The Emergency Services Patrol (ESP) team, in the Behavioral Health and Recovery Division, is one of DCHS’ direct service teams. 24 hours a day, 365 days a year, the team patrols in and around downtown Seattle, looking out for people in crisis. To learn more about their work, the team’s history, and what’s ahead, we sat down with the ESP team.
At any moment, you can find the Emergency Services Patrol (ESP) team out in community. Whether on regular patrol or responding to calls from law enforcement or local hospitals, they’re constantly on the lookout for people in crisis in and around downtown Seattle.
While crisis can mean many things, often they interact with people suffering from substance use disorders. Sometimes, this looks like checking in and building a relationship with people they see frequently. Other times, they might give someone a ride to a treatment center, a shelter, or a local hospital.
The team is carrying out a 50-year legacy of looking out for our community. In 1975, Dutch Shisler, a DCHS employee who had suffered from alcoholism himself, saw a need to support people in a drug or alcohol-related crisis. He secured a station wagon – the county’s first detox van – and did his rounds, checking in on people and providing transportation to critical services.
Fifty years later, the team and the county have seen significant changes. The crises, and the people experiencing them, are still there, but things look different.
One change is that in the wake of the COVID-19 pandemic, community partners are under more strain than ever before. Where before some providers could take people in any time of day, now there’s often a line first thing in the morning to access services, limiting the providers’ capacity to take in people being transported by ESP.
The most challenging change has been the shift from serving people primarily suffering from chronic alcoholism, to now serving people suffering from opioid use disorder. The needs have changed, and the ESP team has found that people in behavioral health crisis are at times more hesitant to engage with them. Relationship building, one of the team’s most important goals, takes more time, as the team works to understand what people need and how they can meet those needs.
In 50 years, the team has grown, as has the number of people they interact with. In 2025, the ESP engaged with people 37,407 times – averaging over 100 times a day. Of these, nearly a quarter were transported to receive treatment somewhere.
In the midst of all these changes, the ESP team is quick to point out reasons for hope. Just last year, King County purchased the site for a future, permanent sobering center in SODO, which will provide a safe space for people to sleep off the effects of acute alcohol or drug intoxication or opiate overdose. The center is expected to open in 2027.
In the past year, more treatment centers have come online, including the ORCA Center and the STAR Center. These facilities, part of DCHS’ larger efforts to expand Crisis Services, are critical partners for the ESP, and allow them to ensure they have a safe place to transport people to. In the next two years, DCHS will also open a Crisis Care Center on First Hill in Seattle, a place where anyone can walk in anytime for any kind of mental health or substance use care. ESP will be able to take people there for treatment as well.
Another positive change is that over the last two years, they’ve seen the need for overdose reversals dramatically decline. In 2024, they administered 23 overdose reversals (all successfully, thankfully), and in 2025, that number dropped to 12 (all successful, again). So far in 2026, that number is zero. Many factors have supported this decline, including more accessible medications for opioid use disorder and overdose reversal.
While the team and the county have changed significantly over 50 years, the ESP team’s mission is fundamentally the same. As members of the ESP team reflected, “What we try to remember is that we have an opportunity to make a difference with every person we interact with. We might not be able to with everyone, but the opportunity is always there.”
