• 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.

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?

One in four people will experience mental illness in their lives, costing the global economy an estimated $6 trillion by 2030.

Mental ill-health is the leading cause of disability and poor life outcomes in young people aged 10–24 years, contributing up to 45% of the overall burden of disease in this age-group. Yet globally, young people have the worst access to youth mental health care within the lifespan and across all the stages of illness (particularly during the early stages).

In response, the Forum has launched a global dialogue series to discuss the ideas, tools and architecture in which public and private stakeholders can build an ecosystem for health promotion and disease management on mental health.

One of the current key priorities is to support global efforts toward mental health outcomes - promoting key recommendations toward achieving the global targets on mental health, such as the WHO Knowledge-Action-Portal and the Countdown Global Mental Health

Read more about the work of our Platform for Shaping the Future of Health and Healthcare, and contact us to get involved.

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?

The COVID-19 pandemic and recent social and political unrest have created a profound sense of urgency for companies to actively work to tackle inequity.

The Forum's work on Diversity, Equality, Inclusion and Social Justice is driven by the New Economy and Society Platform, which is focused on building prosperous, inclusive and just economies and societies. In addition to its work on economic growth, revival and transformation, work, wages and job creation, and education, skills and learning, the Platform takes an integrated and holistic approach to diversity, equity, inclusion and social justice, and aims to tackle exclusion, bias and discrimination related to race, gender, ability, sexual orientation and all other forms of human diversity.

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.