"Baltimore is reimagining its approach to emergency calls, moving beyond traditional law enforcement responses to address a growing number of non-criminal crises with specialized community teams, funded in part by significant opioid settlement funds."
Baltimore is embarking on a transformative shift in how it handles 911 calls, recognizing that a substantial portion of emergencies do not require the intervention of law enforcement, fire departments, or EMTs. This strategic pivot, bolstered by approximately $400 million in opioid-related legal settlements, aims to establish a comprehensive, around-the-clock crisis response system that prioritizes mental health professionals and peer counselors over police. The initiative seeks to divert calls related to homelessness, mental health distress, and other community-level issues away from the traditional emergency services, ensuring individuals receive appropriate care and support, thereby reducing unnecessary arrests and fostering more effective resolutions.
The urgency of this transformation is underscored by real-life scenarios, such as the experience of a 38-year-old woman in Baltimore. In March, she found herself in a McDonald’s parking lot, distraught and contemplating self-harm. When mental health clinician Michala Williams arrived, the woman revealed a cascade of overwhelming challenges: responsibility for children aged two to twenty-two, ongoing health issues, and the recent incarceration of her fiancé. Her distress was so profound that she had lost her appetite. Her previous attempt to seek help at a hospital had ended in arrest when she was pulled over due to an expired car registration while en route. Instead of receiving medical attention, she was confined to a jail cell, an experience she described as isolating and dehumanizing.
This incident highlights a critical gap in emergency response: the misdirection of individuals in mental health crises towards the criminal justice system. Fortunately, in her most recent moment of desperation, the woman’s 911 call was intercepted by a dispatcher who recognized her need for a specialized response. This led to the dispatch of one of Baltimore’s mobile crisis teams, comprised of a clinician and a peer counselor. Within an hour, Williams had provided the woman with crucial referrals to a psychiatrist, a therapist, legal assistance, and a case manager to explore eligibility for services for her child with autism. Williams acknowledged the profound trauma the woman had endured but emphasized the importance of breaking down the path to recovery into actionable steps, offering a sliver of hope in her dire circumstances.
These mobile crisis teams, overseen by Behavioral Health System Baltimore, the city’s designated mental health authority, have long served as a vital conduit, diverting calls from police to mental health professionals. However, their current scope is limited to acute mental health crises. The expanded service, fueled by opioid settlement funds, aims to broaden this reach, operating 24/7 and addressing a wider spectrum of non-police-requiring emergencies.
Baltimore’s 911 system, which logged an estimated 1.68 million calls in 2024, frequently receives dispatches that do not necessitate traditional emergency services. Tahir Duckett, an expert in community safety at Georgetown Law, notes that tens of thousands of these calls involve situations such as a homeless individual sleeping in a store, someone appearing disoriented in a public park, or an individual exhibiting disruptive behavior on the street. These are not scenarios that inherently require the presence of law enforcement.
"Such calls don’t require a badge, a gun, and handcuffs to resolve," Duckett explains. He points out that individuals experiencing these non-criminal crises are often inadvertently funneled into the justice system, missing out on the support they truly need. A recent study in Durham, North Carolina, demonstrated that when non-law enforcement teams responded to 911 calls, arrests were significantly reduced, particularly for Black individuals, men, and those aged 25-39. Furthermore, police interventions can inflict further trauma and may not yield as satisfactory an outcome as a community service-based approach. The core philosophy behind Baltimore’s evolving crisis response model is to identify the needs of individuals in distress and connect them with appropriate resources, moving away from punitive measures.
This strategic allocation of resources comes at a time when Baltimore has experienced a notable decrease in its homicide rate, dropping by 60% between 2021 and 2025, setting records for violence reduction. Concurrently, the city, like much of the nation, has grappled with an escalating drug overdose crisis, with approximately 1,000 residents dying from overdoses annually between 2020 and 2023.
Baltimore’s proactive stance on the opioid crisis dates back to 2018 when it opted out of a global settlement with opioid manufacturers and distributors, choosing instead to pursue its own legal action. The resulting settlement awards have been earmarked for addressing drug-related harms and supporting preventative services such as housing assistance, healthcare, and education.
A tangible manifestation of this commitment is a new program that aims to combat overdoses by distributing naloxone, the overdose reversal drug, at every subway station. The expansion of 911 services is a key component of a broader strategy to bolster city services, with $15 million of the settlement funds already allocated, according to Sara Whaley, Baltimore’s director of overdose response. Whaley envisions this expansion as an opportunity to fundamentally alter the city’s approach to residents in crisis, irrespective of the reason for their 911 call.
Whaley views these calls as opportunities for problem-solving rather than punitive action. "What are the wraparound services and support that can help prevent them from being involved in this, in that emergency system?" she poses. The aim is to connect individuals to resources that address the root causes of their distress, such as linking someone found sleeping in a store to community housing. The ultimate goal is to reduce violence, ensure individuals receive adequate support, and break the cycle of incarceration for those facing challenges related to poverty, addiction, and mental health.
Rebecca Neusteter, executive director of the Health Lab at the University of Chicago, who studies the impact of such initiatives, highlights the peace of mind these programs offer callers, assuring them they will "be met with the right response at the right time." She also notes the positive impact on responders, who "feel like they have a better toolbox in their ability to pursue actual resolution to these calls."
In developing its expanded system, Baltimore has studied models in other cities, including Durham, North Carolina, which has successfully rerouted non-emergency calls. Durham’s diversion program, known as the Holistic Empathetic Assistance Response Team (HEART), has reportedly diverted over 12,000 calls in four years, with police backup required in only 0.02% of cases. This has also led to improved response times across all types of 911 calls.
The descriptions of HEART calls in Durham illustrate the program’s broad utility. Non-police responders have assisted individuals in securing housing, even for a woman fleeing domestic violence, and have arranged medical appointments for homeless veterans. In one notable instance, HEART responders helped a blind man find overnight accommodation when a hotel lacked accessible rooms, and the following day, provided transportation to an organization that could assist with long-term housing solutions. These examples underscore the efficacy of specialized, community-based responses in addressing the multifaceted needs of individuals in crisis, offering a more compassionate and effective alternative to traditional law enforcement interventions.
This article is a product of a partnership including WYPR, NPR, and KFF Health News.
