"Baltimore is transforming its emergency response by leveraging opioid settlement funds to create a 24/7 crisis intervention system, moving away from police involvement for non-criminal matters and connecting residents with appropriate social and mental health services."
Baltimore is embarking on a significant shift in how it addresses community crises, aiming to de-escalate situations and provide more effective support by diverting non-criminal calls from law enforcement to specialized mental health and social service professionals. This ambitious initiative is being fueled by substantial funding secured through opioid-related legal settlements, enabling the city to build a comprehensive, around-the-clock service designed to respond to a wider array of needs beyond immediate medical emergencies. The strategy recognizes that many 911 calls involve individuals experiencing homelessness, mental health distress, or other social challenges that do not require the intervention of armed officers, thereby preventing unnecessary arrests and ensuring individuals receive the most appropriate care.
The urgency for such a paradigm shift was underscored by a recent encounter in a Baltimore McDonald’s parking lot. Mental health clinician Michala Williams met a 38-year-old woman in profound distress, sobbing uncontrollably and expressing suicidal ideation. The woman, a mother of children aged two to twenty-two, was grappling with severe health issues and the recent incarceration of her fiancé, leaving her feeling overwhelmed to the point of being unable to eat. Her desperation to seek help had previously led her to drive to a hospital, only to be pulled over for an expired car registration. The ensuing arrest, initiated due to her erratic behavior, resulted in her being taken to jail instead of receiving the mental health care she urgently needed. "I had to sit inside of a cold cell. I couldn’t use the bathroom or anything," the woman recounted, highlighting the punitive and counterproductive nature of the existing response.
Fortunately, on this occasion, the 911 dispatcher recognized that the woman’s call did not necessitate a police response but rather the expertise of Baltimore’s mobile crisis teams. These existing units, overseen by Behavioral Health System Baltimore, the city’s mental health authority, are designed to dispatch a clinician and a peer counselor to individuals experiencing mental health crises. The hour-long intervention by Williams provided a crucial turning point. The clinician successfully connected the woman with vital resources, including referrals to a psychiatrist and therapist, legal assistance, and a case manager to explore eligibility for government services for her child with autism. Williams emphasized the importance of this approach, stating, "She’s been through a lot of trauma, and no one is going to deny that. 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."
For years, Baltimore’s mobile crisis teams have played a critical role in diverting calls from police to mental health professionals, focusing specifically on acute mental health emergencies. However, their scope has been limited. Now, the city is strategically allocating approximately $400 million received from opioid-related legal settlements to expand these services significantly. This funding will facilitate the establishment of a 24/7 operation capable of responding to a broader spectrum of crises where police intervention is not required.
The sheer volume of calls to Baltimore’s 911 system, which logged 1.68 million calls in 2024, includes tens of thousands that do not demand traditional emergency services. Tahir Duckett, an expert in community safety at Georgetown Law, points out that these calls often involve individuals who are homeless, disoriented in public spaces, or exhibiting agitated behavior, situations that "don’t require a badge, a gun, and handcuffs to resolve." The current system, he notes, frequently results in these individuals ending up in jail rather than receiving the help they need. Research supports this observation; a study in Durham, North Carolina, found that non-law enforcement teams responding to 911 calls led to fewer arrests, particularly for Black individuals, men, and those aged 25-39. Moreover, police responses can inflict further trauma and yield less satisfactory outcomes compared to community-based service interventions. The core philosophy behind Baltimore’s expanded mobile crisis initiative is to identify the specific needs of individuals in crisis and connect them with appropriate resources, thereby de-escalating situations and promoting healing.
Baltimore has experienced a notable decrease in its homicide rate, dropping by 60% between 2021 and 2025, setting records for reduced violence. Concurrently, however, the city has grappled with a national crisis of drug overdoses, with approximately 1,000 residents dying annually from overdoses between 2020 and 2023. In 2018, Baltimore opted out of a global settlement with opioid manufacturers and distributors, choosing instead to pursue its own legal action. The resulting settlements have been earmarked for addressing drug-related harms and funding preventative services such as housing support, healthcare, and education.
This strategic allocation of funds is evident in new programs like the placement of naloxone, an overdose reversal drug, at every subway stop. The expansion of 911 services is a central component of a larger strategy to bolster city services, with $15 million in settlement funds already allocated. Sara Whaley, Baltimore’s director of overdose response, expressed optimism that this expansion will foster a more nuanced approach to responding to residents in crisis, irrespective of the nature of their 911 call. Whaley views each call as an opportunity for intervention rather than punishment, asking, "What are the wraparound services and support that can help prevent them from being involved in this, in that emergency system?" The aim is to connect individuals with resources like community housing for those experiencing homelessness or those needing assistance with addiction and mental health challenges, thereby reducing violence and avoiding the costly cycle of incarceration.
Rebecca Neusteter, executive director of the Health Lab at the University of Chicago, a researcher specializing in the impact of such services, highlights the peace of mind these programs offer callers, ensuring "they’re going to be met with the right response at the right time." She also notes that responders themselves feel better equipped with a broader range of tools to achieve positive resolutions. Baltimore’s expansion efforts have drawn inspiration from cities like Durham, which have successfully implemented similar models for diverting non-emergency calls.
Durham’s 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 program has also contributed to improved response times across all 911 call types. Records from Durham’s HEART initiative detail a wide array of interventions, from securing housing for a woman fleeing domestic violence to arranging medical appointments for a homeless veteran. In one instance, HEART responders assisted a blind man by booking him a hotel room and later providing transportation to a housing assistance organization, demonstrating a comprehensive and compassionate approach to community needs. This model exemplifies Baltimore’s vision: a coordinated system that prioritizes human needs and social support over punitive measures, ultimately fostering a safer and more supportive community for all residents.
