"We have to find a sliver of something to give people hope that there’s help out there." This sentiment, expressed by a Baltimore mental health clinician, encapsulates the city’s ambitious pivot from traditional law enforcement responses to community-based crisis intervention, leveraging significant opioid settlement funds to build a more comprehensive and empathetic support system for its residents.
Baltimore is significantly enhancing its capacity to respond to non-criminal emergencies by expanding its mobile crisis teams, a move fueled by substantial opioid settlement funds. This initiative aims to divert calls away from police and toward mental health professionals and other specialized responders, recognizing that many 911 dispatches involve individuals in distress who do not require an armed intervention. The program draws inspiration from successful models in other cities and seeks to provide timely, appropriate support for a wide range of non-violent crises, from mental health emergencies to homelessness and public intoxication, ultimately fostering a more compassionate and effective approach to public safety and well-being.
The transformative shift in Baltimore’s approach to emergency calls is vividly illustrated by the experience of a 38-year-old woman encountered in a McDonald’s parking lot. Approached by mental health clinician Michala Williams, the woman was experiencing profound emotional distress, tearfully admitting to thoughts of self-harm. Her overwhelming circumstances—including the care of children aged two to twenty-two, personal health issues, and the recent incarceration of her fiancé—had rendered her unable to eat and deeply despondent. Her prior attempt to seek help by driving to a hospital was thwarted when she was pulled over due to an expired car registration. The ensuing interaction with law enforcement, stemming from her erratic behavior described by the officer, led to her arrest and a night spent in a jail cell, a stark contrast to the medical attention she desperately needed.
This incident, however, marked a turning point. The woman’s call to 911 on that day was met with a discerning dispatcher who recognized her urgent need for mental health support rather than a police response. Consequently, a mobile crisis team, comprising a clinician and a peer counselor, was dispatched to meet her. Within an hour, Williams had connected the woman with crucial resources, including referrals to a psychiatrist and therapist, legal assistance, and a case manager tasked with exploring eligibility for government services for her child with autism. Williams reflected on the woman’s profound trauma, emphasizing the necessity of a structured, step-by-step approach to rekindle hope. "We got to find a little bit of sliver of something to give her some hope that there’s help out here," she stated, underscoring the core mission of these teams.
For years, Baltimore’s mobile crisis teams, overseen by Behavioral Health System Baltimore (BHSB), the city’s designated mental health authority, have been instrumental in diverting calls from police to mental health professionals. However, their scope has historically been limited to individuals experiencing acute mental health crises. The city’s new strategy aims to broaden this reach significantly, utilizing approximately $400 million received from opioid-related legal settlements. This funding is earmarked for developing a comprehensive, 24/7 crisis response service that can address a wider array of non-police-requiring situations.
The sheer volume of 911 calls in Baltimore, which reached 1.68 million in 2024, highlights the need for a more nuanced response system. Tahir Duckett, an expert in community safety at Georgetown Law, points out that a substantial portion of these calls do not necessitate the intervention of traditional emergency services like police, firefighters, or EMTs. These might include instances of homelessness, public confusion, or individuals exhibiting disruptive behavior in public spaces. Duckett argues that such situations "don’t require a badge, a gun, and handcuffs to resolve."
Without specialized intervention, individuals facing these non-criminal challenges are often criminalized, ending up in jail instead of receiving the support they require. Research, such as a recent study in Durham, North Carolina, indicates that non-law enforcement teams responding to 911 calls lead to fewer arrests, particularly for Black individuals, men, and those aged 25-39. Furthermore, police responses can inflict trauma and may not yield as effective an outcome as a community service-oriented approach. The underlying principle of Baltimore’s expanded mobile crisis teams is to identify the specific needs of individuals in crisis and connect them with appropriate resources, thereby circumventing unnecessary arrests.
Baltimore has experienced a significant reduction in its homicide rate, decreasing by 60% between 2021 and 2025, a notable achievement in combating violence. Concurrently, the city has grappled with a severe opioid crisis, with drug overdose deaths reaching national records, claiming approximately 1,000 lives annually from 2020 to 2023. In 2018, Baltimore chose to pursue independent legal action against opioid manufacturers and distributors, diverging from a global settlement accepted by other jurisdictions. The resulting settlement funds have been strategically allocated to address drug-related harms and support addiction prevention services, including housing assistance, healthcare, and education.
A tangible manifestation of this commitment is a new program that places naloxone, the overdose reversal drug, at every subway station across the city. The expansion of 911 services is a critical component of a broader strategy to bolster city resources, with $15 million in settlement funds already designated for this purpose, according to Sara Whaley, Baltimore’s director of overdose response. Whaley envisions this expansion as a catalyst for a paradigm shift in how the city perceives and responds to residents in crisis, regardless of the nature of their 911 call. She views these calls not as problems to be punished, but as opportunities to provide preventative support. "What are the wraparound services and support that can help prevent them from being involved in this, in that emergency system?" she questions, highlighting the focus on proactive, holistic solutions.
The goal is to connect individuals experiencing difficulties, such as falling asleep in a public place, with appropriate community housing. Ultimately, the initiative aims to reduce violence, ensure individuals receive the necessary resources, and break the cycle of incarceration for those struggling with poverty, addiction, and mental health challenges. Rebecca Neusteter, executive director of the Health Lab at the University of Chicago, a researcher in the field of community crisis response services, emphasizes the profound impact these programs have. She notes that they provide callers with the reassurance of receiving the "right response at the right time," and that responders themselves feel better equipped with a "better toolbox in their ability to pursue actual resolution to these calls."
In developing its expanded system, Baltimore has studied models in cities like Durham, which have successfully rerouted non-emergency 911 calls. Durham’s initiative, known as the Holistic Empathetic Assistance Response Team (HEART), has, by its estimates, diverted over 12,000 calls in four years. The program reports that police backup was required in only 0.02% of these instances, and overall 911 response times have improved. Records from Durham’s HEART program illustrate the diverse range of issues addressed by non-police responders, from securing housing for a woman fleeing domestic violence to arranging medical appointments for a homeless veteran. One notable case involved a hotel manager calling for assistance in finding overnight accommodation for a blind man, as the hotel lacked accessible rooms. HEART responders not only booked him a room but also provided transportation the following day to connect him with an organization that could help secure permanent housing. This collaborative approach, involving partnerships with organizations like WYPR, NPR, and KFF Health News, signifies a growing commitment to innovative and compassionate crisis management in urban centers.
