"Baltimore is revolutionizing its emergency response system by leveraging opioid settlement funds to create a 24/7 service that dispatches mental health professionals and peer counselors instead of police for non-violent crises, aiming to provide compassionate care and better connect residents with necessary resources."
Baltimore is fundamentally reshaping its approach to public safety and crisis intervention by investing significant opioid settlement funds into a comprehensive, round-the-clock service designed to respond to a wider array of non-emergency calls. This initiative aims to divert individuals in distress away from the criminal justice system and towards appropriate mental health, social, and community support services. The program builds upon the success of existing mobile crisis teams, which have already demonstrated the efficacy of dispatching clinicians and peer counselors for mental health emergencies, thereby reducing the burden on law enforcement and improving outcomes for vulnerable residents. By expanding this model, Baltimore seeks to address the multifaceted needs of its population, offering timely and specialized assistance for issues ranging from mental health crises and homelessness to confusion in public spaces, ultimately fostering a more supportive and effective community safety net.
The transformative initiative in Baltimore is rooted in a strategic reallocation of funds derived from opioid-related legal settlements, totaling approximately $400 million. This substantial financial infusion is being channeled into developing a robust, around-the-clock service capable of responding to a broader spectrum of crises where police intervention is not only unnecessary but often counterproductive. This expansion signifies a significant shift from traditional emergency response paradigms, prioritizing de-escalation, specialized care, and connection to long-term solutions over punitive measures.
A compelling illustration of the need for such a program unfolded in March when Michala Williams, a mental health clinician, met a 38-year-old woman in a McDonald’s parking lot. The woman, overwhelmed by a confluence of personal crises including her children’s needs (ranging from age 2 to 22), personal health issues, and her fiancé’s recent incarceration, was experiencing severe distress and suicidal ideation. Her attempt to seek help by driving to the hospital the previous month was thwarted when she was pulled over due to an expired car registration. This encounter led to her arrest for erratic behavior, resulting in her being taken to jail instead of receiving medical attention. "I had to sit inside of a cold cell. I couldn’t use the bathroom or anything," the woman recounted, highlighting the detrimental consequences of a system ill-equipped to handle mental health emergencies.
Fortunately, on this occasion, the woman’s 911 call was recognized by the dispatcher as a situation requiring a mental health response rather than a police one. This led to the dispatch of one of Baltimore’s mobile crisis teams, comprising a clinician and a peer counselor. Within an hour, Williams had facilitated referrals for psychiatric care, therapy, legal assistance, and connected the family with a case manager to explore eligibility for government services for her child with autism. "She’s been through a lot of trauma, and no one is going to deny that," Williams observed. "But I now have to take all of that and decide, ‘OK, here’s steps 1, 2, and 3,’ because we got to find a little bit of sliver of something to give her some hope that there’s help out here."
The mobile crisis teams, overseen by Behavioral Health System Baltimore, the city’s mental health authority, have for years served as a crucial conduit, diverting calls from law enforcement to mental health professionals. However, their scope has historically been confined to acute mental health crises. The new initiative aims to broaden this scope significantly, ensuring that a wider range of non-police-requiring situations are met with appropriate expertise.
Baltimore’s 911 system handles a substantial volume of calls, with 1.68 million logged in 2024. According to Tahir Duckett, an expert in community safety at Georgetown Law, tens of thousands of these calls do not necessitate traditional emergency services like police, firefighters, or EMTs. These might include individuals experiencing homelessness, confusion in public spaces, or disruptive behavior. Duckett emphasizes that such situations "don’t require a badge, a gun, and handcuffs to resolve."
The consequence of these calls often landing in the hands of law enforcement can be detrimental. A recent study in Durham, North Carolina, found that non-law enforcement teams responding to 911 calls resulted in fewer arrests, particularly for Black individuals, men, and those aged 25-39. Police responses can also inflict trauma and lead to less favorable outcomes compared to specialized community service interventions. The core philosophy behind Baltimore’s expanded crisis response is to identify the specific needs of individuals in crisis and connect them with the most suitable resources, thereby preventing unnecessary arrests and fostering healing.
This expansion comes at a time when Baltimore has experienced a significant decrease in its homicide rate, dropping by 60% between 2021 and 2025. Concurrently, the city, like much of the nation, has grappled with an escalating drug overdose crisis, with approximately 1,000 residents dying annually from overdoses between 2020 and 2023. This dual challenge underscores the complex needs of the community and the imperative for multifaceted solutions.
In 2018, Baltimore strategically opted out of a global settlement with opioid manufacturers and distributors, pursuing its own independent lawsuits. The subsequent settlements have been earmarked for addressing drug-related harms and funding preventative services such as housing support, healthcare, and education. This deliberate allocation ensures that the financial recovery directly benefits the communities most affected by the opioid epidemic.
One tangible program born from these funds is the placement of naloxone, an overdose reversal drug, at every subway stop, a direct effort to combat the rising tide of fatal overdoses. The expansion of 911 services is a key component of a broader strategy, with $15 million in settlement funds already allocated, according to Sara Whaley, Baltimore’s director of overdose response. Whaley envisions this expansion as an opportunity to fundamentally alter 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 for intervention and support. "What are the wraparound services and support that can help prevent them from being involved in this, in that emergency system?" she asks, highlighting the focus on preventative and holistic care.
The goal is to connect individuals with essential services like community housing for those experiencing homelessness, thereby reducing reliance on the criminal justice system for issues stemming from poverty, addiction, or mental health challenges. Rebecca Neusteter, executive director of the Health Lab at the University of Chicago, who studies the impact of such services, notes that they provide callers with peace of mind, assuring them "they’re going to be met with the right response at the right time." Furthermore, Neusteter observes that these programs also empower responders by equipping them with "a better toolbox in their ability to pursue actual resolution to these calls."
Baltimore’s strategic expansion draws inspiration from cities like Durham, which have successfully implemented similar models to redirect non-emergency calls. Durham’s program, known as the Holistic Empathetic Assistance Response Team (HEART), has, by its own estimates, diverted over 12,000 calls in four years, with police backup required in only 0.02% of cases. This has led to improved response times across all types of 911 calls.
The data collected by Durham’s HEART program illustrates the diverse range of assistance provided by non-police responders. These interventions have included securing housing for a woman escaping domestic violence and arranging medical appointments for a homeless veteran. In one notable instance, a hotel manager contacted 911 seeking housing for a blind guest due to a lack of accessible rooms. HEART responders not only booked the guest a room but also provided transportation the following day to connect him with an organization dedicated to securing long-term housing. This model exemplifies the potential for specialized crisis response teams to offer effective, compassionate, and resource-efficient solutions, transforming how cities address the complex needs of their residents.
This article is a product of a partnership involving WYPR, NPR, and KFF Health News.
