If individuals in Denver, Colorado, call 911 for a mental health crisis or substance use issue, they may be helped by a specialized civilian team rather than a police or fire department. This is thanks to the Support Team Assisted Response (STAR) Program, an alternative response approach to some calls that come through the city’s 911 system.

The Need for Nonpolice Response

The idea for STAR grew from another city program that paired a behavioral health clinician with a police officer to respond to mental health–related calls. “We knew that sometimes the presence of a police officer can trigger or exacerbate a mental health crisis,” said Program Administrator Evan Thompkins. “So, the idea started percolating: what if, in certain low-risk cases, we don’t need a police response at all?” The city decided to give it a try and in 2020 launched a pilot based on the popular Eugene, Oregon, Crisis Assistance Helping Out on the Streets (CAHOOTS) program. The pilot focused on nonviolent calls (as determined by 911 dispatchers) for issues such as intoxication, threats of suicide, welfare checks, indecent exposure, trespassing, and syringe disposal. It was a great success, and every year since then the program has expanded to meet the growing need for nonpolice responses to these types of calls. “In the first 6 months of the program, the STAR team responded to 748 calls,” Thompkins says. “By 2023, it was well over 6,000 per year.”

How the STAR Program Works

STAR is a partnership between Denver’s Department of Public Health and Environment, 911 call center, police, paramedics, and community partners, including WellPower, a community behavioral health agency that helps staff the STAR team, and Servicos de la Raza, an organization that provides culturally relevant wraparound services. For 16 hours a day, 7 days a week, eight 2-person teams are available to respond to STAR calls citywide in one of the program’s dedicated mobile crisis vans. Each team includes a behavioral health clinician and an emergency medical technician who provide onsite support in response to needs ranging from intoxication to homelessness. The team has connections to several community agencies to link people to services and resources that can provide them with support, including case management and residential services. “Because the team includes both an emergency medical technician and behavioral health provider, they can provide medical assessment and triage, along with crisis intervention and de-escalation, and importantly, transportation to locations such a shelter or other community resource,” Thompkins says. Around 80 percent of STAR calls are categorized as “mental health” concerns, and close to half of those served are experiencing homelessness. More than 40 percent of individuals served by STAR were referred for formal mental or substance use disorder treatment; 38 percent were immediately transported to a community resource.

A review of the 2020 pilot program found a 34 percent drop in nonviolent crime in Denver during the pilot period. Analysts found the greatest reductions in what was called “STAR-related offenses,” such as loitering, resisting arrest, and public fighting. Among the 748 calls responded to during the pilot, zero resulted in police involvement.