In-Depth: Program in Oregon provides blueprint for San Diego mental health services

San Diego looks to 'CAHOOTS' for guidance
Mental Health Police Shootings
Posted at 5:59 AM, May 10, 2021
and last updated 2021-05-10 10:59:08-04

SAN DIEGO (KGTV) - San Diego leaders looking for solutions to the county's mental health issues have turned to other cities around for ideas. They may have found a blueprint in Eugene, Oregon.

"If the wheel had already been created, we wanted to copy it and make it 'San Diego,'" says San Diego County District Attorney Summer Stephan.

For 31 years, Eugene, Oregon, has used the "Crisis Assistance Helping Out on the Streets" or "CAHOOTS" program to respond to mental health calls.

Instead of sending police, the program sends a crisis specialist and a medic to every call where public safety isn't threatened.

"We recognized early on that police officers were not the right resource for that," says Eugene Chief of Police Chris Skinner.

In 2019, CAHOOTS handled 18,583 calls for help. That number equals about 8% of all the calls that go to Eugene's 911 system.

Skinner says his officers are glad they can focus on law enforcement instead of mental health issues.

"If we can keep them focused on that, and find a different way to respond to some of our lower priority kind of livability crimes or behavioral health issues, then most of them say sign me up," he says.

The CAHOOTS program costs the City of Eugene just over one million dollars each year. Skinner says that money is well spent.

"Really, that's what CAHOOTS is," says Skinner. "It's being thoughtful about matching the right resource with the need that we have in our community."

CAHOOTS is one of several programs that San Diego County leaders looked at when creating their "Blueprint for Mental Health Reform."

Local leaders wanted a better way to respond to mental health calls than a police presence.

"The idea is that if you're in a police car, you're being treated like a criminal," says DA Stephan. "Police recognize that they are not always the best suited for a situation that doesn't involve violence or threat of violence."

As part of the blueprint, San Diego County launched its "Mobile Crisis Response Team" in January. The MCRT operates in coastal cities in North County as part of a pilot program.

According to Stephan, the MCRT has already responded to 34 calls, and only one needed help from the police.

"This sets us on a path of longer-term, more compassionate, more real solutions that work," says Stephan.

County Board of Supervisors Chair Nathan Fletcher adds that the MCRT is part of a cultural shift. He wants San Diego to start treating these incidents as health issues, not crimes.

"If you're having a stroke, you don't send law enforcement as a response," Fletcher says. "It should be the same if you're having a mental health episode unless you're a danger to yourself or someone else."

Stephan and Fletcher hope to expand the program throughout the county. They hope to get proposals starting this summer.

Even if that happens, it will still be a long build-up. Fletcher says a wide-scale expansion would need to get people hired and trained while also creating the infrastructure to support the people they serve.

"These mobile crisis response teams need to have somewhere appropriate to take someone to get the care they need," Fletcher says. "And then when they get discharged from there, we need the permanent housing and ongoing services and care."

There are also issues with how to reach the MCRT. Right now, anyone who needs mental health assistance should call the Crisis Hotline at 888-724-7240. But most people call 911 instead, which can only dispatch emergency first responders like the police.

The County is working on streamlining the system so calls that go to either place can dispatch the MCRT.

Chief Skinner in Eugene says his department faced the same issue. It took years to work out the kinks while also "training" the public to know that CAHOOTS should be their first option when it comes to a mental, behavioral, or addiction-related crisis.

"Now we answer the phone, '911 - police, fire, and CAHOOTS,'" Skinner says. "We give them that option as a resource when they call 911. And then people think, Oh, that's right. Maybe CAHOOTS is the right resource for this."

San Diego leaders hope the success of CAHOOTS in Oregon is something they can replicate here, providing a new solution for San Diego's mental health problems.

"We're moving in the right direction, and we're moving with a sense of urgency," says Fletcher. "There's no doubt this is doable. This is very, very doable."