Since the killing of George Floyd by a group of Minneapolis police officers triggered international protests last summer, cities across the globe have begun to look at new ways to handle episodes of mental health, addiction, and poverty that don’t involve police presence.
In Toronto, that conversation became especially personal to people of colour after the deaths of Regis Korchinski-Paquet—a 29-year-old Black woman who fell 24 storeys from a balcony after Toronto police entered her family’s apartment during a wellness check—and Ejaz Chaudry—a 62-year-old Canadian Pakistani man who was shot to death by police, also during a wellness check.
Both incidents, which happened in the weeks after the Floyd killing, joined a long list of instances in which Black, brown, and Indigenous Canadians have been killed by police or died in their presence during a mental health episode.
Last week, Toronto city council voted to approve the launch of a program that would see police officers replaced with civilian-led teams specializing in mental health and addiction for non-violent 911 calls.
The move comes weeks after Toronto police—in response to city-wide protests last summer calling for the police agency to be defunded—put forward a budget of $1.076 billion, a zero percent increase from the previous year.
“This past year, we saw and heard from a record number of Torontonians who want to see a reformed, modernized, and efficient police service,” interim police chief James Ramer told the Toronto Police Board in January.
“This is a priority that we share jointly.”
While the exact details of the program, including funding, remain unclear, a pilot is slated to launch in 2022, with full implementation of the program promised by 2025. This would mean that as early as next year, some calls relating to mental health, homelessness, and/or addiction may not have to involve the use of police officers at all.
Asante Haughton, co-founder of Reach Out Response network—an organization that advocates for alternatives solutions to policing—called the city’s decision a welcome change in direction, and expressed optimism that both politicians and the police are starting to come around to the idea that a police response is not suited for a large number of emergency situations.
“The reason why we are arguing (for a non-police solution) is not necessarily a response to the ongoing conversation about police brutality,” Haughton said, adding that while the two issues are inseparable, the core message is about specifying expertise in emergency response.
“Our primary concern is highlighting that a mental health emergency is not a crime, so we need people who are equipped with the tools to respond to mental health emergencies, which are not the police.”
In the months since the Floyd protests, politicians, and advocates on all sides of the aisle have argued that police are not adequately equipped to deal with people in crisis. The reasons for this belief are numerous, but all mainly boil down to cops receiving little to no mental health training, and the historically fraught relationship between police and marginalized communities.
Rachel Bromberg, who co-founded Reach Out Response Network with Haughton, has worked with groups in the United States that have already launched or are in the process of launching similar programs.
Most programs, Bromberg said, are based off of the CAHOOTS system, which stands for Crisis Assistance Helping Out on The Streets, and was designed in 1989 by the White Bird Clinic in Eugene, Oregon.
According to the clinic’s website, CAHOOTS provides “mobile crisis intervention” by dispatching teams of medical specialists (ranging from paramedics to street nurses) and crisis workers (who are trained in communicating with people in crisis) to emergency calls that are deemed by the 911 dispatcher to be non-violent in nature. This includes everything from suicide prevention to substance abuse, domestic violence, homelessness, and other poverty-based services such as supplying access to transportation, food, and housing.
Since its introduction, CAHOOTS has been hailed as a significant success—not just in Oregon, but across the United States and in some parts of Europe, where its framework has been used to design dozens of similar programs such as in Denver, Austin, San Francisco, and Albuquerque.
“We need to change the way that people think about the role of police calls,” said Bromberg, who pointed to numerous reports that have shown a near-zero incidence rate of violence during CAHOOTS encounters (Denver, for example, has reported zero arrests in the first six months of operating its own CAHOOTS-style program).
“The perception that people have—that most of these calls are dangerous and violent or could go violent at any time—just is not borne out by the data.”
In Olympia, Washington, where a CAHOOTS-inspired team has been active for almost two years, the results have been nothing short of “remarkable,” according to coordinator Anne Larsen.
The program—called the Crisis Response Unit (CRU)—acts as an extension of the Olympia police department, and handles a large number of calls relating to homelessness, domestic violence, and substance abuse.
Larsen, who was hired in 2018 to head up the program, said the program has been especially helpful to marginalized individuals during the COVID-19 pandemic, which caused the shutdown of a number of essential services, such as transportation, access to addiction service, and shelters.
Like most the original CAHOOTS program, the CRU operates on a dispatcher triage model, in which 911 calls are evaluated based on the potential for violence or crime. If deemed appropriate, dispatch lets CRU operators know about an incident, and the CRU then attends.
“Everything we do is within the community. We don’t sit in an office and wait for something to come to us,” Larsen said, emphasizing how important regular involvement with the community is in earning the trust of the program’s users.
“If you see someone having a bad day, you pull over and stop to check in on them. You don’t force the community to call 911 to respond to people in the community.”
Unlike the CAHOOTS model, the CRU does not respond to medical emergencies, which means they cannot attend to situations in which someone is overdosing, for example. Larsen said this is because Washington state requires all paramedic services to be accompanied by fire services as well, and because the CRU does not yet co-respond with other emergency services, they are not allowed to have a paramedic on their team.
In Portland, however, just a stone’s throw away from the birthplace of CAHOOTS, Portland Street Response (PSR) program manager Robyn Burek is preparing to launch the city’s own initiative on February 16.
Burek, who was brought on board to launch the program’s pilot plan in November, said the program has been significantly expanded since the George Floyd protests. Notably, after the city of Portland defunded a portion of its police budget, the amount of money allocated to the PSR rose from $500,000 to $4.8 million.
This has allowed Burek to expand the scope of the program, with the goal of having two full-time, four-person teams in play by the end of 2021. Diverging from the route taken by the CRU, the first PRS team will include a paramedic, a licensed therapist, and two community health workers, while the second team will swap the paramedic and health workers for an EMT and two peer support workers respectively.
Just recently, Oregon became one of the first states to decriminalize the possession of small amounts of all drugs. Burek said this is a welcome change, but argues that one of the primary obstacles she expects in the coming months and years is a lack of resources available to people with substance abuse issues.
“The problem that I think we’ll probably run up against here in Oregon is that Oregon is one of the worst—I think we’re in the bottom four—for mental health and substance use treatment,” she said.
“We can assess people all day long and say, ‘Yes you have a substance use issue and you should seek treatment,’ but we don’t actually have the facilitates in place to meet that demand.”
In terms of timeframes, Burek said while goals like Toronto’s aim for full implementation of its program by 2025 may come across as unambitious to many who have been calling for programs like these for years, she advises caution to anyone attempting to rush the setup of a CAHOOTS-style program.
Pointing to places like San Francisco, both Burek and Bromberg said there are significant challenges in setting these sorts of programs up, including establishing prior rapport with the communities that these programs serve, as well as preparing for the sheer size and scope of calls that will be fielded by a relatively small number of people.
“I know there is a lot of urgency from community members to get a service like this up and running and out there, but you risk a lot,” Burek said.
“Trust is everything, and if you recognize (an issue), and you’re not ready to go and you’re not set up right, I think that cities can potentially be risking failure, to be honest.”
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