Editor’s Note: Eugene, Oregon’s Crisis Assistance Helping Out On The Streets (CAHOOTS) program, which offers people in mental health crises law enforcement-free emergency assistance, is steadily making its way across the country.
The program, which dispatches two-person teams made up of a medic and a mental health professional, differs from LA’s mental health crisis teams, which, for both the LA County Sheriff’s Department and the LAPD, are each comprised of a mental health clinician and a law enforcement officer.
The mental health crisis teams in Los Angeles have received high praise for helping to de-escalate tense situations involving mental health and substance use crises.
However, the CAHOOTS program — and its elimination of law enforcement from the equation, freeing up police to handle more dangerous matters — is considered a program worthy of replication across the U.S.
In June, LA County’s Alternatives to Incarceration Workgroup presented its June report” rel=”noopener” target=”_blank”>more than 100 recommendations for prioritizing diversion and mental health care over incarceration in the adult justice system.
Within that report, one of the workgroup’s recommended goals was to reduce contact between law enforcement and people with mental health and substance use disorders, and thus reducing avoidable arrests and unnecessary criminalization. The workgroup pointed to CAHOOTS as a possible model, although it noted that implementing such a strategy in Los Angeles would require a reworking of the 911 system to connect 911 operators with the Department of Mental Health.
By LJ Dawson, Kaiser Health News
Every day that Janet van der Laak drives between car dealerships in her sales job, she keeps size 12 shoes, some clothes and a packed lunch — a PB&J sandwich, fruit and a granola bar — beside her, in case she sees her 27-year-old son on the streets.
“’Jito, come home,” she always tells him, using a Spanish endearment. There he can have a bed and food, but her son, Matt Vinnola, rarely returns home. If he does, it is temporary. The streets are easier for him. Home can be too peaceful.
But the same streets that give Vinnola comfort are also unsafe for a man battling dual demons of drug use and chronic paranoid schizophrenia.
Police and criminal courts often intervene before Vinnola gets treatment or care. Since his first diagnosis of severe mental illness in 2014, Vinnola has collected a litany of charges from misdemeanors to felony trespassing and drug offenses. Over the past four years, Vinnola has been charged in four separate Colorado courts and arrested multiple times almost every month either for new offenses or on warrants for failing to appear in court.
But soon, he might encounter mental health professionals on the street instead of cops. Denver is one of at least eight cities considering an Oregon program called Crisis Assistance Helping Out On The Streets to decriminalize and improve the treatment of people with severe mental illness — while saving the city money. The 30-year-old CAHOOTS program diverts nonviolent, often mental health-related 911 calls to a medic and a mental health professional instead of law enforcement.
Denver police and community service providers visited Eugene, Ore., in May to shadow CAHOOTS teams. Denver police officials said they are considering the model as an option to push beyond their existing co-responder program that sends mental health professionals on about six 911 calls a day.
Over 8 million people struggle with schizophrenia or bipolar disorder in America, and an estimated 40% of people diagnosed with schizophrenia go untreated, according to the Treatment Advocacy Center, a nonprofit focused on mental health. Individuals with those illnesses often lose the ability to realize their deficits, creating a roadblock in accessing care and attending medical or court appointments.
Low-level offenses can land those with paranoia, hallucinations or a reduced ability to communicate, like Vinnola, in the criminal justice system. An estimated 383,000 people with severe mental illness are behind bars nationwide, according to the Treatment Advocacy Center, while only a tenth of that number are in state hospitals.
The Push to Rethink Safety
Since the 2018 publication of a Wall Street Journal article about CAHOOTS, calls have poured into its organizers from officials in Los Angeles; Oakland, Calif.; New York; Vancouver, Wash.; and Portland, Ore., among others.
The Eugene CAHOOTS team shows up in work boots, jeans and T-shirts — and without police officers — in response to 911 calls diverted to the program.
“That difference in uniforms can assist folks with letting their guard down and being open to accepting the help that is being offered,” said Tim Black, the Eugene CAHOOTS’ operations coordinator.
For people with a history of volatile arrests often while in mental health crisis, this could make treatment more accessible, less traumatic and safer. One in 4 deaths from police shootings represent people with mental illness, according to the Treatment Advocacy Center.
Vinnie Cervantes, the organizing director for Denver Alliance for Street Health Response, believes using medics and mental health professionals as response teams means treating people with dignity.
“There are plenty of fantastic officers, as people, but they have their roles enforcing a system that has been violent, that has been racist, that has been dehumanizing,” Cervantes said.
Van der Laak said she thinks her son would be more willing to accept treatment if police were not part of the intervention in his mental health crises. She worries that his delayed responses to commands and difficulty answering cops will be perceived as defiance and escalate into an arrest — or worse.
Giving Voice to Her Son
After van der Laak’s son was diagnosed with paranoid schizophrenia in 2014, her everyday gaze shifted from the city skyscrapers and Colorado blue sky to the people living on Denver’s streets. It’s hard for her to pretend they don’t exist. That would mean her son doesn’t exist.
She doesn’t understand how people do it — walk by her son as if he’s just a tree, or nothing, even when his bare feet are bloody, his clothes torn and his face visibly dehydrated, all visible signs of Vinnola fighting his internal battle with schizophrenia.
“His brain just doesn’t work like yours and mine,” she said.
Janet van der Laak walks on Federal Boulevard in Denver looking for her son, Matt Vinnola, on July 19, 2019. Van der Laak tries to make contact with business owners and employees along this stretch of road, giving them her phone number to call instead of the police if they see her son. (LJ Dawson for KHN)
Vinnola’s mother said her son is not a danger to anyone other than himself, but many people associate mental illness with violence. People with severe mental illness are more than 10 times more likely to be victims of a violent crime than the general population, according to the U.S. Department of Health and Human Services.
Vinnola agreed to be interviewed for this article but was unable to answer questions for more than a few minutes. His answers were fragmented and short. He struggled to understand the questions. Van der Laak said he answers the same way in the courtroom.
Van der Laak is outspoken for her son, calling herself his advocate and voice. She attends his court dates, toting legal and medical paperwork in a thick manila folder. He might not attend, but she won’t miss a chance to speak up against a justice system she sees as incapable of being responsible for her son’s treatment.
“It’s critical that I’m there. Because if I am not, they will railroad him and he will end up in jail for long periods of time,” she said. “And that’s not where he needs to be.”
Dr. Sasha Rai, director of behavioral health at the Denver County Jail, said a person in a mental health crisis needs to be in a more therapeutic place for treatment than jail. To him, the biggest obstacles to care for the people he treats in jail are a lack of stable housing and the stigma of mental illness.
“If you were sick with cancer, they’re not going to stick you in jail for 84 days until they find a place to get you care,” van der Laak added, referring to when her son spent over two months in jail in 2017, awaiting one of the 455 beds in the state’s mental health hospital after being arrested for violating probation.
A Burden Lifted
The Eugene Police Department uses its CAHOOTS staff for more than mental health calls. They deliver death notices across the city, hand out water bottles and socks to people living on the streets, and take after-hours community medical referrals. The staff offers those services to the city for half the cost of a police officer.
Nationally, police officers carry the brunt of responding to mental health issues. In 2017, law enforcement agencies spent $918 million transporting people with severe mental illness, according to a 2019 survey from the Treatment Advocacy Center. It also estimated that officers spend 21% of their time responding to and transferring people for mental health issues.
“Our police officers try the best they can, but they are not mental health professionals,” said Eugene Police Lt. Ron Tinseth.
In 2017, Eugene diverted 17% of an estimated 130,000 calls to its CAHOOTS teams. This freed up Eugene police officers to respond to higher-level emergencies.
Like many police departments, Denver is feeling the pressure of mental health issues. From July 2018 to July 2019, the department said, it received 15,915 mental health-related calls, almost a 9% increase from its annual average over three years.
To enact a program like CAHOOTS, the Denver Police Department would have to iron out details such as insurance to cover responders and partnerships with local nonprofits that offer services like sobering-up shelters, medical care and substance-abuse counseling.
Lisa Raville, executive director of Denver’s Harm Reduction Action Center, a Denver nonprofit focused on helping those who use drugs, asserts that the power of a CAHOOTS program lies in its community relationships and the ability of first responders to simply ask, “How can I support you today?”
“And then you can do it. Maybe it can be possible. Maybe this person can find some sort of safety,” she said. “We all deserve that.”
Until then, when van der Laak’s son is on the streets, she uses Facebook and her neighbors to keep track of him. She gives store clerks near the streets he chooses to live on her phone number in the hope they will call her to pick up her son during a crisis, not 911.
This story originally appeared in Kaiser Health News.
Top photo: Matt Vinnola (center) sits with his mother, Janet van der Laak, and stepfather, Onne van der Laak, at the van der Laak’s Denver apartment on July 25, 2019. Vinnola had recently come home after spending a week on the streets of Denver. (LJ Dawson for KHN)
Yawn. The whole article can be translated into: cops bad, everyone else good. LASD MET teams are not in uniform and identifiable as cops teamed up with clinicians. There goes half of this article’s premise. The other, unspoken one, is what happens when a 911 call is generated and goes to this CAHOOTS team only to discover it is a life and death situation and now a second 911 call is generated. Is it oops, so sorry?
Cops are bad. YOU JUST SHOT A WOMAN AT HER HOUSE!!!! What does everyone have to do with this? Why am I trippin tho? Giving guns and badges to you lames is lasd staandard procedure please forgive me.
PS…CELESTE FREMON WHEN ARE YOU GOING TO SPEAK ON ATATIANA JEFFERSON?
Why would a story about an incident in Texas be discussed here? All stories are local because of the internet? Just no. You can’t internalize all of the world’s woes as though you are the victim.
Finally, a sober and articulate commenter from the left, cf you taking notes on this?
A Dallas cop shot her, moron. Keep the hate up!
As a long time cop and a person who has a close family member with just those same issues as Jito, I am of the opinion that a program like CAHOOTS would be a welcome sight to both the law enforcement community and to those of us who are looking for assistance with our troubled loved ones.
Absent criminal conduct, mental health disorders are not a law enforcement issue. Families needing help in Los Angeles and surrounding counties have no one to turn to when they have a family member who is in crisis EXCEPT the police. The current mental health teams deployed by the LASD and LAPD are few and are only called after deputies or officers are initially dispatched to the scene. Often, they are not available or it takes an extended amount of time for them to arrive on scene. Two unfortunate fairly recent LASD incidents come to mind where the scene spun out of control (one in Lakewood and one in Malibu) and, before mental health professionals were on scene, Deputies were forced to use lethal force. I am willing to bet that both the families of those killed AND the Deputies involved with that the initial call, wish that call had gone to a mental health team and allow them to respond to the location to deal with the individual in crisis.
This is not a criticism of the Deputies. Had I been there and faced with the same situation, no doubt my actions would have been the same. My comments are critical of a system that puts we as law enforcement personnel, not trained mental health experts, at ground zero of a true mental health crisis. This is not a clinical counseling session, this is a crisis situation that needs the expertise of a professional. As that Lieutenant from Eugene said in the article, we are not mental health experts. Nor do I want to be. But as a family member I want one there.
In reality, our politicians have a habit of ignoring problems and letting them fester and spin out of control in our society. Inevitably, it is the police who are the ones who are left with dealing with the aftermath of their inaction. It has always reminded me of the crew who is responsible for cleaning up road-apples after horses have pranced down a street in a parade. So is it with the lack of action by politicians to head-off problems before they become major concerns and, all of a sudden, these problems become a law enforcement “problem.” I only need to point to the issue of homelessness to make my point.
Likewise, mental health. The LA County Jail has been the largest mental health facility in the state for decades and all of a sudden the Board of Supervisors have their shorts in a wad wanting to build some sort of mental health jail that isn’t a jail (forgive me if I’m confused) that is going to cost only God knows what. (I’m seeing road-apple patrol in the works here when/if this fiasco gets built) Yet in Oregon, far-sighted politicians 30 years ago saw a need to go the root of the mental health problem and develop a program which focused in on the need of the persons who required help. Gee, a novel approach – help the people who needed help at the time they needed it – not after the individual has acted out and done something that REQUIRED police intervention.
So, for heavens sake, County of Los Angeles and surrounding county politicians, take a look at something that looks like it actually works for the people who need help. If you don’t care about people needing help until it is too late – we all know you only care about acting like you’ve solved “problems” so you can garner votes for your next elected office – do it so you can honestly put in your next political flyer how much you’ve impacted jail overcrowding, homelessness AND mental health issues in our communities. Because this program looks like it will do all those things.
@Laughably…”cops are bad.” Hmm, hope you do not ever need the assistance of law enforcement for anything.
I do not know why you are trippin. However, I am tripping because of the lack of constructing a grammatically, coherent sentence. “YOU JUST SHOT A WOMAN AT HER HOUSE!!!!”
I think the proper sentence structure would be, law enforcement or A Fort Worth police officer, shot a woman in her house. When you utilized the pronoun “YOU,” who are you referring to? Are you generalizing all of law enforcement?
Further, you stated, “CELESTE FREMON WHEN ARE YOU GOING TO SPEAK ON ATATIANA JEFFERSON?” Celeste does not speak about people, she writes articles on subjects, issues, problems that pertain to the state of California.
Evidently, the family cannot even make proper funeral arrangements because of discourse between family members. Nonetheless, I would presume that you want Celeste to write an article on Ms. Jefferson so that you can get all BLM on this topic and begin your slanderous, vitriol rants.
Editor’s Note:
Dear “Laughably,”
WitnessLA, as our name suggests, primarily covers criminal justice news in Los Angeles and also around the state. But our free weekly newsletter, The California Justice Report, in addition to local and California stories, does cover crucial justice stories from around the nation.
This past week, CJR covered the horrific story of the killing* of Atatiana Jefferson inside her own home in front of her 8-year-old nephew by a Fort Worth police officer who was supposed to be conducting a welfare check, and will continue to track Atatiana Jefferson’s story.
You can find that issue of the newsletter here. https://us10.campaign-archive.com/?u=59add16bfc7b486a781b0ac8c&id=1c9363d763
And you can sign up to receive the CJR yourself here: https://witnessla.us10.list-manage.com/subscribe?u=59add16bfc7b486a781b0ac8c&id=abadc0e410
We always welcome suggestions about important stories you think we might miss, for both WLA and CJR.
I hope that helps.
C.
*PS: I just edited the above comment to change the word “murder” to “killing,” apropos of what Maj Kong rightly suggested.
Murder eh? Not even Laughably went that far. I’m sure if the shooter were a gang member of color there would have been a couple of “allegedly and unfortunately s” in there. Something like, “he found himself standing outside the house with a gun in his hand, unsure of what had just happened”, or something like that.
Witness la usually touts decriminalization, diversion and is against over-incarceration. But sometimes witness finds itself out for blood, interesting facet of human nature I guess.
Madame Dong, thank you for thinking of me. Your support of my efforts at self-improvement are much appreciated. I appreciate you taking time from your breakfast at Winchell’s to send the note. Thank you.
Keep Dreaming, no, not all cops are bad. There are some decent ones, but there are also terrible ones, some criminal ones, some lazy ones, some ignorant ones, some racist ones, some are rapist, some pedophiles, some alcoholic, some drug addicts, some murderers, some are just rude, and so on. So, not all, but many are bad. And, when they are on the tax payer dime, one bad cop is one too many. At COSTCO or Sam’ Club people will fired if they are accused of such things.
Fat Roleman, thank you for the English lesson. If you are a man with a gun and badge, I am impressed. If not, I am not. You may want to do some trainings with your colleagues. Have you seen some of those police reports? Also, I, too, hope Laughably never needs the assistance of the police. If he does, however, the public still expects you to be professional and respectful. And, so long as you are on the public dime and feed of its trough, you’ll have to answer the call. If you want and to pick and choose who you help or how you help, become self-employed. Finally, keep in mind that truth is a defense to slander.
You realize she was pointing a gun at the cop right? Thats not to excuse his actions but its far from a murder by a brutal cop. The cop used poor tactics which put him in a place where Mrs Jefferson thought someone in her backyard might be attempting to break in. Its a tragedy but it shouldnt be painted as a cops are evil killers scenario.
Well said ! MET team aka professional bed finders that’s it, I wish there was this mysterious team that would come and handle all the ding calls without us
There was a time that a mental health team was called out to deal with mental health issues in the community. This is not new, just abandoned in Cal.
Good article and sounds like a program worth at least piloting.
Actually I didn’t shoot a women And so have tens of thousands more.
“…Just abandoned in Cal.”
Case in point is the Mendocino State Hospital up in Ukiah, Calif. Police taking people into custody for 72 hour observation under 5150 W.I.C. would take the arrestee to Mendocino State for the 72 hour observation.
But the A.C.L.U. initiated a lawsuit alleging patient mistreatment in the State Hospitals. It won the lawsuit, and Mendocino State was closed in 1972.
Mendocino State is now a Buddhist Monastery.
As usual…CF’s comments quickly digress into insults and disdain for law enforcement. Nothing of any value can be gleaned except a reinforcement of its hate, sick fascination and jealously of the police.
Maybe you should avail yourself of the services of a good mental health professional or better yet self admit.