In 2021, former Chicago Mayor Lori Lightfoot launched a pilot program called Crisis Assistance Response and Engagement (CARE) aimed at integrating mental health professionals into the city’s emergency response system. Designed as a co-responder model, CARE combined the efforts of Chicago police officers, mental health clinicians, and Chicago Fire Department paramedics to respond to 911 calls involving individuals experiencing psychiatric crises or related conditions such as severe depression, schizophrenia, bipolar disorder, or substance abuse. The program sought to provide appropriate, compassionate crisis intervention while maintaining coordination within the broader public safety framework.

However, significant changes occurred after Mayor Brandon Johnson took office in 2023. During his campaign, Johnson criticized the co-responder approach, and once in office, he transformed CARE from a collaborative effort into a program operated solely by the Chicago Department of Public Health (CDPH). This restructuring removed police officers from field responses, leaving clinicians and emergency medical technicians (EMTs) to respond independently without law enforcement involvement. Johnson’s administration framed the shift as moving CARE toward a pure public health model, rather than an integrated public safety response.

Since the transition, CARE’s activity has declined sharply. Data obtained by reporters revealed that CARE responses peaked at 773 during 2023 but fell to 239 in 2024—coinciding with the program’s redesign. The city has also restricted public access to program data, replacing a detailed dashboard with a single data point, limiting transparency. Additionally, CARE lost access to police dispatch terminals, operates with limited staffing, and functions only on weekdays from 10 a.m. to 4:30 p.m., a schedule critics argue fails to address mental health emergencies that occur around the clock. Interagency conflicts have reportedly compounded these operational challenges.

An independent analysis by the University of Chicago Health Lab offers a different perspective on the original pilot. While acknowledging some difficulties, the evaluators found that both the Chicago Police Department and Fire Department were engaged and supportive partners in the co-responder model. The Health Lab report recommended enhancing coordination among CDPH, Chicago police, fire departments, and emergency dispatch, rather than separating CARE from public safety agencies altogether. It advocated for better governance, integrated dispatching, and improved staffing to strengthen the program.

Critics of Johnson’s changes contend that his reduction in coordination reflects an ideologically driven mistrust of police that ultimately undermines service quality for residents. Some point to Denver’s approach as an example of successful integration, where civilian STAR teams operate within the health department alongside police co-responder teams as part of the city’s unified 911 emergency response system.

The Johnson administration says it is developing additional ways to route mental health calls to CARE and plans to introduce a second evening shift by October. Still, questions remain about why CARE has not been more deeply embedded within Chicago’s existing emergency response infrastructure. Alderman Andre Vásquez, co-chair of the Progressive Caucus, emphasized the need for a model that treats mental health crises as 24/7 emergencies requiring comprehensive public safety collaboration. As Chicago continues to refine its crisis intervention strategies, the debate centers on how best to balance public health expertise with coordinated emergency response to effectively serve those in crisis.