Hope Coleman’s greatest regret is dialing 911 when her 31-year-old son Terrence refused to come inside one cold October night in 2016.

Terrence Coleman suffered from schizophrenia, so Hope called his therapist, who recommended he be evaluated at Tufts Medical Center. Coleman called 911, explained his condition to an operator, and asked for an ambulance. Minutes later, Boston police officer Garrett Boyle arrived and wound up shooting Terrence several times in her foyer. Terrence died later that day.

“I suffer every day, every minute because of that 911 call. I feel so bad that I dialed the help for my son, which turned into ... I don’t have my son,” she told GBH News.

For years, advocates and municipalities have tried to figure out whether rerouting 911 calls to mental health clinicians, social workers and even volunteers might be the answer to these tragedies. State Rep. Lindsay Sabadosa and Sen. Sonia Chang-Díaz decided to put that idea into action, introducing legislation in January that would establish a grant program for communities to fund unarmed alternatives to the traditional 911 system.

An Act to Create Alternatives for Community Emergency Services, or the ACES Act, would be initially funded through federal pandemic relief money, and cover 80% of grants for the first three years after it launches.

Under the ACES Act, local governments and community-based organizations could get funds to develop systems that reduce “government use of force, in emergency and non-emergency situations that do not necessitate the presence of law enforcement personnel,” and provide another option if a caller asked for a response other than law enforcement in their 911 call.

Chang-Díaz mentioned Coleman and said his death and the guilt Hope Coleman carries for dialing 911 are something no parent should have to deal with.

“The reasons why for this bill are threefold,” Chang-Díaz told GBH News. “I think it’s going to save lives. It’s going to save dollars. And it’s going to provide critical services to people in need.”

It’s also a matter of mental and racial justice, she said. Terrence Coleman was Black and living with mental illness, and he isn’t alone. One in four people shot and killed by police display a symptom of mental illness at the time of the encounter, Chang-Díaz said.

Rethinking 911 calls

Sabadosa said the way 911 is structured allows emergencies to be “dumped on” police departments. Many communities have started a “co-response” model over the years, which pairs up law enforcement with clinicians to respond to calls for service involving someone who has a mental health issue.

The Northampton legislator said the ACES Act rejects that model, and instead looks to send crisis response teams that don’t include law enforcement.

“If you have a co-response, the culture is really for the police to respond first and the social worker to be there as backup,” she said. “We’re looking for something else instead, whether it’s the social worker, the behavioral health of the peer response model that is leading the scene and working to make sure that everybody is secure and safe.”

“The ACES Act calls for something a little bit different,” said Rebekah Gewirtz, executive director at the Massachusetts chapter of the National Association of Social Workers, which spearheaded the bill. “The community-based organizations and municipalities working closely together to create a program versus community-based organizations and police departments creating a program. So, it's an important distinction.”

A program run out of Eugene, Oregon is considered the model of how communities can reconceive 911 response.

Crisis Assistance Helping Out On The Streets, or CAHOOTS, is a crisis intervention team staffed by White Bird Clinic, a mental health service provider, and uses the City of Eugene’s vehicles. Since 1989, the program has provided support to the Eugene Police Department by deploying medics and crisis teams to handle social service–type 911 calls.

CAHOOTS currently employs 35 van workers, working on 12-hour shifts, and has a $2.1 million annual budget. CAHOOTS personnel often transport people who are intoxicated, mentally ill or disoriented, or help people to non-emergency medical care. Law enforcement doesn’t join them on the vast majority of dispatches.

“The police bring an immense amount of trauma for people who are living on the streets or dealing with compounding issues of mental health, experience being incarcerated, arrested, who are generally poor, working class, or unhoused,” said Rory Elliott, a communications staffer for CAHOOTS.

CAHOOTS staff can carry a police radio dialed to a special channel if they need to ask for help. They’re paid between $18 to $25 an hour — more for overnight shifts. Funding comes from the city through the police department.

"If you have a co-response, the culture is really for the police to respond first and the social worker to be there as backup. ... We're looking for something else instead."
Lindsay Sabadosa, Massachusetts state representative

The need for the service has grown. In 2014, CAHOOTS handled 9,646 service calls. That number climbed to over 24,000 in 2019.

The program diverts 5-8% of calls from police. According to a Vera Institute study of the program, of the 24,000 CAHOOTS service calls, only 311 — just over 1% — required police backup.

Elliott cautioned that the CAHOOTS model is not a “one-size-fits-all” solution. Eugene has a medium-sized population of 168,000, and CAHOOTS has a uniquely long relationship with the community. But parts of the model, she said, can be replicated.

“I think the fundamental element of having a mobile crisis response team with an EMT, healthcare and mental healthcare worker is a phenomenal project for any city to embark on,” she said.

Cities test new strategies

Since the Terrence Coleman killing, Boston City Councilors have called for change. When City Councilor at-large Michelle Wu introduced her idea for a non-police 911 agency in 2020, she mentioned the shooting. “Terrence Coleman was killed in an officer-involved shooting when his mother just wanted her son, who lived with mental illness, to get inside from the cold.”

Cities across Massachusetts have already begun experimenting with co-response programs. Boston launched its own co-response program in 2011, and the city is looking to pilot an alternate response program under a program launched by former acting Mayor Kim Janey in August. Framingham’s co-response program has been operational for nearly two decades with a nonprofit partner.

But communities are now eyeing separate response systems that don’t include the police, and the ACES Act would fund exactly that type of effort.

In Cambridge, nonprofit Cambridge HEART and the Cambridge City Council agreed to work on improving the city’s emergency response system. HEART wants a program that would provide non-violent public and private emergency response by trained community members.

“We hope to continue conversations with the city about which calls will be allocated to HEART,” said Sara Suzuki, development coordinator at HEART. “It is critical that community members can reach HEART through calling 911, as well as directly reach us on our own line.”

The nonprofit is hoping for a CAHOOTS-style program, which would be funded by the city’s FY22 budget. The idea is to reroute 911 calls to HEART members for nonviolent incidences — like wellness checks, public intoxication, family disputes, rowdy groups of teens, and noise complaints.

In Western Massachusetts, Northampton recently launched the Department of Community Care with funding from its city council, and a state budget appropriation. The plan is to create a peer-led team of unarmed responders to deal with nonviolent calls, which the city aims to launch in the summer.

“We have a lot ahead of us,” said Sean Donovan, the department’s first director. Donovan said the city is working with consultants to “help us figure out what type of staffing we need. How integrated into dispatch we're going to be.” He said the city is also considering whether to set up a system separate from 911 to dispatch community care teams.

“There’s a desire for a team in our city that can respond to particular calls that qualify as so-called mental health, to have a different response. But what gets called mental health includes a whole range of different calls and different experiences,” Donovan said.

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Hope Coleman says calling 911 to get help for her son Terrence is her greatest regret.
Courtesy of Coleman family

Dominique Price-Conley says having police respond to mental health calls is a particular concern for Black and brown families. The social worker was at a Dorchester birthday party a few years ago when her cousin, an African American male, had a mental health episode.

“What I knew about the police was, all these identifiers in terms of his identity can potentially place him in harm and not only harm him, but it can also harm and weaponize the family as well,” she said.

In the end, the family didn’t call 911, and Price-Conley used her professional knowledge to defuse the situation. She wondered what would have happened if she couldn’t handle the situation, and why Black people must face these issues in silos.

Hope Coleman says she tries to remember Terrence at his best: his quiet kindness when giving away his new bicycle to someone who needed it, filling up a bag with CDs to hand out to friends or listening to 50 Cent with her. She wishes something like CAHOOTS had been implemented before her son died.

“Anything but the police showing up. Because people with schizophrenic paranoia don’t need to see no police or police lights when they’re in a situation,” she said.