Community Safety Response

What it is

A community-based response program for non-violent, non-criminal incidents: behavioral health crises, substance use, welfare checks, homelessness-related calls, conflict between neighbors, noise complaints. Civilian teams (typically a paramedic or EMT with a crisis worker or social worker) respond instead of police. They use de-escalation, harm reduction, and connection-to-care rather than enforcement.

The most-cited model is CAHOOTS (Crisis Assistance Helping Out on the Streets) in Eugene, Oregon, which has operated for over 30 years and handles ~24,000 calls a year. Many cities have launched programs since 2020.

Why it works

Police were never trained or staffed to be the all-purpose response to community distress. When a person in a mental health crisis is met by armed officers, the encounter often escalates, sometimes fatally. Civilian crisis teams trained in de-escalation produce different outcomes: lower injury rates, lower arrest rates, higher rates of connection to services.

Between 2020 and 2022, 62% of the 50 largest U.S. cities established alternative response programs. The model is no longer experimental. It works.

What you need

• Time: 6 to 12 months of planning. 4 to 8 weeks of training. Ongoing 24/7 or expanding hours.
• People: Medics or paramedics, crisis counselors, dispatchers, coordinators. Community members from the served areas in leadership roles.
• Space: Mobile response (vans). A dispatch center. An office for coordination.
• Materials: Mobile response vehicles. De-escalation and basic medical equipment. Communication systems. Training curricula. Connection-to-services materials.
• Skills: Mental health first aid, de-escalation, medical response, trauma-informed care, community knowledge, cultural competency.
• Energy level: High. Trained teams on call.

How to host it

This is one of the recipes in this book that requires formal infrastructure and usually city or county collaboration. The neighborhood-scale version is community organizing to bring such a program to your area.

If you're organizing to bring it to your area

1. Map the existing landscape. What does your city do today? Are 911 calls routed to police automatically? Is there any crisis line that isn't 911?
2. Find allies. Public defenders, social workers, mental health advocates, faith communities, racial justice organizations. They are often already organizing on this.
3. Build the case. Most cities respond to data and case studies. CAHOOTS, STAR, and others have published detailed outcomes. Use them.
4. Pitch a pilot. A defined neighborhood, a defined time window, a defined set of call types. Smaller pilots build the evidence and the constituency for citywide programs.
5. Demand community involvement. Implementation matters. Programs designed without community leadership often default to lighter versions of the same approach. Push for civilian governance and community advisory boards from the start.

If you're standing up a program

1. Partner with city and county. The strongest programs have city or county financial support and 911 dispatch integration. Free-standing community programs without dispatch integration can do useful work but operate at smaller scale.
2. Recruit and train staff. Look for paramedics, EMTs, mental health practitioners, peer support specialists, social workers. Training includes mental health first aid, de-escalation, harm reduction, trauma-informed care, and cultural competency.
3. Decide on dispatch. Programs vary: some are dispatched by 911, some by their own line, some by hospitals and community calls.
4. Equip the teams. Vehicles, communication, basic medical kits. No weapons.
5. Build the referral network. A response team can de-escalate a moment but cannot solve underlying issues. Strong programs have warm handoffs to mental health services, substance use treatment, housing programs, food access, and other social services.
6. Measure and report. Outcomes that matter: response times, de-escalation rates, transport to care vs. arrest, follow-up engagement. Transparency builds the constituency.

Variations

Co-responder model. A clinician rides with a police officer. Slower to deploy but lower political resistance in some cities.

Community ambassador. Less formal, focused on welfare checks and connection rather than crisis response. Often used for homelessness outreach.

24/7 vs. limited hours. Most programs start with limited hours and expand. CAHOOTS in Eugene is now 24/7.

Community-led variant. Some programs are entirely community-led without city integration. Lower scale; high credibility in the communities they serve.

Stories from neighborhoods

CAHOOTS (Crisis Assistance Helping Out on the Streets) in Eugene, Oregon has operated since 1989. It is integrated with 911 dispatch and handles roughly 24,000 calls per year. It saves the city an estimated $14 million annually in police and ambulance costs while producing better outcomes.

STAR (Support Team Assisted Response) in Denver launched in 2020 and has handled thousands of calls with zero arrests and zero use-of-force incidents.

Similar programs are now operating in San Francisco, Seattle, Los Angeles, Oakland, Austin, Albuquerque, Atlanta, and 60+ other cities. The model has been adopted bipartisan in cities with significantly different politics, because the outcomes (lower costs, better outcomes for people in crisis) hold across contexts.

Where to learn more

• The model: Vera Institute: CAHOOTS
• A growing database: Vera Institute: Behavioral Health Crisis Alternatives
• A practitioner network: Transform911
• Adjacent recipes: [Resilience Hub](./resilience-hub.md), [Peacemaking Circles](../08-healing-and-conflict/peacemaking-circles.md), [Creative Interventions](../08-healing-and-conflict/creative-interventions.md)

Details

• steps: **Map the existing landscape.** What does your city do today? Are 911 calls routed to police automatically? Is there any crisis line that isn't 911?, **Find allies.** Public defenders, social workers, mental health advocates, faith communities, racial justice organizations. They are often already organizing on this., **Build the case.** Most cities respond to data and case studies. CAHOOTS, STAR, and others have published detailed outcomes. Use them., **Pitch a pilot.** A defined neighborhood, a defined time window, a defined set of call types. Smaller pilots build the evidence and the constituency for citywide programs., **Demand community involvement.** Implementation matters. Programs designed without community leadership often default to lighter versions of the same approach. Push for civilian governance and community advisory boards from the start. ### If you're standing up a program, **Partner with city and county.** The strongest programs have city or county financial support and 911 dispatch integration. Free-standing community programs without dispatch integration can do useful work but operate at smaller scale., **Recruit and train staff.** Look for paramedics, EMTs, mental health practitioners, peer support specialists, social workers. Training includes mental health first aid, de-escalation, harm reduction, trauma-informed care, and cultural competency., **Decide on dispatch.** Programs vary: some are dispatched by 911, some by their own line, some by hospitals and community calls., **Equip the teams.** Vehicles, communication, basic medical kits. No weapons., **Build the referral network.** A response team can de-escalate a moment but cannot solve underlying issues. Strong programs have warm handoffs to mental health services, substance use treatment, housing programs, food access, and other social services., **Measure and report.** Outcomes that matter: response times, de-escalation rates, transport to care vs. arrest, follow-up engagement. Transparency builds the constituency.
• file path: recipes/07-resilience/community-safety.md
• variations: **Co-responder model.** A clinician rides with a police officer. Slower to deploy but lower political resistance in some cities. **Community ambassador.** Less formal, focused on welfare checks and connection rather than crisis response. Often used for homelessness outreach. **24/7 vs. limited hours.** Most programs start with limited hours and expand. CAHOOTS in Eugene is now 24/7. **Community-led variant.** Some programs are entirely community-led without city integration. Lower scale; high credibility in the communities they serve.
• ingredients: {"time":"6 to 12 months of planning. 4 to 8 weeks of training. Ongoing 24/7 or expanding hours.","space":"Mobile response (vans). A dispatch center. An office for coordination.","people":"Medics or paramedics, crisis counselors, dispatchers, coordinators. Community members from the served areas in leadership roles.","skills":"Mental health first aid, de-escalation, medical response, trauma-informed care, community knowledge, cultural competency.","materials":"Mobile response vehicles. De-escalation and basic medical equipment. Communication systems. Training curricula. Connection-to-services materials.","energy_level":"High. Trained teams on call."}
• where to learn more: - The model: [Vera Institute: CAHOOTS](https://www.vera.org/behavioral-health-crisis-alternatives/cahoots) - A growing database: [Vera Institute: Behavioral Health Crisis Alternatives](https://www.vera.org/behavioral-health-crisis-alternatives) - A practitioner network: [Transform911](https://transform911.org/) - Adjacent recipes: [Resilience Hub](./resilience-hub.md), [Peacemaking Circles](../08-healing-and-conflict/peacemaking-circles.md), [Creative Interventions](../08-healing-and-conflict/creative-interventions.md)
• stories from neighborhoods: **CAHOOTS (Crisis Assistance Helping Out on the Streets)** in Eugene, Oregon has operated since 1989. It is integrated with 911 dispatch and handles roughly 24,000 calls per year. It saves the city an estimated $14 million annually in police and ambulance costs while producing better outcomes. **STAR (Support Team Assisted Response)** in Denver launched in 2020 and has handled thousands of calls with zero arrests and zero use-of-force incidents. **Similar programs** are now operating in San Francisco, Seattle, Los Angeles, Oakland, Austin, Albuquerque, Atlanta, and 60+ other cities. The model has been adopted bipartisan in cities with significantly different politics, because the outcomes (lower costs, better outcomes for people in crisis) hold across contexts.