Timeline of First Responder history and the birth Crisis Response Programs

London Metropolitan Police Dept. founded. Source

The sinking of the Titanic highlights the need for disaster and emergency communications that did not exist. Read more.

1829

1850s

1912

Chicago and Boston PDs begin issuing uniforms to their officers. Source

August Volmer founds first Police Academy in Berkely, CA, ushering in era of police "professionalism." Read more.

1949

1908

National Institute of Mental Health is founded, providing funding for research and treatment. Source

The National Association of Fire Chiefs expressed their desire for a single number to report fires. Source

1954

1957

First antipsychotic drugs are introduced, increasing the popularity of "self-management" amongst individuals with mental illness. This coincides with shifting public opinion and awareness of inhumane treatment in state run psychiatric facilities. Source

Peak of "institutionalization" - populations in state psychiatric hospitals reach their peak of 560k patients in this year. Source

Pior to

late 1960s

1955

Police departments + funeral homes served as first responders - offering transportation with no emergency assistance or medical training. Source

Freedom House Ambulance Service established in Pittsburg to aid the Black neighborhood of Hill District. Source

1963

1967

1968

JFK introduces Community Mental Health Centers Act, with an aim of "deinstitutionalizing" 50% of the population of psychiatric hospitals - ultimately leads to 90% decrease in population. Services are transferred from state run institutions to federally funded community programs, which is seen as a shift of services from psychiatrists to general counselors. Source

The Johnson Commission on Law Enforcement issued a report that recommended a single number for people to call to reach police departments. Source

The first 911 call is officially placed by Alabama Senator Rankin Fite. Prior to this, callers reporting an emergency were to dial 0 for an operator. From its inception, 911 has been a localized service under state jurisdiction in which calls are directed to Public Safety Answering Points (PSAPs). Source

Mid-1970s

Enhanced 911 is developed to automatically share call location details with 911 dispatchers. Source

CAHOOTS Established In Eugene, OR

White Bird Clinic (established in the late 1960s) formed a formal partnership with the City of Eugene and began the CAHOOTS program (Crisis Assistance Helping Out on the Streets). The crisis assistance service has served as a model for other cities across the nation. Calls came through 911 or the city's nonemergency number, and a CAHOOTS team of one medic and one crisis worker were dispatched together. The program operated 7 days a week for 12 hours a day. Source

The Public Safety Act designates 911 as the national emergency number. Source

CRU In Olympia, WA

Olympia modeled their Crisis Response Unit (CRU) after the Eugene CAHOOTS Program. As of 2021, the program has 3 different sections: a mobile unit, a downtown walking unit, and a "Familiar Faces" unit that is comprised of peer specialists. The program is fully integrated within the police department, and mobile CRU services are provided from 7am-2am daily. CRU is funded through a tax levy and grants, with some contributions from the city. Source

Minneapolis City Council Recommendations

City Council adopted the Transforming Community Safety Resolution in June to start developing a tailored alternative response program for Minneapolis. By September, a Department of Public Health and Safety Committee was established to work specifically on this issue. Source

MCRT Program Established in San Diego, CA

San Diego piloted its program in an effort to provide alternatives to law enforcement for people facing mental health and substance abuse issues. Mobile Crisis Response Teams (MCRT) are available 24/7 and are made up of 3 responders - 1 mental health clinician, 1 case manager, and 1 peer support specialist. This service is available through San Diego Access and Crisis Line. The county has contracts with Exodus Recovery and Telecare Corp to staff and fund the program. Source

B-HEARD Program Established in NYC, NY

The Behavioral Health Emergency Assistance Response Division (B-HEARD) began as a pilot program is select neighborhoods of Harlem and has since been expanded to service much of the city. The program operates 16 hours a day (9am to 1am) and dispatches 2 EMTs and 1 mental health professional when responding to 911 calls. The program exists through partnerships between FDNY, the Department of Health, NYPD, and the mayor's office of community mental health. Source

CARE Program Established in Chicago, IL

The Crisis Assistance Response and Engagement Program in Chicago is available Monday through Friday from 10:30am-4pm in select neighborhoods. 911 dispatches a Mental Health Crisis Clinician and an EMT as responders. The Chicago Department of Public Health oversees the programs and partners with the mayors office and the Office of Emergency Management and Communications. Source


CRT Program Established at Cornell University

The CRT program works a Monday-Saturday schedule and is housed under the Division of Public Safety established in spring of 2022 to encompasses all of Cornell's emergency services. The CRT program provides necessary services for all faculty, staff, students, and persons on the Cornell main campus. The CRT team can be reached through the Cornell Public Safety Communications Center number. Source

1975

1989

Freedom House Ambulance Service shut down by Pittsburg, which established their own EMT service. Freedom House Paramedics were not granted positions in this new service. Source

"Memphis Model" of CIT (Crisis Intervention training created in collaboration between University of Memphis, Memphis PD, and NAMI. Source

1997

1999

2017

2019

May 2020

June-Aug

2020

June

2020

January

2021

February

2021

June 

2021

July 

2021

September 

2021

October 

2021

1988

Section 1033 Established. Part of the National Defense Authorization Act, this section established the transfer of excess military equipment to police departments and school districts. Source

MCAT in Indianapolis, IN

The Mobile Crisis Assistance Team (MCAT) was piloted with the goal of addressing incarceration rates for those suffering from mental illness. The 3 person response team consists of 1 police officer, 1 paramedic, and 1 licensed mental health professional. MCAT operates Monday-Friday in rotating shifts. Under the Office of Public Health and Safety, Indianapolis now offers a program called Clinician Led Community Response that operates 24/7 in certain areas of the city. 911 dispatches a team of 1 clinician and 1 peer support specialist in partnership with Stepping Stones Therapy Center. MCAT is funded through the Substance Abuse and Mental Health Services Administration budget. Source

George Floyd Murdered by Minneapolis Police

Cornell University Campus Safety Recommendations

Former president of Cornell Martha Pollack called for the Public Safety Advisory Committee (PSAC) to formulate a report of recommendations for how Cornell could improve its campus safety measures. They called for a restructuring of public safety and suggested the formation of an alternative response team to be fully operational within two years of the issue date of the report, which was July 2021. Source

LA County Department of Mental Health Hiring Campaign

LA County found itself facing a staffing crisis, specifically when it came to the expanding ACR program. The department launched its campaign "Do Worthwhile Work" to highlight the incentives of becoming a mental health worker and specifically working in the LACDMH. The campaign was successful at achieving its staffing goals and engagement, according to a study done by the RAND Corporation. Source

STAR Program Established in Denver, CO

Denver established a pilot STAR program (Support Team Assisted Response), that was expanded by 2021. The programs runs 7 days a week from 6am-10pm with the goal of expanding to 24/7 capacity by 2025. STAR partners with WellPower who staffs the trained professionals on call. In response to 911 calls, 1 paramedic and 1 behavioral health clinician are dispatched to respond to a calls in street clothes. The program is funded by the Caring for Denver Foundation that was passed through a ballot initiative in 2018. Source

PSR Program Established in Portland, OR

As a result of community partnership and advocacy, Portland launched the Portland Street Response (PSR) team. Responders answer calls in groups of 2 or 3, comprised of a community EMT, a licensed mental health crisis responder, and a peer support specialist. PSR is specifically designed to support the unhoused populations having mental health challenges. The program responds to calls 7 days a week from 8am to 10pm. PSR teams are now allowed to provide transport services themselves as well as enter public unlocked indoor spaces to respond to calls. PSR has faced numerous funding challenges through its infancy stage. Source

CSG Justice Center Presents "Taking the Call:" National Conference exploring community responder models

CSG Justice Center partnered with the U.S. Department of Justice’s Bureau of Justice Assistance and Office of Justice Programs and the University of Cincinnati to present this virtual conference on community response programs. It was free and open to the public and featured keynote remarks from former Attorney General Merrick Garland. Source

San Diego Announces MCRT Communication Campaign

After early success from MCRT, San Diego embarked on a communication campaign to promote the program. The campaign was split into 2 phases - a general campaign rollout and a targeted campaign. The campaign included billboard ads, radio ads, op-eds in local papers by members of the Behavioral Health Services. Source

CR Program Established in Minneapolis, MN

The Minneapolis Behavioral Crisis Response (BCR) program is operated by Canopy Roots, a black-owned non-profit that dispatches teams of 2 mental health professionals to respond to 911 calls. In the city of Minneapolis, BCR is now one of the 4 emergency response units and operates 24/7, with 3 vans servicing the city and a staff of 20 full time responders. The BCR is funded by the city budget and collaborates with the Minneapolis Office of Community Safety. Source

Ithaca Reimagining Public Safety Working Group Releases Report

In March of 2021, an executive order from NY Governor Cuomo calling for city governments to reform their public safety mechanism led Ithaca to develop a working group to compile a report on possible reform measures for the police department. The report was released a year later and suggested the creation of a Division of Community Solutions to house the armed police responders as well as a new team of unarmed community responders. Source

Minneapolis Reimagining Public Safety Campaign

In April 2021, the NYU School of Law Policing Project released a report on the results of a working group meeting of community leaders in Minneapolis in which two of the "priority solutions" identified for addressing police violence were using social media as a catalyst for good and using technology as a vehicle for capturing experiences. The City of Minneapolis formed a partnership with the graphic design company Juice House to launch the Reimagining Public Safety Campaign to bring attention to the unarmed crisis response programs the city of Minneapolis offers. The campaign featured the hashtag #IAMMPLS across social media and was comprised of social media posts, a video series, and large posters in prominent locations across the city. Source

December 

2021

February 

2022

March 

2022

July

2022

September 

2023

LACDMH Launches "Who Do I Call For Help?" Campaign

This campaign was designed for citizens to become aware of who to call given the nature of their emergency or need for services. The campaign included bookmarks, magnets, posters, and wallet cards and were distributed to community partners and across government agencies. Source

June 

2024

March 

2025

LACDMH ACR Awareness Campaign

In an effort to raise awareness about the ACR and FIT programs, IDEO was contracted for a design campaign across social media, buses, metro stations, TV and radio, and the LACDMH website landing page for ACR. Additionally, they created videos to highlight and introduce many of the team members who work for the ACR program. In the first month of the campaign, IDEO recorded a 16% increase in calls to the ACR helpline. Source

CAHOOTS Reduces Service

On April 7, 2025, White Bird Clinic announced that after over 30 years of service to the community, CAHOOTS would no longer run in the city of Eugene due to funding concerns. In 2023, the program was moved under the jurisdiction of the fire department, which faced serious budgetary cuts this year. The administration at White Bird warned that if the fire department budget was cut, the clinic would not be able to support CAHOOTS services through its own funding. Source

April 

2025

History of First Responder Programs 

The modern system of emergency response integral to public safety today has a relatively short history in the United States. 911 was first designated as a universal emergency number by AT&T in 1968, following nearly a decade of advocacy by the National Association of Fire Chiefs that culminated in a supportive report issued by President Johnson’s Commission on Law Enforcement and Administration (Industry Council, n.d.). Before this shift, the burden of emergency calls was placed on telephone operators, who were not adequately trained for this task. After 1968, 911 was established as a service under state control, but administered locally by telephone companies. The localized nature of 911 remains an important feature, allowing for adaptation and area-specific knowledge to influence practices (Industry Council, n.d.). 

Universal 911 and EMT services progressed concurrently, furthered by calls for reform from inadequate first response and emergency care (Industrial Council, n.d.).  

The modern emergency response system came to fruition in the 1960s and 70s. 

As calls for universal 911 heightened in the 50s and 60s, so did those for the expansion of EMS services. Without an organized system of first response, police, firefighters, and even funeral homes transported people to hospitals (National EMS, 2021). The infamous police “swoop and scoop,” method of first response was conducted by officers with rudimentary medical training who often left patients unattended in the back of patrol cars (Yang, 2021, p. 1083). In 1972, the Ambulance Association of America estimated as many as 25,000 people annually may have been permanently disabled due to the inadequate training of first responders (National EMS, 2021). Significant change began in 1966 when a landmark white paper highlighted the “neglected disease” of traffic accidents and called for the development of a clear, consistent EMS system (Bucher & Zaidi, 2021). The Highway Safety Act, passed that same year, established the Department of Transportation and National Highway Safety Administration, agencies that created vital curriculum, education, and framework for EMS development. In 1973, The EMS Systems Act formally introduced hundreds of EMS networks across the country, and the years following saw broad expansion of EMS specific medical residency programs (Bucher & Zaidi, 2021).  

Today, EMS continues to grow and improve, utilizing technology like electronic charting for increased incorporation with hospital emergency departments (Bucher & Zaidi, 2021). 911 too seeks to improve quality and efficiency of response through “any networked communication device” while mitigating cyber security concerns associated with increased inter-organizational data sharing (Industry Council, n.d., p. 10).  

The development of first responder services proves relevant to the current advancement of Crisis Response Programs, reflecting a pattern of police de-tasking. In response to police mistreatment, both EMS and Crisis Response Programs aim to divert certain police responsibilities to more qualified service providers. Ultimately, the relatively short history of both universal 911 and EMS serves as evidence for the possibility, necessity and efficacy of implementing new public safety services.   

The growth of first responder services reflects a process of police de-tasking that continues today within Crisis Response Programs.