June 24, 2020


Recent calls to “defund” police agencies have focused on shifting some responsibilities and funding away from police departments and toward agencies that provide services to people experiencing mental illness, drug addictions, homelessness, and other issues.

It’s unlikely that police will ever be able to completely disengage from these types of social service calls, if for no other reason than the fact that unlike most social service agencies, police respond to calls 24-7. And social service providers often need police to ensure their safety when they are called to help clients who are behaving dangerously.

However, many police chiefs have said they would welcome opportunities to share more of the responsibility for social service-related calls with social service agencies.  And this is already occurring to various degrees in cities across the country.

In today’s Critical Issues Report, we explore “co-responder programs” that pair up police officers with mental health professionals (and sometimes other first responders) to provide both immediate and long-term responses to individuals with mental illness.

These programs may serve as blueprints for other jurisdictions that are looking to improve their response to mental health-related calls for service.

We will highlight five police agencies that have adopted different models for handling the complex challenge of mental illness in their communities.


Eugene, Oregon CAHOOTS Program:

Mental health crisis teams are the first responders in most cases

Three decades ago, the Eugene Police Department partnered with the White Bird Clinic and other first responders to create the Crisis Assistance Helping Out On the Streets (CAHOOTS) program. It provides 24/7 mobile crisis intervention in the Eugene-Springfield metropolitan area.

CAHOOTS program teams include a medical professional (usually a nurse or EMT) and a crisis worker from the White Bird Clinic. These persons have several years of experience in the mental health field.

The teams are dispatched on mental health calls that do not involve a crime by either the Eugene police-fire-ambulance communications center, or the Springfield non-emergency number.  Police officers are dispatched only if needed for enforcement action.

According to the Clinic, CAHOOTS teams responded to about 24,000 calls in 2019. In only about 150 of those cases did the teams require police backup.

CAHOOTS teams conduct assessments and provide information, referrals, advocacy, and transportation (if needed) for individuals in a mental health crisis. The goals are to resolve the immediate crisis and to connect individuals to mental health treatment and services. Community members in crisis receive confidential assistance from the CAHOOTS team at no charge, and their participation is strictly voluntary. In addition to mental health calls, CAHOOTS teams can respond to other types of crises, including homelessness, public intoxication, and substance abuse-related problems.

Funded jointly by the cities of Eugene and Springfield, the CAHOOTS program costs about $2 million a year, which is equal to just over 2% of the two police departments’ annual combined budgets of about $90 million.

According to the White Bird Clinic, CAHOOTS teams answered 17% of the Eugene Police Department’s overall call volume in 2017. The Clinic estimates that CAHOOTS saved the city an average of $8.5 million each year from 2014-2017.

The CAHOOTS programs has longer-term impacts by diverting individuals away from the criminal justice system and into mental health treatment and other services.

For more information:


Los Angeles Police Department SMART Teams:

Part of a comprehensive approach to addressing mental health calls

For four decades, the Los Angeles Police Department’s Mental Evaluation Unit (MEU) has assisted patrol officers with mental health-related calls. In 1993, the LAPD expanded the unit with the System-wide Mental Assessment Response Team (SMART), which pairs police officers and mental health clinicians to respond to certain mental health crises.

Here is how the process works. When officers are dispatched to a call for service that may be mental health-related, they can call the MEU’s Triage Desk. The desk is staffed by LAPD officers and mental health nurses from the Los Angeles County Department of Mental Health (LACDMH). They can check MEU and LACDMH databases for information on prior contacts that the individual may have had with the police, along with information on case managers and treatment centers. These individual profiles provide a more complete picture of what services the individual has used in the past and what type of response might be best in the present situation.

Based on that assessment, the Triage Desk decides whether to dispatch a SMART team or have the patrol officers handle the call. Each SMART team consists of an LAPD officer and a mental health clinician who have the training and expertise to handle the most challenging mental health crisis calls. There are currently 17 SMART teams that are deployed 24/7.

The MEU fields more than 15,000 calls a year, and SMART teams respond to approximately 5,000 of those calls. A 2014 study estimated that the SMART teams saved more than 6,600 hours of patrol time for LAPD officers. 

While the SMART teams focus on individual calls for service, another component of the MEU, the Case Assessment Management Program (CAMP), concentrates on the individuals who have frequent and sometimes violent encounters with the criminal justice system. CAMP pairs LAPD detectives with psychologists, nurses and social workers from the LACDMH to develop long-term plans for these more complex cases.

For more information:


Denver Police Department – Crisis Intervention Response Unit:

A step-by-step, layered approach to handling mental health-related calls

The Crisis Intervention Response Unit (CIRU) is a mental health co-responder partnership of the Denver Police Department and the Mental Health Care Center of Denver. The CIRU includes 15 licensed clinicians, 12 of whom cover Denver’s six police districts, with the other 3 working at the Denver Downtown Detention Center.

The CIRU responds to certain mental health-related calls in a step-by-step, layered approach. Teams are usually composed of a police officer and a mental health professional.  In some cases, other emergency responders may respond as well. Typically, the team’s police officer assesses the situation to ensure that the scene is safe for the mental health clinician to step in. Prior to responding, the clinician researches what is known about the person’s mental health status and history, information that police cannot access because of privacy laws. This context helps the clinician identify the best approach to take and the most appropriate referrals.

In 2018, the CIRU responded to 1,725 incidents; fewer than 70 people received a citation or were arrested.

  • More than 550 people were provided services from the Mental Health Center of Denver.
  • Approximately 300 individuals were placed on an emergency 72-hour mental health hold and received treatment and evaluation because they were deemed an imminent danger to themselves or others.
  • 70 people were connected to housing and treatment.
  • 13 were given detox treatment.

Another element of the partnership focuses on individuals in jail. The Mental Health Care Center of Denver provides a Behavioral Health Care Coordinator who is integrated into the co-responder program. The coordinator works with Denver Police, Denver District and County Courts, and the Denver Sheriff’s Department to provide service referrals, advocacy, case management, and system navigation for persons with mental illness in jail who meet certain criteria.

Earlier this year, the city of Denver granted a $700,000 contract extension to the Mental Health Center of Denver for continued operation of the CIRU through the end of 2020, bringing the total grant to $1.7 million.

For more information:


Dallas Police Department – Rapid Integrated Group Healthcare Team (RIGHT Care):

Teaming up police officers, paramedics, and mental health clinicians

The Rapid Integrated Group Healthcare Team (RIGHT Care) is a partnership of two public safety agencies – the Dallas Police Department and the Dallas Fire-Rescue Department – and two community-based organizations – the Meadows Mental Health Policy Institute (MMHPI) and Parkland Health & Hospital System.

RIGHT Care teams include a specially trained and equipped paramedic, a police officer, and a mental health professional, who respond to mental health-related calls in South Central Dallas. The team operates 16 hours a day, seven days a week. Operating hours are determined based on peak call times for behavioral health-related emergencies in that area.

When the 3-person team responds to a mental health-related call, the paramedic initiates the contact and determines if emergency medical service is necessary. The clinician makes the next contact and serves as the primary communicator with the individual in crisis. The clinician conducts a mental health evaluation and assesses the need for services. The police officer’s role is primarily to secure the scene and address any enforcement or crime victimization issues.

An important element of the partnership is accurate screening of incoming calls. A mental health clinician from Parkland is housed in the Dallas 911 center to monitor calls and serve as a liaison to first responders on mental health-related calls citywide.

The RIGHT Care program is showing some promising results. According to Parkland Health, in 2019 the number of psychiatric patients arriving at Parkland's emergency rooms overall rose by 30%, but in areas covered by the RIGHT Care program, the number of patients dropped 20%. Only 2% of the calls to which the RIGHT Care team was dispatched led to arrests, and less than 7% of the calls involve repeat users of the team’s services.

For more information:


Tucson (AZ) Police Department – Mental Health Support Team:

A specially trained police unit that helps other officers

The City of Tucson’s mental health response program has many components, including a Mental Health Support Team (MHST), Crisis Mobile Teams (CMT), a Crisis Response Center (CRC), and extensive training for law enforcement personnel, mental health workers, call takers and dispatchers, emergency medical technicians, paramedics, and firefighters.

The Tucson Police Department’s MHST is the co-responder component. It consists of a specially trained unit that includes a captain, lieutenant, sergeant, two detectives, and seven officers who serve as a mental health resource for other Tucson police officers, as well as community members and health care providers.

Other partners include the National Alliance on Mental Illness (NAMI), the University of Arizona, the CRC, the Pima County Attorney’s Office, Pima County Behavioral Heath, local courts, Pima County Sheriff’s Department, and other community-based behavioral health and substance addiction treatment providers. Their goal is to divert individuals in mental health crisis away from the criminal justice system with a health-first intervention approach.

Within the MHST, a police officer in civilian clothes is paired with a Masters-level licensed mental health clinician. Riding in an unmarked police vehicle, the team monitors the radio and responds to mental-health related calls, providing support to other officers who may have responded.

In addition to immediate response on the street, MHST members also focus on longer-range prevention and intervention efforts. The team works with mental health case managers, behavioral health professionals, prosecutors, and community partners to identify treatment and other service options for individuals in crisis.

MHST officers also participate in monthly meetings with leaders from Tucson’s criminal justice and behavioral health systems. At these meetings, participants exchange data to identify trends and develop case plans for individuals who frequent both systems.

For more information:


The PERF Critical Issues Report is part of the Critical Issues in Policing project, supported by the Motorola Solutions Foundation.


PERF also is grateful to the Howard G. Buffett Foundation for supporting this work.

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