Program Self-Definition and Purpose

Across our interviews, crisis response programs define themselves primarily through their relationship to traditional emergency services and their institutional housing. CARE positions itself as a direct alternative to police response for mental health calls, with Amy Barden emphasizing, “I’m replacing police” and noting that “80% of the 900,000 [911 calls] a year have nothing to do with law enforcement.” This framing places CARE squarely as a public safety department addressing a systemic gap in emergency response. In contrast, MIH defines itself as an extension of fire department services, with Jon Ehrenfeld describing it as “explicitly designed around the operational needs and referrals of Seattle firefighters.” The CRT-SPD operates within the police department framework, focusing on high-risk situations, while CCORS and MRRCT define themselves primarily through population served—youth and adults respectively—rather than their relationship to emergency services. These institutional foundations profoundly shape each program’s approach, with police-housed CRT focusing on safety and risk assessment, while CCORS and MRRCT, housed within larger non-profit community service organizations (YMCA and SOUND), leverage their parent organizations’ therapeutic expertise and community connections to emphasize recovery and reintegration with ongoing services. Even UW CRT, which is still in the pre-launch planning stages, reflects its institutional housing – with Sally Clark emphasizing the use of data and research, including research tours of other university crisis response programs, in the development of their model.

The problems these programs aim to solve vary significantly based on their positioning. CARE and the MIH team focus on immediate crisis de-escalation and appropriate emergency response, addressing the problem of mismatched resources for behavioral health emergencies. Meanwhile, CCORS emphasizes longer-term stabilization, with Dianne Boyd highlighting the importance of the full “eight weeks of stabilization services” to address underlying family dynamics. Generally speaking, emergency service-embedded teams prioritize rapid response, safety protocols, and efficient handoffs, measuring success through response times and call volumes. In contrast, community-based programs emphasize relationship-building, cultural competency, and extended engagement periods, viewing crisis as an opportunity for systemic intervention rather than acute stabilization. This divide becomes particularly evident in staffing choices: emergency-aligned programs require professional credentials and background checks that may exclude those with lived experience, while community programs explicitly value peer support as fundamental to their effectiveness. MIH provides a notable exception – dually housed within Seattle Fire and the Human Services Department, their hiring emphasizes case management and shared lived experience rather than rapid clinical stabilization.

Finally, the institutional housing of programs (perhaps unsurprisingly) has a large influence on their orientation toward traditional police response. Programs housed within traditional emergency departments inevitably absorb that sector’s culture and terminology, speaking of “partnership” with law enforcement, while nonprofit-operated teams frame police involvement as a last resort, reflecting deeper philosophical differences about the nature of crisis intervention itself. 

Implications for Smart Decarceration

The institutional housing of crisis response programs creates divergent pathways for smart decarceration, with emergency service-embedded programs offering substantial immediate diversion potential but potentially perpetuating systemic limitations. Programs like CARE provide rapid decarceration benefits by intercepting 911 calls before law enforcement involvement. However, their adoption of traditional emergency frameworks—prioritizing rapid response over sustained engagement—may limit their ability to address root causes of crisis and prevent future system involvement. Community-based programs’ emphasis on extended stabilization, peer support, and therapeutic intervention offers deeper resolution of root causes, but their narrower scope and distance from 911 dispatch mean fewer individuals access these services at the point of crisis. The philosophical divide between programs viewing police as “partners” versus those seeing law enforcement as a “last resort” reveals fundamental tensions in how the system conceptualizes both crisis and appropriate response. For crisis response to succeed, Seattle needs both 1) programs that combine the accessibility of emergency-embedded services with the transformative potential of community-based approaches, and 2) much stronger coordination mechanisms that allow these distinct programs to leverage their respective strengths in service of keeping individuals out of the criminal justice system.

Relevant Quotations

“I’m replacing police. So, with 911 calls, about 80% of the 900,000 a year have nothing to do with law enforcement.” (Amy Barden, CARE)

“We are not a community resource and we are not a 988 resource. We are pretty much exclusively accessed through the 911 system and specifically the fire side of the 911 system.” (Jon Ehrenfeld, MIH)

“We are structured as a fire based mobile integrated health co-responder team. We are a collaborative between fire department and the human services department.” (Jon Ehrenfeld, MIH)

“I really want to professionalize the community responder workforce. I want it to be a good professional ambition where you can work for 20 or 30 years and then retire the same as you would in police and fire.” (Amy Barden, CARE)

“Our program meets with them at least weekly. Sometimes it’s more often than that… We’re going through a major change at the present time… CCORS is going to be the main responder for children throughout King County.” (Jamie, CCORS)

“We don’t have any special MOUs or contracts with anybody out there specifically… a lot of our follow-up is focused on service connection, whatever that service connection needs to be.” (Zee Andrignis, CRT-SPD)

“I think in a perfect world what you would’ve done… you’ve got case managers, you’ve got clinical workers going out with fire. To me, what would’ve made more sense is scaling those teams and then starting to test for low acuity calls.” (Amy Barden, CARE)

“The peers, certified specialists are the key because they’re the ones who bridge communication.” (Joe Vela, MRRCT)

“We are not the gap fillers, we’re just the bandaid to slap on in between… safety is always going to be one of our focuses.” (Zee Andrignis, CRT-SPD)

“Our stabilization services can be up to eight weeks… sometimes it’s much shorter depending on how quickly we can get things stable and connected.” (Dianne Boyd, CCORS)

“We’re still in that growing and developmental stage.” (Joe Vela, MRRCT)