Oakland Police Seek to Replicate Successful Oregon Mental Health Program

By: Sonya Chalaka

The percentage of California prisoners with a mental illness has increased by 77 percent over the past decade, according to the Stanford Justice Advocacy Project. Since 2000, there has been a 150 percent increase in the number of California prisoners currently being treated for serious mental disorders, such as schizophrenia, psychotic disorder and bipolar disorder.

Oakland, along with six other U.S. cities, is planning to replicate a mental health emergency program in Oregon, called CAHOOTS. This program seeks to address the medical and mental health needs of the community by adding mental health experts to police and fire teams responding to emergency calls. 

With its emphasis on proactive diversion from incarceration to care, Crisis Assistance Helping Out On The Streets (CAHOOTS) offers a myriad of services, including crisis de-escalation, transportation to care facilities and housing, dispute resolution services and substance abuse intervention. CAHOOTS teams consist of medics and mental health crisis specialists, who respond to calls, unarmed and without police backup.

Last year alone, “we responded to 23,000 total calls in Eugene and [the neighboring city of] Springfield,” said Tim Black, CAHOOTS’ program manager. Those calls absorbed nearly 20 percent of the public safety call volume. 

Reducing calls for officers is one of the main reasons Oakland is looking to CAHOOTS, said Oakland Police Sergeant Doria Neff. 

“We are always open to any solution to reducing calls for officers so we can focus on what is most appropriate for officers to respond to, and if we can work in collaboration with other agencies or other professions that can do a more effective job, especially with this community [people who have a mental illness], then we are open to that,” said Neff, who has attended several CAHOOTS presentations and is in the process of scheduling a site visit for the Oakland Police Department. 

Oakland, Alameda County’s largest city, sends the largest percentage of inmates with mental illness to state prison –– 42 percent. In 2011, Neff explained, the Oakland police “... started the ball rolling as to all things mental health related” by creating a “mental health on the scene coordinator” position and introducing crisis intervention training to its officers. 

Yet, as Alameda County Assistant District Attorney L.D. Louis said, there are several other underlying issues affecting people with mental illnesses that must also be addressed, such as insufficient housing, food insecurity and limited social support. 

“This model is a piece in the puzzle. There are a lot of pieces that are already connected but a lot of those pieces need to be doubled, tripled, or quadrupled,” Louis said. 

While the CAHOOTS model targets the moment of crisis, crisis aversion involves more than just diversion, explained Louis. In Alameda County, low-income neighborhoods and communities of color bear a disproportionate burden of mental illness and incarceration rates, according to the Alameda County Community Health Assessment.

“The main destabilizing factor is a lack of housing,” Louis said. Housing insufficiency, mental illness and incarceration tend to perpetuate one another, and understanding this relationship is critical to meaningful problem solving, Louis explained. 

“The big barrier is that we're not [providing] food, clothing and shelter. You have to take care of peoples’ basic needs before we can then focus on the state of mind,” Louis said.  

In the Bay Area, housing insufficiency has escalated into a public health crisis, with tens of thousands falling into homelessness annually, according to the San Francisco Chronicle. Although the state legislature has responded with promising housing development initiatives, the Chronicle noted that meeting the actual needs of the Bay Area would require some 190,000 housing units costing $94 billion. 

While these numbers are staggering, the focus is on proactive progress. Black advised that while CAHOOTS has demonstrated success in Eugene and Springfield, the program has to be tailored to fit the needs of the new cities that are implementing it. 

At the local level, Louis and Neff contended, this means implementing a CAHOOTS-like program in tandem with creative, sustainable housing solutions, as well as bridging communication across agencies and communities. 

With new housing projects underway and the CAHOOTS program nearing implementation in the Oakland Police Department, the pieces are coming together. Meanwhile, the District Attorney’s office is expanding a mental health diversion program for low-level offenders with mental illness, in collaboration with the Alameda County Public Health Department, adding dimension to the solution.

(Editor's Note: This article was originally published in the December 2019 [Volume 50, Issue 2] version of The Advocate.)