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--:-- Sean Rameswaram: This message is brought to you by Apple Card. Each Apple product, like the iPhone, is thoughtfully designed by skilled designers. The titanium Apple Card is no different. It's laser etched, has no numbers, and it earns you daily cash on everything you buy, including 3% back on everything at Apple. Apply for Apple Card on your iPhone in minutes. Subject to credit approval, Apple Card is issued by Goldman Sachs Bank USA, Salt Lake City Branch. Terms and more at applecard.com.
--:-- Sean Rameswaram: 2020 was a big year for police reform, maybe the biggest year ever. Protests across the country led to protests across the planet. Activists, athletes, celebrities, even the former president, among the biggest known boosters of police, had to acknowledge that things weren't up to snuff.
--:-- Sean Rameswaram: Now, what all that extra attention on policing accomplished varies. There was some defunding, there was some rethinking, but it's most definitely a work in progress. And we've had at least two recent reminders of the country's open wound, both out of New York. A grand jury declined to pursue charges against two police officers who were filmed shoving a 75-year-old protester to the ground in Buffalo during last year's protests.
--:-- Sean Rameswaram: And another grand jury declined to bring charges against any of the officers involved in the death of Daniel Prude. Prude died after police officers placed a mesh hood over his head and handcuffed him while he was having a psychotic episode on the street outside his brother's house in Rochester last March.
--:-- Sean Rameswaram: Both incidents scream there must be another way. Another way to respond to people having psychotic episodes. It's another way to deal with a 75-year-old man who is peacefully protesting. And in Eugene, Oregon, they've found another way. They actually found another way like 30-something years ago. And the police are on board.
--:-- Sean Rameswaram: Rowan Moore Garrity wrote about it for The Atlantic. So I wrote about a program in Eugene, Oregon called CAHOOTS, which stands for Crisis Assistance Helping Out on the Streets. And basically what it is, is a mobile crisis response service that's integrated into their 911 dispatch system.
--:-- Sean Rameswaram: So you call 911 for one of any number of things, whether it is someone having a mental health crisis in the street, or somebody who just looks like they might be too intoxicated to get themselves home safely, or perhaps even a domestic dispute. And based on the particulars of what you say, the 911 dispatchers might say, you know, this looks like a call where instead of sending a cop, it might be better for us to send cahoots.
--:-- Sean Rameswaram: And what cahoots is, is basically two people, one with a crisis or outreach background, the other with some kind of a medical background, whether it's a nurse, an EMT, or a paramedic, on a van with first aid supplies, snacks, and just an approach that is all about de-escalation and connecting with the person at the center of the call.
--:-- Sean Rameswaram: Okay, before we get any more into Cahoots, I think we have to talk about the fact that this is a serious program in a serious place that is called Cahoots. That is right. So the name is funny and it gets at one of the things that I think is vital and what's made it successful, which is Cahoots is a program of a community health clinic that's been around since the 60s in Eugene.
--:-- Sean Rameswaram: And that clinic, White Bird, really came out of the sort of hippie movement of that era. There was an earlier clinic in Haight-Ashbury in San Francisco that sort of pioneered this model of, hey, the authorities, the medical establishment doesn't know how to deal with people who are having a bad trip. They're not sort of meeting alienated youth where they are.
--:-- Sean Rameswaram: So we need to start a free clinic. So Whitebird began that way and has retained a lot of that counterculture, institutional culture. And so by the time Cahoots was born in the late 80s, obviously it had matured a lot. But there was still a lot of, I think, distrust or at least the sense that, hey, we may be able to help more established institutions like the police intervene in people's lives, but we still need to keep our distance.
--:-- Sean Rameswaram: And so the name Cahoots was actually a joke, kind of like, hey, wink. Yes, it's really us and we're really collaborating with the cops. I mean, kudos to them because it still hits decades later.
--:-- Sean Rameswaram: Jumping from the 80s to now, what does this program look like in the 2020s? So today, you would think that the Cahoots fans look and feel something like a kind of a lower tech ambulance. They carry first aid supplies, they carry snacks, and basically they drive around town.
--:-- Sean Rameswaram: It's two people, one person with a medical background, whether it's an EMT or a nurse, and one person with a sort of street outreach or crisis intervention, mental health type background. And those people basically tag team on every call. It could be someone who got out of the hospital with very bad burns and now 10 days have gone by and they haven't had their bandages changed because they're living in a rainy climate in a tent and it's hard for them to get back to the hospital or to the burn care clinic.
--:-- Sean Rameswaram: It might be somebody whose 13-year-old is cutting their wrists and they're not really sure what's going on. It could be someone with schizophrenia in the midst of a full-blown psychotic episode. It could be a death notification. It could be really any number of things.
--:-- Sean Rameswaram: And so it's a good way to both appreciate the variety of things we call on the police to do, and also when you see someone with a very different skill set approach those same tasks, just how different those calls look from the ones that make the news.
--:-- Sean Rameswaram: And you got to witness this firsthand back in August when you went for what, a ride along in a Cahoots car?
--:-- Rowan Moore Garrity: Yeah, so I followed Cahoots on two shifts, one overnight and one during the day. And about 60% of their calls involve the homeless community in Eugene in some form or fashion.
--:-- Sean Rameswaram: And most calls are what they call first party callers. So somebody saying, I need help, my family member needs help, my neighbor needs help, my friend needs help, or something like that.
--:-- Rowan Moore Garrity: So when I rode along, the first shift I went on started about 5 o'clock in the afternoon. We went and gave one man first aid for some cuts on his hands. This is a guy who's living outside.
--:-- Sean Rameswaram: We went to the campus of the University of Oregon to a call where the police and the fire department had already been because there was a young man who people kept sort of being I guess for lack of a better term sketched out by A guy who was laying on the grass, you know, according to the 911 call, acting erratically.
--:-- Rowan Moore Garrity: When we got there, he was laying on the grass, kind of taking a nap. But then there was also a little pile of latex gloves burning by his head. And by the time we pulled up, he was sort of poking at it with a knife.
--:-- Sean Rameswaram: And so that was one of those calls where you could say, oh my goodness, if the police arrived here, it would be a completely different thing.
--:-- Rowan Moore Garrity: And what happened in that instance is the medic in the coots call, Chelsea Swift, walked up, pulled the knife out of reach because the guy didn't seem too worked up about anything, sat and talked to him.
--:-- Sean Rameswaram: And we ended up just giving him a ride back to the middle of town. It wasn't that there was anything in particular he kind of needed. But it was very clear that his behavior was alarming to some people on campus and that maybe it wouldn't be great for him if he stayed there and continued acting that way.
--:-- Sean Rameswaram: Rowan, tell me more about someone like Chelsea Swift. Is she a crisis intervention worker? She's not a cop, but she did go up to this person and take away his knife. It sounds like it could be dangerous.
--:-- Rowan Moore Garrity: Swift, she goes by Swift, was on the night that I rode along a medic. She had also done crisis outreach work on the CAHOOTS van and before that. So has a lot of experience.
--:-- Sean Rameswaram: She worked in the Bay Area doing harm reduction work with IV drug users. Her own background, I think, is part of what sort of sent her in that direction.
--:-- Rowan Moore Garrity: She grew up in Connecticut. Her mother had an undiagnosed mental illness and some struggles with addiction. This has been, And as she put it, a job I'm so good at, I would never have wanted, meaning that she ends up doing something that looks a lot like kind of EMT emergency response work in many places, but that has a completely different culture.
--:-- Sean Rameswaram: The policies are very clear that if there's any possibility of violence, if there's anything, you know, that seems dangerous about the call. Now, those are subjective terms. But if there's anything that seems dangerous about the call, then that is a police call. It's not a Cahoots call, or possibly it's a Cahoots call once the police are through.
--:-- Sean Rameswaram: In practice, a 911 call doesn't tell you everything. Somebody could be lying. They could be really angry. The connection could be really bad. And the dispatchers are trying to take as much information as they can get in 30, 60, 90 seconds and get somebody on their way there.
--:-- Sean Rameswaram: And so often Cahoots is responding to places where there hasn't been complete information about the overall situation. And because Cahoots has been around for 30 years and a lot of the people who they help probably wouldn't be thrilled to see the cops, it's also true that some people will call 911 but try to phrase their need in such a way that it will lead to cahoots being sent and not the police.
--:-- Sean Rameswaram: All of that's to say that really a lot of cahoots' work, like a lot of police work, happens in a kind of gray area. You don't know how dangerous it is. It may be dramatically more dangerous in five minutes than it was five minutes ago.
--:-- Sean Rameswaram: And there's a lot of kind of quick thinking on your feet. And there are some number of calls, about 1% of the calls Cahoots handled last year, for instance, they called police for backup. But that's a few hundred calls out of more than 15,000.
--:-- Sean Rameswaram: Yeah, I was curious, actually, how much of 911's calls are being diverged from police to Cahoots. So there are a few reasons that's really tricky. If you just look at the raw data, how many calls come into the 911 center, right, or how many calls get dispatched in the city of Eugene by police dispatchers and how many calls is Cahoots handling?
--:-- Sean Rameswaram: The number is around 17% or just shy of one out of every five 911 calls. But if you ask the police, okay, so did CAHOOTS divert 17% of your police calls? That sounds really impressive. They'll say, whoa, whoa, don't get carried away.
--:-- Sean Rameswaram: A lot of those things wouldn't be police calls. And I think there's some truth to that. So for instance, one of the most common requests that CAHOOTS gets is transport. people who are living on the street in Eugene who badly need to get to a medical appointment.
--:-- Sean Rameswaram: Cahoots can do that. The police aren't just going to throw you in the back of their cruiser and then take you to your friend's house, right? So there is some truth to that, that not every call that comes in via 911 is truly a police call.
--:-- Sean Rameswaram: It sounds a little bit like a program that you could take advantage of if you were, say, intoxicated, but maybe feeling a little frugal and didn't want to call an Uber or a Lyft or a taxi. Could you just call Cahoots and get a ride home?
--:-- Sean Rameswaram: Yes, you could. I don't think that in reality, that's the way it has worked in Eugene, because response times are long. Unless you are really in the midst of an ongoing emergency, they're not likely to get to you in less than an hour.
--:-- Sean Rameswaram: So the rest of us have a question to ask, which is what is a 911 system for? On one level, the fact that Cahoots exists in Eugene and you could call them, you know, if you're really drunk and just need a ride home, suggests like, yeah, there is some mission creep that's possible.
--:-- Sean Rameswaram: But on another level, it suggests, wow, we have this 911 system that in most places can only send you police or the fire department. But we have a lot of what one Cahootz employee I spoke to called emergencies of need, particularly in the case of Eugene with people who are homeless, where there are emergencies that the police department may not be able to solve and that the fire department may not be the best response for.
--:-- Sean Rameswaram: And Eugene is a place where we have given people a way to voice those as emergencies and get a response to that on some kind of emergency basis. And we don't really have a good sense of, is that something that really should be in our 911 system and other places, or shouldn't it be?
--:-- Sean Rameswaram: My view is it really should be somehow, because you see in so many different places, the cops do end up getting called, and the cops do end up showing up. And when they do show up, it doesn't really seem like they're always the right people for the job.
--:-- Sean Rameswaram: Cahoots sounds super functional, but police alternatives are pretty controversial elsewhere. Do people dunk on Cahoots? Does it have detractors in Eugene?
--:-- Rowan Moore Garrity: In Eugene, it's actually remarkable. It's very hard to find anybody who wants to say anything bad about Cahoots. Really?
--:-- Sean Rameswaram: For the most part, people like it. They rely on it or know people who have relied on it at the very least. Or perhaps if you're a business owner downtown, you know, you've relied on it by sort of getting somebody else help or something like that.
--:-- Rowan Moore Garrity: But I'd say the number one drawback is people feel like it's a resource that there should be more of.
--:-- Sean Rameswaram: And I think one of the things I've been heartened to see this year is we're starting to see our society do a lot more critical thinking around how we engage with 911.
--:-- Sean Rameswaram: You'll see signs up on people's fences that say, don't call 911, call this community resource. And in a way, people in Eugene who say, call 911 and then make it seem like you don need the cops when really the cops are going to want to be there they doing the same thing What they trying to do is respond to or avoid the risk of police violence if things should escalate.
--:-- Sean Rameswaram: And I think we are at a moment where we have a real crisis of legitimacy in some places and with some communities in terms of that 911 response. If people just broadly don't trust your 911 system enough to opt in to the right parts of it, then it's not just that they're misusing it, but it's that the system is not necessarily handling things in a way that it should.
--:-- Sean Rameswaram: In other words, if the risk of police violence is so great or is perceived as so great that telling the truth about your emergency could get someone you love killed, then we really need to recalibrate.
--:-- Sean Rameswaram: More with Rowan in a minute. I'm Sean Ramos from Today Explained.
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--:-- Sean Rameswaram: Take The Guardian. Our coverage has something unique. Fierce independence. Nobody owns us or tells us what we can and can't say. So we're free to report the whole picture.
--:-- Sean Rameswaram: We connect what's happening in Washington to the rest of the globe, expose corruption wherever we find it, and give fresh perspective on everything from wellness and soccer to culture, the climate and more.
--:-- Sean Rameswaram: Read, watch and listen to The Guardian for free at theguardian.com.
--:-- Sean Rameswaram: Roan, I asked you how people felt about Cahoots and whether there were drawbacks to the system, and you said it was pretty much widely approved of and praised.
--:-- Rowan Moore Garrity: The mayor of Eugene said to me, until this whole defund the police movement, I don't think the police ever sort of thought of it as competition. I'm paraphrasing here.
--:-- Sean Rameswaram: She said, I think they thought of it as very good service for a very low price.
--:-- Rowan Moore Garrity: And I think over 30 years working together, the police and Cahoots have developed a really good basis for collaboration, where from the police point of view, Cahoots is someone who can show up
--:-- Sean Rameswaram: And instead of your only tool being, okay, well, I can drop you off at the emergency room, or I can arrest you and take you to the city jail. Now you can call somebody who can both take over from there so you can go get on to other things.
--:-- Rowan Moore Garrity: And they can also say, hey, do you need a place to stay tonight? Are you seeing any mental health counselors?
--:-- Sean Rameswaram: And I think that's a resource that the police have really come to rely on.
--:-- Sean Rameswaram: Did you talk to any police officers about the program?
--:-- Rowan Moore Garrity: I did. I walked with an officer who sort of patrols a downtown area in Eugene on foot and deals with a lot of the same population of people experiencing homelessness there.
--:-- Sean Rameswaram: And she sort of, I think, calls cahoots on an almost daily basis on behalf of the people that she runs across because they're able to help in ways that she just can or may not have time for or would rather not deal with sometimes.
--:-- Rowan Moore Garrity: I think this past year, 2020, police brutality becoming a huge focus of a national protest movement, becoming the focus of our sort of very partisan political divisions and so forth, has complicated the working relationship between Cahoots and the police in Eugene quite a lot.
--:-- Sean Rameswaram: And I think right now there's this challenge where if people in Eugene are pointing at Cahoots and saying, they should have half of your budget instead of 2%, and we should fire half of you and bring on five times as many of them, regardless of the opinions within CAHOOTS, that makes it a really difficult thing to navigate with people who are essentially your colleagues.
--:-- Rowan Moore Garrity: So I think it's been a challenge for them to sort of avoid seeing each other in the context of this national debate around what role should police play in our society.
--:-- Sean Rameswaram: Well, let's talk about how the program's funded. So the program is directly funded by contract with the police department. They are a vendor who sells their services to the police department.
--:-- Sean Rameswaram: And in a city with a police department budget of about $66 million a year, the cost of cahoots is somewhere between $1 and $2 million a year, or right around 2%.
--:-- Sean Rameswaram: At the low end, they respond to 5% or 8% of 911 calls. And at the high end, maybe they respond to 17, 18% of 911 calls.
--:-- Sean Rameswaram: And they do it for 2% of the budget. People look at those numbers and they say, well, geez, why shouldn't we have three times as much Cahoots, four times as much Cahoots, or at the very least, reduce the police budget because Cahoots is doing so much?
--:-- Sean Rameswaram: And I think in the next few years, Eugene and other cities may find out more kind of where does it make sense to place that line? How far should we move the needle or how far can we move the needle safely away from police and onto people with a different kind of skill set?
--:-- Sean Rameswaram: Are there other cities that have programs like this and that have had similar levels of success as cahoots?
--:-- Rowan Moore Garrity: Yes, absolutely. I think the main difference, what sets cahoots apart is scale. So there are a variety of ways that other cities have responded to, I think, a similar set of challenges around homelessness, drug addiction, mental health issues, and so forth.
--:-- Sean Rameswaram: In Austin, for instance, there's a program they call the Community Health Paramedic Program, where basically there's a unit within their fire department's emergency response service that has specialized training.
--:-- Sean Rameswaram: There are cities, you know, in the Bay Area, there's a program where a licensed mental health professional is paired with a police officer or sheriff's deputy with special training, and they will go out to acute mental health crisis calls.
--:-- Sean Rameswaram: But both of those handle kind of well under 1%. In the case of the Alameda County program, it might just be a few calls a day, whereas CAHOOTS in a city of only 170,000 goes to 15,000, 16,000 calls a year.
--:-- Sean Rameswaram: It interesting you know I mean it just sounds like cahoots is the middle ground between all these calls to defund the police and police reform that so many people have essentially been asking for
--:-- Sean Rameswaram: And here it is, this quiet program that's found success for decades in Eugene, Oregon. How did they feel when the whole country started debating about whether or not it could pull off something they'd been doing for, you know, a generation or two?
--:-- Rowan Moore Garrity: And on one level, I think they're very inspired and excited about the notion that Cahoots has caught fire as a model.
--:-- Sean Rameswaram: I think the thing that I heard from a lot of people in Eugene, including people who have worked at Cahoots, is if other cities really want to adopt a model like this, don't discount how much the sort of particular history, culture, and context of Eugene, and in particular, what kind of an organization Whitebird is.
--:-- Sean Rameswaram: Don't discount how much that has played a role in its success. And what I mean by that is CAHOOTS has worked very closely with the police for 30 years, and not in a million years would you mistake CAHOOTS for kind of an arm of the police department.
--:-- Sean Rameswaram: They have a very different culture. It's a non-hierarchical organization. They make decisions by consensus. Everybody gets paid around the same amount.
--:-- Sean Rameswaram: And so they have a level of credibility and trust with people who are living on the street, with people who are using drugs in public, with people of all stripes from all walks of life.
--:-- Sean Rameswaram: They have a level of credibility and trust and a kind of a brand that says to people, don't worry, I'm here for you. It's going to be okay.
--:-- Sean Rameswaram: And a lot of those same people have an extremely different relationship with the police. And I think that's a product of that 30-year collaboration.
--:-- Sean Rameswaram: And I think if you're the mayor of Houston and you want to start something like this, or you're the mayor of Miami or LA or New York or whoever, right? And you want to start a program like this, one of the biggest challenges is going to be, okay, I don't have 30 years.
--:-- Sean Rameswaram: I don't have a white bird free clinic that everybody already knows. It sounds like hard work. Is that why more cities haven't been able to pull it off?
--:-- Rowan Moore Garrity: I don't think all that many cities have tried. And I don't mean to diminish efforts by a lot of smart people in a lot of places to find a more humane way to respond to different kinds of emergencies.
--:-- Sean Rameswaram: But we really have not glimpsed a kind of different paradigm in this country. I mean, the fact that it only exists in Eugene is still telling.
--:-- Sean Rameswaram: You know, when you see Cahoots approach a young man laying on the grass with a knife, and you imagine the way that the police might have reacted in that same situation.
--:-- Sean Rameswaram: Now, I didn't say would have reacted or all police might have reacted, right? But nevertheless, when you see Cahoots approach somebody in that situation, it was mind-blowing to me.
--:-- Sean Rameswaram: And it kind of felt like, oh my gosh, like, you mean there is another way? Because a lot of our political debate and a lot of the sort of passion in the protests around police brutality has been very vivid and powerful in the model it's denouncing.
--:-- Sean Rameswaram: But we just don't have a frame of reference for somebody without a badge and a gun stepping in in a role of authority in these tense situations.
--:-- Sean Rameswaram: Somebody whose training really is focused on how do we talk somebody off a ledge here. Every police officer on the force has 40 hours of special training for crisis intervention.
--:-- Sean Rameswaram: But, you know, CAHOOTS has 500 hours. And it's also probably a very different group of people who are recruited into that program than the group of people who get recruited into police departments.
--:-- Sean Rameswaram: And I think that is really important, too.
--:-- Sean Rameswaram: It's amazing to hear how functional this program is in a place like Eugene, Oregon, and compare that with the kinds of vitriol you heard to these kinds of ideas on presidential debate stages or in Congress or all over social media.
--:-- Sean Rameswaram: The reality of considering alternate emergency services isn't quite as radical as it might seem.
--:-- Sean Rameswaram: Yeah. And so I think there's a good and growing body of academic research or academic literature about what people sometimes call the skills mismatch.
--:-- Sean Rameswaram: In other words, police officers are hired to do one narrow crime-fighting oriented job, and then they get into their squad car or start to patrol their beat, and all of a sudden, the job the community needs them to do requires them not to just be an investigator or a crime fighter, but also a grief counselor, right, if they're doing death notifications, but also a social worker if they're mediating between, you know, members of the community.
--:-- Sean Rameswaram: A family and there's a possibility of domestic violence. Also a substance abuse counselor, if they're dealing with somebody who is dealing with substance use disorder in some way or another. Also a mental health counselor, right?
--:-- Sean Rameswaram: So the police have all these different hats that they do in fact need to try and wear in the course of doing their jobs.
--:-- Sean Rameswaram: And in most places, it's not what they were hired for, it's not what they were trained for, and it's not what they ever thought of their job as being.
--:-- Sean Rameswaram: And so then you see the collateral damage everywhere. I mean, of course, this is all happening in the context of an intensely racist society that is still working through that in all kinds of institutions, not just in police departments.
--:-- Sean Rameswaram: So when you start from the perspective of, hey, what are the emergencies in our community and what kinds of people would be well-placed to respond to each of those emergencies, you probably wouldn't arrive at, okay, it's either the police department or the fire department.
--:-- Sean Rameswaram: But because when 911 systems started out and it was, okay, police or fire, and all of this stuff, all of the sort of challenges of city living, right, has been layered on top of it, we still just have police or fire.
--:-- Sean Rameswaram: So when you start from that place of what do we need these people to do, I think you'd get to a very different emergency response system than the one we have now.
--:-- Sean Rameswaram: And I think Cahoots is powerful because it's one of the few real world examples we have of what that looks like in an American city.
--:-- Sean Rameswaram: Today's episode was inspired by an article in The Atlantic. It's titled An Alternative to Police that police can get behind. You can read it at theatlantic.com.
--:-- Sean Rameswaram: It was written by our guest, Rowan Moore Garrity.
--:-- Sean Rameswaram: I'm a journalist. I live in Phoenix. I wrote a book about Mozambique that I'm still trying to promote two years later. What's it called?
--:-- Rowan Moore Garrity: You're doing a terrible job. Oh, sorry. It's called Go Tell the Crocodiles, Chasing Prosperity in Mozambique.
--:-- Sean Rameswaram: That's a good title. Thank you. Thank you.
