Big changes for lauded mental health crisis team

June 21, 2023

By Courtney Wise

Also today, learn about the relationship between psychedelics and a leading Rastafari community. And more.

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City moves CAHOOTS crisis response team from police to fire department

For more than thirty years, citizens of Eugene, Oregon have been served by Crisis Assistance Helping Out On The Streets, or CAHOOTS, a mobile crisis intervention program. Its efforts drew national attention, as reported by MindSite News, for reducing the number of mental health calls directed to police and saving the local government money. Since its founding in 1989, CAHOOTS has helped citizens in mental health crises in partnership with Eugene’s police department, taking both its budget and oversight from there. But earlier this year, officials moved CAHOOTS’ contract to the city’s fire department, Eugene Springfield Fire, with some citing a need to restructure and integrate city services. “It’s a new partnership,” CAHOOTS crisis worker and clinical supervision coordinator Michelle Perin told The Register-Guard. “It almost feels like what it must have been like in 1989. What is this relationship going to look like? How can we play together?”

Although pairing up with a fire department rather than armed police might seem ideal, CAHOOTS was apparently left out of the discussion about the change. Its leadership wants to hold onto its peer-based model, in which a mental health crisis worker and trained paramedic take calls together in a mobile van. “We stand absolutely behind it because holistically, mind, body and spirit matter,” Perin said.  Unfortunately, the peer-based model makes it harder to access federal funding since existing legislation favors programs driven by clinicians. “The academics and the regulatory bodies want it to look clinical,” said Perin. “Those who are doing the peer-supported lived-experience field work, the boots on the ground who’ve been around for 30 some years, we’re saying that that [clinical] model is not what’s needed.”

A third-party review by a consulting team recommended some changes to CAHOOTS, and Perin worries that the trend is to focus on mental health issues to the exclusion of social needs.. “If you’re not getting any sleep because you’re living on the street, because you’re having to survive, you’re hungry, you’re wet, you’re cold, you’re tired, and you throw in a pre-existing mental health condition, that is a deadly police encounter waiting to happen,” Perin said. “We are preventing things from getting out of control, being more expensive, having more deadly escalation encounters.”

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Want to know how much your locale received to fight the opioid epidemic? Search here

“Knowledge is power and, in this case, it’s the power to know how much money is available to be used to prevent overdoses,” Dennis Cauchon, president of Harm Reduction Ohio, said to NPR. He’s been on the search for how much money was sent to Ohio since April 2022. Billions in settlement funds are being distributed, with the national opioid settlements the second-largest public health settlement ever, topped only by the tobacco settlement of the 1990s. KFF Health News (formerly Kaiser Health News) just made those documents public so that people could track the settlement funds given out down to the penny.

“Opioid remediation work is done at the local level, at the individual level, and, now, for the first time, local people working on the issues will know how much money is available in their community,” said Cauchon.

The funds from drug makers whose marketing for opioid painkillers helped drive the crisis are intended to halt overdose crisis plaguing the nation. Funds haven’t been dispersed in their entirety, but BrownGreer PLC, a court-appointed firm responsible for overseeing the payments, says $3 billion has already been transferred to state and local governments across the country. Each state is charged with distributing monies across local jurisdictions; payments began last year and are slated to continue until 2038. KFF Health News, which discussed the distribution of funds with NPR and other outlets, is in the midst of an investigative project that will track how governments use the money for at least one year. It’s a herculean task since only 12 states have vowed to share how they spend 100 percent of settlement dollars. 

So far, the data coming out is tantalizing. For example, Louisville, Kentucky, received $860,657 to date, but Knox County, in rural Appalachia – described as that region’s “ground zero of the crisis” – received only $45,395. Addiction and public policy researcher Regina LaBelle said the public is key to finding solutions on how to spend the much needed dollars. To do that, though, knowing the amounts is critical. It wouldn’t make sense to advocate for a detox facility that costs $500,000 if your region only received $5,000, LaBelle said.

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In other news…

For the first time ever, the US Preventive Services Task Force has recommended that all adults under age 65 be routinely screened for anxiety and depression at their annual doctor’s exam. “Not everybody’s going to come in your office in a ball of nerves, shaking, having panic attacks,” Chivonna Childs, a staff psychologist at the Cleveland Clinic, told NBC News. “Most people don’t have any of that.” For that reason, experts say, it’s even more necessary to screen as a general rule. “When you screen someone you say, ‘OK, you have some of the symptoms that are consistent with anxiety. Let’s talk about that more in detail and see if you meet the criteria for this condition,” explained Gary Maslow, an associate professor of psychiatry and behavioral science at Duke University, who was not involved in the study. 

Scientists believe they’ve found out how Huntington’s Disease starts in the brain. They also say that they know how to stop it—in the lab, anyway. It’s exciting news that researchers hope will lead to breakthroughs in other degenerative brain diseases such as Alzheimer’s and Parkinson’s. Through trial and error, scientists told NPR they found that Huntington’s begins with a single molecule of PolyQ, a structurally unstable protein segment that becomes toxic in Huntington’s. They hope to take what they’ve learned and create a pharmaceutical treatment. “Ultimately, it only matters if we actually create a therapy,” said Randal Halfmann, a coauthor of the study. “Otherwise, it’s just academics.”

What exactly is mind-body therapy and how does it work? A couple of weeks ago, the NYT published a close look at the growth of somatic therapies, speaking with people who believe focusing on the physical body offers a pathway to heal the mind.

What’s the relationship between psychedelics and a leading Rastafari community? In a guest column for Lucid News, Firstman of the Rastafari Indigenous Village in Montego Bay, Jamaica wrote of the importance of “visionary plants” like ayahuasca and psilocybin, which the community employs for “celebration, enlightenment and gratitude.”

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If you or someone you know is in crisis or experiencing suicidal thoughts, call or text 988 to reach the 988 Suicide & Crisis Lifeline and connect in English or Spanish. If you’re a veteran press 1. If you’re deaf or hard of hearing dial 711, then 988. Services are free and available 24/7.

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