When people with mental illness or behavioral health disorders face a crisis, traditional emergency responses often escalate the situation. In Oakland, the need for community-based crisis response is especially urgent. Nearly 1 in 4 people shot by police in the U.S. are experiencing a mental or behavioral health episode, and 67% of these encounters are fatal. With Oakland’s high homelessness rates intersecting with mental health challenges, alternative crisis responses are more important than ever.

Shaping MACRO: A New Framework

Community advocates pushed leaders reconsider how it responds to crises involving mental illness, homelessness, and addiction. They called for the City of Oakland to implement a community-based crisis response system inspired by Eugene, Oregon’s Crisis Assistance Helping Out On the Streets (CAHOOTS) program. In response, Oakland funded a pilot program called Mobile Assistance Community Responders of Oakland (MACRO). Overseen by the Oakland Fire Department, MACRO addresses non-emergency, non-violent, and non-criminal situations by connecting individuals to essential community resources.

Jeweld Consulting helped the Fire Department shape and launch MACRO. We mapped alternative crisis programs across the region, hosted peer learning convenings, and created an advisory board to guide implementation. Additionally, we developed evaluation processes to track the program’s progress and impact.

MACRO’s Expanding Impact

Since launching in April 2022, MACRO responders have been dispatched over 17,500 times. Nearly 90% of those calls have involved individuals experiencing homelessness. The program’s success has sparked key expansions. In 2024, MACRO introduced a dedicated phone line, and there are plans to triple its staff size. Available seven days a week for 15 hours a day, MACRO reduces emergency responses by police and fire departments while boosting access to vital community-based care and services.