Aerial view of historic homes in the Riverside neighborhood of Baltimore, Maryland. Matt Gush/Getty Images hide title toggle title Matt Gush/Getty Images In March, in the parking lot of a McDonald’s on a busy Baltimore street, mental health doctor Michala Williams met a 38-year-old woman in a car. “So, you called the police for help?”
Aerial view of historic homes in the Riverside neighborhood of Baltimore, Maryland.
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In March, in the parking lot of a McDonald’s on a busy Baltimore street, mental health doctor Michala Williams met a 38-year-old woman in a car.
“So, you called the police for help?” Williams asked the woman, who was sobbing uncontrollably and said she sometimes thinks about hurting herself.
She told Williams that she has children between the ages of 2 and 22, that she was dealing with health issues and that her fiancé had recently been incarcerated. She felt so overwhelmed that she couldn’t eat.
The woman, who asked not to be identified so she could speak freely about her mental health, explained that she had tried to get help the previous month by driving to the hospital, but was stopped on the way because her vehicle’s registration had expired.
“I don’t care if they stop me,” he said. “But I was like, ‘I don’t know what to do. I just want to go to the hospital.'”
The officer arrested her for acting erratically, so instead of going to the hospital she went to jail.
“I had to sit inside a cold cell. I couldn’t use the bathroom or anything,” the woman said.
The day she met Williams, she decided to call 911. The operator recognized that the woman did not need a police response, but rather one of Baltimore’s mobile crisis teams, which send a doctor and a counselor to care for people with mental health problems.
At the end of an hour-long conversation, Williams provided the woman with referrals to a psychiatrist, a therapist, legal help and a case manager to determine if her son with autism was eligible for government services.
Operators handle mental health crisis calls at Behavioral Health System’s Baltimore office. They can send a mobile response team to help people who are experiencing distress, but do not need police intervention.
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“She’s been through a lot of trauma and no one is going to deny that,” Williams said. “But now I have to take all of that and decide, ‘OK, here are steps 1, 2 and 3,’ because we have to find a little bit of something to give him some hope that there is help here.”
24/7 problem solving, no badges, guns or handcuffs.
For years, mobile crisis teams, overseen by Behavioral Health System Baltimore, a nonprofit that serves as the city’s mental health department, have diverted calls from police to mental health professionals. However, the units are limited in scope, focused on people in mental health crises.
Now Baltimore is leveraging some of the roughly $400 million it has received from opioid-related legal settlements to build a broader service that operates around the clock and responds to other types of crises when police are not needed.
Baltimore recorded 1.68 million 911 calls in 2024, but tens of thousands of them did not require traditional emergency services, such as police, firefighters or paramedics, according to Tahir Duckett, a community safety expert at Georgetown Law.
Instead, the calls concerned, for example, a homeless person who fell asleep in a store, a person who seemed confused in a public park and someone yelling at passersby on the street.
These types of calls “don’t require a badge, a gun and handcuffs to resolve,” Duckett said.
Often those people end up in jail instead of getting the help they need, he said.
A recent study found that when a non-police team responded to 911 calls in Durham, North Carolina, fewer arrests occurred than when police responded, especially for callers who were black, male, or between 25 and 39 years old.
Police responses can also result in trauma for that person or a less satisfactory outcome than another community service response would produce, Duckett said.
The idea behind Baltimore’s mobile crisis teams (and the new service) is to figure out what people in crisis may need and how to connect them to those resources instead of arresting them.
How a legal windfall will pay for 911 expansion
From 2021 to 2025, Baltimore’s homicide rate decreased by 60%, setting records for drops in violence. But at the same time, drug overdoses broke national records, with around 1,000 people dying here from overdoses each year between 2020 and 2023.
In 2018, Baltimore opted out of a global settlement that other jurisdictions made with opioid manufacturers and distributors and instead sued them independently.
As these opioid-related lawsuits were resolved, city officials decided that any awards you receive should be spent on drug-related harm, or on services that help prevent addiction, such as housing support, health care and education.
A new program seeks to directly address overdoses by placing boxes of naloxone, an overdose-reversing medication, at every subway stop.
The expansion of 911 services is part of a broader strategy to bolster city services, with $15 million in settlement funds allocated so far, according to Sara Whaley, Baltimore’s overdose response director.
Whaley hopes the expansion will help the city think differently about how to respond to residents in crisis, regardless of why they call 911.
She sees the calls as an opportunity to help solve a problem rather than as a punishment. “What are the comprehensive services and supports that can help prevent them from getting involved in this, in that emergency system?” she said.
For example, the person who falls asleep in a tent may need connection to community housing. The goal is to reduce violence, get people adequate resources, and avoid the cycle of incarcerating people suffering from poverty, addiction, and mental health.
‘The right answer at the right time’
Rebecca Neusteter, executive director of the University of Chicago Health Laboratory, studies the impacts of services like these. He said they offer callers the peace of mind of knowing they will “receive the right answer at the right time.”
“We also see that first responders themselves feel like they have a better toolbox in their ability to seek real resolution to these calls,” he said.
To expand its system, Baltimore turned to cities, including Durham, that have adopted similar models to divert callers who do not need emergency services.
Durham’s diversion program is called the Holistic Empathic Assistance Response Team, or HEART. The program estimates that it has diverted more than 12,000 calls in four years. He said police backup was only needed for 0.02% of those calls and that response times have improved for all types of 911 calls.
Durham has compiled descriptions of HEART calls, showing that non-police first responders in Durham have helped with everything from finding housing for a woman fleeing domestic violence to scheduling medical appointments for a homeless veteran.
In one case, a hotel manager called 911 asking for help finding lodging for a blind man to spend the night, since the hotel had no accessible rooms available. HEART first responders reserved a room for him and the next day took him to meet with an organization that could help him find housing.
This story comes from NPR’s health reporting partnership with WYPR and KFF Health News.
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