South Bend Tribune
SOUTH BEND — As the group Faith In Indiana pushes for a mobile response unit to give South Bend area police forces an alternative to jailing those with mental illness and substance abuse problems, both activists and officials cite Eugene, Oregon as a community that’s getting it right.
The city that’s home to the University of Oregon implemented the “Crisis Assistance Helping Out On The Streets” (CAHOOTS) program in 1989. Officials there say it’s been effective for diverting people needing mental health, substance abuse and other services away from jail, Lt. Ron Tinseth, director of the program, said by phone last week.
An analysis of the CAHOOTS program from 2019 shows 5% to 8% of calls for service that would have been handled by the Eugene Police Department were diverted to the mobile response team.
Similarly, an analysis of the city of Indianapolis’s “Mobile Crisis Assistance Team” that was conducted in 2017 when it was a pilot program operating in a neighborhood that had a high number of mental health crisis-related 911 calls, showed that program was effective at keeping those dealing with mental health or substance abuse crises out of jail.
The study, conducted by the Indiana University Public Policy Institute’s Center for Criminal Justice Research, showed that MCAT personnel took fewer than 2% of the people they interacted with to jail.
Tinseth said CAHOOTS was Eugene’s response to nonprofit organizations that often came to annual budget hearings asking for more money to address issues such as homelessness, substance abuse and mental health.
“What the city decided to do is instead of giving something small to many groups to centralize the service and give a larger chunk to White Bird Clinic to form a CAHOOTS team,” he said.
White Bird Clinic is the mental health agency that administers CAHOOTS, but the program’s $798,000 budget comes from the police department’s budget. Those dollars pay for mobile units consisting of a medic (a nurse, paramedic or EMT) and a trained crisis manager. Tinseth said the CAHOOTS teams are available around the clock and respond to a range of mental health related crises, including substance abuse, suicide threats, conflict resolution and welfare checks.
Most calls come to the 911 center, but some come to the department’s non-emergency line or from people who request help after seeing the CAHOOTS vehicle.
“A caller takes the information and makes a determination if the call is appropriate for a CAHOOTS response,” Tinseth said.
A dispatcher then reviews the details and will send the CAHOOTS team if that is the appropriate response.
For example, the team would not be sent to deal with an armed person who is considering suicide.
The dispatcher may decide to send the police, as well as the CAHOOTS team, or the team could request police assistance.
Once on scene, the team contacts the person who needs services, determines what that person needs and then tries to meet those needs.
“Many times, it’s checking vitals to make sure there is not a medical issue,” Tinseth said. “Sometimes it’s counseling and sometimes it’s access because the team is the gateway to many social services.
“If the crisis is around housing, they can make some referrals, or if it’s for alcohol or mental health treatment they can make referrals on that.”
Collaborating with the agencies that have the resources and expertise to help people dealing with substance abuse, homelessness or mental health emergencies is crucial to the success of programs like CAHOOTS, Tinseth said.
“If you don’t have the basic services to underlie this program, it is going to struggle,” Tinseth said. “For example, Olympia, Washington set up a program based on ours, but at that time they didn’t have a sobering center so they had nowhere to take anybody who was intoxicated.”
Rebekah Go, a Faith In Indiana member who has been working with St. Joseph County officials on finding alternatives to jail for those dealing with mental health crises, said the fact the county doesn’t have a walk-in center for mental health emergencies means those people end up either in a hospital emergency room or jail.
“A crisis response team would be amazing because very rarely do these things happen between 8 and 5, Monday through Friday and it can be pretty scary to have something happen late in the afternoon on Friday or in the middle of the night on a Tuesday,” Go said.
Go believes the crisis response center could be a way for people having a mental health crisis to get assessments, help and referrals. The center could be a place where people could receive emergency services and get referrals to other agencies that could address their longer-term needs.
Still, Go said, there needs to be better coordination and communication between the agencies currently helping people with mental health, substance abuse, housing and other issues. She added that the St. Joseph County Health Department should take the leading role in working with agencies to develop a coordinated system of mental health care.
Here is where discussions of reforming or reimagining policing can become that elusive good news story where change is not only possible, but more likely than not to happen.
Nearly all the stakeholders believe jail should not be the default treatment center for those dealing with mental health or substance abuse issues, and there is perhaps no stronger change advocate than St. Joseph County Sheriff William Redman.
Redman said he’s made it a priority to find alternatives to jail for people having mental health emergencies, and has been working with Faith In Indiana on this issue for several years.
There’s also broad agreement about the importance of having the health department play a leading role in coordinating a systematic response so it will be easier for a mobile unit to connect those in need of services with the agencies that provide them. Just ask county health officer Robert Einterz.
“We recognize that the various organizations have their respective roles and their primary focus is on doing the best job possible (and) they don’t always think about the system as a whole,” Einterz said. “So, it becomes the responsibility of the department of health to take a step back and help envision the system and then convene representatives of the organizations to work together to identify where there might be gaps and to work together on solutions to those gaps.”
Email South Bend Tribune reporter Howard Dukes at hdukes@gannett.com
Follow him on Twitter: @DukesHoward