A medic leans over a desk in a darkened room, preparing medical supplies.
Chelsea Swift, a CAHOOTS medic, prepares medical supplies for an evening shift.

An Alternative to Police That Police Can Get Behind

In Eugene, Oregon, a successful crisis-response program has reduced the footprint of law enforcement—and maybe even the likelihood of police violence.

Photographs by Ricardo Nagaoka

Should American cities defund their police departments? The question has been asked continually—with varying degrees of hope, fear, anger, confusion, and cynicism—since the killing of George Floyd on Memorial Day. It hung over the November election: on the right, as a caricature in attack ads (call 911, get a recording) and on the left as a litmus test separating the incrementalists from the abolitionists. “Defund the police” has sparked polarized debate, in part, because it conveys just one half of an equation, describing what is to be taken away, not what might replace it. Earlier this month, former President Barack Obama called it a “snappy slogan” that risks alienating more people than it will win over to the cause of criminal-justice reform.

Yet the defund idea cannot simply be dismissed. Its backers argue that armed agents of the state are called upon to address too many of society’s problems—problems that can’t be solved at the end of a service weapon. And continued cases of police violence in response to calls for help have provided regular reminders of what can go wrong as a result.

In September, for example, new details came to light about the death of a man in Rochester, New York, which police officials had initially described as a drug overdose. Two months before Floyd’s death, Joe Prude had called 911 because his brother Daniel was acting erratically. Body-cam footage obtained by the family’s attorney revealed that the officers who responded to the call placed a mesh hood over Daniel’s head and held him to the ground until he stopped moving. He died a week later from “complications of asphyxia in the setting of physical restraint,” according to the medical examiner. Joe Prude had called 911 to help his brother in the midst of a mental-health crisis. “I didn’t call them to come help my brother die,” he has said.

A few weeks after a video showing Daniel Prude’s asphyxiation was made public, police in Salt Lake City posted body-cam footage that captured the moments before the shooting of a 13-year-old autistic boy. The boy’s mother had called 911 seeking help getting him to the hospital. While she waited outside, a trio of officers prepared to approach the home. One of them hesitated. “If it’s a psych problem and [the mother] is out of the house, I don’t see why we should even approach, in my opinion,” she said. “I’m not about to get in a shooting because [the boy] is upset.” Despite these misgivings, the officers pursued the distressed 13-year-old into an alley and shot him multiple times, leaving him, his family has said, with injuries to his intestines, bladder, shoulder, and both ankles.

Neither these catastrophic outcomes nor the misgivings of police themselves have produced an answer to the obvious question: How should society handle these kinds of incidents? If not law enforcement, who should intervene?

Left: A sign displays the number to dial for CAHOOTS. Right: Dennis Ekanger, a co-founder of the White Bird Clinic.

One possible answer comes from Eugene, Oregon, a leafy college town of 172,000 that feels half that size. For more than 30 years, Eugene has been home to Crisis Assistance Helping Out on the Streets, or CAHOOTS, an initiative designed to help the city’s most vulnerable citizens in ways the police cannot. In Eugene, if you dial 911 because your brother or son is having a mental-health or drug-related episode, the call is likely to get a response from CAHOOTS, whose staff of unarmed outreach workers and medics is trained in crisis intervention and de-escalation. Operated by a community health clinic and funded through the police department, CAHOOTS accounts for just 2 percent of the department’s $66 million annual budget.

When I visited Eugene one week this summer, city-council members in Minneapolis, Los Angeles, Houston, and Durham, North Carolina, had recently held CAHOOTS up as a model for how to shift the work of emergency response from police to a different kind of public servant. CAHOOTS had 310 outstanding requests for information from communities around the country.

A pilot program modeled in part on CAHOOTS recently began in San Francisco, and others will start soon in Oakland, California, and Portland, Oregon. Even the federal government has expressed interest. In August, Oregon’s senior senator, Ron Wyden, introduced the CAHOOTS Act, which would offer Medicaid funds for programs that send unarmed first responders to intervene in addiction and behavioral-health crises. “It’s long past time to reimagine policing in ways that reduce violence and structural racism,” he said, calling CAHOOTS a “proven model” to do just that. A police-funded program that costs $1 out of every $50 Eugene spends on cops hardly qualifies as defunding the police. But it may be the closest thing the United States has to an example of whom you might call instead.

A pile of belongings on the sidewalk in a Eugene neighborhood bears a note: “I’m going to White Bird.” The White Bird Clinic runs the CAHOOTS crisis-response program.

In 1968, Dennis Ekanger was a University of Oregon graduate student finishing up an internship as a counselor for families with children facing charges in the state’s juvenile-justice system when he started to get calls in the middle of the night. Through his work in court, word had spread that “I knew something about substance-abuse problems,” Ekanger told me recently. Anxious mothers were arriving at his doorstep desperate for help but afraid to go to the authorities. It was a turbulent time in Eugene, with anti-war protests on the University of Oregon campus and a counterculture that spilled over into the surrounding neighborhoods in the form of tie-dye, pot smoke, and psychedelic drugs.

The following year, Ekanger and another student in the university’s counseling-psychology program, Frank Lemons, met with a prominent Eugene doctor who agreed to help them mount a more organized response by recruiting local health-care providers to volunteer their time. Ekanger went to San Francisco to visit a new community health clinic in Haight-Ashbury that had pioneered such a model, offering free medical treatment to anyone who walked in. Back in Oregon, Ekanger and Lemons each put up $250 and signed a lease on a dilapidated two-story Victorian near downtown.

The White Bird Clinic opened its doors a few days later, with a mission to provide free treatment when possible and to connect patients to existing services when it wasn’t. But the city’s established institutions didn’t yet have a clue how to deal with people on psychedelic drugs. Teenagers who showed up in the emergency room on LSD were prescribed antipsychotic medications. Unruly patients got passed to the police and ended up having their bad trips in jail.

The forerunner to CAHOOTS was an ad hoc mobile crisis-response team called the “bummer squad” (for “bum trip”), formed in White Bird’s first year for callers to the clinic’s crisis line who were unable or unwilling to come in. The bummer squad responded in pairs in whatever vehicle was available. For a while, that was a 1950 Ford Sunbeam bread truck that did double duty as the home of its owner, Tod Schneider, who’d dropped out of college on the East Coast to drive out to Eugene.

It didn’t take long for the bummer squad to start showing up at some of the same incidents that drew a response from Eugene police. One day in the late 1970s, Schneider answered a call from a mother concerned about her son. “Mom, I think I made a mistake,” he’d told her. “I took some PCP, and I’m feeling weird.” Schneider showed up to the family’s home to find the teenager in “full psychotic PCP condition.” As Schneider got out of the truck, the boy came running out of a neighboring house naked and bloody, and tackled him. Another neighbor called the police, thinking they were witnessing an assault. “So police came out and figured out what was going on—they talked to me a little bit, and they just left,” Schneider told me. “The police realized … they didn’t know what to do with these people that was productive.”

White Bird continued its volunteer-run mobile crisis service—and its informal collaboration with the police—into the early 1980s. Bummer-squad volunteers periodically gave role-playing training to the police department, and some beat officers grew to appreciate Eugene’s peculiar grassroots crisis-response network.

In the late ’80s, Eugene was struggling to respond to a trio of convergent issues that still plague the city more than 30 years later: mental illness, homelessness, and substance abuse. Police in Eugene were caught in a cycle of arresting the same people over and over for violations such as drinking in public parks and sleeping where they weren’t allowed to.

“The police hated it; we were doing absolutely nothing for public safety, we were tangling up the courts, and we were spending a horrendous amount of money,” Mike Gleason, who was the city manager at the time, recalled. Gleason convened a roundtable with Eugene’s social-service providers, offering city funding for programs that could break the logjam. A local detox facility made plans to launch a sobering center where people could dry out or sleep it off. White Bird and the police department began a dialogue about a mobile crisis service that could be dispatched through the 911 system.

White Bird and the police were not a natural pairing. To the city’s establishment types, White Bird staffers were “extreme counterculture people.” Standing by as the bummer squad defused a bad trip was one thing; giving the team police radios was quite another. White Bird’s clinic coordinator at the time, Bob Dritz, wore a uniform of jeans and a T-shirt; for meetings with city officials, he’d occasionally add a rumpled corduroy jacket. With his defiantly disheveled appearance, Dritz seemed to be declaring, in the words of one colleague, “Look, I’m different from you people, and you have to listen to me.” White Bird staff members worried that working with the police would erode their credibility, and maybe even lead to arrests of the very people they were trying to help. But in the space of a couple of months, Dritz and a counterpart at the police department drafted the outlines of a partnership. The acronym Dritz landed on was an ironic nod to the discomfort of working openly with the cops.

Things were slow at first. Jim Hill, the police lieutenant who oversaw CAHOOTS at the police department, recalls sitting at his desk listening to dispatch traffic on the radio. “I would literally have to call dispatch and say, ‘How come you didn’t send CAHOOTS to that?’ And they go, ‘Oh, yeah, okay.’” Before long, though, CAHOOTS was in high demand.

Chelsea Swift and Simone Tessler talk with a person who needs a place to stay.

CAHOOTS teams work in 12-hour shifts, mostly responding without the police. Each van is staffed by a medic (usually an EMT or a nurse) and a crisis worker, typically someone with a background in mental-health support or street outreach, who takes the lead in conversation and de-escalation. Most people at White Bird make $18 an hour (it’s a “nonhierarchical” organization; internal decisions are made by consensus), and some have day jobs elsewhere.

One Tuesday night this summer, the medic driving the van was Chelsea Swift. Swift grew up in Connecticut and, like White Bird’s co-founder a generation before her, was introduced to harm-reduction work in Haight-Ashbury, where she sold Doc Martens to the punks who staffed the neighborhood needle-exchange program. Swift’s childhood had been marked by her mother’s struggle with opiate addiction and mental illness. She never thought she’d be a first responder, or could be. She was too queer, too radical. “I don’t fit into that culture,” she told me. And yet, she said, “I am so good at this job I never would have wanted.”

Around 6 p.m., Swift and her partner, a crisis worker named Simone Tessler, drove to assist an officer responding to a disorderly-subject call in the Whiteaker, a central-Eugene neighborhood with a lively street life, even in pandemic times. When we arrived, a military veteran in his 20s was standing with the officer on the corner, wearing a backpack, a toothbrush tucked behind his ear. The man said he’d worked in restaurants in Seattle until the coronavirus hit, then moved to Eugene to stay with his girlfriend.

That day, he’d worked his first shift at a fast-food restaurant. Soon after he got home, a sheriff’s deputy working for the county court knocked on the door to serve him a restraining order stemming from an earlier dispute with his girlfriend. He did not take the news well. The deputy called for police backup, and when it arrived, the man agreed to walk a block away to wait for CAHOOTS and figure out his next move. He had to stay 200 feet away from the place where he’d been living, and he couldn’t drive. “I been drinking a bit, and—I’m not gonna lie—I want to keep drinking,” he said. He needed somewhere to stay, and a way to move his car to a place where he could safely leave it overnight with his stuff in the back.

Swift and the officer talked logistics while Tessler leaned against the wall beside the man and chatted with him. She told him that she’d worked in restaurants before joining CAHOOTS.

The Eugene Mission, the city’s largest homeless shelter, had an available spot, the officer explained, thumbs tucked inside the shoulder straps of his duty vest. You can show up drunk if you commit to staying for 14 days and agree not to use alcohol or drugs while you’re there.

The man hesitated, thinking through other options. He had enough cash for a motel room, as long as it didn’t require a big deposit. The officer prepared to leave so CAHOOTS could take over. Swift, Tessler, and the veteran took out their phones and began looking up budget motels along a nearby strip, settling on one with a military discount and a low cash deposit.

“Do you know how to drive stick?” the man asked. Tessler and Swift exchanged blank looks, then continued to spitball. Did the man have AAA? Was another CAHOOTS unit free to help? I felt a lump rising in my throat. I’d wanted to keep my reporterly distance, but I was also a person watching a trivial problem stand in the way as calls stacked up at the dispatch center. I drove the car three blocks to the motel with Swift in the front seat.

“So much of what people call CAHOOTS for is just ordinary favors,” she said. “We’re professional people who do this every day, but what was that? We were helping him make phone calls and move his car.”

A couple of hours later, CAHOOTS received a call from a sprawling apartment complex on the north side of town. Tessler and Swift showed up just as the last hint of blue drained from the sky. The call had come from a concerned mother who lived in Portland, 100 miles away from her 23-year-old daughter; she believed that her daughter was suicidal. The young woman’s grandmother, who lived nearby, stood in the parking lot and gave Tessler and Swift a synopsis: Her granddaughter was bipolar, with borderline personality disorder. She’d run away at 17 after her diagnosis, and never seemed to fully accept it, traveling across the West with a series of boyfriends, sleeping in encampments. She’d been back in Eugene for a few months now, the longest the family had ever gotten her to stay.

Tessler walked around the corner and knocked. “It’s CAHOOTS.” No answer.

“Can you come and talk to us for a minute?”

The door was unlocked from the inside and left slightly ajar.

The apartment was dark. A tiny Chihuahua mix barked frantically. A tearful voice called out from the bedroom, “I just want a hug. Are you going to take me away?”

Tessler crouched down in the bedroom doorway. “I’m not gonna take you anywhere you don’t want to go.”

“I’m really sorry I’ve caused all this,” the young woman said, sitting up.

Swift grabbed a handful of kibble from a bowl on the floor to quiet the dog. “My family tries to put me away a lot,” the young woman explained. Breathing fast between sobs, she seemed both overwhelmed by grief and adrenaline and primed to answer questions she’d come to expect in the midst of a crisis.

Unprompted, she told the CAHOOTS team her full name, letter by letter. “I know my Social Security number, and I know I’m a harm to myself and others.” She took a deep breath. “I’m just feeling really sad and alone, and I don’t know how I got here.”

Tessler turned on a light, and Swift went out to the parking lot to summon the young woman’s grandmother.

“Nana! Nana!” The young woman dissolved into her embrace.

Swift surveyed the bathroom scene that had prompted the call. An open pack of cigarettes lay on the wet floor along with a belt and an electrical cord. There was a straw in a bottle of gin on the edge of the tub, a six-pack on the toilet, and half a dozen pill bottles strewn across the bathroom sink and countertop. Swift unfolded a soggy piece of paper marked “Patient Safety Plan Contract” that identified seeing San Francisco as the one thing the young woman wanted to do before she died.

As Swift took her vitals, the young woman’s tearful reunion with her grandmother continued. “I love your blue eyes, Nana,” she said.

“I love your brown ones.”

CAHOOTS brought her to the emergency room, and she was discharged less than 24 hours later.

Left: A CAHOOTS van. Right: A CAHOOTS caller receives treatment.

On my first morning in Eugene, I spent a couple of hours in Scobert Gardens, a pocket-size park on a residential block not far from the Mission. Many of the park’s visitors are part of Eugene’s unhoused population, which accounts for about 60 percent of CAHOOTS calls. Everyone I met in Scobert Gardens had a CAHOOTS story. One man had woken up shivering on the grass before dawn, after the park’s sprinklers had soaked him through; CAHOOTS gave him dry clothes and a ride to the hospital to make sure he didn’t have hypothermia. A woman had received first aid after getting a spider bite on her face while sleeping on the ground. Another man hadn’t had a place to stay since he got out of prison more than a year ago. When he had a stroke in the park earlier this summer, a friend called CAHOOTS. “If you go with the ambulance, it will cost you big money, so a lot of people go the CAHOOTS route,” the man explained.

Earlier this year, Barry Friedman, a law professor at NYU, posted a working paper on policing that highlighted the mismatch between police training and the jobs officers are called on to do—not just law enforcer, but first responder, mediator, and social worker. Reducing the number of instances in which police are called to assist Eugene’s unhoused population reduces the number of calls for which their skill set is a poor match. But if the goal is eliminating unnecessary use of force, helping people without housing is hardly sufficient.

In a 2015 analysis of citizen-police interactions, the Bureau of Justice Statistics found that traffic stops accounted for the majority of police-initiated contact: 25 million people reported traffic stops, versus 5.5 million people who reported other kinds of contact. And police are regularly involved in incidents that escalate partly because of a failure to consider mental-health issues. In October, Walter Wallace Jr.’s family members and a neighbor called 911 because he was arguing with his parents; according to the family’s attorney, Wallace had bipolar disorder. Two Philadelphia police officers arrived, found Wallace with a knife, and fatally shot him, despite his mother’s attempts to intercede. (Police and district-attorney investigations are ongoing, and no arrests have been made.) Near Eugene, police in the neighboring city of Springfield in March 2019 killed Stacy Kenny, who had schizophrenia, in an incident that began with a possible parking violation. None of the officers involved was criminally charged, though a lawsuit brought by the Kenny family resulted in the largest police settlement in Oregon history. Springfield also committed to overhauling police-department policy and oversight practices around use of force.

In July 2015, police responded to the home of Ayisha Elliott, a race and equity trainer and the host of a podcast called Black Girl From Eugene. Elliott’s 19-year-old son had been experiencing a mental-health crisis, she told me, which was the result of a traumatic brain injury. At 2:43 a.m., Elliott called Eugene’s nonemergency number and asked for CAHOOTS, not realizing that the service ran only until 3 a.m. In a subsequent call, to 911, Elliott’s ex-husband indicated that Elliott was in danger; authorities say it was this second call that led dispatchers to send police to the scene. Elliott greeted the officers on the front porch, and explained that she needed help getting her son to the hospital. Instead, in an incident that escalated over the course of 15 minutes, her son became agitated and began to yell. Elliott attempted to shield him from officers as they ordered her to stand back. Police say her son charged as they tried to separate him from his mother. Her son was punched in the face and tased. Elliott herself was pulled to the ground, resulting in a concussion, she said. She was arrested for interfering with a police officer. (She was released the following morning.) She and her son sued the city of Eugene as well as individual police officers in federal court, for excessive use of force and racial discrimination, among other claims; the court found against the plaintiffs on all counts. Elliott told me the experience didn’t change her view of the police so much as confirm it. “I realized that it didn’t matter who I was; I’m still Black.”

Together with the fatal police shooting that year of a veteran who had PTSD, the incident helped focus public attention on Eugene’s response to mental-health crises. In its next annual budget, the city included $225,000 to make CAHOOTS a 24/7 service for the first time. (Both the mayor’s office and the police department say the increase in funding was not related to a specific incident.)

Yet CAHOOTS is still limited by the rules that govern its role in crisis response. Its teams are not permitted to respond when there’s “any indication of violence or weapons,” or to handle calls involving “a crime, a potentially hostile person, a potentially dangerous situation … or an emergency medical problem.”

Many 911 calls unfold in the gray area at the limits of CAHOOTS’s scope of work; in Eugene, the same dispatch system handles both emergency and nonemergency calls, in part because so many callers fail to grasp the distinction. One call I went on with Swift and Tessler was to check on the welfare of a young man with face tattoos who was reportedly acting strangely on the University of Oregon campus. The fire department and the police had been out to see him, without incident, but also without resolution: The man was still there, unsettling passersby, who kept calling him in as a potential threat to himself and others.

By the time CAHOOTS arrived, the man was lying on the grass with a small burning pile of latex gloves next to his head. When Swift jumped out of the van, alarmed, he sat halfway up and poked at the fire with a kitchen knife, then lay back down. Had the cops been called again, I thought, the incident might have played out differently, and landed in the next day’s paper: “A young man setting objects on fire was shot after brandishing a knife.” But that’s not how it went. Swift grabbed the knife, threw it well out of reach, and began talking to him.

Nathan Bemiller has been staying under an overpass near Washington Jefferson Park. He has gotten help from CAHOOTS several times. Eugene’s unhoused population accounts for 60 percent of CAHOOTS calls.

At 11 a.m. on a Friday, I met Jennifer Peckels, one of the few cops in Eugene who walk their beat, to tag along as she patrolled a quadrant of restaurants and curbside gardens downtown. Born and raised in Eugene, Peckels is now in her fifth year on the force. Many of her interactions downtown are with a core group of people experiencing homelessness, mental-health crises, and addiction, or some combination thereof.

Across the street from the library, Peckels recognized a woman who was sitting on a bench, crying inconsolably. When Peckels approached her, the woman explained in breathless bursts that her daughter’s surrogate parents were telling lies about her. She feared she might never see her daughter again. Over the radio, Peckels called in the woman’s location to dispatch. “CAHOOTS will come help you—they gotta help the fire department, then they gotta help a suicidal subject, and then they’ll come. You’re on the list.”

“I’m suicidal,” the woman said.

“Do you have any means to hurt yourself?” Peckels asked.

The woman explained that she was afraid she would start drinking again. She began to slap herself in the face. “I’m tired of Eugene,” she said, gesturing across the street at a statue of Rosa Parks seated on a pair of bronze bus seats. “I got threatened to be arrested for sitting next to Rosa Parks, and I said ‘Fuck the police.’ I haven’t done anything wrong here except be loud and drink in public!”

“You know, when I get upset, I do this breathing exercise,” Peckels suggested.

Together, they inhaled for four seconds, then held their breath. The woman closed her eyes and, by the exhale, appeared calmer for the first time. “You’re on the list,” Peckels repeated. The woman wanted to know when CAHOOTS was coming, but Peckels had no way of knowing. We continued walking.

The most common complaint about CAHOOTS you’ll hear in Eugene is that its response times are too slow. Last year, across roughly 15,000 calls in the city, the average time between receipt of a call and the arrival of a CAHOOTS team was an hour and 56 minutes, compared with an hour and 11 minutes across 46,000 calls for the police department. Having more CAHOOTS units on the street could serve to reduce Eugene Police Department response times as well, by freeing up officers to do what Peckels called “police work.” She said it’s not uncommon for reports of even very serious crimes that are no longer in progress—such as rapes or burglaries—to sit in the dispatch queue for hours while officers race to work through a backlog of calls.

White Bird and the EPD are trying to come to an agreement about the best way to quantify CAHOOTS’s contributions. CAHOOTS has circulated its own estimate, saying it responds to 17 percent of all calls handled by dispatchers. Yet the police department contends that most of those calls wouldn’t have gotten a police response to begin with, because many of the requests that CAHOOTS receives—to check on a person who seems heavily intoxicated, or for transport to a medical appointment—aren’t really “police calls.” According to the police department’s analysis, the true diversion rate is between 5 and 8 percent. Which number is the “right” one to evaluate CAHOOTS’s contributions to the city?

I asked Eugene’s chief of police, Chris Skinner, about the prospect of increasing CAHOOTS’s capacity to respond to calls. He told me he thinks of the benefit to the police as a question of probability: “The less time I put police officers in conflicts with people, the less of the time those conflicts go bad.” That, in a sense, is the same argument made by activists who have mentioned alternatives such as CAHOOTS in their demands to shrink the footprint of policing nationwide.

Before the coronavirus pandemic hit, Eugene voters approved a payroll tax projected to bring in $23 million a year for 126 community-safety positions. Originally, two-thirds of that money was slated to pay for positions in the police department; as several police officials I spoke with pointed out, Oregon has among the lowest number of police officers per capita of any state in the country. Now, in response to Black Lives Matter protests, Mayor Lucy Vinis told me, the city council is consulting with community organizations to revise that plan. “Until this challenge around ‘Defund the police,’” Vinis said, “I don’t think that the police department ever really looked at CAHOOTS as depriving them of funds: It was really excellent service for a very low price.”

Anecdotally, at least, Eugene’s citizens have come to appreciate the CAHOOTS approach to crisis response, perhaps too keenly. CAHOOTS exists in a society where many feel that the risk of police violence outweighs the potential benefit of calling 911, and where an encounter with EMS can wreck a household’s finances. Last December, a CAHOOTS team showed up to a fatal drug overdose hours after the victim’s friend had called in for help. The caller had avoided language that would have brought a faster police or EMS response.

Brenton Gicker, who has worked for CAHOOTS for 12 years and as an emergency-room nurse for the past five, told me that callers have sometimes omitted key details to bypass police. “They’ll say, ‘My friend is bipolar; he’s in a manic episode. I’d like CAHOOTS to talk to them.’ And we show up, and they’ve set the kitchen on fire, or they’re running around naked, stabbing holes in the wall.”

A structured camp for people experiencing homelessness. Even in Eugene, beds in shelters can be scarce. Similar bottlenecks exist for inpatient drug treatment and mental-health facilities.

CAHOOTS has undoubtedly saved lives in Eugene. The question for cities hoping to emulate its success is how its approach might be adapted and scaled up. Eugene is a small, homogenous city (its population is 83 percent white). The proud hippie culture that helped give birth to the White Bird Clinic, the bummer squad, and eventually CAHOOTS continues to thrive there. The city supports a robust network of homeless shelters, crisis centers, and mental-health and drug-treatment providers that have a long history of working with CAHOOTS, which makes it easier to connect people in need with services that can help. Los Angeles has 23 times as many people as Eugene, living in dozens of far-flung neighborhoods, each with its own landscape of language, history, and social services. In October, L.A.’s city council voted unanimously to develop a CAHOOTS-like program of unarmed crisis responders. It will face different challenges.

When the pandemic struck, it revealed just how reliant CAHOOTS is on the city’s safety net—and just how fragile that net is, even in progressive Eugene. CAHOOTS was the rare social-service provider in the city that was able to carry on its regular operations. The Buckley Center closed its sobering program; the Eugene Mission continued to serve residents but closed the door to new arrivals for months; social-service agencies asked their caseworkers to work from home, which made it harder to help clients who don’t have stable addresses, schedules, or cellphones.

For a stretch, measures taken to stop the spread of the virus among Eugene’s poorest residents made up for the absence of some of the usual services. Federal CARES Act funding enabled Lane County to open a new 250-bed homeless shelter in buildings on its fairgrounds. To Gicker, the new shelter was a revelation. “This is the first time ever in my CAHOOTS experience where I can take somebody somewhere to sleep with no questions asked: They don’t have to be a battered woman; they don’t have to be experiencing a mental-health crisis; they don’t have to be ill or injured. I don’t have to sell it in some way.”

The CARES Act money ran out in June, however, and the fairground shelter closed. CAHOOTS was back to having very few places to take people in need of a bed. Similar bottlenecks exist for inpatient drug treatment and mental-health facilities. Eugene might have more social services than some American cities, but it’s still an American city. If it can’t manage the cries for help, how will larger, more diverse cities that lack Eugene’s long-standing interagency collaborations or progressive attitudes fare? In rural areas, gaps in service are even more pronounced. Earlier this year, officials from another jurisdiction called White Bird’s director of consulting, Tim Black, to announce with excitement that they’d received funding to “bring CAHOOTS here” in a matter of months. Black replied, “Where are you going to bring someone if not to the hospital or the jail?”

Around 5 p.m. on a Wednesday, I was halfway through the day shift with another CAHOOTS team, Tatanka Maker and Brian Troutz, when it was called to a parking lot just south of Washington Jefferson Park. A woman in her 50s stood at the lot’s edge, surrounded by a swirl of trash. She was barefoot and had a sheath of plastic wrapped around her midriff. This was someone the CAHOOTS team had known for years.

An employee of a nearby aquarium shop had made the call to CAHOOTS, and Maker approached him to get a sense of the situation. “She’s been trespassing since nine,” the employee said.

“I’m packing up,” the woman replied. She picked up armfuls of newspaper and takeout containers, then dropped them just as quickly, as though she’d spotted something else in the pile that she’d been looking for.

“That’s not an option any longer,” Maker said, addressing the woman by her first name. “You can pack one bag of important stuff, and then we’ll take off.”

“Where are we going?” the woman asked.

“Somewhere else,” Maker said.

Troutz brought a clean garbage bag from the van. Maker began guessing what she might want to put inside: “Do you want this sleeping bag?”

Imploring her to cooperate, Maker said she could bring a second garbage bag along too.

“If you don’t come to the van right now, they’re gonna take you to jail and throw it out,” Maker said. But the woman was stuck in another world.

“Can I focus on getting this done?” she asked, annoyed.

At last, Maker and Troutz succeeded in leading the woman to the van. They’d avoided an arrest, but it was a temporary victory. The woman had only just gotten out of jail. Before that, she’d been in and out of the state mental hospital for years. Space constraints, insurance issues, and time limits on residential programs all contributed to the difficulty of finding a place where she could receive long-term mental-health services and drug treatment.

Lacking a better option, Maker and Troutz opted to take her to White Bird. The clinic was closed, but a large shaded parking lot sits behind it.

“This is one of those cases where there is no perfect place to take her, but it’s better to take her out of the part of town where she’s been causing some trouble,” Maker said. The van stopped, and the woman got out and took a seat on a discarded couch in the parking lot.

“You know those orange cones they put on the highway?” Maker said when we got back in the van to head to the next call. “Last summer, there was a day that she spent 10 hours meticulously climbing up the embankment, grabbing them, and throwing them over the edge.” The police, the fire department, and CAHOOTS had all responded multiple times, she said. “We ended up bringing her to White Bird that day too.”

This article is part of our project “The Cycle,” which is supported by a grant from the John D. and Catherine T. MacArthur Foundation’s Safety and Justice Challenge.