"We have to find a sliver of something to give her some hope that there’s help out here." This sentiment encapsulates Baltimore’s transformative approach to public safety, shifting from punitive measures to compassionate, community-centered crisis intervention, particularly for those facing mental health and addiction challenges.
Baltimore is pioneering a significant expansion of its emergency response system, moving beyond traditional police intervention to address a wider spectrum of community crises. Leveraging substantial funds from opioid-related legal settlements, the city is developing a robust, 24/7 service designed to provide specialized assistance when law enforcement is not the most appropriate or effective response. This initiative aims to connect individuals in distress with the right resources, thereby reducing unnecessary arrests, mitigating trauma, and fostering long-term solutions for complex social issues. The program builds upon the success of existing mobile crisis teams, demonstrating a commitment to a more holistic and effective model of public safety and community well-being.
The urgency for such a paradigm shift was underscored by the experience of a 38-year-old woman, who, in March, found herself in a McDonald’s parking lot, sobbing uncontrollably and contemplating self-harm. Her call to the police, born out of desperation, led to an arrest rather than the mental health support she desperately needed. The woman, who requested anonymity to speak openly about her struggles, recounted a harrowing experience where her attempt to seek hospital care for her mental health distress was thwarted by an expired car registration, resulting in her being pulled over and subsequently arrested for erratic behavior. Instead of receiving medical attention, she found herself in a cold jail cell, unable to access basic necessities.
Her situation is far from isolated. Dispatchers at Baltimore’s 911 center increasingly recognize that a significant number of calls do not necessitate a police response. These calls often involve individuals grappling with homelessness, confusion in public spaces, or behavioral disturbances that are symptomatic of underlying mental health or substance use issues. Tahir Duckett, an expert in community safety at Georgetown Law, highlights that these situations "don’t require a badge, a gun, and handcuffs to resolve." The current model, however, frequently defaults to law enforcement, leading to outcomes that can be detrimental, including unnecessary arrests and further trauma for vulnerable individuals.
Baltimore’s existing mobile crisis teams, overseen by Behavioral Health System Baltimore, have for years acted as a crucial diversion mechanism, connecting individuals in acute mental health crises with clinicians and peer counselors. These teams offer a vital alternative to police responses, providing a more empathetic and effective initial point of contact. However, their scope has traditionally been limited to specific mental health emergencies. The new initiative seeks to broaden this scope significantly, leveraging approximately $400 million in opioid-related legal settlements to create a comprehensive, round-the-clock service capable of responding to a wider array of non-violent crises.
The city logged a substantial 1.68 million calls to 911 in 2024. According to Duckett, tens of thousands of these calls did not require traditional emergency services like police, firefighters, or EMTs. These might include calls about a homeless person sleeping in a store, an individual appearing disoriented in a park, or someone exhibiting disruptive behavior on the street. The current system’s tendency to dispatch police to such situations can inadvertently criminalize individuals who are primarily in need of social services, healthcare, or other forms of support.
A recent study in Durham, North Carolina, provides compelling evidence for the efficacy of non-law enforcement crisis response. When a civilian team responded to 911 calls, it resulted in fewer arrests compared to police responses, particularly for Black individuals, men, and those aged 25-39. This suggests that police interventions can disproportionately impact certain demographics and may not always yield the most constructive outcomes. Duckett emphasizes that police responses can inflict trauma and may be less effective than a dedicated community service approach. The fundamental principle behind Baltimore’s expanded crisis response is to identify individuals’ needs and connect them with appropriate resources, thereby preventing escalation and incarceration.
Baltimore’s efforts to enhance crisis response are intertwined with its broader strategy to address public health challenges, particularly the opioid epidemic. From 2021 to 2025, the city experienced a significant decrease in its homicide rate, a positive trend in violence reduction. However, this period also coincided with a national record in drug overdose deaths, with approximately 1,000 residents succumbing to overdoses annually between 2020 and 2023.
In 2018, Baltimore strategically opted out of a global settlement with opioid manufacturers and distributors, choosing instead to pursue its own litigation. The resulting settlement awards have been earmarked for addressing drug-related harms and supporting preventative services, including housing assistance, healthcare, and education. One tangible example of this commitment is a new program that places naloxone, the overdose reversal drug, at every subway station, directly confronting the overdose crisis.
Sara Whaley, Baltimore’s director of overdose response, stated that $15 million in settlement funds have been allocated to expand 911 services as part of a larger strategy to bolster city services. Whaley views these expanded services as an opportunity to fundamentally alter how the city responds to residents in crisis, regardless of the nature of their 911 call. She advocates for a proactive approach, asking, "What are the wraparound services and support that can help prevent them from being involved in this, in that emergency system?" The goal is to identify the root causes of crises – such as the need for housing for someone sleeping in a store – and provide comprehensive solutions that go beyond immediate intervention. This approach aims to reduce violence, ensure individuals receive appropriate resources, and break the cycle of incarceration for those struggling with poverty, addiction, and mental health issues.
Rebecca Neusteter, executive director of the Health Lab at the University of Chicago, whose research focuses on the impact of such services, noted that these programs offer "peace of mind for callers that they’re going to be met with the right response at the right time." She also observes that responders themselves feel better equipped with a more diverse set of tools to effectively resolve calls.
Baltimore’s expansion efforts have drawn inspiration from other cities that have successfully implemented similar models for diverting non-emergency calls. Durham, North Carolina, serves as a prime example with its Holistic Empathetic Assistance Response Team, or HEART program. In its four years of operation, HEART has reportedly diverted over 12,000 calls, with police backup required in only 0.02% of cases. This program has also contributed to improved response times across all categories of 911 calls.
The HEART program’s data offers a glimpse into the diverse situations non-police responders handle. These include assisting a woman fleeing domestic violence with finding housing and arranging medical appointments for a homeless veteran. In one documented instance, a hotel manager called 911 seeking help for a blind guest who couldn’t be accommodated in accessible rooms. HEART responders secured a room for the individual and, the following day, facilitated transportation to a housing assistance organization. Such interventions demonstrate the profound impact of specialized, compassionate response in addressing the complex needs of community members, ultimately fostering a safer and more supportive environment for all of Baltimore’s residents.
This article is the product of a partnership involving WYPR, NPR, and KFF Health News.
