera is seen on an officer during a news conference on the pilot program involving 60 NYPD officers dubbed 'Big Brother' at the NYPD police academy in the Queens borough of New York, December 3, 2014.  REUTERS/Shannon Stapleton (UNITED STATES - Tags: CIVIL UNREST CRIME LAW SCIENCE TECHNOLOGY) - GM1EAC4054101

Recent Black Lives Matter protests have stirred debate around police funding. Image: REUTERS/Shannon Stapleton

Alex Thornton
Senior Writer, Forum Agenda
Our Impact
What's the World Economic Forum doing to accelerate action on Wellbeing and Mental Health?
The Big Picture
Explore and monitor how Systemic Racism is affecting economies, industries and global issues
A hand holding a looking glass by a lake
Crowdsource Innovation
Get involved with our crowdsourced digital platform to deliver impact at scale
Stay up to date:

Systemic Racism

  • Mental health workers, rather than police, respond to non-criminal emergency 911 calls in Eugene, Oregon.
  • The CAHOOTS programme reduces confrontations involving police officers, saves money, and allows police to concentrate on law enforcement.
  • The programme could be an alternative model for policing in the wake of the Black Lives Matter protests and calls to defund the police.
mental health police america defund the police george floyd protests anti establishment
The CAHOOTS programme reduces confrontations involving police officers. Image: White Bird Clinic

For many Americans experiencing a mental health crisis, the first professional they encounter will be a police officer. It isn’t an ideal combination. Often, someone acting irrationally, erratically or aggressively is confronted by an armed officer trained in the use of force if they feel the public - or themselves - are in danger.

Have you read?

Tragically, the results can be fatal. An analysis of police shootings reported by the Washington Post in 2015/16 suggests a quarter of those killed displayed signs of mental illness. In countless more cases, someone in need of medical or psychological care ends up in a cell, rather than getting the treatment they need. With mental illness affecting as many as a quarter of young Americans, the need for an alternative solution is clear.

mental health police america defund the police george floyd protests anti establishment
In 2018, the share of US adults with any mental illness over the last year, by age and gender Image: Statista

What is the World Economic Forum doing about mental health?

A different approach

The city of Eugene, Oregon, takes a different approach. For 30 years, the CAHOOTS (Crisis Assistance Helping Out On The Streets) programme has been sending teams of unarmed civilians to deal with 911 calls that elsewhere are dealt with by police.

Each team consists of a mental health crisis worker and an EMT (emergency medical technician, or paramedic). Between them, they have the skills and training to deal with mental health issues, homelessness, intoxication, substance abuse, disorientation and dispute resolution.

The programme developed from the work of the White Bird Clinic, a collective founded in 1970 that originally had strong links to counterculture activists, and now provides a range of health, education and community support services.


When 911 calls are assessed by dispatchers, any situations involving violence or criminal activity are routed straight to the police, while CAHOOTS is called in when their expertise is likely to lead to a better outcome. In 2019, CAHOOTS responded to 24,000 calls, and only required back-up from police 150 times.

mental health police america defund the police george floyd protests anti establishment
Savings for the Eugene Police Department from diverting calls to CAHOOTS. Image: White Bird Clinic

'Symbiotic relationship'

Eugene’s police department acknowledges that the CAHOOTS teams are often far better equipped to deal with situations where a police response is not the best option. Eugene Police Chief Chris Skinner told CNN the two organizations have a “symbiotic relationship”.

“When they show up, they have better success than police officers do. We’re wearing a uniform, a gun, a badge – it feels very demonstrative for someone in crisis.”

CAHOOTS services are voluntary and free of charge, funded by the city. The group claims it has saved the Eugene Police Department an average of $8.5 million a year in call-outs that would otherwise be handled by their officers – leaving the police to concentrate on law enforcement instead.

A better use of police funds?

Interest in the success of the CAHOOTS model has surged in the wake of the death of George Floyd, the subsequent Black Lives Matter protests, and growing calls to defund the police.


What's the World Economic Forum doing about diversity, equity and inclusion?

Deaths at the hands of the police are much more frequent in the US compared with many other countries, with race seen as a significant factor. There have been several high-profile examples of so-called “welfare checks” – the kind of situations that in Eugene would be handled by CAHOOTS – ending in tragedy.

mental health police america defund the police george floyd protests anti establishment
Rate of civilians killed by the police annually in selected countries, as of 2019(per 10 million residents). Image: Statista

Some proponents of moves to defund the police argue that redirecting money from police departments to mental health, homelessness, drug and alcohol rehabilitation, and community outreach services would not only reduce the number of confrontations involving the police, but lead to significantly better outcomes for individuals and communities, and deliver better value for money.

mental health police america defund the police george floyd protests anti establishment
Police spending per capita in major U.S. cities. Image: Statista

So could the CAHOOTS model be the answer? The programme’s co-founder, David Zeiss, is at pains to point out that CAHOOTS is not, and never could be, a replacement for police altogether.

“Partnership with police has always been essential to our model,” he told CNN. “A CAHOOTS-like programme 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.”


However, the White Bird Clinic is already in discussions with authorities in other cities, offering lessons from their experience and advice about how to successfully build partnerships with local services and community groups. There is no simple template that can be easily copied nationwide, but the volunteers at CAHOOTS in Eugene may well serve as the inspiration for a new way of policing in a fairer, and safer, world.

Don't miss any update on this topic

Create a free account and access your personalized content collection with our latest publications and analyses.

Sign up for free

License and Republishing

World Economic Forum articles may be republished in accordance with the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Public License, and in accordance with our Terms of Use.

The views expressed in this article are those of the author alone and not the World Economic Forum.

World Economic Forum logo
Global Agenda

The Agenda Weekly

A weekly update of the most important issues driving the global agenda

Subscribe today

You can unsubscribe at any time using the link in our emails. For more details, review our privacy policy.

Shifting spaces: Could tackling climate change in cities help solve the youth mental health crisis?

Natalie Marchant and Julie Masiga

July 19, 2024

About Us



Partners & Members

  • Sign in
  • Join Us

Language Editions

Privacy Policy & Terms of Service

© 2024 World Economic Forum