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Community responder program    

Community responder programs position health professionals and staff trained in crisis response as first responders to 911 and other emergency calls for service, as well as social disturbances. These teams provide immediate assistance for people experiencing behavioral health (i.e., mental health and substance use) crises, conduct wellness checks, help people with housing needs, and more. 

For more information on this intervention, see this resource:
Local Examples

Olympia, WA Olympia Police Department

  • The crisis response program is housed within the Olympia Police Department and is staffed by four crisis response specialists and two crisis response lead workers. Both positions engage with, assess, and transport people with behavioral health needs, but the leads oversee the specialists and act as coaches.
  • Staff attend de-escalation, trauma-informed response, motivational interviewing, crisis intervention team, and anger management training. Staff have also been trained in radio procedures and have received general information about what to expect when they have been requested by law enforcement or when they request law enforcement assistance.
For more information on this example, see this resource:

Albuquerque, NM Albuquerque Community Safety Department

  • As a part of the Albuquerque first responder system, the Albuquerque Community Safety Department (ACS) receives and triages calls primarily through 911. It also receives calls through referrals and the non-emergency 311 line, with an option to self-dispatch as appropriate. That is, responders can address crisis-related problems they see without requiring an inbound call to 911 or 311 for service. Additionally, ACS is the primary stakeholder in the rollout of the 988 national crisis line in New Mexico.
  • ACS’s Community Response Division consists of two street outreach and resource responders; 10 community responders; and one position to coordinate efforts among the Community-Oriented Response Assistance team, which includes first responders and mental health professionals who provide outreach to communities affected by tragedy and violence.
  • Responders are only dispatched if the call indicates no immediate threat or danger, and they are instructed to leave a scene if an individual shows aggression or resistance. Albuquerque Police Department officers can also request ACS responders after they have secured the scene.
  • Responders usually take calls in pairs. If there is a potential for danger, Mobile Crisis Team clinicians will co-respond with a uniformed Crisis Intervention Unit police officer.
For more information on this example, see this resource:

San Francisco, CA San Francisco Crisis Response Team

  • The San Francisco Street Crisis Response Team (SCRT) engaged with community-level groups to gather information about crisis response needs in the community, in addition to collecting and analyzing data on 911 call volume and SCRT engagements in different zip codes to identify service needs.
  • SCRT operates six three-person response teams consisting of a San Francisco Fire Department community paramedic, a mental health clinician, and a peer counselor to provide rapid, trauma-informed response 24/7.
  • People can contact SCRT by dialing 911. The San Francisco Department of Emergency Management receives, codes, and sends calls to SCRT for review. SCRT responders currently address one specific call type: lower priority behavioral health crisis calls.
For more information on this example, see this resource:

Atlanta, GA Policing Alternatives and Diversion Initiative

  • The Policing Alternatives and Diversion Initiative (PAD) led a community engagement process to help think through how to design, plan, and implement their Community Referral Services. Community engagement consisted of 3 listening sessions, 6 stakeholder working groups, a survey of 597 Atlanta residents, and presentations at 41 community meetings.
  • PAD contracted with a research organization to analyze 911 calls for service data and identified 600,000, or approximately 18.4 percent, of all incoming 911 calls as suitable for diversion.
  • PAD responds to a variety of call types including basic needs, mental health, public disturbance, welfare, public health, public indecency, and substance use.
  • PAD accepts community referrals through 311, the city’s non-emergency services line, and calls deemed as urgent or important are responded to by a Harm Reduction Team within 30 minutes. Calls determined to be less urgent are responded to within 72 hours.
  • Two-person Harm Reduction Teams provide immediate, consent-based outreach to individuals on issues such as poverty, public indecency, mental health, substance use, basic needs, welfare, and public health.
  • The team meets with the individual in need, discusses their concerns, and then provides ongoing support to address those issues. People with open legal cases or connection to the criminal justice system who need ongoing support are paired with a PAD care navigator. This navigator works with the individual to identify goals, initiate case management, provide direct services (including emergency housing support as well as food and transportation assistance), and establish connections with social services and other community supports.
For more information on this example, see this resource:

Eugene, OR Crisis Assistance Helping Out On The Streets (CAHOOTS)

  • Crisis Assistance Helping Out On The Streets (CAHOOTS) is a community responder program that has been operating out of Eugene, Oregon, for more than 30 years. The CAHOOTS model has inspired similar programs around the country, and White Bird Clinic (their local nonprofit mental health and crisis services partner) has a consultant team that assists other jurisdictions seeking to develop their own models.
  • CAHOOTS leaders reviewed what the public health entities in Eugene were highlighting as key concerns and compared it to input that they received from the community to determine what services they should provide.
  • The program also gathered information on call center scripts and training processes, and has continued coordinating with local service providers to ensure clients are sent to the appropriate providers based on the services that are available and when.
  • CAHOOTS developed a Stewardship Council to receive input from a diverse representation of the community, including organizations and community members. Diversity of staff at every level has been critical to their operations, both in the field and in decision-making conversations.
  • Some call types are sent to CAHOOTS by default. These include “public assist,” which is a general category of requests for officer assistance that can involve minor disputes or anything noncriminal; transport request; suicidal subject; housing crisis; counseling and mediation; welfare check; “subject down,” which refers to an unresponsive person, often related to intoxication; and emergency messages, e.g., death notifications to family members.
  • For other call types, like a reported intoxicated person, a CAHOOTS team is not the default response, but dispatchers can deploy them at their discretion or at the request of the caller.
  • Each CAHOOTS team includes two people: a medical professional (either a nurse or an emergency medical technician) and a mental health crisis worker.
  • In its hiring process, CAHOOTS focuses on identifying crisis workers who have lived experiences with behavioral health needs and people with previous experience working in social services focusing on mental health, homelessness/poverty, and/or substance use.
  • The CAHOOTS program handles about 19 percent of all police calls for service in Eugene, and less than 1 percent of their calls require police backup. In more than 3 decades, the program has never had a casualty, and police and program staff are unable to remember an injury or close call.
For more information on this example, see this resource:
Type

Program

Measures

1 - Reduce bookings into jail
3 - Increase connection to treatment