Baltimore is rethinking its 911 system to send mental health professionals instead of police officers for many calls. The city is tapping into opioid settlement funds to build a broader service that operates around the clock. Officials hope this approach will help residents in crisis get the support they need without the trauma of jail.
In March, mental health clinician Michala Williams met a 38-year-old woman in a McDonald’s parking lot. The woman was sobbing and said she sometimes thought about harming herself. She told Williams she had children ranging in age from 2 to 22 and was dealing with health issues. Her fiancé had recently been jailed, and she felt so overwhelmed she could not eat.
The woman, who asked not to be named, explained she tried to get help the previous month by driving to the hospital. She was pulled over because her car registration had expired. She said she did not care about the ticket but was desperate to reach the hospital.
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Instead of going to the hospital, the officer arrested her for acting erratically. She spent time in a cold jail cell where she could not use the bathroom. On the day she met Williams, she called 911 again. The dispatcher recognized she needed a mental health response and sent Williams and a peer counselor. The conversation lasted an hour. Williams set her up with referrals to a psychiatrist, a therapist, legal help, and a case manager.
For years, Baltimore’s mobile crisis teams have diverted calls from police to mental health professionals. The teams, overseen by Behavioral Health System Baltimore, focus on people in mental health distress. However, the units have a limited scope. Now the city is using roughly $400 million from opioid-related legal settlements to build out a broader service.
Shifting resources to meet demand
Baltimore logged 1.68 million calls to 911 in 2024. Tahir Duckett, an expert in community safety at Georgetown Law, said tens of thousands of those calls did not require traditional emergency services like police, firefighters, or EMTs. He cited examples such as a homeless person who fell asleep in a store, a confused person in a public park, or someone yelling at passersby.
Such calls “don’t require a badge, a gun, and handcuffs to resolve,” Duckett said. He noted that people often end up in jail instead of getting the help they need. A recent study found that when a non-law enforcement team responded to 911 calls in Durham, North Carolina, it resulted in fewer arrests than when police responded, especially for Black men and those ages 25-39. Police responses can also cause trauma for the person in crisis.
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From 2021 to 2025, Baltimore’s homicide rate decreased by 60%, setting records for the drop in violence. At the same time, drug overdoses made national records, with about 1,000 people dying each year from 2020 to 2023. In 2018, Baltimore opted out of a global settlement with opioid makers and distributors and instead sued them independently. City officials decided the settlement awards must be spent on drug-related harms or services that help prevent addiction, such as housing support and healthcare.
One new program places boxes of the overdose reversal drug naloxone at every subway stop. Expanding 911 services is part of a larger strategy to beef up city services. Sara Whaley, Baltimore’s director of overdose response, said $15 million in settlement funds has been allocated so far. She hopes the expansion helps the city think differently about how it responds to residents in crisis.
She views the calls as an opportunity to help solve a problem rather than be punitive. “What are the wraparound services and support that can help prevent them from being involved in this, in that emergency system?” she said. For example, a person falling asleep in a store may need connection to community housing. The goal is to reduce violence, get people proper resources, and avoid the cycle of incarcerating people dealing with poverty, addiction, and mental health.
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Rebecca Neusteter, executive director of the Health Lab at the University of Chicago, studies the impacts of these services. She said they offer peace of mind for callers that “they’re going to be met with the right response at the right time.” She also noted that responders feel like they have a better toolbox in their ability to pursue actual resolution to these calls.
Baltimore looked to cities like Durham that have adopted similar models to reroute callers who don’t need emergency responders. Durham’s diversion program is called the Holistic Empathetic Assistance Response Team, or HEART. The program estimates it has diverted more than 12,000 calls in four years. It said police backup was needed for only 0.02% of those calls and that response times have improved for all types of 911 calls.
Durham has collected descriptions of the HEART calls. Nonpolice responders in Durham have helped with everything from finding housing for a woman fleeing domestic violence to setting up medical appointments for a homeless veteran. In one case, a hotel manager called 911 asking for help finding a blind man housing for the night. The HEART responders booked him a room and provided a ride to meet with an organization that could help secure housing.
